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.

Comparison of horizontal muscle transposition and Inferior oblique weakening combined with horizontal surgery in V-pattern exotropia.

PURPOSE: The objective of this study was to compare the effects of horizontal muscle transposition and inferior oblique weakening combined with horizontal surgery performed for V-pattern exotropia (XT) and to determine the most successful approach. METHODS: In our retrospective study, 52 patients who underwent horizontal surgery due to V-pattern XT and were followed up for at least 6 months were divided into two groups. Group 1 (n = 26) consisted of patients who underwent vertical transposition of the rectus muscles combined with horizontal surgery, and group 2 (n = 26) consisted of patients who underwent inferior oblique weakening combined with horizontal surgery. The two groups were compared before and after surgery in terms of visual acuity, refractive errors, deviation angles, pattern strabismus, fusion, stereopsis, over/under correction and surgical success. RESULTS: There was no difference between the two groups in terms of age, follow-up period, visual acuity, refractive errors, fusion or stereopsis. The amount of horizontal deviation was smaller in group 2 at the 1-6-month follow-ups. There was no difference between the two groups in terms of pattern collapse; however, the amount of pattern postoperatively was lower in group 2. The two groups were similar in terms of overcorrection; however, the undercorrection rate was higher in group 1. The surgical success rate was higher in group 2. CONCLUSIONS: Inferior oblique weakening combined with horizontal surgery due to V-pattern XT was found to be superior to vertical transposition of the horizontal muscles in terms of surgical success and the amount of pattern postoperatively.

A Comparison of Refraction Defects in Childhood Measured Using Plusoptix S09, 2WIN Photorefractometer, Benchtop Autorefractometer, and Cycloplegic Retinoscopy.

PURPOSE: To compare Plusoptix (Gmbh, Nuremberg, Germany), 2WIN (Adaptica, Padua, Italy), the benchtop refractometer (Auto-Kerato-Refractometer KR-8900; Topcon Co, Tokyo, Japan), and retinoscopy with regard to the consistencies. MATERIALS AND METHODS: In our prospective study, 200 eyes of 100 patients were included. We analyzed the demographics and characteristics of the patients, the percentage of patients from whom measurements could not be obtained, the measurements from both patients' eyes of pupil diameter, spherical, cylindrical, axis, and spherical equivalence. RESULTS: The mean age ± SD was 7.8±4.5 years (range, 1-18 years). Pupil diameter measurements were found to be consistent (Cronbach's alpha value >0.8). The sphere and spherical equivalence measurements for both eyes were found to be consistent with each other in all apparatus (Cronbach's alpha value >0.8). However, consistency was found to be lower in cylindrical values and the Jackson cross-cylinder measurements at 0° and 45° axis were found to be inconsistent with each other (Cronbach's alpha value <0.8). CONCLUSIONS: While consistency was observed in all methods in terms of sphere and spherical equivalence, consistency dropped in cylindrical values and no consistency was observed in axis values. It is important to take this point into consideration, especially in axis measurements.

Peripapillary retinal nerve fiber layer and foveal thickness in hypermetropic anisometropic amblyopia.

PURPOSE: To evaluate whether there was a difference in peripapillary retinal nerve fiber layer (RNFL) and foveal thickness between amblyopic and normal individuals with optical coherence tomography. MATERIALS AND METHODS: Sixty patients, 30 patients with hypermetropic anisometropic amblyopia and 30 normal emmetropic subjects, were enrolled in this study. The eyes of the participants were divided into three groups: 30 eyes of 30 patients with amblyopia (A), 30 fellow eyes of the amblyopic patients (B), and 30 eyes of 30 normal subjects (C). Emmetropic normal subjects included cases with normal visual acuity and unremarkable ocular examinations. After routine ophthalmic examination, peripapillary retinal nerve fiber layer and foveal thickness measurements were measured by time-domain optical coherence tomography and compared among the three groups. RESULTS: The difference in RNFL thickness between amblyopic eyes, fellow eyes of the amblyopic patients, and normal eyes of the emmetropic subjects was not clinically significant. However, the mean foveal thickness was significantly thicker in amblyopic eyes versus the fellow eyes and normal subjects' eyes. CONCLUSION: Our results suggest that amblyopia seems to have an effect on the foveal thickness, but not on the RNFL thickness.

Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity function in adult hypermetropic anisometropic amblyopia.

BACKGROUND: The purpose of this study was to evaluate the efficacy of neural vision therapy, also termed perceptual vision therapy, in enhancing best corrected visual acuity (BCVA) and contrast sensitivity function in amblyopic patients. METHODS: This prospective study enrolled 99 subjects previously diagnosed with unilateral hypermetropic amblyopia aged 9-50 years. The subjects were divided into two groups, with 53 subjects (53 eyes) in the perceptual vision therapy group and 46 subjects (46 eyes) in the control group. Because the nature of the treatment demands hard work and strict compliance, we enrolled the minimal number of subjects required to achieve statistically significant results. Informed consent was obtained from all subjects. Study phases included a baseline screening, a series of 45 training sessions with perceptual vision therapy, and an end-of-treatment examination. BCVA and contrast sensitivity function at 1.5, 3, 6, 12, and 18 cycles per degree spatial frequencies were obtained for statistical analysis in both groups. All subjects had follow-up examinations within 4-8 months. With the exception of one subject from the study group and two subjects from the control group, all subjects had occlusion during childhood. The study was not masked. RESULTS: The results for the study group demonstrated a mean improvement of 2.6 logarithm of the minimum angle of resolution (logMAR) lines in visual acuity (from 0.42 to 0.16 logMAR). Contrast sensitivity function improved at 1.5, 3, 6, 12, and 18 cycles per degree spatial frequencies. The control group did not show any significant change in visual acuity or contrast sensitivity function. None of the treated eyes showed a drop in visual acuity. Manifest refractions remained unchanged during the study. CONCLUSION: The results of our study demonstrate the efficacy of perceptual vision therapy in improving visual acuity. The 2.6 logMAR lines improvement in visual acuity is encouraging, and is consistent with the results of previous studies. However, long-term follow-up and further studies are needed.

The relationship between anemia and accommodative esotropia in children.

BACKGROUND: Refraction problems, motor disorders, sensorial disorders, physical and psychic traumas of eye may be responsible for development of strabismus. Anemia may cause sensory-neural disorders in children. We investigated the relationship between anemia and accommodative esotropia in children. MATERIALS AND METHODS: Sixty-four patients with accommodative esotropia were evaluated. This group was identified as patient group (group 1). Eighty-three pediatric patients, who were not esotropia and only had refraction problems, were identified as control group (group 2). The difference between the groups was statistically analyzed evaluating patients for anemia. RESULTS: 33 of 64 patients with accommodative esotropia in group 1 were male, as 43 of 83 patients with refractive error in group 2 were male. The mean age of patients in group 1 and 2 were 6 ± 3.92 and 6.37 ± 2.74 (P > 0.05) respectively. There was significant difference between two groups, when mean hemoglobin value of those was compared (P < 0.05). CONCLUSION: Hb level may affects the accommodative esotropia.

Association of extensive myelinated nerve fibers and high degree myopia: case report.

Unilateral extensive myelination of the peripapillary nerve fibers may be associated with anisometropic myopia, strabismus, and reduced vision. Myelination of optic nerve fibers terminate at lamina cribrosa. Yet in some patients, myelination progresses into the peripapillary retinal nerve fibers and may affect the visual acuity. In this report, we described 4 patients. All patients presented extensive peripapillary myelinated nerve fibers associated with myopic anisometropia. After routine ophthalmic and orthoptic examinations, all patients underwent treatment for amblyopia through correction with spectacles, contact lenses, and the occlusion of the good eye. Corrected visual acuity improved in 1 patient, but 3 patients had no increase in visual acuity despite treatment with full cycloplegic refraction and appropriate patching. Probably because of structural abnormalies of the macula, visual results are often disappointing with appropriate correction of the refractive error and occlusion.

N-acetylcysteine in chronic blepharitis.

PURPOSE: To investigate the effects of N-acetylcysteine (NAC) in chronic posterior blepharitis. METHODS: This was a prospective randomized, controlled study that included 79 eyes of 40 patients with chronic posterior blepharitis. Routine ophthalmologic examination, Schirmer-1 test, fluorescein break-up time (FBUT), and mucous fern tests were carried out during the first visit of all patients. A topical steroid, topical antibiotic, and artificial tears were started in 36 eyes of 18 patients. The therapy group (43 eyes of 22 patients) was administered three daily doses of 100 mg oral NAC. All patients were examined weekly for 1 to 4 months (average, 24 +/- 0.7). A Schirmer-1 test and FBUT were administered at every visit, but mucous fern tests were administered every two weeks. The results of the first and last Schirmer-1 tests, FBUT, and mucous fern test were compared between the therapy and control groups. Student's t and Mann-Whitney U tests were used for statistical analysis. RESULTS: FBUT was significantly increased (p < 0.0001), and the mucous fern pattern was also significantly improved (p = 0.0096) in the therapy group. CONCLUSION: NAC is thought to increase FBUT and improve mucous fern pattern by blocking lipid peroxidation in chronic blepharitis.