Turkish Journal of Ophthalmology最新文献

Objectives: This study aimed to examine factors associated with strabismus in patients with retinopathy of prematurity (ROP) and the relationship between strabismus and macular ectopia.

Materials and methods: Patients with ROP were divided into three groups: Group 1, patients with spontaneous regression (n=45); Group 2, patients who received laser treatment (n=70); and Group 3, patients who underwent surgical treatment (n=91). Rates of anisometropia, amblyopia, nystagmus, macular ectopia, and retinal pathologies were evaluated and their impacts on strabismus development were determined. Disc-to-fovea distance (DFD) was measured from color fundus photographs and the correlation of macular ectopia with severity of strabismus was evaluated.

Results: A total of 206 patients were included. Rates of anisometropia, amblyopia, nystagmus, macular ectopia, retinal pathologies causing vision loss, and strabismus were higher in Group 3 (p=0.0001) and correlated with higher stages of ROP (p=0.0001). Macular ectopia (p=0.005), retinal pathologies (p=0.005), and amblyopia (p=0.012) had the strongest impact on strabismus development in ROP patients. DFD and strabismus severity were not significantly correlated (p=0.364). Mean visual acuity (VA) was significantly higher in orthophoric patients compared to those with esotropia and exotropia (p=0.027). Esotropic patients had lower VA compared to patients with exotropia, but this finding was not statistically significant (p=0.729).

Conclusion: Presence of macular ectopia, retinal pathologies, and amblyopia were the most strongly correlated risk factors for strabismus development in ROP patients. DFD was not associated with severity of strabismus. Exotropia was mostly related to higher DFD and a possible relationship between esotropia and lower VA was observed.

Objectives: To investigate the effects of pupil diameter on the evaluation of lens and corneal densitometry measured by Scheimpflug tomography.

Materials and methods: This cross-sectional and comparative study used the right eyes of 32 participants. Corneal and lenticular optical densitometries, corneal volume, anterior segment volume, and anterior chamber depth measurements were taken with the Scheimpflug imaging system when the pupils were mid-dilated and fully dilated. The results were statistically compared.

Results: The mean lens density was 19.20±3.05 when the pupils were mid-dilated (mean pupil diameter 2.98±0.89 mm) and 23.25±3.88 at full dilation (mean pupil diameter 5.01±0.92 mm) (p<0.001). The mean corneal density was 16.15±0.99 with mid-dilated pupils and 16.38±0.95 with fully dilated pupils (p=0.065). Anterior chamber depth and anterior segment volume measurements increased with larger pupil diameter (p<0.05).

Conclusion: The lens densitometry values increased with an increase in pupil diameter. The corneal density measurements increased minimally but the differences were not statistically significant. This study revealed that lens densitometry was significantly affected by pupil diameter.

Pseudoexfoliation syndrome (PES) is one of the most common causes of open-angle glaucoma, with a higher risk of vision loss, a higher maximum and mean intraocular pressure (IOP) at diagnosis, and a wider range of IOP fluctuation compared to primary open-angle glaucoma. Patients with this syndrome have a ten-fold higher risk of developing glaucoma than the normal population. A definite diagnosis can be made by the observation of pseudoexfoliation material (PEM) on the anterior lens surface, ciliary processes, zonules, and iris. PEM deposits on the zonules may explain the clinically observed zonular weakness and lens subluxation or dislocation. An increased incidence of cataract development is also associated with PES. There is growing evidence for systemic associations of PES with peripheral, cardiovascular, and cerebrovascular system diseases, Alzheimer's disease, hearing loss, and increased plasma homocysteine levels. Indications for surgery are markedly more common in patients with pseudoexfoliation glaucoma than primary open-angle glaucoma. The goal of this article is to review the latest perspectives on the clinical features, therapy, and systemic associations of this clinically and biologically challenging disease.

Objectives: To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals.

Materials and methods: This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms.

Results: The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups.

Conclusion: Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.

Objectives: To investigate the macular imaging features in patients with unilateral myelinated retinal nerve fiber (MRNF) and high myopia syndrome.

Materials and methods: Six patients with unilateral MRNF and high myopia syndrome and 13 myopic controls were enrolled in this study. Spectral domain (SD) optical coherence tomography (OCT), SD enhanced depth imaging OCT, and OCT angiography (OCTA) imaging results of MRNF-affected eyes were compared with the fellow eyes and myopic controls.

Results: All patients had abnormal foveal reflex and/or ectopia. No significant difference in retinal thickness parameters were noted between the groups. In OCT scans, posterior vitreous detachment (PVD) was observed in 4 out of the 6 MRNF-affected eyes. Regarding OCTA parameters, only a significant increase in acircularity index was noted in myelinated eyes (p=0.01).

Conclusion: All patients demonstrated normal foveal contours, macular structure, and OCTA features except for a higher acircularity index. The incidence of PVD was notably increased in the myelinated eyes.

Isolated from Streptomyces caespitosus, mitomycin C (MMC) has various applications in the management of corneal and external disease due to its ability to modulate cellular proliferation. It has been employed in pterygium surgery, ocular surface neoplasia, and refractive surgery. Currently, there is no definite consensus on the treatment protocols for each of the aforementioned applications. Although its benefits in the management of corneal and external diseases are promising, MMC use has potential complications including endothelial cell loss, corneal perforation, scleral melt, secondary glaucoma, iritis, and endophthalmitis. This article will review the literature regarding the use of MMC in the field of cornea and external disease and describe protocols employed with corresponding outcomes.

Objectives: The study aimed to investigate inner retinal changes in multiple sclerosis (MS) patients by comparing them with healthy controls. The study also aimed to assess regional differences of inner retinal layer involvement in eyes with and without optic neuritis (ON).

Materials and methods: This retrospective, cross-sectional study consisted of 141 eyes of 74 relapsing-remitting MS patients and 80 eyes of 40 healthy controls. The study group was separated into two subgroups according to the presence of ON history. Peripapillary retinal nerve fiber layer (pRNFL) thickness, total macular thickness, and thicknesses of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer were compared between the MS and healthy control groups and between eyes with and without ON history.

Results: Mean pRNFL, total macular, mRNFL, GCL, and IPL thicknesses were significantly thinner in the MS group than in the control group (p<0.001) and in eyes with ON compared to those without ON (p<0.05). Comparison of inner retinal layer thicknesses in the inner 3-mm ring subfields of the ETDRS grid revealed significant thinning in all subfields of the GCL and IPL of eyes with ON (p<0.05). The inferior subfield demonstrated the highest difference.

Conclusion: The study demonstrated that GCL and IPL thinning is a robust and reliable biomarker in all MS patients. The thinning was significantly greater in eyes with ON than in eyes without ON. The study also documented that the inferior region showed significantly greater GCL and IPL thinning in eyes with previous ON attacks.

Objectives: Our purpose was to investigate vascular alterations in the non-glaucomatous eyes of patients with unilateral primary open angle glaucoma using optical coherence tomography angiography and to evaluate the role of vascular damage in glaucoma pathogenesis.

Materials and methods: This cross-sectional study included 60 eyes of 30 patients with unilateral glaucoma (63.4±8.8 years) and 30 eyes of 30 healthy subjects (65.6±9.1 years). Three groups were formed: group A, affected eyes of unilateral glaucoma patients; Group B, non-glaucomatous eyes of unilateral glaucoma patients; and group C, healthy controls.

Results: When group A was compared with groups B and C, significant differences were detected in rim area, cup volume, mean cup/disc ratio, and retinal nerve fiber layer thickness parameters (p<0.001 for all). No significant difference was detected between groups B and C (p>0.05 for all). In peripapillary and macular vessel density (VD) comparisons, all parameters except intradisc VD were found to be lower in group A (p<0.0167 for all). No statistically significant difference was detected between groups B and C (p>0.05 for all).

Conclusion: The VD values in eyes with glaucoma were found to be lower than in the other two groups. However, no difference was observed between the non-glaucomatous eyes of glaucoma patients and those of healthy individuals. Thus, the results did not support our hypothesis that VD alterations would be observed in the fellow eyes of patients with unilateral glaucoma if the vascular pathway were responsible in the pathogenesis of glaucoma.

We present a 65-year-old woman who developed sudden and severe vision loss in her left eye one day after the administration of the second dose of COVID vaccine. The best corrected visual acuity in this eye was 1/10. Diffuse paracentral acute middle maculopathy was detected on spectral domain optical coherence tomography (OCT). OCT angiography images revealed concurrent vascular flow defects consistent with acute macular neuroretinopathy in the deep retinal capillary plexus and choriocapillaris layers. At the end of the six-month follow-up, there was no improvement in visual acuity, and atrophy and thinning developed in all layers of the retina.

Eight syndrome is defined as the combination of a unilateral conjugate gaze palsy and ipsilateral seventh cranial nerve palsy. It may occur as a result of demyelinating, vascular, infectious, or compressive lesions of the brainstem localized to the caudal pontine tegmentum. A 43-year-old woman was admitted to our clinic with complaints of headache, inability to look to the left, and weakness on the left side of her face. The complaints had begun abruptly about a month before her admission. Suboccipital decompression surgery for type I Chiari malformation had been performed 10 years earlier. Neuro-ophthalmological examination revealed left-sided horizontal gaze palsy and anisocoria. Cranial and cervical magnetic resonance images revealed cerebellar tonsillar herniation and syringomyelia, the latter of which was considered to be the cause of eight syndrome. No interventions were performed, and periodic follow-up was advised on neurosurgical consultation. Left gaze palsy and facial palsy recovered almost completely in three months, while the anisocoria persisted. Syringomyelia should be considered among the causes of horizontal gaze palsy plus ipsilateral seventh nerve palsy, termed as eight syndrome. Clinical suspicion and appropriate radiological examination can aid in the diagnosis.