Evaluating Turkish Readability and Quality of Strabismus-Related Websites.

Background This cross-sectional study aimed to assess the readability of strabismus-related websites and the quality of their content. Methodology This cross-sectional study evaluated the websites on strabismus disease using Atesman and Bezirci-Yilmaz's readability formulas, which have been scientifically verified to be effective for Turkish people. The study picked texts from the first 50 websites that appeared on the screen after typing "strabismus treatment" into the Google search engine based on their Turkish reading level and information reliability. In this study, 41 of the first 50 websites were reviewed. Furthermore, two separate senior ophthalmologists evaluated the JAMA and DISCERN indexes, as well as the credibility of the content on these sites. Results The Bezirci-Yilmaz readability index indicated that the websites were readable for individuals with an average education level of 10.5 ± 2.3 years. The websites scored an average of 55.2 ± 7.9 on the Atesman readability formula, indicating that they were readable for students in the 11-12th grade. The websites had an average JAMA score of 0.8 ± 0.7 points and a DISCERN score of 34.2 ± 8.6 points, indicating low-quality content. Conclusions The readability of websites providing information regarding strabismus was significantly higher than Turkey's average educational level. Websites should not only be designed to be easy to read so that strabismus patients may learn about their condition but should also provide higher-quality strabismus content.

Ocular posterior segment microstructural and microvascular morphological changes in protein supplement-consuming bodybuilders.

BACKGROUND: To determine the effects of protein supplement (whey protein powder (PP)) on retinal, choroidal and optic nerve head (ONH) microstructure and microvascular morphology in healthy bodybuilders. METHODS: This cross-sectional study included 23 male adults (consumers, 23 right eyes) who had been routinely consuming whey PP for bodybuilding purposes for ≥ 3 months, and 21 age- and gender-matched healthy volunteers (non-consumers, 21 right eyes) who also attended the gym but did not consume any nutritional supplements. Participants underwent standard ocular exams, enhanced depth imaging optical coherence tomography (EDI OCT), and optical coherence tomography angiography (OCTA) after ≥ 8 h of rest and fasting. RESULTS: Whey PP was consumed for a median of 9.5 (6-12) months. Whey PP consumers had a median age of 22 (21-22) years, while non-consumers had 21 (20-22) years (p = 0.067). Whey PP consumers had greater microstructural thickness than non-consumers, with subfoveal choroidal thickness (301.40 ± 38.91 versus 278.12 ± 33.58 µm; p = 0.035) being significantly different but not central macular thickness (270.55 ± 24.60 versus 265.85 ± 12.44 µm; p = 0.402). Despite a non-significant difference in superficial and deep capillary plexus vascular densities (VDs), whey PP consumers had relatively lower VDs than non-consumers in all macular regions (p > 0.05). Despite this, whey PP consumers displayed greater ONH VDs, as well as higher global RNFL thickness (116.75 ± 10.41 versus 114.50 ± 11.70 µm) than non-consumers (p > 0.05). CONCLUSION: Protein supplements, particularly whey PPs, appear to be associated with different changes in the retina and choroid, as well as ONH microstructural and microvascular morphology, implying that paying attention to these clinical aspects when performing ocular tests in bodybuilders who consume nutritional supplements could be critical.

Optical coherence tomography angiography characteristics of retinochoroidal and optic nerve head microcirculation in cryptogenic organizing pneumonia.

BACKGROUND: To assess retinochoroidal and optic nerve head microcirculation alterations in cryptogenic organizing pneumonia. METHODS: Thirty cryptogenic organizing pneumonia patients in the resolution phase (group 1, 30 right eyes) and 33 healthy subjects (group 2, 33 right eyes) were compared. Patients had 40 mg/day corticosteroids for 8-10 days, and a pulmonary function test, which revealed only minimally restrictive ventilation features. After gathering demographic data, a comprehensive ophthalmological exam and optical coherence tomography angiography were performed three months following maximum disease resolution with corticosteroid therapy RESULTS: Groups 1 and 2 had mean ages of 54.37±14.87 and 49.61±12.36 years, respectively (P = 0.171). Despite the lack of statistical significance, superficial and deep capillary plexus vessel densities in all macular regions were lower in group 1, as were foveal avascular zone parameters (P>0.05). However, the outer retinal and choriocapillaris flows increased significantly in group 1, especially in select areas (P<0.001, for both). There were no significant differences in whole image (P = 0.346), inside disk (P = 0.438), or peripapillary (P = 0.185) optic nerve head vessel densities between the two groups; however, nasal (P<0.001) and inferior quadrant (P = 0.006) vessel densities differed significantly. Global retinal nerve fiber layer thickness did not differ significantly between groups 1 and 2 (112.83±14.71 versus 111.45±12.74 µm, respectively; P = 0.692). Group 1, however, had significantly higher superior, nasal, and inferior quadrant, and significantly lower temporal quadrant retinal nerve fiber layer thickness (P<0.001, for all). CONCLUSIONS: Concerning the impact of probable cryptogenic organizing pneumonia-induced hypoxia on ocular tissues, optical coherence tomography angiography assessments of retinochoroidal and optic nerve head microcirculation could be employed as a biomarker for cerebral microcirculation.

Optical coherence tomography angiography aspects of the retinal and optic disc microvascular morphology in erythemato-telangectatic rosacea.

BACKGROUND: To investigate retinal and optic disc (OD) microvascular morphological changes in erythemato-telangiectatic rosacea (ETR) patients using optical coherence tomography angiography (OCTA), and compare the findings to age- and gender-matched healthy individuals. METHODS: This study included newly diagnosed 31 ETR patients (31 right eyes, group 1) who were clinically diagnosed by two experienced dermatologists. A control group had 32 healthy individuals (32 right eyes, group 2). Demographic data, including age and gender were collected, followed by a thorough ophthalmologic exam. A 6 × 6 mm macular OCTA analysis of superficial and deep capillary plexus (SCP and DCP) vessel densities (VDs), as well as foveal avascular zone (FAZ) area, FAZ perimeter (PERIM), foveal VDs 300 µm area around FAZ (FD-300), and flow areas in the outer retinal and choriocapillaris, was then performed. RESULTS: Mean age in groups 1 and 2 was 43.70 ± 13.02 and 43.62 ± 12.30 years, respectively (p=0.979). Male-to-female ratio in group 1 was 4:27 and 4:28 in group 2. Capillary flow analysis revealed slightly higher values in group 1 than in group 2, with the former having a significantly higher select area in the outer retinal layer (p=0.001) and flow area in the choriocapillaris (p=0.002). Despite slightly higher values in group 1, there were no significant differences in SCP and DCP VDs (p > 0.05), FAZ area (p=0.471), PERIM (p=0.778), or FD-300 (p=0.527). CONCLUSIONS: ETR appears to be associated with posterior segment changes, especially retinal microvascular morphology, even in asymptomatic ocular conditions. Given the disease's high rate of misdiagnosis, understanding rosacea-induced ocular manifestations is critical for ophthalmologists.

Is a Dry Eye Disorder in Firefighters an Occupational Disease?

BACKGROUND: To examine firefighters (FFs) exposed to high levels of fire smoke and, as a result, to uncover risk factors for dry eye disorder (DED) compared to age-and gender-matched healthy individuals. METHODS: In this cross-sectional study, 51 FFs from the Afyonkarahisar Municipality Fire Department were chosen at random (group 1). A control group (group 2) included 51 age- and gender-matched healthy individuals. The Ocular Surface Disease Index (OSDI) questionnaire was administered after all participants were thoroughly explained the study's objectives and procedures. Then, using a portable hand biomicroscope, an ocular exam was performed on-site. DED was defined as a non-anesthetic Schirmer test result of <10 mm and/or a tear film break-up time (TBUT) of <5 seconds. RESULTS: Groups 1 and 2 had mean ages of 44.82±7.29 and 44.73±7.41 years, respectively (p=0.946). The median work duration in group 1 was 14 years (min-max: 1-27 years). TBUT test revealed a significantly increased DED prevalence in group 1 than group 2 (p=0.046). Despite the non-significant difference (p=0.276), Schirmer test revealed that group 1 had a higher DED prevalence than group 2. The OSDI score revealed that group 1 had more mild, moderate, and severe DED than group 2 (p=0.359). Longer work duration was associated with a higher DED prevalence (p=0.179). CONCLUSIONS: Given the high prevalence of fire smoke-induced DED in FFs, preventive measures such as regular ocular exams, encouraging personal protective equipment usage, and health education programs can assist in avoiding complications and reducing the burden of ocular diseases.

Is it useful to do OCTA in coronary artery disease patients to improve SYNTAX-based cardiac revascularization decision?

BACKGROUND: To investigate retinal and optic disk microcirculation using optical coherence tomography angiography (OCTA) in order to predict related outcomes based on the SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) score (SS) system in coronary artery disease patients. METHODS: 104 patients were grouped based on coronary angiography results: 32 chronic coronary syndrome (CCS) patients, 35 acute coronary syndrome (ACS) patients, and 37 healthy controls. The SS system determined atherosclerosis degree and lesion-related mortality risk, followed by scoring as SYNTAX I score (SS-I) and SYNTAX II score (SS-II). Patients were further subdivided into SS-I, SS-II percutaneous coronary intervention (PCI), and SS-II coronary artery by-pass grafting (CABG) groups. Following a thorough ophthalmological examination, an OCTA Angio Retina mode (6 × 6 mm) automatically quantified retinal and optic disk microcirculation. RESULTS: The mean ages did not differ significantly among groups (p = 0.940). The outer retinal select area varied significantly among groups, with the highest values found in ACS patients (p = 0.040). Despite non-significant differences between SS-I patients and healthy controls, the former had lower capillary plexus vessel densities in all regions and in foveal vessel density 300 µm around foveal avascular zone (FD-300) (p>0.05). Vessel densities were lowest in SS-II PCI≥28.5 patients, particularly in whole (p = 0.034) and parafoveal (p = 0.009) superficial capillary plexus, and in FD-300 (p = 0.019). Vessel densities were lowest in SS-II CABG (p = 0.020), and perifoveal (p = 0.017) deep capillary plexus, and in FD-300 (p = 0.003). The outer retina flow area increased the most in SS-II CABG≥25.1 patients (p = 0.020). CONCLUSIONS: Using OCTA, a non-invasive imaging technique, to assess retinal and optic disk microcirculation appears to have the potential to yield significant clinical results in the early diagnosis or prognosis of cardiovascular diseases.

Optical coherence tomography angiography evaluation of retinal and optic disc microvascular morphological characteristics in retinal vein occlusion.

BACKGROUND: To evaluate microvascular morphological characteristics of the retina and optic disc (OD) in retinal vein occlusion (RVO) patients using optical coherence tomography angiography (OCTA), compare the results to age- and gender-matched healthy subjects, and determine correlations between OCTA parameters and best-corrected visual acuity (BCVA) and age. METHODS: In this retrospective study, right eyes of 53 RVO patients and 51 healthy subjects were compared regarding BCVA, as well as superficial and deep capillary plexus (SCP and DCP) vessel densities (VDs), foveal avascular zone (FAZ) parameters, outer retinal and choriocapillaris flow areas, OD whole and peripapillary VDs, and retinal nerve fiber layer thickness (RNFLT). Retinal vein occlusion patients were further divided into subgroups based on therapy and risk factors, and OCTA parameters were compared. RESULTS: Retinal vein occlusion rate or OCTA parameters did not differ significantly by gender (p > 0.05). Retinal vein occlusion patients had significantly decreased BCVA, whole, parafoveal and perifoveal SCP and DCP VDs, as well as VDs 300 µm area around FAZ (FD-300) than healthy subjects (p < 0.001). Their choriocapillaris flow area, RNFLT, whole and peripapillary VDs were also affected. However, FAZ area did not differ significantly between groups. Superior RNFLT (p = 0.016) and whole peripapillary VD (p < 0.001) differed significantly between laser photocoagulation-treated and non-treated patients. The remaining OCTA parameters revealed no significant differences CONCLUSIONS: The RVO and its therapeutic alternatives may affect both OD and retinal VDs. Given its numerous benefits, it seems that OCTA will be used more frequently in clinics for RVO diagnosis, monitoring, and therapeutic response evaluation.

Ocular health among industrial workers: a prevalence study of foreign body injury, refractive error, dry eye, pterygium and pingueculae.

BACKGROUND: Workplaces play a critical role in developing ocular diseases, owing to the risk of accidents. This study aimed to evaluate the ocular health of industrial workers by determining the prevalence of foreign body injury, refractive error, dry eye, and pterygium/pingueculae, as well as the factors influencing these diseases. METHODS: This study involved on-site examinations of workers from an industrial area hosting marble processing factories and metal sectors. Data such as refractive error, foreign body injury-related corneal nephelium, pterygium/pingueculae presence, and Schirmer test-assisted dry eye evaluation were all collected. RESULTS: The average age of workers was 35.78±10.05 years, with a female-to-male ratio of 20:220. The majority of workers had completed primary school (56.3%), smoked >1 cigarette/day (57.6%), and did not use any assistive devices for bodily functions (88.3%). On average, working hours/week were 55.07±8.79, and working years were 5.99±7.00. Dry eyes were found in 31 (22%), and 35 (34%) marble and metal workers, respectively (p=0.042). 11 (7.9%) marble workers and 29 (28%) metal workers had foreign body ocular injury-related corneal nephelium (p=0.0001). Furthermore, pterygium/pingueculae were revealed in 17 marble workers (12.3%) and three metal workers (3%) (p=0.009). CONCLUSIONS: Ocular health is essential, and routine ocular health screening in industrial workers, as well as workplace safety measures, should be implemented to prevent potential occupational accidents.

A comparison of scientometric data and publication policies of ophthalmology journals.

Purpose: This retrospective database analysis study aims to present the scientometric data of journals publishing in the field of ophthalmology and to compare the scientometric data of ophthalmology journals according to the open access (OA) publishing policies. Methods: The scientometric data of 48 journals were obtained from Clarivate Analytics InCites and Scimago Journal & Country Rank websites. Journal impact factor (JIF), Eigenfactor score (ES), scientific journal ranking (SJR), and Hirsch index (HI) were included. The OA publishing policies were separated into full OA with publishing fees, full OA without fees, and hybrid OA. The fees were stated as US dollars (USD). Results: Four scientometric indexes had strong positive correlations; the highest correlation coefficients were observed between the SJR and JIF (R = 0.906) and the SJR and HI (R = 0.798). However, journals in the first quartile according to JIF were in the second and third quartiles according to the SJR and HI and in the fourth quartile in the ES. The OA articles published in hybrid journals received a median of 1.17-fold (0.15-2.71) more citations. Only HI was higher in hybrid OA; other scientometric indexes were similar with full OA journals. Full OA journals charged a median of 1525 USD lower than hybrid journals. Conclusion: Full OA model in ophthalmology journals does not have a positive effect on the scientometric indexes. In hybrid OA journals, choosing to publish OA may increase citations, but it would be more accurate to evaluate this on a journal basis.

Prospective Study: Frequency of Ophthalmic Findings, Relationship with Inflammation Markers, and Effect on Prognosis in Patients Treated in the COVID-19 Intensive Care Unit

Objectives: To prospectively evaluate the frequency of ocular findings and inflammation markers levels in patients treated in the intensive care unit due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to determine the relationship between these parameters and mortality. Materials and Methods: We prospectively evaluated 53 patients who were treated in the intensive care unit of a pandemic hospital between January 1 and June 30, 2021 and whose SARS-CoV-2 diagnosis was confirmed by reverse transcriptase polymerase chain reaction test from nasopharyngeal swab samples. Ocular findings were evaluated together with white blood cell, neutrophil, lymphocyte count, C-reactive protein, lactate dehydrogenase and ferritin levels, and mortality rate. Results: There was no statistically significant correlation between lactate dehydrogenase, white blood cell, neutrophil, and lymphocyte count elevation and the frequency of inflammatory eye signs (p=0.308, p=0.694, p=0.535, p=0.374). In multivariate analyses, no statistically significant correlation was observed between ferritin level and the frequency of inflammatory eye findings (p=0.087). In addition, for each 1 mg/dL increase in C-reactive protein level, the detection of inflammatory eye findings decreased by 1.9% (95% confidence interval: 3.3%-0.4%; p=0.015). It was determined that 7 of 13 patients with inflammatory eye findings died and this was not statistically significant (p=0.810). Conclusion: Inflammatory examination findings of the ocular surface were detected in 13 (24.5%) of 53 patients treated in the intensive care unit for SARS-CoV-2 infection. Ocular surface examination of patients treated in the intensive care unit due to the SARS-CoV-2 epidemic is important.

An Evaluation of the Comprehensibility Levels of Ophthalmology Surgical Consent Forms.

Background/Aim This study aimed to evaluate the comprehensibility of the consent forms used for interventional procedures in the ophthalmology clinic of a university hospital and to determine which texts could be read according to patient age and education level. Materials and methods Forty separate consent forms used as the standard for various interventional procedures in the ophthalmology department of a university hospital were evaluated. The comprehensibility formulas used were developed for the Turkish language by Atesman and Bezirci-Yilmaz. Results As a result of the evaluation of the consent forms in this study, a mean of 55.6±5.73 points was obtained according to the Atesman comprehensibility index, and this value was found to correspond to being understood by eleventh and twelfth-grade school students. According to the Bezirci-Yilmaz comprehensibility index, the mean points of the consent forms were 10.05±2, which corresponded to a level that could be understood by 10th and 11th-grade students. Conclusion The comprehensibility level of the consent forms given to patients was found to be low in this study, which was similar to the findings of previous studies in the literature. When preparing informed consent forms, the education level of the country must be taken into consideration.