Alterations in Retinal Vascularity in Severe Psoriasis.

PURPOSE: To evaluate the changes in retinal vascularity in patients with severe psoriasis. MATERIALS AND METHODS: Patients with severe psoriasis [psoriasis area-severity index (PASI) >10] who did not get any systemic treatment in the last year and do not have any ocular diseases were included. All patients underwent detailed ophthalmological examination, including optical coherence tomography (OCT) and OCT angiography (OCTA). Vessel densities (VD) of Superficial (SCP) and deep (DCP) capillary plexus, foveal avascular zone (FAZ) diameter, central retinal thickness (CRT) were analyzed and compared with age-sex matched healthy adults. RESULTS: Fifty-three patients (13 F, 40 M) and 56 controls (16 F, 40 M) were included in the study. VD of SCP (50.4%±3.9 vs. 51.4%±3.2) and DCP (52.6%±6.4 vs. 55.4%±5.7) were lower in psoriasis group compared to controls (p < .05). Presence of psoriatic arthritis was related with an increased CRT (p = .000), larger FAZ and decreased foveal VD in SCP (p = .01, p = .02, respectively). CONCLUSION: Severe psoriasis causes a decrease in retinal blood flow and presence of psoriatic arthritis is related with decreased foveal VD.

Efficacy of Pegylated Interferon Alpha-2a in Uveitic Macular Edema Refractory to Biologic Agents.

PURPOSE: To report the efficacy of pegylated interferon alpha-2a (Roferon, Hoffmann-La Roche brands, Switzerland) in uveitic macular edema refractory to biologic agents. METHODS: Herein, we present two cases of non-infectious uveitis with cystoid macular edema (CME) who were unresponsive to immunosuppressant treatment, and whose uveitis and macular edema recurrences were prevented with subcutaneous injections of pegylated interferon α-2a. RESULTS: Two young males (27- and 30-year-old) diagnosed with non-infectious uveitis and CME were on immunosuppressive treatment. Although both received systemic steroids and biologic agents, macular edema persists. After initiation of pegylated interferon alpha-2a (Pegasys, Genentech, USA) CME regressed significantly and did not occur during their follow-ups of 14 and 12 months. CONCLUSION: Pegylated interferon-alpha-2a can be used as an effective alternative to interferon alpha-2a in uveitic macular edema cases, resistant to other immunosuppressive agents.

Effect of Cycloplegia on Anterior Segment Structures and Scleral Thickness in Emmetropic Eyes.

Purpose: To evaluate the effects of topical cyclopentolate hydrochloride-induced cycloplegia on anterior segment biomechanics in emmetropic eyes using anterior segment-optical coherence tomography (AS-OCT). Methods: Twenty-five emmetropic eyes of 25 volunteers were included. All underwent central corneal thickness (CCT) and anterior chamber depth (ACD) measurements. Anterior scleral thickness (AST) was measured at the level of the scleral spur (SS)(AST-0), 1,000 µm posterior of the SS (AST-1), and 2,000 µm posterior of the SS (AST-2) in the nasal and temporal quadrants using AS-OCT. All measurements were repeated after cycloplegia. Results: The mean age was 30.6 ± 12.4 (8-45) years. The mean CCT did not significantly change after cycloplegia (P = 0.7). The mean ACD was significantly increased [3.3 ± 0.2 (2.7-3.9) to 3.7 ± 0.3 (3-4.2) µm; P = 0.001]. In the nasal quadrant, the mean AST-1 and AST-2 were 512.3 ± 34.4 (433-570) and 529.6 ± 34.2 (449-599); decreased to 478 ± 26.8 (423-530) and 486.2 ± 28.3 (422-544) µm, respectively, after cycloplegia (P = 0.00; P = 0.00). In the temporal quadrant, the mean AST-1 and AST-2 were 522.5 ± 24.7 (473-578) and 527.2 ± 39.9 (450-604); decreased to 481.1 ± 33.7 (421-550) and 484.6 ± 26.6 (433-528) µm, respectively (P = 0.00; P = 0.00). There was no significant difference in AST-0 after cycloplegia in both quadrants [from 697.5 ± 46 (605-785) to 709.5 ± 64.7 (565-785) for nasal and from 718.4 ± 40.1 (632-796) to 722.9 ± 60.6 (596-838) for temporal; P = 0.2; P = 0.3, respectively]. Conclusion: After cycloplegia, there was a significant thinning of ASTs posterior to SS and a slight increase in AST in the SS level. ACD deepened after cycloplegia, and there was no significant change in CCT. Cycloplegic agents temporarily inhibit ciliary muscle contraction and may affect anterior segment parameters and sclera. Inhibition of forward-inward movement of the ciliary body by cycloplegia affects ASTs and ACD by causing a change in the mechanical force of the ciliary muscle on the sclera.

Optic coherence tomography angiography findings in fuchs heterochromic iridocyclitis.

PURPOSE: To evaluate macular capillary perfusion in patients with fuchs heterochromic iridocyclitis (FHI) by using optical coherence tomography angiography (OCTA). MATERIAL AND METHOD: A total of 19 eyes of 19 patients with unilateral FHI underwent detailed eye examination. OCTA (RTVue-XR Avanti) images were obtained from both eyes. OCTA parameters, including foveal avascular zone, superficial capillary plexus and deep capillary plexus vessel densities, were compared between the involved and fellow control eyes. RESULTS: The median age of the patients (11 females, 8 males) was 42.0 ± 9.63 (range 24-57) years. DCP and SCP densities at the parafoveal and perifoveal area were significantly lower in the FHI eyes compared to the control eyes (44.80 ± 5.24% vs. 54.70 ± 3.76% and 43.30 ± 5.10% vs. 53.70 ± 2.73%, respectively; p < 0.05). The median FAZ was 0.29 ± 0.12 (0.11-0.42) mm2 in the FHI eyes and 0.26 ± 0.09 (0.10-0.40) mm2 in the control eyes. This difference did not reach statistical significance (p = 0.199). CONCLUSION: Macular capillary perfusion was significantly reduced in both SCP and DCP in the eyes with FHI. FHI, which is known to affect the choroid layer, could also compromise macular capillary perfusion of the retina.

Impact of COVID-19-Related Lockdown on Glaucoma Patients

Objectives: To analyze emergency and outpatient admissions by glaucoma patients during complete lockdown due to coronavirus disease 2019 (COVID-19) to assess the effect of pandemic-related complete lockdown on glaucoma patients. Materials and Methods: This retrospective chart review included all glaucoma patients who were either examined and/or underwent emergency surgery between March 11, 2020 and May 31, 2020, a period of complete COVID-19-related lockdown in Turkey. The data were compared with data from patients seen during the same time period in 2019. Visual acuity and intraocular pressure data from patients examined after the lifting of the lockdown were also evaluated. Results: According to Turkish Ministry of Health guidelines, only emergency examinations and surgeries could be performed during the 82 days of the COVID-19 lockdown. During this period, a total of 11 eyes of 10 patients were operated and 123 patients were examined in the outpatient clinic. During the same period in 2019, 122 surgeries were performed, 39 of which were emergencies. In the first 4 weeks after the lockdown ended, 163 patients were examined at the outpatient clinic and marked visual loss was detected in 10 eyes of 9 (5.5%) patients who did not attend follow-up visits due to the pandemic. Conclusion: During the lockdown, emergency surgeries related to glaucoma decreased by 71.7% and marked visual loss was detected in 5.5% of the patients examined after the lockdown. These findings suggest that some patients were unable to present to clinics despite needing emergency care.

Impact of prolonged face mask wearing on tear break-up time and dry eye symptoms in health care professionals.

PURPOSE: To evaluate the impact of prolonged surgical face mask wearing on dry eye symptoms and tear film break-up time (T-BUT) in health care professionals. MATERIALS AND METHODS: A total of 33 health care professionals were included in the present cross sectional prospective study. In addition to a complete ophthalmological examination T-BUT measurements were performed twice for all participants in the morning (8 am) and in the afternoon (5 pm). The subjects also filled-in the ocular surface disease index (OSDI) questionnaire twice, before and after wearing the face mask, on the same day. RESULTS: Sixty-six eyes of 33 participants (17 female and 16 male) were evaluated. The mean age was 33.6 ± 7.55 (24-48) years and mean total duration with mask on between the two evaluations was 514 ± 12.5 (495-526) minutes. The mean T-BUT was 9.3 ± 1.0 (3-16) seconds at 8 am and 8.3 ± 1.5 (3-14) seconds at 5 pm (p = 0.01). The mean OSDI score was 20.1 ± 8.3 (0-68.75) at 8 am and 27.4 ± 10.4 (0-81.25) at 5 pm (p < 0.01). CONCLUSION: Use of a surgical mask for the entire work-day was seen to worsen T-BUT and increase dry eye symptoms in healthy individuals. Ophthalmologists should be aware of the possibility of worsening of dry eye symptoms with the prolonged use of surgical face masks and consider modifications if necessary.

Iris Juvenile Xanthogranuloma Presenting with Hypopyon.

PURPOSE: To report a case an iris juvenile xanthogranuloma presenting with hypopyon. CASE REPORT: A 45-day-old infant was referred to our clinic for unilateral hypopyon. Slit-lamp examination revealed a 2 mm hypopyon in the left eye while visible areas of the iris were normal. Fundus examination was normal. Topical corticosteroids and antibiotics were initiated. The hypopyon regressed to 0.5 mm after 2 weeks of treatment. The now visible peripheral iris revealed an inferotemporal yellow-brown iris mass. Clinical findings were consistent with juvenile xanthogranuloma of the iris. The patient was referred to the pediatrics department which revealed no systemic involvement. Two months after total regression of hypopyon, the baby presented with a 3 mm spontaneous hyphema causing 50 mmHg intraocular pressure. The patient was followed with topical corticosteroids and antiglaucomatous drops until the hyphema was resolved. CONCLUSION: ocular involvement, which is the most common extracutaneous 15 manifestation of juvenile xanthogranuloma, should be considered in the differential diagnosis of hypopyon and/or hyphema in young children.

The effects of tropicamide and cyclopentolate hydrochloride on laser flare meter measurements in uveitis patients: a comparative study.

PURPOSE: To investigate the effects of 1% cyclopentolate hydrochloride and 1% tropicamide eye drops on aqueous flare measurements by using the laser flare meter. METHODS: One hundred forty eight eyes of 83 patients with inactive uveitis were enrolled. The patients were randomly assigned to receive either 1% tropicamide (Group 1) or 1% cyclopentolate hydrochloride (Group 2) as the mydriatic agent. Best corrected visual acuity (BCVA), intraocular pressure (IOP), aqueous flare reaction levels measured by laser flare meter device (FM 600, Kowa, Kowa Company Ltd, Nagoya, Japan) before and post dilatation agents were evaluated. RESULTS: Group 1 consisted of 75 eyes and Group 2 consisted of 77 eyes. The mean age of Group 1 patients was 34.85 ± 12.60 (range, 12-64) years; the mean age of Group 2 was 36.92 ± 13.30 (range, 12-70) years (p > 0.05). The mean BCVAs of two groups were 0.16 ± 0.43 (range, 0.00-3.10) logMAR and 0.17 ± 0.42 (range, 0.00-3.10) logMAR, respectively. There were no statistically significant differences between Groups 1 and 2 regarding gender or clinical characteristics (p > 0.05). No significant differences were detected in pre- or post-dilatation values between two groups (p = 0.470, p = 0.998). CONCLUSIONS: As a result, anterior chamber flare values in uveitis patients do not differ significantly between 1% tropicamide and 1% cyclopentolate hydrochloride, and both agents can be safely used for dilatation during examination of patients with uveitis.

Evaluation of ocular surface and meibomian glands in patients with uveitis related to oligoarticular juvenile idiopathic arthritis.

PURPOSE: To evaluate ocular surface changes and meibomian gland scores in patients with oligoarticular juvenile idiopathic arthritis. MATERIALS AND METHODS: This prospective study was conducted at Ege University School of Medicine, Department of Ophthalmology. A total of 34 eyes of 17 patients with oligoarticular juvenile idiopathic arthritis and 30 right eyes of 30 age and gender-matched healthy subjects were included. Besides ophthalmic examination Schirmer 1 test, tear film break up time, Oxford staining scale and meibography were performed. RESULTS: There was no statistically significant differences between groups in terms of age, mean intraocular pressure, mean Schirmer 1 test value, tear film break up time and Oxford staining score. The median upper and lower eyelid meiboscore were 1 ± 0.60 (IQR = 1), and 0 ± 0.34 (IQR = 0) in Group 1, and they were 1 ± 0.56 (IQR = 0), 1 ± 0.12 (IQR = 1) in Group 2. Also, mean upper and lower meiboscores were statistically similar (p values 0.068 and 0.545, respectively). However, the median total meiboscore was 1 ± 0.42 (IQR = 1) in Group 1 and 1 ± 0.66 (IQR = 1) in Group 2. The difference was statistically significant (p = 0.041). CONCLUSION: Aqueous-deficient dry eye is a well-known condition in patients with rheumatologic diseases. However, evaporative dry eye and meibomian glands were not studied earlier. The current study demonstrated that total meiboscores of oligoarticular juvenile idiopathic arthritis patients are higher than normal subjects, which indicates a possible evaporative dry eye tendency in this entity.

Effect of Tropicamide on Laser Flare Meter Measurements in Patients with Pseudoexfoliation.

PURPOSE: To investigate the effect of 1% tropicamide on anterior chamber aqueous flare (ACAF) measurements acquired with laser flare meter in patients with pseudoexfoliation. METHODS: Thirty-three eyes of 33 patients with pseudoexfoliation were enrolled. Patients with the history of other ocular diseases, intraocular surgeries, and the presence of severe posterior synechia were excluded. Besides routine ophthalmological examination, ACAF levels were measured by laser flare meter device (Kowa FM 600) before and after instillation of 1% tropicamide. RESULTS: The mean age of 33 patients was 67.3±7.1 (53-85) years. Patients had a mean best corrected visual acuity of 0.25±0.41 (1.80-0.00) logMAR, cup-to-disc ratio of 0.45±0.22 (0.2-1), and IOP of 15.33±2.82 (9-20) mmHg. Although the mean ACAF value increased from 14.68±8.40 (3.4-40.4) photon/ms predilation to 15.41±10.74 (3.8-46.8) photon/ms post-dilation, the difference was not statistically significant (p=0.835). CONCLUSIONS: ACAF values in patients with pseudoexfoliation did not significantly differ after instillation of 1% tropicamide.

Optical coherence tomography angiography findings in Behcet patients.

PURPOSE: Retinal vasculitis and vein occlusions are common causes of serious visual loss in Behçet's disease. We aimed to evaluate the optical coherence tomography angiography (OCTA) findings of Behcet uveitis (BU) patients. METHODS: We evaluated 32 eyes of 16 patients with BU and 30 eyes of 15 healthy controls. Superficial capillary plexus (SCP) and deeper capillary plexuses (DCP) were evaluated using OCTA RTVue XR AVANTI. RESULTS: On SCP, nonperfusion/hypoperfusion areas (NPA) were seen in 10 eyes, perifoveal capillary arcade disruption (PCAD) was seen in 10 eyes, capillary network disorganization (CND) was seen in 7 eyes and intraretinal cystoid spaces (ICS) were seen in 2 eyes. On DCP, NPA were seen in 13 eyes, PCAD was seen in 11 eyes, CND was seen in 7 eyes and ICS were seen in 4 eyes. CONCLUSION: We showed that DCP were affected more than SCP in these patients. In addition, capillary vessel density of BU group was significantly lower than control group.

Evaluation of Ocular Surface and Meibomian Glands Alterations with Meibography in Patients with Inactive Behçet's Uveitis.

PURPOSE: To evaluate the ocular surface and meibography of patients with inactive Behçet's uveitis. METHODS: Twenty-five right eyes of 25 patients with inactive Behçet's uveitis (Group 1) and 25 right eyes of 25 healthy individuals (Group 2) were enrolled. Detailed eye examination along with Schirmer 1 test, tear film break-up time (t-BUT), ocular surface staining with fluorescein and Oxford scoring, and ocular surface disease index (OSDI) score assessment were performed. Lower and upper eyelid Meibomian glands were examined with infrared filter of slit-lamp biomicroscope (SL-D701 with DC-4 digital camera and BG-5 background illuminator, TOPCON, Tokyo, Japan (from grade 0 (no dropout of Meibomian glands) to grade 3 (gland dropout >2/3 of the total Meibomian glands)). RESULTS: The mean ages were 36.84 ± 7.39 (range, 23-59) and 33.88 ± 8.25 (range, 18-55) in Group 1 and Group 2, respectively (p = 0.547). When compared with Group 2, in Group 1, best-corrected visual acuity (0.28 vs. 0.00 logMAR, p < 0.001), Schirmer 1 test (18.68 vs. 23.69, p = 0.017) and mean tear film break-up time (10.76 vs. 13.36, p = 0.026) were significantly lower; Oxford scale and OSDI scores were higher (p = 0.039 and p < 0.001, respectively). No significant difference in lower, upper and total (upper + lower) meiboscores were detected in between groups (p = 0.062, p = 0.228 and p = 0.152, respectively). CONCLUSION: Despite the tendency toward dry eye syndrome, Behçet's uveitis does not seem to be associated with quantitative Meibomian gland changes, which is demonstrated by gland drop-out with meibography.

Evaluation of development of subclinical atherosclerosis in children with uveitis.

Uveitis is a chronic inflammatory disease. Chronic inflammation has been shown to have a role in pathogenesis of atherosclerosis. Atherosclerosis is the most important risk factor of cardiovascular diseases and is shown to start as early as childhood. In this study, we investigated the presence of subclinical atherosclerosis in children with uveitis. Seventy five patients who were diagnosed as having uveitis in ophthalmology and pediatric rheumatology clinics were included in the study. Patients with hypertension, obesity, dyslipidemia, diabetes, and with history of early cardiovascular disease were excluded. Arterial stiffness, carotid-femoral pulse wave velocity (PWV), augmentation index (AIx), and carotid artery intima-media thickness (cIMT) were measured for each patient. These measurements were compared with 50 healthy children with similar age and sex as controls. The mean age of patients in this study was 12.24 ± 2.69 years, and the mean age of controls was 11.32 ± 4.52 years. PWV and AIx values were higher in the patient group (p = 0.04, p = 0.03). cIMT levels were not different in patient and control groups. When patients were grouped as having uveitis for more than 5 years or not, patients with longer duration of uveitis had higher PWV, AIx, and cIMT levels (p values were 0.01, 0.02, and 0.04 respectively). Vascular functions deteriorate first with endothelial damage in children with uveitis and as disease continues, increase in cIMT is added. We think that for follow-up of the disease and evaluation of the treatment, non-invasive subclinical atherosclerosis markers should be used along with activation criteria of primary diseases.

The efficacy and safety of bimatoprost/timolol maleate, latanoprost/timolol maleate, and travoprost/timolol maleate fixed combinations on 24-h IOP.

PURPOSE: To evaluate the effect of bimatoprost/timolol maleate fixed combination (BTFC), latanoprost/timolol maleate fixed combination (LTFC), and travoprost/timolol maleate fixed combination (TTFC) on 24-h intraocular pressure (IOP) in patients with open-angle glaucoma. METHODS: This prospective, observer-masked, randomized study included 50 patients with primary open-angle glaucoma. All patients were using hypotensive lipids and timolol maleate fixed combination treatment for ≥4 weeks and had an IOP ≤ 21 mmHg. Group 1 (n = 18) received BTFC, group 2 (n = 14) received LTFC, and group 3 (n = 18) received TTFC. All patients were hospitalized, and IOP was monitored for 24-h (10:00, 14:00, 18:00, 22:00, 02:00, and 06:00). Mean diurnal IOP variation measurements were taken between 06:00 and 18:00, and mean nocturnal IOP variation measurements were taken between 22:00 and 02:00. Mean IOP and IOP variation in the three groups were compared. RESULTS: Mean 24-h IOP did not differ significantly between the three groups (group 1: 14.6 ± 2.9 mmHg; group 2: 14.1 ± 3.7 mmHg and group 3: 15.8 ± 2.0 mmHg; P > 0.05). Mean diurnal IOP variation was 4.6 ± 2.3 mmHg in group 1, 5.8 ± 2.4 mmHg in group 2, and 4.3 ± 1.7 mmHg in group 3, and mean nocturnal IOP variation was 3.2 ± 2.8 mmHg in group 1, 2.9 ± 1.9 mmHg in group 2, and 3.0 ± 1.6 mmHg group 3. There were not any significant differences in diurnal or nocturnal IOP variation between the three groups (P < 0.05). CONCLUSION: All three fixed combinations effectively controlled IOP for 24-h and had a similar effect on diurnal and nocturnal IOP variations.

Evaluation of the Radiation Dose-Volume Effects of Optic Nerves and Chiasm by Psychophysical, Electrophysiologic Tests, and Optical Coherence Tomography in Nasopharyngeal Carcinoma.

PURPOSE: To evaluate the radiation dose-volume effects of optic nerves and chiasm by visual psychophysical, electrophysiologic tests, and optical coherence tomography in patients with locally advanced nasopharyngeal carcinoma. MATERIALS AND METHODS: A series of visual tests including visual acuity, visual field, contrast sensitivity, visual evoked potential, and optical coherence tomography were administered to 20 patients with locally advanced (T3-T4) nasopharyngeal carcinoma who were treated with definitive chemoradiotherapy. Volume that received 55 Gy (V55), mean dose (Dmean), highest dose to 5% of the volume (D5), and maximum dose (Dmax) for optic nerves and chiasm were evaluated for each patient. Cutoff values were identified as V55: 50%, Dmean: 50 Gy, D5: 55 Gy, and Dmax: 60 Gy. The effects of radiation dose-volume on ophthalmologic tests were evaluated. RESULTS: Ophthalmological evaluation revealed optic neuropathy with simultaneous retinopathy in 6 eyes of 4 patients and radiation retinopathy alone in both eyes of 1 patient. Regarding radiation dose-volume effects of the optic nerve, significant detrimental effect of all parameters was observed on visual acuity. Visual field and contrast sensitivity were affected significantly with V55 ≥ 50% and Dmean ≥ 50 Gy. Visual evoked potential latency was affected significantly with Dmean ≥ 50 Gy, D5 ≥ 55 Gy, and Dmax ≥ 60 Gy. For the chiasm, significant detrimental effect of all parameters was observed on visual acuity as well. Retinal nerve fiber layer thickness and visual evoked potential amplitude were not affected by any of the dose-volume parameters neither optic nerves nor chiasm. CONCLUSION: The volume receiving the threshold dose, mean dose, and 5% of the volume receiving the maximum dose are important parameters besides maximum dose to optic nerves and chiasm. A comprehensive ophthalmological evaluation including visual field, contrast sensitivity, visual evoked potential latency, and amplitude should be performed for these patients. Visual evoked potential latency is an objective predictor of vision loss before the onset of clinical signs.

The effect of convergence and divergence stress on near stereoacuity.

The aim of this study was to evaluate the effect of convergence and divergence stress on near stereoacuity in healthy individuals. In this experimental study, 38 subjects with fine stereoacuity (≤30 arcsec in TNO test, 17th edition) were enrolled. Near fusional convergence and divergence amplitudes were measured. Near stereoacuity was evaluated at different levels of convergence and divergence stress induced with base-in and base-out prisms. The amount of base-in and base-out prisms that cause a decreased stereoacuity level of >240 and >60 arcsec were noted for each subject. There were 21 female and 17 male visually normal adults (aged 25-32 years) in the study. The mean near convergence amplitude of the subjects was 37.7 ± 6.9 (25-54) prism dioptres (PD), and the mean near divergence amplitude was 16.5 ± 2.8 (10-25) PD. The mean convergence stress that decreased the stereoacuity level to >240 and >60 arcsec were 20.1 ± 7.9 (4-35) PD and 13.9 ± 5.4 (4-30) PD, respectively. The mean divergence stress that decreased the stereoacuity levels to >240 arcsec was 11.5 ± 2.9 (4-18) PD, and to >60 arcsec was 8.7 ± 2.9 (4-18) PD. Decreased stereoacuity is an important criterion for judging deterioration for patients with intermittent deviations. However, it is not clear what might be occurring in these deteriorating patients. We specifically determined that short periods of prism-induced convergence and divergence are accompanied by a decrease in fine near stereoacuity in visually normal adults. Controlling intermittent deviations by using vergence system could be the simple cause of decreased stereoacuity in these patients.

Bilateral acute iris transillumination: Case report.

Bilateral acute iris transillumination (BAIT) is a recently defined disease characterized with bilateral acute, severe pigment dispersion of iris and pupil sphincter paralysis. The etiopathogenesis of the disease is unknown, but antibiotics such as moxifloxacin, clarithromycin, viral infections, and fumigation therapies were considered as probable etiologic factors. A 33-year-old female was referred to our clinic for acute iridocyclitis refractory to azathioprine, colchicum and corticosteroid treatments. Ophthalmic examination revealed bilateral pigment dispersion, significant iris transillumination, heavy pigment deposition in iridocorneal angle, and elevated intraocular pressure. Upon systemic evaluation she was found to have bacterial urinary tract infection. BAIT is an important cause of pigment dispersion and clinicians must be vigilant for this condition to avoid unnecessary diagnostic tests and treatment.

Acute pulmonary oedema due to single dose acetazolamide taken after cataract surgery.

An increase in intraocular pressure following cataract surgery is very common. The main reason for this condition is viscoelastic agent remaining in the eye, which leads to mechanical obstruction of the trabecular meshwork. Prophylaxis with oral acetazolamide is frequently practised to prevent this early rise in intraocular pressure in the preoperative and postoperative periods. We report a case of an 81-year-old man with acute pulmonary oedema due to prophylactic acetazolamide intake after cataract surgery. The case is presented in order to draw attention to this serious complication.

Effect of gingival inflammation on the inflammatory response in patients with idiopathic uveitis.

OBJECTIVES: This study aimed to investigate the levels of 11 oral species in plaque samples and cytokine levels in biofluid samples of patients with idiopathic uveitis (IU) and systemically healthy individuals (H) with or without gingival inflammation. MATERIAL & METHODS: Twenty-one patients with IU (n = 21), and 22 systemically healthy individuals (n = 22) were enrolled in the study. Clinical periodontal measurements were recorded. Cytokine levels in the biofluid samples were determined by ELISA. Bacterial gene copy numbers were determined by qPCR on plaque microbial DNA preparations. RESULTS: According to two-step cluster analysis, anova and t-test: GCF, serum and salivary TNF-α, IL-17A, IL-17A/E; GCF and serum IL-6; salivary IL-17F, and salivary and serum IL-17A/F levels were higher in the IU group than the H group (p < 0.05). However, serum IL-10 and IL-17E levels were higher in the H group than the IU group (p < 0.05). A. actinomycetemcomitans, F. nucleatum, S. oralis, A. naeslundii, and V. dispar counts were higher in IU group compared to H group (p < 0.05). CONCLUSION: Altered local and systemic cytokine profiles are associated with differences in the microbial plaque composition in IU. Anti-inflammatory cytokines; IL-10, IL-17E are reduced in patients with IU and Th-1 and Th-17 driven inflammatory responses in biofluids are altered.