The relationship between optic disc-foveal distance with choroidal and retinal nerve fiber thickness.

BACKGROUND: The optic disc-foveal distance is very important as it is an anatomical measure of the fundus. As this distance increases and the fundus tension, there may be variability in retinal and choroidal thickness. The aim of this study was to determine the relationship between optic disc-foveal distance and choroidal and retinal nerve fiber thickness in healthy subjects. MATERIALS AND METHODS: A total of 72 people between the ages of 20-36 participated in the study. Optic disc-foveal distance was measured with a fundus camera and choroidal and retinal nerve fiber thicknesses were measured with an OCT (Optical coherence tomography) device. Littmann's formula (t = p × q × s) as modified by Bennett was applied to correct the magnification at the fundus camera imaging stage. RESULTS: The thickness of the nasal choroid (p=0.005; p=0.006), subfoveal choroid (p=0.004; p < 0.001) and temporal choroid (p=0.001; p=0.001) layers decreased as the DFD (Optic disc-to-foveal distance) increased in both right and left eyes of the individuals participating in the study, which was statistically significant. In addition, it was observed that the RNLF (Retinal nerve fiber layer) increased as the DFD distance increased, but this was not statistically significant. CONCLUSION: This study demonstrated that the optic disc-foveal distance, an anatomical measure of the fundus, does not affect RNLF in young and healthy subjects, but choroidal thickness does.

Optical Coherence Tomography Findings in Bipolar Disorder Patients and the Related Factors.

Background: This study's purpose is to determine the effects of current episode and the mood stabilizers on chorioretinal layer thicknesses of bipolar disorder (BD) patients using spectral-domain optical coherence tomography (SD-OCT). Methods: Sixty-seven patients were diagnosed with BD I and using lithium (Li) or valproic acid (VPA), of whom 20 were manic, 24 were depressive, and 23 were in remission, and 49 healthy individuals were included in the study. Peripapillary retinal nerve fiber layer (RNFL), ganglion cell layer, and macular thicknesses of the participants were measured automatically using SD-OCT, and their choroid layer thicknesses were measured manually using the depth imaging mode of SD-OCT. Statistical analysis of the data was performed using Statistical Package for the Social Sciences version 23.0. Results: The patient group's mean age was 39.78 ± 11.78, and the control group's mean age was 42.06 ± 12.10. The mean disease duration was 13.22 ± 8.23 in the patient group, and 26 patients were using Li. While peripapillary RNFL thicknesses were lower in the patient group (P < .05), other layer measurements were similar between the groups. Moreover, the episodes experienced by BD patients did not affect chorioretinal SD-OCT measurements. The patients on VPA had significantly lower RNFL thicknesses compared to the control and the Li groups, and all chorioretinal measurements were similar between the Li and the control groups. Conclusion: As a result of the study, it was established that neurodegenerative processes play a role in the pathophysiology of BD and the usage of Li is protective against the neurodegeneration of RNFL. Retinal changes measured with SD-OCT can be used for the diagnosis and prognosis of BD and for evaluating responses to mood stabilizers.

An Optical Coherence Tomography Study that Supports the Neurovascular Basis of Schizophrenia Disease.

Objectives: Spectral domain optical coherence tomography (SD-OCT) is a non--penetrating, quick, and practical device which enables measurement of the chorioretinal layers. In this study, our purpose was to investigate the retinal nerve fiber layer (RNFL) and choroidal thickness in schizophrenia patients, using SD-OCT, and compare the -findings with those of the control group. Methods: For the study, 44 patients with a diagnosis of schizophrenia, and 41 age- and gender- matched healthy controls were enrolled. Both eyes of each participant were -evaluated. RNFL was measured and analyzed automatically with optical coherence tomography. Scans for choroidal thickness were obtained with the enhanced depth imaging mode of the SD-OCT device and measured manually. Results: The average age of schizophrenia patients was 47.82, and it was 45.5 for the control group. The mean illness duration of the patients was 24.79 years. According to the results of this study, all choroidal measures (nasal, subfoveal, and temporal) of both eyes, and the RNFL thickness of schizophrenia patients, were significantly thinner than that of healthy controls. The chorioretinal measures of both eyes were similar. The results showed that a weak negative correlation was present between illness duration and choroidal diameter. Conclusion: In addition to demonstrating the thinning of RNFL in schizophrenia patients, as frequently reported in the literature, the results of this study show, for the first time, that choroidal thickness is considerably decreased in schizophrenia patients compared to the healthy controls, using SD-OCT. Keeping in mind that the choroid is a vascular layer, these results support the neurovascular hypothesis of schizophrenia.

Do static and dynamic pupillary parameters differ according to childhood, adulthood, and old age? A quantitative study in healthy volunteers.

Purpose: We aimed to evaluate the normative pupillometry values and mean pupil dilatation speed in healthy individuals in different age groups in our study. Methods: The study group included 180 eyes of 90 healthy volunteers in different age groups. Group 1 consisted of 30 participants between the ages of 6 and 18, group 2 consisted of 30 participants aged 19-40, and group 3 consisted of 30 participants aged 41-75. Scotopic, mesopic, photopic, and dynamic measurements were taken with automatic pupillometry of Sirius Topographer (CSO, Firenze, Italy). The mean pupil dilation speed at the 18th second was calculated according to dynamic measurements. Results: Group 1 had a significantly larger pupil diameter than groups 2 and 3 in all static and dynamic parameters, and the mean pupil dilation speed was the highest among the groups (P < 0.001 for all static and dynamic parameters). In addition, group 2 had a significantly larger pupil diameter than group 3 (P < 0.001 for all static and dynamic parameters) and the mean pupil dilation speed was faster than group 3 (P = 0.027). Conclusion: We have presented the static and dynamic parameters and the mean speed of pupil dilatation at the 18th second with automatic pupillometry in healthy individuals in childhood, adulthood, and old age. More studies with higher participants and younger age children are needed.

Evaluation of oxidative stress, 3-Nitrotyrosine, and HMGB-1 levels in patients with wet type Age-Related Macular Degeneration.

Background: This study aims to compare serum HMGB-1, 3-nitrotyrosine (3-NT), TAS, TOS, and OSI levels in Wettype Age-Related Macular Degeneration (wAMD) patients and healthy controls to determine the correlation of these parameters with each other. Methods: Thirty patients with Wet-type Age-Related Macular Degeneration (wAMD) and 27 healthy adults, as controls were enrolled in the study. We determined the TAS and TOS levels in serum samples of both groups using commercial kits on a microplate reader. Serum HMGB-1 and 3-NT levels were measured with the enzyme-linked immunosorbent assay method. Results: HMGB-1 levels were significantly higher in the patient group (137.51 pg/mL, p=0.001), while there was no difference between the two groups in serum 3-NT levels (p=0.428). A statistically significant difference found in the levels of TOS and OSI (p=0.001 and p=0.045, respectively) between the patients and controls, however, no significant difference was observed between the groups in terms of TAS levels (p=0.228). Conclusions: Oxidative stress and HMGB-1 levels were increased in wAMD patients and enhanced oxidative stress may be associated with increased tissue necrosis and inflammation. Thus administration of antioxidant treatment in addition to routine therapy should be considered in wAMD.

Repeated use of fibrin sealants kept at room temperature in conjunctival autografting: An animal study.

Purpose: In this study, our aim was to investigate if fibrin adhesives used in conjunctival wound surgery with autologous conjunctival grafts could be used repeatedly at different times after surgical opening. Methods: 40 New Zealand rabbits were used in the study. These animals were divided into four groups, each consisting of 10 rabbits, and hence 20 eyes. In the first group (control group), Tisseel fibrin sealant was used on the day the eye was first opened surgically; in the second group, it was used on the seventh day; on the third group, it was used on the 14th day; and in the fourth group, it was used 28 days after surgical opening. The graft from the inferior bulbar conjunctiva was attached using Tisseel fibrin glue to the superior scleral bed at the location where the superior bulbar conjunctiva was excised in the same eye. Results: No microbial growth was detected in the cultures of the samples tested. There were two partial graft loss in group 2 and there was one partial graft loss in each group of the other groups, and further total graft loss was present in one rabbit in group 3. None of the rabbits had any complications like granuloma, Corneal dellen or infection. Conclusion: Based on these results, fibrin sealants can be used repeatedly by storing them at room temperature. Repeated use of fibrin adhesives will reduce the cost of ophthalmologic surgeries and non-ophthalmologic surgeries.

Isolated Bilateral Macular Edema due to Le Fort Type 1 and Mandibular Fracture: A Case Report.

We report the diagnosis and follow-up process of a case who had bilateral macular edema after blunt facial trauma. A 36-year-old male patient with Le Fort type 1 and mandibular fracture without direct ocular trauma referred to the ophthalmology clinic. Visual acuity was 0.1 in both eyes according to Snellen chart. Ocular examination was normal except bilateral macular edema. The patient did not have any prior systemic or neurological diseases. The patient did not have cotton-wool spots, retinal hemorrhage, or Purtscher flecken in the fundus examination. He used topical 0.1% nepafenac solution for 1 month. Visual acuity returned to normal after complete resolution of the macular edema at 1 month and did not recur in the follow-up. We think that this case may be an isolated macular edema due to facial trauma or an atypical presentation of Purtscher retinopathy. Although facial fractures and trauma may cause Purtscher retinopathy with involvement of different retinal structures, the findings in this case suggest that isolated involvement of macula can also occur in these injuries.

Does choroidal thickness change in advanced hemorrhoids patients?

BACKGROUND: This study was conducted to examine the choroidal thickness of patients with grade 4 hemorrhoids to see if vascular abnormalities in hemorrhoid patients may affect other `parts of the body. METHODS: 51 patients diagnosed with grade 4 hemorrhoids in the last two years and 49 healthy volunteers were included. Choroidal evaluation was done by measurements from various points of the choroid using a spectral domain Cirrus HD-OCT (Carl Zeiss Meditec Inc.) in enhanced-depth imaging mode. Choroidal thicknesses were compared between the two groups. RESULTS: Nasal choroidal thickness, temporal choroidal thickness and mean choroidal thickness measurements were significantly higher in the hemoroid group (p<0.05), while subfoveal choroidal thickness did not differ significantly between the groups. Macular thickness was also significantly higher in the hemoroid group compared to the control group (p<0.05). CONCLUSION: There was an increase in choroidal thickness in patients with grade 4 hemorrhoids. KEY WORDS: Choroidal thickness, Hemorrhoids, Macular thickness, Optical coherence tomography, Vascular pathologies.

Can the long term using of pregabalin in fibromyalgia affect the choroid and retinal nerve fiber layer?

BACKGROUND: In this study, the effects of long-term pregabalin use on the choroid and retinal nerve fiber layer were investigated in the fibromyalgia disease. METHODS: The patient group consisted of 41 fibromyalgia patients using pregabalin. The control group consisted of 41 newly diagnosed fibromyalgia patients who had not received any treatment yet. Choroidal and retinal nerve fiber layer thickness measurements were performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) 30 minutes after pupil dilation with 1% tropicamide. RESULTS: There was no difference in subfoveal choroidal thickness, nasal choroidal thickness and temporal choroidal thickness between the patient and control groups (p > 0.05). Increasing the duration of drug use within the patient group was found to thin the retinal nerve fiber layer (p < 0.05). CONCLUSION: We found that pregabalin had no effect on the choroid, while it had a thinning effect for retinal nerve fiber layer. It is recommended not to be preferred pregabalin in fibromyalgia patients with retinal nerve fiber layer damage such as diabetic retinopathy and glaucoma. Patients treated with pregabalin should have regular control in the ophthalmology clinic.

The Inhibitory Effect of Capparis Ovata Polysaccharides on Cultured Pterygium Fibroblasts.

OBJECTIVES: Pterygium recurrence after removal surgery is an important problem. Polysaccharides obtained from Capparis species have been shown to possess various biological properties, including anti-tumor activity. This study was an investigation of the effect of Capparis ovata polysaccharides on cultured pterygium fibroblasts and a comparison with the effects of mitomycin C (MMC). METHODS: Pterygium tissue samples were obtained during excision surgery from 3 patients with primary pterygium, and fibroblasts were isolated. Pterygium fibroblast cultures and L929 cell cultures were treated with different concentrations of MMC and Capparis ovata polysaccharides. Cell proliferation and migration were evaluated. RESULTS: An MTT assay revealed that cell viability decreased with increasing concentrations of Capparis ovata polysaccharides in both cell types. MMC also inhibited the proliferation of both cell types. A scratch-wound assay indicated that both Capparis ovata polysaccharides and MMC molecules reduced proliferation and migration in the pterygium fibroblasts and L929 cells. CONCLUSION: The in vitro Capparis ovata polysaccharide inhibition of proliferation and migration of pterygium fibroblasts was similar to that of MMC. The results of this study suggested that Capparis ovata polysaccharides may be a valuable candidate drug to treat pterygium.

Serum malondialdehyde, monocyte chemoattractant protein-1, and vitamin C levels in wet type age-related macular degeneration patients.

PURPOSE: The purpose of this study was to investigate the serum levels of malondialdehyde (MDA) which is a marker of oxidative stress, monocyte chemoattractant protein-1 (MCP-1) which has an important role in inflammation, and vitamin C which has antioxidant properties in patients with wet age-related macular degeneration (wAMD). METHODS: Thirty patients with wAMD were included in the study and serum levels of MDA, MCP-1, and vitamin C were compared with healthy participants (n = 30). Serum vitamin C and MDA levels were measured using a spectrophotometric method. Serum MCP-1 levels were determined by the ELISA method. RESULTS: MCP-1 and MDA levels were higher in patients with wAMD compared with the control group (p < 0.05). Serum vitamin C levels were lower in patients with wAMD compared with the control group (p < 0.05). CONCLUSIONS: The increase in the MCP-1 levels in patients with wAMD may be associated with increased inflammation in wAMD. Decreased serum vitamin C and elevated MDA levels in patients with wAMD suggest increased oxidative stress in wAMD patients. These results indicate that the increased oxidative stress and inflammation can play a role in the pathogenesis of wAMD.

X-Linked Retinoschisis in Females in a Consanguineous Family: A Rare Entity

X-linked juvenile retinoschisis (XLRS) is a disease considered characteristic for males. In this study we report a consanguineous family in which 3 daughters were diagnosed with XLRS. Typical signs of XLRS were detected in 2 girls, aged 4 and 15. Fundoscopic examination of the father and the oldest daughter (age 17) revealed bilateral atrophic macula and retinal thinning. Although rare and considered characteristic for males, XLRS can be seen in females in Middle-East countries that have a high rate of consanguineous marriage. It can be overlooked by ophthalmologists and these patients may be misdiagnosed.

Outcomes and comparison of nasolacrimal probing for patients older than 12 months.

OBJECTIVE: In this study, we report the results of probing done in our clinic. We also want investigate role of late probing on outcome, especially in children older than 24 and 48 months. METHODS: We retrospectively evaluated records of patients who underwent probing under general anaesthesia due to congenital nasolacrimal duct obstruction between 2013 and 2017 in Nigde Ömer Halisdemir University Faculty of Medicine in Nigde, Turkey. Success rates of probing for different age groups were compared. RESULTS: 143 eyes of 123 patients were included in the study. Overall success rate was 93.7% (134 eyes out of 143). We found the success rate as 95.5 in 12-18 months age group, 93.3% in 18-24 months age group, 93.8% in the 24-48 months age group, 86.6% in the 48 months and older age group. Overall success rate in 24 months and older age group was 91.5%. The second operation was performed on seven of the nine patients where the initial surgery failed, and successful results were achieved in six patients. Success rate was 100% after the second surgery in patients older than 48 months. CONCLUSION: The success rate of probing is high in patients with congenital nasolacrimal duct obstruction from 12 to 84 months. In patients with congenital nasolacrimal duct obstruction who are older than 48 months probing is effective and should be first-choice in this age group in management of congenital nasolacrimal duct obstruction. Probing may be used even in older patients who had previous unsuccessful probing.

Inhibitory Effect of Valsartan on Pterygium Fibroblasts.

PURPOSE: Angiotensin receptor blockers (ARBs) were shown to have antifibrotic properties in ocular and systemic diseases. In this study, our aim was to investigate the effect of an angiotensin receptor blocker, valsartan, on pterygium fibroblasts and compare this effect with that of mitomycin C (MMC). METHODS: Pterygium tissue samples were obtained from 3 patients during surgical excision. Primary cultured pterygium fibroblasts and L929 cell cultures were treated with different concentrations of MMC and valsartan. RESULTS: The cell viability decreased with increasing concentrations of valsartan at 48 hours for both cell types. MMC inhibited the proliferation of both cell types at 48 hours. Both agents significantly decreased the cell migration of the 2 cell types, although it was more prominent in the MMC-treated group. CONCLUSIONS: Valsartan inhibited the proliferation and migration of pterygium fibroblasts. The known favorable safety profile of these drugs and the results of this study showing inhibitory effect on pterygium fibroblasts make valsartan a potential therapeutic agent for pterygium treatment.

Dry eye in chronic stroke patients with hemiplegia: A cross-sectional study.

Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group.Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared.Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group.Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients.

The effect of retrobulbar anesthesia for cataract surgery on the retinal nerve fiber layer thickness.

OBJECTIVE: The aim of this study was to evaluate the effect retrobulbar and topical anesthesia on optic nerve by measuring retinal nerve fiber layer (RNFL) thickness before and after phacoemulsification cataract surgery using optical coherence tomography (OCT). METHODS: A total of 126 eyes of 108 patients were included in the study. Retrobulbar anesthesia was used in 61 eyes of 53 patients, and topical anesthesia was used in 65 eyes of 55 patients. OCT scans were done 1 week before the surgery and 4 weeks after surgery, and the results were evaluated. RESULTS: The average RNFL thickness increased postoperatively in both groups (p < 0.001 for topical anesthesia group and p = 0.001 for retrobulbar anesthesia group). The preoperative and postoperative average and quadrant RNFL thickness and the change in RNFL thickness were not significantly different between the two anesthesia groups (p > 0.05). CONCLUSION: Our results suggest that retrobulbar anesthesia has no unfavorable effect on the retinal nerve fiber layer.

Tear Film Functions and Dry Eye Symptoms in Young Patients with Pterygium.

OBJECTIVES: This study was performed to evaluate the Schirmer II test (ST2) results, tear breakup time (TBUT) findings, and Ocular Surface Disease Index (OSDI) scores of pterygium patients under 30 years of age, and to compare the results with pterygium patients aged 30 years and older and healthy controls. METHODS: Eighty-four eyes of 60 patients who had primary pterygium and were younger than 30 years of age (Group 1), 79 eyes of 53 patients who had primary pterygium and were 30 years of age and older (Group 2), and 64 eyes of 64 healthy controls (Group 3) were included in the study. The results of ST2 and TBUT tests and the OSDI questionnaire scores were recorded and compared. RESULTS: Group 1 had lower TBUT values compared to Group 2 and the control group (p= 0.03 and p<0.001, respectively). Group 1 had lower ST2 values than the control group (p<0.001). There was no significant difference in the ST2 results between Group 1 and Group 2 (p=0.08). Group 1 had higher OSDI scores than the control group (p=0.003). There was no significant difference in the OSDI scores between Group 1 and Group 2 (p=0.7). CONCLUSION: The results indicated that young patients with pterygium had lower ST2 results, lower TBUT values, and higher OSDI scores compared to the control group, and lower TBUT values compared to older patients with pterygium. Tear film abnormality may be a factor in the pterygium pathogenesis, especially in young patients, and may increase the vulnerability of the ocular surface of young people to environmental factors, leading to pterygium formation.

The contribution of scholars to the anatomy of the eye and adnexa in islamic geography.

From the early period of Islam, Muslim scholars have translated the ancient Greek medical works, and they reached a much more advanced level. Blindness was a major cause of disability in all Islamic geography, so physicians from Islamic territory, particularly Yuhanna ibn Masawayh, Hunain Ibn Ishaq, Rhazes, Ali bin Isa, Ibn-i Sina, and Ibn Al-Haitam, were particularly focused on the anatomy of the eye and diagnosis and treatment of eye diseases. In this study, we aimed to report the contributions of the Muslim scholar on the anatomy of the eye and adnexa for the first time in the literature.

Ocular findings in posterior microphthalmos.

AIM: To report a critical case series of six patients with posterior microphthalmos (PM). METHOD: Complete ophthalmologic examinations of all patients were performed using best-corrected visual acuity (BCVA), cycloplegic refraction, applanation tonometry, slit lamp biomicroscopy of the anterior segment, fundoscopy, A and B mode ultrasonography (USG), keratometry, and optic coherence tomography (OCT). RESULTS: The most significant clinical characteristics of male patients aged 10-25 years was the presence of shorter posterior segments (mean: 15.27-18.91 mm) accompanying high hyperopia (mean +9.00 - +18.50 diopter) despite the normal anterior segment findings. The BCVA ranged between 20/320 and 40/100. Retinal folds were detected bilaterally on the papillomacular band in all patients. Although neurosensory retina was included in the fold in OCT images, retinal pigment epithelium, choroid, and sclera were not included in the fold. Pigmentary retinopathy was detected in one patient. CONCLUSION: Despite normal anterior segment, posterior microphthalmos is characterized with high hyperopia, and shorter axial length and bilateral papillomacular retinal fold. Refractive amblyopia, uveal effusion syndrome, retinal detachment and macular hole are complications that can be corrected. Posterior microphthalmos must be kept in mind in patients with a normal anterior segment, and high hyperopia.

Corneal Epithelial Damage and Impaired Tear Functions in Patients with Inflamed Pinguecula.

PURPOSE: In this study, we evaluated corneal epithelial integrity and tear film parameters in patients with inflamed pinguecula and compared these findings with their fellow eyes and with healthy controls. METHODS: We evaluated the fluorescein staining properties and performed the tear break-up time (TBUT) test and Schirmer 2 test (ST2) measurements of 32 patients who had symptomatic unilateral inflamed pinguecula and compared the results with their fellow eyes and also with an age- and sex-matched control group. RESULTS: Twenty-three eyes (72%) in the inflamed pinguecula group and 1 eye (3.1%) in the fellow eyes group had punctate epithelial staining (PES) or epithelial defect on the nasal cornea (p < 0.001). There was no PES or epithelial defect in the control group. Eyes with inflamed pinguecula (n = 32) had lower TBUT and ST2 values compared to the control group (n = 32) (p < 0.001 for both). Fellow eyes (n = 32) also had lower TBUT and ST2 values compared to the control group (p=0.003 for both). There was no difference in the TBUT and ST2 results between the eyes with inflamed pinguecula and fellow eyes (p=0.286 and p=0.951, respectively). CONCLUSION: A high percentage of eyes with inflamed pinguecula had nasal corneal epithelial staining or epithelial defect. We also found lower TBUT and ST2 results in eyes with inflamed pinguecula and the fellow eyes compared to the control group. These findings may be important in pathogenesis of pinguecula and pterygium and also in uncovering their relation.