Prevalence of Serous Macular Detachment in Recurrent Macular Edema Secondary to Retinal Vein Occlusion.

Objectives: To evaluate the prevalence of serous macular detachment (SMD) accompanying recurrent cystoid macular edema (CME) in patients initially treated for CME secondary to retinal vein occlusion (RVO) with accompanying SMD, and discuss the factors that affect the prevalence. Materials and Methods: We retrospectively evaluated the medical records of 71 patients with RVO-associated CME and SMD who achieved complete anatomical resolution after treatment with either a single dexamethasone implant or three loading doses of ranibizumab and developed recurrent CME during follow-up. Results: Initial treatment was a single intravitreal dexamethasone implant in 45 patients (63.4%) (Group 1) and three loading doses of intravitreal ranibizumab in 26 patients (36.6%) (Group 2). The mean time to CME recurrence was 4.7±0.8 months (range, 4-7 months) and was similar in both groups (p=0.984). At the time of CME recurrence, SMD was present in 41 patients (57.7%) and absent in 30 patients (42.3%). SMD was present in 27 (60.0%) of the 45 Group 1 patients and 14 (53.8%) of the 26 Group 2 patients (p=0.613). SMD was present in 48.8% of branch RVO and 71.4% of central RVO patients at the time of recurrence (p<0.001). Conclusion: SMD accompanied recurrent CME in only 57.7% of patients previously treated for CME and SMD and seems to be more frequent in patients with central RVO. Initial intravitreal treatment choice of either ranibizumab or dexamethasone implant did not affect the prevalence of concurrent SMD in patients with recurrent CME.

The Effect of ChromaGen Contact Lenses on Corneal Clarity: A Corneal Densitometry.

Objectives: The purpose of this study is to investigate the effect of ChromaGen contact lens (CCL) on corneal clarity, expressed through the measurement of corneal densitometry (CD) values. Methods: This study included 22 eyes of 22 patients with congenital red-green color vision deficiency who were admitted to our clinic for the CCL trial. After a detailed ophthalmological examination and CD measurement with Pentacam HR (Oculus Optikgerate GmbH, Wetzlar, Germany), the most appropriate CCLs were defined through pseudoisochromatic plates and inserted for 2 h. The CD measurement was repeated after the removal of the CCL. Comparison was made of CD values before and after the insertion of the most appropriate CCL. The after-CCL/before-CCL ratio was calculated, and the effect of CCL type on this ratio was investigated. Results: The after-CCL values were higher in the anterior, central, posterior, and total thickness of the 0-2 mm concentric zone (p=0.044, p=0.040, p=0.021, and p=0.032, respectively) when compared to the before-CCL values. There was no statistically significant difference between before-CCL and after-CCL values in any layer of the 2-6, 6-10, and 10-12 mm concentric zones (p>0.05, for all). After-CCL/before-CCL ratios were similar in the Magenta2 (M2), Magenta3 (M3), and Violet3 (V3) types of CCLs (p>0.017). Conclusion: Usage for 2 h of CCL was observed to increase CD values in all layers of the 0-2 mm concentric zone irrespective of the type of CCL. Further studies with longer follow-up are required to determine the long-term effects and detect differing effects of CCL with different base curves.

The pupillary dynamics of patients with physiological anisocoria.

BACKGROUND: To evaluate static pupillometric measurements and making inter-ocular comparative analysis in healthy subjects for demonstrating the prevalance of physiological anisocoria in various lighting conditions and to compare the variations of the dynamic pupillometric measurements of the patients with physiological anisocoria. METHODS: Automatic quantitative pupillometry system was used to measure pupillary diameters in low mesopic (0.1 cd/m2), high mesopic (1 cd/m2), low photopic (10 cd/m2) and high photopic (100 cd/m2) conditions. After inter-ocular comparison of these data, the prevalance of physiological anisocoria was detected in four different lighting conditions. The inter-ocular dynamic pupillometric parameters (amplitude, latency, duration and velocity of pupil contraction; latency, duration and velocity of pupil dilation) of these patients were further analysed. RESULTS: After inter-ocular comparison of pupillary diameters of 195 participants [96 females (49.2%) and 99 males (50.8%)] with a mean age of 38.4 ± 18.9 years (range 7-78 years), six (3.1%) participants under high photopic; 11 (5.6%) participants under low photopic; 25 (12.8%) participants under high mesopic, and 34 (17.4%) participants under low mesopic illumination levels exhibited physiological anisocoria. The mean relative amplitude of anisocoric small pupils' contraction was lower than the mean relative amplitudes of pupil contraction of both isocoric and anisocoric large pupils (p = 0.021, p = 0.035, respectively). The mean velocity of anisocoric small pupils' contraction was lower than the mean velocity of anisocoric large pupils' contraction (p = 0.013). CONCLUSIONS: The mean contraction amplitude and contraction velocity of smaller pupils was lower when compared to fellow larger pupils of anisocoric patients.

Effects of diabetes duration and HgA1C level on corneal endothelial morphology.

OBJECTIVE: The aim of this study is to investigate the effects of the HbA1c level and the duration of diabetes mellitus on the corneal endothelium morphology and to compare between healthy individuals and diabetes mellitus patients with non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. MATERIAL AND METHODS: Ninety patients who applied to the Health Sciences University Ulucanlar Eye Training and Research Hospital between January 2016 and January 2017 were included in this prospective randomized study. In the study, 45 diabetes mellitus patients and 45 healthy individuals were evaluated. The diabetes patients were compared in terms of HbA1c level, diabetes mellitus duration, corneal endothelial cell density, coefficient of variation, standard deviation, and hexagonality with healthy control group. RESULTS: A statistically significant difference was found in the endothelial cell densitometer, coefficient of variation, and standard deviation measurements between the diabetes mellitus patients and the control (healthy) group. But, there was no statistically significant difference between 6A (hexagonality) and central corneal thickness measurements. There was a negative correlation between HbA1c levels and diabetes mellitus times and endothelial cell densitometer values in the patients with diabetes mellitus diagnosis and standard deviation values in the positive direction. There was a statistically significant difference between diabetes mellitus patients with the diagnosis of non-proliferative diabetic retinopathy and proliferative diabetic retinopathy in the endothelial cell densitometer and standard deviation values. But there was not any statistically significant difference between coefficient of variation, 6A, and central corneal thickness values. CONCLUSION: The endothelial cell densitometer in diabetes mellitus patients with retinopathy is lower than that in healthy individuals. There is a negative correlation between retinopathy severity and corneal endothelial cell density. Diabetes affects negatively not only vascular tissues but also avascular cornea.

Static and Dynamic Pupillary Responses in Patients with Different Stages of Diabetic Retinopathy.

This study aimed to investigate pupillary involvement in patients with type 2 diabetes mellitus (DM) and to evaluate whether there is a relationship between severity of diabetic retinopathy (DR) and pupillary responses. The study included 133 individuals in four groups: proliferative DR, non-proliferative DR, DM group without retinal involvement and a control group. Static pupillometry measurements including scotopic pupil diameter (PD), mesopic PD, low photopic PD, high photopic PD, and dynamic pupillometry measurements, including resting diameter, amplitude, latency, velocity, duration of pupil contraction and latency, duration, and velocity of pupil dilatation were taken using an automated quantitative pupillometry system. The correlations between glycosylated haemoglobin values and duration of DM with these parameters were also investigated. The study showed that patients with DR may also have diabetic autonomic neuropathy and pupillometry can be a useful screening tool for detecting diabetic autonomic neuropathy.

Static and dynamic pupil characteristics in pseudoexfoliation syndrome and glaucoma.

BACKGROUND: To compare the static and dynamic pupillometry measurements in patients with pseudoexfoliation syndrome (PES), patients with pseudoexfoliation glaucoma (PEG) and age-matched healthy subjects using an automatic quantitative pupillometry system. METHODS: This prospective, cross-sectional study consisted of 40 patients with PES, 30 patients with PEG and 43 control subjects. Static pupillometry measurements including scotopic pupil diameter, mesopic pupil diameter, low photopic pupil diameter, and high photopic pupil diameter were undertaken. Subsequently, dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were undertaken. These measurements were compared between the groups. RESULTS: The scotopic, mesopic, and low photopic pupil diameter values were statistically significantly lower in patients with PES and PEG compared with controls (p < 0.001). However, these parameters were similar between the patients with PES and PEG (p > 0.05). The mean values of high photopic pupil diameter were similar within all groups (p = 0.54). The amplitude of pupil contraction values of the patients with PEG was statistically significantly lower than the patients with PES and the controls (p < 0.05). Patients with PES also had significantly lower amplitude of pupil contraction values compared with controls (p < 0.001). Additionally, the velocity of pupil contraction values was statistically significantly higher in control subjects when compared to the patients with PES and PEG (p < 0.05). CONCLUSION: This study demonstrated that accumulation of pseudoexfoliative material can cause alterations in static and dynamic pupillary characteristics and the progression from PES to PEG may be associated with reduced amplitude of pupil contraction values.

Evaluation of dynamic thiol-disulfide homeostasis in glaucoma patients and the correlation with retinal nerve fiber layer analysis.

PURPOSE: The aim of this study was to evaluate thiol/disulfide homeostasis and ischemia-modified albumin levels with primary open-angle glaucoma, ocular hypertension, and control group; also to interpret the correlation between these biochemical parameters and retinal nerve fiber layer analysis. MATERIAL AND METHODS: In a prospective cross-sectional study, 30 primary open-angle glaucoma cases, 30 ocular hypertension cases, and 30 control subjects were included in the study. Native thiol, total thiol, and disulfide measurements and disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios were evaluated as thiol-disulfide homeostasis. Albumin and ischemia-modified albumin parameters were also evaluated. All cases underwent detailed ophthalmologic examination including visual acuity, retinal nerve fiber layer via optical coherence tomography, intraocular pressure, and central corneal thickness measurements and visual field analysis by 24-2 Swedish Interactive Threshold Algorithm (SITA) Standard visual field test. RESULTS: Primary open-angle glaucoma group had significantly higher ischemia-modified albumin values than ocular hypertension and control group (p < 0.001). Native thiol and total thiol values of control group were statistically higher than those of primary open-angle glaucoma and ocular hypertension groups. The correlation between the temporal retinal nerve fiber layer value and ischemia-modified albumin, disulfide/native thiol, and disulfide/total thiol values of the primary open-angle glaucoma patients included in the study was moderate correlation in negative direction (r = -0.46, r = -0.39, r = -0.39, respectively), whereas there was a statistically significant moderate correlation in positive direction between the native thiol/total thiol values (r = 0.39) (p < 0.05). CONCLUSION: These findings have reinforced the role of oxidative stress in the etiopathogenesis of primary open-angle glaucoma, suggesting that the thinning retinal nerve fiber layer may be associated with oxidative stress in favor of prooxidant shift.

Effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus.

PURPOSE: To investigate the effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus with no or mild diabetic retinopathy and to investigate the relationship between macular thickness and metabolic parameters. MATERIALS AND METHODS: Fifty eight eyes of 58 patients without diabetic retinopathy (group 1) in microalbuminuria stage, 42 eyes of 42 patients with mild diabetic retinopathy (group 2) in microalbuminuria stage, and 50 eyes of 50 patients without diabetic retinopathy and microalbuminuria (group 3) were included in this study. After detailed ophthalmologic examination, all patients underwent spectral domain-optical coherence tomography measurements. Macular thickness was noted from nine different areas (fovea, four parafoveal, and four perifoveal areas) and compared between groups. The correlations between macular thickness and age, duration of diabetes mellitus, microalbuminuria, serum urea, creatinine, glycosylated hemoglobin (HbAIc), albumin, sodium (Na), and urinary Na were evaluated. RESULTS: The mean age was 53.29 ± 6.49 in group 1, 55.86 ± 6.97 in group 2, and 52.98 ± 5.66 years in group 3 (p = 0.06). The macular thickness values of superior, inferior, and nasal parafoveal areas were significantly different between groups (p = 0.001, p = 0.006, and p = 0.03, respectively). Bonferroni post test revealed that this difference originated from the difference between group 2 and 3 (p < 0.05 for all values). There were significant negative correlations between the macular thickness values of parafoveal areas and serum urea, HbA1c, albumin, microalbuminuria levels (p < 0.05 for all values). CONCLUSION: In this study, a significantly decreased parafoveal macular thickness was measured in patients with mild diabetic retinopathy and microalbuminuria compared to patients without diabetic retinopathy and microalbuminuria.

The effect of the ChromaGen contact lens system on visual performance.

BACKGROUND: To evaluate the effects of the ChromaGen contact lens (CCL) on best-corrected visual acuity, contrast sensitivity and pseudoisochromatic test plate performance in patients with congenital colour vision deficiency (CVD). METHODS: CCLs were inserted into 50 eyes of 25 patients with congenital red-green CVD. The patients were tested with the Ishihara and Hardy-Rand-Rittler test plates before and after the insertion of Magenta 2, Magenta 3, and Violet 3 CCLs. The patients' mean numbers of recognised symbols were calculated and the most appropriate CCL was determined for each eye. The best-corrected visual acuity for both far and near vision and contrast sensitivity were evaluated before and after the insertion of the appropriate CCLs, and the results were compared. RESULTS: The mean age of the patients was 26.56 ± 10.30 years. While all CCLs increased the mean numbers of recognised symbols on the Ishihara (p < 0.001 for all), Magenta 3 was observed to be the most useful CCL. On the other hand, while all CCLs increased the mean numbers of recognised symbols on Hardy-Rand-Rittler (p < 0.001 for all), Magenta 2 and Magenta 3 were detected as the most useful CCLs. After insertion of the most appropriate CCL for each eye, the mean best-corrected visual acuity for both far and near vision were decreased (p < 0.001 for both). Statistically significant alterations were also detected at some spatial frequencies of contrast sensitivity measurements. CONCLUSION: CCLs decrease the far and near best-corrected visual acuity, and static and dynamic contrast sensitivity at some spatial frequencies, and invalidate the pass criteria of pseudoisochromatic test plates by increasing the number of recognised symbols.

Pattern electroretinography in patients with unilateral acute central serous chorioretinopathy.

BACKGROUND: To evaluate the pattern electroretinography (PERG) in patients with acute central serous chorioretinopathy (CSCR) at baseline and after spontaneous resolution. METHODS: A total of 32 patients (mean ± SD age: 38.8 ± 8.2 years, 71.9 per cent female) with unilateral acute CSCR and spontaneous resolution during follow-up period were included. The unaffected eyes of the study patients comprised the control group. The best-corrected visual acuity, PERG and optical coherence tomography findings were recorded both at baseline and following spontaneous resolution at two to four months. RESULTS: The P50 and N95 amplitudes of the affected eyes were significantly lower than the control group both at baseline and after CSCR resolution (p < 0.001 for each). A significant increase was noted in both P50 and N95 amplitudes of the affected eyes from baseline to post-resolution (p < 0.001 for each). Subfoveal choroidal thickness was significantly higher in the affected eyes as compared with control eyes both at the baseline and after CSCR resolution along with a significant decrease in the affected eyes from baseline to post-resolution (p < 0.001 for each). The central retinal thickness was higher in the affected eyes as compared with the control eyes at baseline (p = 0.009), along with a significant decrease in the affected eyes from baseline to post-resolution (p < 0.001). Between the baseline P50 amplitude and the visual acuities of the affected eyes, a strong correlation was noted at baseline (r = -0.691, p < 0.001) and a moderate correlation was noted after CSCR resolution (r = -0.422, p = 0.031). CONCLUSIONS: In conclusion, our findings revealed an association of CSCR with impaired P50 and N95 amplitudes and a significant improvement but not a complete recovery in both parameters after CSCR resolution. Our findings emphasise potential utility of PERG in the electrophysiological evaluation of functional impairment in CSCR patients and the likelihood of P50 amplitude to have a prognostic value in CSCR.

Assessment of Corneal and Lens Density in Children With Celiac Disease.

PURPOSE: To assess the early changes of corneal and lens density in a pediatric population with celiac disease. METHODS: One hundred one patients were included in this observational and prospective study. Patients with celiac disease formed the celiac disease group. Healthy individuals with no medical history formed the control group. Corneal and lens density were assessed with Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany). RESULTS: The mean lens and corneal density outcomes in all zones did not differ between groups (P > .05 for each). Maximum lens density outcome was significantly higher in the celiac disease group than in the control group (P = .028). The mean corneal density at the peripheral cornea was significantly higher in females than males in the celiac disease group (P < .05 for each). Compliance with a gluten-free diet, body mass index, and histological classification of celiac disease had no significant effect on lens and corneal density in patients with celiac disease (P > .05 for each). CONCLUSIONS: Celiac disease did not affect the mean lens and corneal density in this pediatric population, but higher maximum lens density in patients with celiac disease and higher peripheral corneal density in female patients with celiac disease may indicate early stages of ocular involvement of celiac disease. [J Pediatr Ophthalmol Strabismus. 2019;56(6):402-406.].

Aqueous humor IL-8, IL-10, and VEGF levels in Fuchs' uveitis syndrome and Behçet's uveitis.

PURPOSE: This study investigated the levels of interleukin (IL)-8, IL-10, and vascular endothelial growth factor (VEGF) in the aqueous humor (AqH) of patients with Behçet's uveitis (BU) and Fuchs' uveitis syndrome (FUS) during an inactive period and compared these levels with those in the AqH of noninflammatory healthy control subjects. METHODS: This prospective and case-control study included 33 patients (16 patients with BU and 17 patients with FUS) and 35 control subjects. IL-8, IL-10, and VEGF levels in the AqH were quantified by performing sandwich enzyme-linked immunosorbent assay. Kruskal-Wallis test was used to compare the cytokine levels in the different groups, and statistical significance was set at p < 0.05. RESULTS: IL-8 levels were significantly higher in the AqH of patients with BU and FUS than in the AqH of control subjects (p < 0.001 and p < 0.001, respectively). IL-10 levels were significantly lower in the AqH of patients with BU than in the AqH of patients with FUS and of control subjects (p = 0.001 and p < 0.001, respectively). Although VEGF levels were higher in the AqH of patients with FUS than in the AqH of patients with BU and of control subjects, the difference was significant only between patients with FUS and control subjects (p < 0.001). CONCLUSIONS: We observed a significant decrease in IL-10 levels in the AqH of patients with BU and a significant increase in VEGF levels in the AqH of patients with FUS compared to controls. IL-8 and VEGF levels showed no significant difference among uveitis patients.

Assessment of corneal and lens clarity in children with Wilson disease.

PURPOSE: To investigate the effect of copper accumulation on corneal and lens clarity in children with Wilson disease (WD) compared to healthy children. METHODS: This multicenter cross-sectional study included 24 subjects with WD and 25 age-matched controls. Clinical and laboratory characteristics of the WD subjects were recorded. The Pentacam HR imaging system was used both for lens densitometry and corneal densitometry. RESULTS: Corneal densitometry values were higher in the posterior 6-10 mm (P = 0.021), posterior 10-12 mm (P < 0.001), posterior total diameter (P = 0.037), total thickness 10-12 mm (P = 0.032), and total thickness 6-10 mm zones and layers (P = 0.040) in the WD eyes than in control eyes. The lens densitometry values of zone 1 were higher in WD eyes (P < 0.001). There was a significant relationship between corneal densitometry values in the posterior 10-12 mm zones (P = 0.012; r = 0.527) and the duration of WD and liver copper content (P = 0.016; r = 0.507). A statistically significant correlation was also detected between lens densitometry values in zone 1 and WD duration (P = 0.018; r = 0.426). CONCLUSION: In this study cohort, children with WD had decreased corneal and lens clarity even in cases without Kayser-Fleischer rings and sunflower cataracts. Densitometry measurements using Scheimpflug imaging provided detection of corneal and lens involvement in the early stages of WD.

23-gauge transconjunctival vitrectomy for posterior segment intraocular foreign bodies.

BACKGROUND: This study is a report of the outcomes of 23-gauge (G) transconjunctival vitrectomy (TV) performed to treat a posterior segment intraocular foreign body (IOFB). METHODS: The data of 14 eyes of 14 patients who underwent 23-G TV for the removal of a posterior segment IOFB were reviewed in this study. Surgery was initiated with a 23-G system in each case and the posterior segment IOFB was removed through the enlarged sclerotomy site. All of the patients were male. The mean age of the patients was 36.6+-11.0 years. RESULTS: The foreign body (FB) was located in the vitreous in 11 eyes and in the retina in 3 eyes. Before the 23-G TV, complicated cataract was detected in 6 eyes, vitreous hemorrhage was detected in 5 eyes, and retinal detachment was detected in 1 eye. The size of the FB ranged from 3 mm to 7 mm; 12 of the FBs were metallic and 2 were glass. Silicone oil was used as a tamponade agent in 5 eyes and gas tamponade (C3F8) was used in 4 eyes. The mean follow-up time was 8.15+-2.9 months. At the last examination, of the 14 eyes included in the study, the visual acuity (VA) was 0.1 or better in 10 eyes and less than 0.1 in 4 eyes because 2 eyes had peri-macular scar, 1 eye had massive sub-epiretinal membrane and 1 eye had retinal re-detachment. CONCLUSION: 23-G TV is seen as an effective and minimally invasive technique to remove posterior segment IOFBs.

Quantitative analysis of retinal microcirculation in children with hyperopic anisometropic amblyopia: an optical coherence tomography angiography study.

PURPOSE: To evaluate optical coherence tomographic angiography (OCTA) findings on retinal microcirculation in hyperopic anisometropic amblyopia compared with fellow eyes and nonamblyopic control eyes. METHODS: A total of 40 pediatric patients with hyperopic anisometropic amblyopia and 57 control subjects were recruited, and 137 eyes (40 amblyopic, 40 fellow, and 57 control eyes) were evaluated. Data on best-corrected visual acuity (logMAR), axial length (mm), refractive error, and OCTA findings (foveal avascular zone parameters, macular vascular density in superficial and deep retinal capillary plexus, central macular thickness) were recorded in amblyopic, fellow, and control eyes. RESULTS: Compared with fellow and control eyes, amblyopic eyes were associated with significantly lower foveal vessel density values within 300 µm around the foveal avascular zone (P < 0.01) and lower vascular density in certain areas of superficial and deep retinal capillary plexus in axial length- and refraction-adjusted analysis (P < 0.05 for all), along with significantly higher full thickness of the central macula (P = 0.04). In amblyopic eyes, best-corrected visual acuity values were negatively correlated with foveal density (r = -0.57; P = 0.02) and deep capillary retinal plexus vascular density in foveal (r = -0.51; P = 0.03) parafovea temporal (r = -0.52; P = 0.03), and parafovea superior (r = -0.51; P = 0.04) areas. CONCLUSIONS: Our findings indicate a possible association between retinal microcirculation and amblyopia.

Evaluation of tear meniscus dimensions using anterior segment optical coherence tomography in video terminal display workers.

BACKGROUND: To evaluate tear meniscus height and tear meniscus area measured by optical coherence tomography (OCT) and to determine the prevalence of dry eye disease in video display terminal (VDT) users. METHODS: This was a case-control study performed on VDT users. The case group consisted of 53 subjects who vocationally use VDT more than six hours per day and the control group consisted of 49 subjects who used VDT not more than one hour per day. The pre-vocational and post-vocational tear meniscus height and tear meniscus area measurements were performed twice in one day using OCT. Tear-film break-up time, Schirmer's test, Ocular Surface Disease Index score and corneal staining score measurements were performed in all subjects. RESULTS: The mean age was 38.9 ± 5.5 years in VDT users and 37.8 ± 5.8 years in the control group (p = 0.426). Twenty patients (37.7 per cent) had dry eye disease in VDT users and five patients (10.2 per cent) had dry eye disease in the control group (p = 0.001). The mean tear meniscus height and tear meniscus area values (pre-vocational and post-vocational) were significantly lower in VDT users than in the control group (p < 0.001, p < 0.001, p = 0.024 and p < 0.001, respectively). The Schirmer's test results, Ocular Surface Disease Index scores, corneal staining scores and tear-film break-up time values revealed significant differences between VDT users and control subjects (p = 0.002, p = 0.006, p < 0.001 and p < 0.001, respectively). In addition, significant correlations were demonstrated between Schirmer's test results, Ocular Surface Disease Index scores, corneal staining scores, tear-film break-up time measurements, tear meniscus height results and tear meniscus area values. CONCLUSION: Tear meniscus evaluation using OCT is an effective, non-invasive and sensitive method for detection of dry eye disease in VDT users.

The ultrastructural alterations in the lens capsule and epithelium in eyes with traumatic white cataract.

PURPOSE: To demonstrate the morphological and physiological characteristics of lens epithelial cells (LECs) in patients with traumatic cataract using transmission electron microscopy (TEM) to further understand penetrating ocular injury-induced cataract morphology and epithelial repair mechanisms involved at a cellular level. METHODS: This is a prospective international study. Sixteen eyes of 16 consecutive patients who were diagnosed as traumatic white cataracts following the anterior lens capsule perforation and 13 eyes of 13 patients with idiopathic posterior subcapsular cataract were included to the study. The anterior lens capsules (aLCs: basement membrane and associated LECs) were obtained from cataract surgery and prepared for TEM. RESULTS: Two prominent cell types were observed in all aLCs of the traumatic cases: degenerated type LECs having variable sized intraepithelial vacuoles close to injury site and normal appearing LECs having an euchromatic nucleus distant from the injury site. In control group, the LECs and all their elements were in normal ultrastructural pattern except some small intraepithelial vacuoles, which were fewer and smaller than the vacuoles in the degenerated LECs of the traumatic group. CONCLUSIONS: The ultrastructural findings of our cases support that traumatically induced dysfunction of the lens epithelium may lead to an edema in superficial cortical lens fibers that subsequently undergo degeneration and produce a localized zone of vacuolization.

CENTRAL RETINAL ARTERY OCCLUSION WITH DOUBLE CILIORETINAL ARTERY SPARING.

PURPOSE: To report a patient with central retinal artery occlusion with double cilioretinal artery sparing. METHODS: Retrospective case report. RESULTS: A 45-year-old woman presented with sudden vision loss in her left eye for 10 days. Her best-corrected visual acuity was counting fingers at 2 meters in the left eye and 20/20 in the right eye. Funduscopy showed retinal opacity of posterior fundus, most marked in the macular region, and two small areas of the normal retina; one temporal to the optic disk and the other superior to the optic disk corresponding to the patent cilioretinal retinal arteries in the left eye; the right eye was normal. Fundus fluorescein angiography showed rapid filling of the two cilioretinal vessels and delayed filling of the central retinal artery at initial and last visits. Spectral domain optical coherence tomography findings disclosed diffuse thickening of the neurosensory retina in the perifoveolar area except two small areas at the first visit. After 6 months, spectral domain optical coherence tomography revealed diffuse thinning of the neurosensory retina except two small areas of the retina fed from two patent cilioretinal arteries. CONCLUSION: In this report, we documented double cilioretinal artery sparing in a patient with central retinal artery occlusion. It seems that a second cilioretinal artery can be present in some patients with central retinal artery occlusion.

Could corneal densitometry be used as a diagnostic and screening tool for ocular involvement in patients with gout?

PURPOSE: To evaluate the corneal and tear film characteristics in patients with gout and compare these data with those of healthy subjects and to investigate the correlation of corneal densitometry with uric acid value and duration of disease. METHODS: Forty-one eyes of 41 patients with gout (group 1) and 40 eyes of 40 healthy subjects (group 2) were included in this study. Detailed ophthalmologic examinations were performed on all participants. Corneal tomographic analyses were performed with the Pentacam HR Scheimpflug imaging system (Oculus, Wetzlar, Germany). Maximum keratometry (Kmax), central corneal thickness (CCT), corneal volume (CV), and corneal densitometric values were compared between groups. Tear function tests including Schirmer, tear breakup time, and fluorescein staining were performed and compared between groups. RESULTS: Groups were similar in terms of age and gender. Kmax, CCT, and CV values were similar between groups. The outcomes of tear function tests were similar between groups. Corneal densitometric values for the 0-2 and 2-6 mm zones of the anterior and center layers were significantly higher in group 1 compared to group 2. This densitometric increase was positively correlated with uric acid levels and gout duration. CONCLUSIONS: Corneal densitometry values of the 0-2 and 2-6 mm zones of the anterior and central layers were higher in patients with gout than those of the control subjects, and the densitometric values increased as uric acid level and disease duration increased.

The effects of chalazion surgery on intraocular pressure and corneal topography.

PURPOSE: To evaluate the effects of chalazion surgery on intraocular pressure (IOP) and the biomechanical, topographic, and topometric properties of the cornea. METHODS: A total of 29 patients with upper eyelid chalazion were included in this study. All patients underwent preoperative and postoperative detailed ophthalmological examinations including scale of chalazion size; IOP (IOPcc and IOPg), corneal hysteresis, and corneal resistance factor measurements using ocular response analyser (ORA; Reichert Instruments, Depew, NY, USA); topographic and topometric properties of the cornea using Pentacam HR (Oculus GmbH, Wetzlar, HE, Germany). Preoperative and postoperative measurements were compared. RESULTS: The mean age of the patients was 29.07 ± 13.74 years (18-54 years). The mean IOPcc was 15.82 ± 4.20 mmHg preoperatively and 14.72 ± 3.96 mmHg postoperatively, and the mean IOPg was 15.21 ± 3.91 mmHg preoperatively and 14.21 ± 4.02 mmHg postoperatively (p = 0.020, p = 0.007, respectively). The mean central keratoconus index (CKI) was 1.006 ± 0.01 preoperatively and 1.002 ± 0.01 postoperatively (p = 0.035). Other biomechanical, keratometric, topographic, and topometric parameters were similar before and after the surgery (all p > 0.05). CONCLUSION: To the best of our knowledge, this is the first report to suggest that IOP and CKI are decreased after the removal of upper eyelid chalazion.