Efficacy of Simultaneous Application of Subretinal Tissue Plasminogen Activator and Bevacizumab for Submacular Hemorrhages.

Objectives: The aim of the study was to evaluate the patients who received simultaneous subretinal tissue plasminogen activator (tPA) and bevacizumab for submacular hemorrhages secondary to neovascular age-related macular degeneration. Methods: This retrospective study included patients who underwent pars plana vitrectomy (PPV) with simultaneous subretinal tPA and subretinal bevacizumab with 18% SF6 tamponade. Anatomical and functional results of the patients before surgery and at the 1st, 6th, and 12th months after surgery, additional treatments, and complications after PPV were evaluated. Results: Eight eyes of eight patients were included in the study. The mean age of the patients was 72.38±92.3. The mean time from the onset of symptoms to treatment was 5.13±1.88 days. The patients' mean best-corrected visual acuity (BCVA) was 2.23±0.14 logMAR at baseline. Mean BCVA increased significantly at 1st, 6th, and 12th months to 1.68±0.47 logMAR, 1.58±0.49 logMAR, and 1.51±0.58 logMAR, respectively (p=0.001 at all). The mean central foveal thickness (CFT) in measurable patients was 836.8±627.02 µm at baseline. Mean CFT decreased significantly to 370.13±66.13 µm in the 1st month, 373.38±78.33 µm in the 6th month, and 367.75±116.43 µm in the 12th month (p<0.05). The maximum measurable subretinal hemorrhage height at baseline was 814.2±556.45 µm. The mean number of anti-VEGFs performed for 12 months after surgery was 4.13±2.1. At month 12, the ellipsoid zone could not be detected in 6 (75%) patients. Conclusion: Administration of subretinal bevacizumab and subretinal tPA effectively removes subretinal hemorrhage under the fovea. Intravitreal anti-VEGF treatment must be continued, as choroidal neovascular membrane activity continues after surgery.

Evaluation of dry eye and meibomian gland function in pregnancy.

PURPOSE: To evaluate the signs and symptoms of dry eye in healthy pregnant women and investigate the effect of pregnancy on meibomian gland loss using non-contact meibography. METHODS: Healthy pregnant women and age-matched healthy non-pregnant women were included in the study. Subjective symptoms were assessed using the Ocular Surface Disease Index (OSDI). The first and average non-invasive break-up times (first-NIBUT and avg-NIBUT, respectively) were determined, and the Schirmer test was applied. Non-contact meibography was performed. RESULTS: The study included a total of 62 women, 30 pregnant (study group) and 32 non-pregnant (control group). There was no significant difference between the groups in terms of OSDI score and the Schirmer test (p > 0.05). The mean first-NIBUT and avg-NIBUT values of the study group (13.1 ± 5.3 and 13.7 ± 4.5 s) were significantly lower than the control group (16.0 ± 2.4 and 16.4 ± 1.5 s) (p: 0.015 and p: 0.040, respectively). The mean meibomian gland losses in the upper and lower eyelids were significantly higher in the study group (16.9 ± 8.2% and 11.6 ± 10.2%) compared to the control group (9.7 ± 6.2% and 5.6 ± 4.7%) (p < 0.001 and p: 0.011, respectively). CONCLUSIONS: It is considered that loss of the meibomian glands may occur during pregnancy, and this may predispose pregnant women to evaporative dry eye. Although dry eye does not cause significant ocular surface symptoms in pregnancy, NIBUT and non-contact meibography can be considered as effective diagnostic methods for the detection of dry eye in pregnant women.

Axenfeld-Rieger syndrome in monozygotic twin brothers: Case report.

Axenfeld-Rieger syndrome (ARS) is a genetic disease affecting multiple organ systems. In the eye, it is associated with anterior segment dysgenesis with a high risk for glaucoma. Dental anomalies, cardiovascular malformations, hypospadias, and craniofacial abnormalities are other associated systemic conditions. Five years old monozygotic twin brothers with ARS were referred to Umraniye Training and Research Hospital, ophthalmology clinic for iris abnormalities. At presentation, pathognomonic components of ARS were found in both patients, including iris anomaly (corectopia, iris hypoplasia, and iris strands in Scwalbe's ring), oligodontia, hypodontia, hypospadias, and periumbilical skin fold. Intraocular pressure was within normal ranges in both of the patients. Patients were followed up in the glaucoma unit.

Comparison of Clinical and Topographic Outcomes of Hybrid and Scleral Lenses in Advanced Keratoconus.

Objectives: To evaluate and compare the effects of hybrid contact lenses (HCLs) and mini-scleral contact lenses (MSCLs) on visual acuity, spherical equivalent, topographic astigmatism, and higher-order aberrations (HOAs) in eyes with advanced keratoconus. Methods: We reviewed the medical records of 43 eyes of 27 patients diagnosed with advanced keratoconus fit hybrid contact lenses (AirFlex®) and mini-scleral contact lenses (Mini-misa®). Pre-fitting examinations included best corrected visual acuity (BCVA), spherical equivalent, topographic findings (topographic astigmatism, maximum keratometry, mean keratometry, central corneal thickness, thinnest corneal thickness, and corneal HOAs. Post-fitting examinations included lens corrected visual acuity, spherical equivalent, topographic astigmatism, corneal HOAs, and contact lens-related discomfort symptoms. Results: Mean BCVA (log MAR) improved significantly from 0.65±0.27 to 0.14±0.09 with HCL and 0.58±0.25 to 0.15±0.13 with MSCL (p<0.05). The mean spherical equivalent and topographic astigmatism measurements decreased significantly in both groups (p<0.05). Eight patients in the HCL group experienced lens-related discomfort. Root-mean square HOA decreased significantly in both groups (p<0.05). Conclusion: Significant improvements in visual acuity, spherical equivalent, topographic astigmatism, and HOAs were observed with both lenses. However, higher patient comfort with scleral lenses may lead to higher compliance in patients with advanced keratoconus.

Bilateral Hypertensive Papillopathy with Diffuse Retinal Telangiectasis.

A 16-year-old type 1 diabetic female patient was consulted to our clinic for acute bilateral painless vision loss with a 2-week history in the right eye and a 1-week history in the left eye. At the initial visit, the best-corrected visual acuity was 0.2 in the right eye and 0.05 in the left eye. In fundus examination, both optic disks were pale and slightly swollen. In both eyes, superficial telangiectatic vessels were extending from the optic disk to the retina. Telangiectatic vessels disappeared within 10 days with systemic hypertension regulation and without any ocular treatment.

Bilateral simultaneous non-arteritic anterior ischemic optic neuropathy with occlusion of unilateral cilioretinal artery: A case report.

A 45-year-old female patient consulted our hospital for bilateral visual loss. She was receiving hemodialysis for 15 years. At presentation ophthalmologic examination, her visual acuity was hand movements in the right eye and light perception negative in the left eye. The direct light response was weak in the right eye and absent in the left eye. A total afferent pupillary defect was detected in the left eye. Fundoscopy revealed bilateral sectorial pale, sectorial hyperaemia and swollen optic discs. On the left papilla, there were splinter haemorrhages. At the right eye, there was pale edema at superior maculo-papillary bunch that coherent with occlusion of the cilioretinal artery. She was diagnosed as non-arteritic ischemic optic neuropathy based on the clinical and funduscopic examination. Methylprednisolone intravenous 1000mg/day for three days, then, oral methylprednisolone 1 mg/kg/day were administered for one week. Simultaneous acetylsalicylic acid 325 mg/day and hydration with 0.9% 1000cc isotonic solution treatment started. After two months, visual acuities did not change in both eyes, and both optic disks were pale.

Evaluation of spectral domain optical coherence tomography parameters in ocular hypertension, preperimetric, and early glaucoma.

PURPOSE: The objective of this study is to evaluate the diagnostic ability of retinal nerve fiber layer (RNFL), macular, optic nerve head (ONH) parameters in healthy subjects, ocular hypertension (OHT), preperimetric glaucoma (PPG), and early glaucoma (EG) patients, to reveal factors affecting the diagnostic ability of spectral domain-optical coherence tomography (SD-OCT) parameters and risk factors for glaucoma. METHODS: Three hundred and twenty-six eyes (89 healthy, 77 OHT, 94 PPG, and 66 EG eyes) were analyzed. RNFL, macular, and ONH parameters were measured with SD-OCT. The area under the receiver operating characteristic curve (AUC) and sensitivity at 95% specificity was calculated. Logistic regression analysis was used to determine the glaucoma risk factors. Receiver operating characteristic regression analysis was used to evaluate the influence of covariates on the diagnostic ability of parameters. RESULTS: In PPG patients, parameters that had the largest AUC value were average RNFL thickness (0.83) and rim volume (0.83). In EG patients, parameter that had the largest AUC value was average RNFL thickness (0.98). The logistic regression analysis showed average RNFL thickness was a risk factor for both PPG and EG. Diagnostic ability of average RNFL and average ganglion cell complex thickness increased as disease severity increased. Signal strength index did not affect diagnostic abilities. Diagnostic ability of average RNFL and rim area increased as disc area increased. CONCLUSION: When evaluating patients with glaucoma, patients at risk for glaucoma, and healthy controls RNFL parameters deserve more attention in clinical practice. Further studies are needed to fully understand the influence of covariates on the diagnostic ability of OCT parameters.

Refractive, Topographic, and Aberrometric Results at 2-Year Follow-Up for Accelerated Corneal Cross-Link for Progressive Keratoconus.

Purpose. To report the visual, refractive, and corneal topography and wavefront aberration results of accelerated corneal cross-linking (CXL) during a 24-month follow-up. Methods. Forty-seven eyes underwent riboflavin-ultraviolet A-induced accelerated CXL treatment (30 mW/cm2 with a total dose of 7.2 joules/cm2). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical values, keratometry (K) measurements (Ksteep, Kflat, Kavg, and Kapex), central corneal thickness, and anterior corneal aberrometric analyses including total wavefront error (WFE), total high order aberration (HOA), astigmatism, trefoil, coma, quadrafoil, secondary astigmatism, and spherical aberration were evaluated. Results. The mean UDVA and CDVA were significantly improved at 1 (p = 0.003 and p = 0.004, resp.) and 2 years after treatment (p = 0.001 and p = 0.001, resp.). The mean Ksteep, Kflat, Kaverage, and Kapex values were significantly lower than baseline at 12 months (p = 0.008, p = 0.024, p = 0.001, and p = 0.014, resp.) and 24 months (p = 0.014, p = 0.017, p = 0.001, and p = 0.012, resp.). Corneal thickness showed a significant decrease at 1 month. Total HOA and coma decreased significantly at the 12-month (p = 0.001 and p = 0.009, resp.) and 24-month visits (p = 0.001 and p = 0.007, resp.). Conclusion. Accelerated CXL (30 mW/cm2) was found to be effective in improving UDVA, CDVA, corneal topography readings, total HOA, and coma aberrations during the 24-month follow-up.

Subfoveal choroidal thickness changes after intravitreal bevacizumab injection for neovascular age-related macular degeneration and diabetic macular edema.

The purpose of this study was to investigate the changes in subfoveal choroidal thickness (SFCT) after intravitreal injection of bevacizumab (IVB) for neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME). This retrospective, consecutive, interventional case series study included 43 eyes [21 affected eyes with neovascular AMD (AMD group) and 22 affected eyes with DME (DME group)] which were treated with 1.25 mg/0.5 ml IVB and 43 untreated fellow eyes of 43 patients. SFCT was measured in all 86 eyes at baseline before IVB injection and at day 1, week 1, and month 1 after injection by use of enhanced depth imaging optical coherence tomography (EDI OCT). Central foveal thickness (CFT) and best-corrected visual acuity were analyzed at baseline and during follow-up visits. Main outcome measure was change in SFCT in 1 month after treatment. All 43 eyes treated with IVB showed a significant reduction in SFCT. Mean SFCT in treated eyes decreased from 237.1 ± 75.3 µm at baseline to 214.0 ± 65.7 µm at day 1, 205.4 ± 59.7 at week 1, and 222.7 ± 73.3 at month 1, whereas SFCT in fellow eyes changed from 228.4 ± 63.6 at baseline to 224.5 ± 68.5 at day 1, 220.4 ± 72.1 at week 1, and 226.9 ± 74.0 at month 1. SFCT demonstrated a similar trend toward decrease in both groups. CFT decreased significantly and visual acuity improved significantly. SFCT decreased significantly in AMD and DME eyes following injection. The decreasing effect of bevacizumab on choroidal thickness was highest at first week and continued to the end of first month after injection.

Subfoveal choroidal thickness changes after intravitreal bevacizumab therapy for central serous chorioretinopathy.

PURPOSE:: To evaluate subfoveal choroidal thickness (SFCT) changes after intravitreal bevacizumab (IVB) therapy for central serous chorioretinopathy (CSC) using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). METHODS:: In this retrospective study, we assessed the medical records of patients with CSC who received IVB (IVB group) or who were observed without intervention (control group). SFCT was measured using EDI-OCT. The main outcome measure was the change in SFCT. RESULTS:: Twenty-one eyes were included in the IVB group and 16 eyes were included in the control group. All patients showed resolution of neurosensory detachment and improvement in vision. In the IVB group, the mean SFCT was 315 µm at baseline, which decreased to 296 µm at the most recent visit. In the control group, the mean SFCT was 307 µm at baseline, which decreased to 266 µm at the most recent visit. Although there was a significant decrease in the mean SFCT for the control group, the decrease was not significant for the IVB group (41 vs 19 µm, p=0.003 vs p=0.071). CONCLUSIONS:: SFCT decreased in both groups with remission of the disease. However, the decrease was significantly greater in the control group. In terms of anatomic and functional outcomes, IVB injection is not promising.

Subfoveal choroidal thickness changes after intravitreal bevacizumab therapy for central serous chorioretinopathy / Alterações da espessura subfoveal coroide após terapia com bevacizumab para coriorretinopatia serosa central

ABSTRACT Purpose: To evaluate subfoveal choroidal thickness (SFCT) changes after intravitreal bevacizumab (IVB) therapy for central serous chorioretinopathy (CSC) using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Methods: In this retrospective study, we assessed the medical records of patients with CSC who received IVB (IVB group) or who were observed without intervention (control group). SFCT was measured using EDI-OCT. The main outcome measure was the change in SFCT. Results: Twenty-one eyes were included in the IVB group and 16 eyes were included in the control group. All patients showed resolution of neurosensory detachment and improvement in vision. In the IVB group, the mean SFCT was 315 μm at baseline, which decreased to 296 μm at the most recent visit. In the control group, the mean SFCT was 307 μm at baseline, which decreased to 266 μm at the most recent visit. Although there was a significant decrease in the mean SFCT for the control group, the decrease was not significant for the IVB group (41 vs 19 μm, p=0.003 vs p=0.071). Conclusions: SFCT decreased in both groups with remission of the disease. However, the decrease was significantly greater in the control group. In terms of anatomic and functional outcomes, IVB injection is not promising.

RESUMO Objetivo: Avaliar as alterações da espessura da coroide subfoveal (SFCT) após terapia com bevacizumab (IVB) para coriorretinopatia serosa central (CSC) usando tomografia de coerência óptica de domínio espectral com profundidade aprimorada (EDI-OCT). Métodos: Neste estudo retrospectivo, foram avaliados prontuários de pacientes com CSC que receberam IVB (grupo IVB) ou que foram apenas observados, sem intervenção (grupo controle). SFCT foi medido por meio de EDI-OCT. O desfecho principal avaliado foi a mudança na SFCT. Resultados: Houve 21 olhos no grupo IVB e 16 olhos no grupo de controle. Todos os pacientes apresentaram resolução de descolamento neurossensorial e melhora na visão. No grupo IVB, a SFCT media foi 315 μm no início e diminuiu para 296 μm na visita mais recente. No grupo controle, a SFCT média foi 307 μm no início e diminuiu para 266 μm na visita mais recente. Embora tenha havido uma diminuição significativa na SFCT média para o grupo controle, a diminuição não foi significativa para o grupo IVB (41 μm contra 19 μm, p=0.003 vs p=0.071). Conclusões: A SFCT diminuiu em ambos os grupos após a remissão da doença. Contudo, a diminuição foi significativamente maior no grupo de controle. Em termos de resultados anatômicos e funcionais, a injeção de IVB não foi promissora.

Accelerated (18 mW/cm(2)) Corneal Cross-Linking for Progressive Keratoconus: 18-Month Results.

PURPOSE: The aim of this study is to report the results of 18 months of follow-up after treatment with accelerated (18 mW/cm(2)) corneal cross-linking in patients with progressive keratoconus. METHODS: Forty-two eyes of 42 patients with progressive keratoconus were included in this retrospective study. All patients underwent accelerated corneal cross-linking at an irradiance of 18 mW/cm(2) for 5 min (total surface dose 5.4 J/cm(2)). Visual acuity, topographic findings (Kflat, Ksteep, Kaverage, and apical keratometry), and central corneal thickness were evaluated during the 18-month follow-up period. RESULTS: The mean ± standard deviation age of the 16 female and 26 male patients was 24.28 ± 6.32 years (range 14-36). Uncorrected distance visual acuity improved clinically significant from 0.52 ± 0.31 to 0.44 ± 0.25 logMAR (P = 0.031), and corrected distance visual acuity improved clinically significant from 0.34 ± 0.21 to 0.28 ± 0.19 logMAR (P = 0.018). At the last examination during the follow-up period, the flat keratometry (Kflat) decreased from a baseline of 45.65 ± 2.71 to 45.41 ± 2.72 diopters (D) (P = 0.001), the steep keratometry (Ksteep) decreased from 49.20 ± 3.54 to 48.96 ± 3.43 D (P = 0.023), and apical keratometry decreased from 56.62 ± 6.43 to 55.19 ± 5.69 D (P = 0.001), all of them were clinically significant at the 18-month visit. The preoperative values of central corneal thickness changed from 458.95 ± 38.79 to 461.85 ± 41.36 µm 18 months after the operation (P = 0.476). CONCLUSION: The accelerated corneal cross-linking was found to be effective for the stabilization of progressive keratoconus during the 18 months of follow-up visits.

Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis.

Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique. Results. The mean age of the patients was 71.9 ± 10.8 years. The mean percentage of ICA stenosis was 74 ± 4.9% in Group 1 and 47.5 ± 7.7% in Group 2. The mean SFCT was 231.9 ± 44.6 µm in Group 1 and 216.2 ± 46.8 µm in Group 2, which was significantly lower (P = 0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r = 0896, P = 0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%.

Accelerated Corneal Collagen Cross-Linking in Thin Keratoconic Corneas.

PURPOSE: To report the outcomes of accelerated corneal collagen cross-linking in patients with thin corneas (minimum corneal thickness < 400 µm). METHODS: Thirty-four eyes of 34 patients with a minimum corneal thickness less than 400 µm were included. All patients underwent accelerated corneal collagen cross-linking (irradiance power of 30 mW/cm² at 3 minutes with a total surface dose of 5.4 J/cm²). Uncorrected (UDVA) and corrected distance visual acuity (CDVA), manifest refraction (diopters [D]), and topography were evaluated at baseline and at the 1-, 6-, and 12-month follow-up visit. Endothelial cell density (cells/mm²) was calculated preoperatively and postoperatively at 12 months. The corneal stromal demarcation line was measured using anterior segment optical coherence tomography at 1 month postoperatively. RESULTS: The mean age of all patients (14 women and 20 men) was 23.08 ± 3.90 years (range: 16 to 29 years). UDVA and CDVA increased but not significantly. UDVA improved from 0.67 ± 0.32 (20/93 ± 20/41 Snellen) to 0.56 ± 0.28 logMAR (20/72 ± 20/38 Snellen) (P = .033) and CDVA improved from 0.49 ± 0.19 (20/61 ± 20/30 Snellen) to 0.42 ± 0.19 logMAR (20/52 ± 20/30 Snellen) (P = .009) at the last follow-up visit. The mean spherical and cylindrical refractions did not significantly change (P = .100 and 0.139, respectively). At the last follow-up visit, the flat keratometry decreased from 47.40 ± 2.52 to 46.95 ± 2.48 D, steep keratometry decreased from 51.04 ± 3.71 to 50.62 ± 3.57 D, and apex keratometry decreased from 57.58 ± 4.49 to 56.26 ± 4.47 D (P = .001, = .0019, = .001, respectively) from baseline. The mean endothelial cell density changed from 2,726.02 ± 230.21 to 2,714.58 ± 218.26 cells/mm² at 12 months postoperatively (P =.086). CONCLUSION: The results of this study revealed that accelerated corneal collagen cross-linking stabilized the progression of keratoconus without a significant endothelial cell density loss during the 12 months of follow-up.

Acute retinal pigment epitheliitis: spectral domain optical coherence tomography, fluorescein angiography, and autofluorescence findings.

A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes' best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

Systemic side effects of antiviral therapy in a patient with acute retinal necrosis.

PURPOSE: To report a case of Acute Retinal Necrosis (ARN)-developed nephrotoxicity during intravenous acyclovir treatment and toxic hepatitis during oral valacyclovir treatment. DESIGN: Interventional case report. METHODS: Retrospective chart review. RESULTS: A 45-year-old male with ARN treated with intravenous acyclovir developed nephrotoxicity. After switching to oral valacyclovir, toxic hepatitis developed. Both renal and liver function tests returned to normal levels after drug cessation CONCLUSIONS: Although rare, clinicians should be aware of the potential nephrotoxic and hepatotoxic side effects of antiviral therapy during ARN treatment.

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery.

PURPOSE: To compare change of macular thickness after uneventful cataract surgery and after cataract surgery complicated with vitreous loss, using optic coherence tomography (OCT). METHODS: Twenty eyes of 20 patients who underwent cataract surgery complicated with posterior capsular tear participated in this retrospective study (Group 2). The fellow eyes of those patients who underwent uneventful cataract surgery served as the control group (Group 1). Best spectacle-corrected visual acuity (BCVA), refraction, keratometry, axial length measurement, intraocular lens power calculation, intraocular pressure, and biomicroscopic and posterior segment examinations were done preoperatively. BCVA was evaluated at the postoperative 1st day, 1st week, 1st month, and 3rd month. Macular thickness and volumetric measurements with OCT with MM5 protocol were conducted at the postoperative 3rd month. RESULTS: Logarithm of the minimum angle of resolution BCVA of Group 1 was significantly better than Group 2 at all intervals (P < 0.05). Foveal, parafoveal (superior and temporal), and perifoveal (superior and temporal) macular thickness measurements were significantly higher in Group 2 at month 3 (P < 0.05). Foveal volume was also significantly higher in Group 2 when compared with Group 1 (P < 0.05). In Group 2, two eyes (10%) were diagnosed with clinically significant cystoid macular edema at the 1-month visit. CONCLUSION: Macular thickness was found to be significantly high in eyes undergoing complicated cataract surgery (with posterior capsular tear) when compared with uneventful cataract surgeries of fellow eyes.

Comparison of ocular-surface disease index questionnaire, tearfilm break-up time, and Schirmer tests for the evaluation of the tearfilm in computer users with and without dry-eye symptomatology.

OBJECTIVE: To compare the diagnostic values of the Schirmer's and tearfilm breakup time (TBUT) tests and the Ocular Surface Disease Index (OSDI) in dry-eye syndrome. SUBJECTS AND METHODS: Thirty-five employees of Ümraniye Training and Research Hospital who used computers in their daily work participated in this prospective study. All participants completed the OSDI. Following routine ophthalmologic examination, the TBUT and Schirmer's test were undertaken and outcomes were compared. RESULTS: The mean age was 29.09 ± 6.73 (range 20-46) years. Mean OSDI questionnaire, TBUT, and Schirmer's test scores were detected as 37.12 ± 19.05 (range 4-75), 11.37 ± 3.69 seconds (range 4-18 seconds), and 25.80 ± 8.43 mm (range 6-35 mm), respectively. There was a significant inverse correlation between the OSDI and TBUT scores (r = -0.385, P = 0.022). No significant correlation existed between the OSDI and Schirmer's test scores. CONCLUSION: Dry eye is a common problem among computer users. The OSDI questionnaire, used together with the TBUT, is easily performed and may be of benefit in supporting the diagnosis of dry-eye syndrome.

The etiological features of anterior uveitis in a Turkish population.

PURPOSE: To identify any patterns in the cause of anterior uveitis in a Turkish population and compare them with results from previous studies. METHODS: The clinical records of 75 patients between January 2009 and January 2010 were retrospectively analyzed and classified as anterior uveitis according to Standardization of Uveitis Nomenclature criteria. Complete blood count, sedimentation rate, chest radiography, purified protein derivative skin test, and venereal disease research laboratory test were done on all patients. Additional serologic and radiographic tests were performed when indicated. RESULTS: Forty-one (54.6%) were male and 34 (45.3%) were female patients. The mean age at presentation was 39.1 ± 12.6 years. Fifty-six (74.6%) had unilateral and 19 (25.3%) had bilateral disease at presentation. A specific diagnosis was able to be established in 54 (72%) patients. The most common diagnoses were anterior uveitis associated with human leukocyte antigen B27 (14.6%) and Fuchs uveitis syndrome (14.6%). The second most common diagnosis was uveitis associated with herpes simplex virus (13.3%), followed by Behcet's uveitis (6.6%). Systemic disease associations were noted in 15 (20%) patients, and the most commonly associated systemic disease was Behcet's disease (6.6%). CONCLUSION: Fuchs uveitis syndrome and anterior uveitis associated with human leukocyte antigen B27 were the most common form of anterior uveitis in this study. Using a systematic approach, a diagnosis was able to be established in 72% of the anterior uveitis cases.

Outcomes of 23-gauge pars plana vitrectomy in vitreoretinal diseases.

PURPOSE: The aim of this study was to assess the efficiency and reliability of the 23-gauge (23G) transconjunctival vitrectomy system and examine possible complications of this surgical technique in a variety of vitreoretinal conditions along with early postoperative intraocular pressure (IOP) changes. MATERIALS AND METHODS: A total of 350 eyes of 324 patients having undergone 23G transconjunctival vitrectomy were included in this prospective study. A total of 150 (46.2%) were male and 174 (53.8%) female, with a mean age of 61.28 ± 15.67 years. Mean follow-up time was 8.3 months. RESULTS: Mean BCVA logMARs were as follows: preoperatively 0.839 ± 0.59, postoperatively first day 2.07 ± 0.76, first week 1.14 ± 0,43, first month 0.63 ± 0.26 and last examination 0.359 ± 0.17. Mean BCVA decreased significantly (P < 0.001, P < 0.028, respectively) on postoperative first day and first week, mainly due to air or gas tamponade, and increased significantly in the first month and final control in almost all indications (P < 0.001). Postoperative mild hypotony (IOP ≤ 10 mmHg) was detected in 112 (32%) eyes on day 1 and in 59 (16.8%) eyes in week 1. While postoperative serious hypotony (≤ 5 mmHg) was detected in 34 (9.7%) eyes on day 1, it was not detected in any eyes at the end of the first week. None of the eyes required an additional gas tamponade or any other procedure in the early postoperative period due to hypotony. A total of 13 (3.7%) eyes were reoperated for recurrent vitreous hemorrhage; 23 (6.5%) eyes were reoperated on a second time, nine (2.5%) a third time, and 1 (0.2%) a fourth time for recurrent rhegmatogenous retinal detachment. Postoperative fibrinoid reaction was seen in 17 (4.8%) eyes on the first day and responded well to the medications. Cataract development was found in 61 (22.5%) of the 270 phakic eyes after a mean duration of 6.4 ± 3.5 months. Anatomical success was obtained in 86% of the patients and functional success in 72%. CONCLUSION: The 23G transconjunctival vitrectomy system is safe and effective in a wide field of vitreoretinal conditions. It is a good alternative to 20G and 25G techniques but needs some improvement mainly in regards to the instruments and related techniques; further larger controlled group studies are needed.