Ophthalmologists' perspectives on corneal transplantation and donation: a survey from Türkiye.

PURPOSE: To evaluate ophthalmologists' interest and opinions regarding corneal transplantation and donation in Türkiye. MATERIAL AND METHODS: An online questionnaire was prepared using Google Forms, and the electronic link to this questionnaire was sent via WhatsApp to ophthalmologists working in Türkiye. Eighteen open-ended/multiple-choice questions were asked about ophthalmologists' demographic information and their opinions regarding corneal transplantation and donation. The answers were analyzed by transferring the data to Excel. RESULTS: A total of 195 ophthalmologists participated in the survey. While 68.6% of them stated that they wanted to donate their corneas, 21.1% stated that they were undecided, and 10.3% did not want to donate their corneas. While 93.8% of the participants agreed to have a cornea transplant in case of need, 5.7% of them stated that they were undecided, and 0.5% said that they would not accept a cornea transplant. The most frequent (90.5%) reason for being willing to donate one's cornea was to give hope to patients with low vision. The most frequent (46.2%) reason for not wanting to donate one's cornea was the unwillingness to have one's body/eye integrity impaired. The vast majority (80.8%) of the participants thought that there was not enough corneal donation in Türkiye and that this was mostly (85.9%) due to cultural and/or religious reasons. CONCLUSIONS: Even in a sample with a high level of education and the most knowledge about corneal transplantation, the willingness to donate corneas may remain below the expected rates. Therefore, it is necessary to alleviate unrealistic concerns and prejudices about corneal donation and transplantation.

Corneal innervation changes in Alzheimer's: implications for sensory dysfunction.

PURPOSE: To compare, between Alzheimer's disease (AD) patients and healthy individuals, corneal subbasal nerve plexus (CSNP) parameters and corneal sensitivities. METHODS: Twenty-two patients who were followed up with Alzheimer's disease (Alzheimer's group) and 18 age- and gender-matched healthy individuals (control group) were included in this cross-sectional study. CSNP parameters, including nerve fiber length (NFL), nerve fiber density (NFD), and nerve branch density (NBD), were evaluated using in vivo confocal microscopy. Corneal sensitivity was evaluated using a Cochet-Bonnet esthesiometer. The results were compared between the two groups. RESULTS: In the Alzheimer's group, NFL was 12.2 (2.4) mm/mm2, NFD was 12.5 [3.1] fibers/mm2, and NBD was 29.7 [9.37] branches/mm2. In the control group, NFL was 16.5 (2.0) mm/mm2, NFD was 25.0 [3.13] fibers/mm2, and NBD was 37.5 [10.9] branches/mm2. All three parameters were significantly lower in the Alzheimer's group compared to the control group (p < 0.001, p < 0.001, and p = 0.001, respectively). Similarly, corneal sensitivity was significantly lower in the Alzheimer's group (55.0 [5.0] mm) compared to the control group (60.0 [5.0] mm) (p < 0.001). CONCLUSION: We determined that, in AD, corneal sensitivity decreases significantly, in parallel with the decrease in corneal nerves. Changes in the corneal nerve plexus and a decrease in corneal sensitivity may be used in the early diagnosis and follow-up of AD. In addition, ocular surface problems secondary to these changes should also be kept in mind.

Quantitative assessment of the effect of SARS-CoV-2 on the corneal sub-basal nerve plexus of post-COVID-19 patients using in vivo confocal microscopy.

OBJECTIVES: To investigate whether SARS-CoV-2 causes morphological changes in the corneal sub-basal nerve plexus (CSNP) of post-COVID-19 patients using in vivo confocal microscopy (IVCM). METHODS: A total of 70 participants were included in the study and were divided into three groups. Post-COVID-19 patients with neurological manifestations were considered Group 1 (n = 24), and post-COVID-19 patients without neurological manifestations were considered Group 2 (n = 24). Healthy control participants were considered Group 3 (n = 22). The parameters of the CSNP, including nerve fibre density (NFD), nerve branch density (NBD), and nerve fibre length (NFL), were investigated in all participants using IVCM. Additionally, corneal sensitivity was tested by corneal esthesiometry. RESULTS: The mean NFD, NBD, and NFL values of Group 1 (16.12 ± 4.84 fibre/mm2, 27.97 ± 9.62 branch/mm2, and 11.60 ± 2.89 mm/mm2) were significantly lower than those of Group 2 (19.55 ± 3.01 fibre/mm2, 40.44 ± 7.16 branch/mm2, and 15.92 ± 2.08 mm/mm2) and Group 3 (25.24 ± 3.75 fibre/mm2, 44.61 ± 11.80 branch/mm2, and 17.76 ± 3.32 mm/mm2) (p < 0.05 for all). Except the mean NFD value (p < 0.001), there were no significant differences in terms of the mean NBD and NFL values between Group 2 and Group 3 (p = 0.445, p = 0.085). The value of the mean corneal sensitivity was significantly higher in Group 3 (59.09 ± 1.97 mm) compared to Group 1 (55.21 ± 1.02 mm) and Group 2 (55.28 ± 1.18 mm) (p < 0.001, p < 0.001) but there was no significant difference between Group 1 and Group 2 (p = 1.000). CONCLUSION: In post-COVID-19 patients, the mean parameters of CSNP were lower than in the control group. These differences were more pronounced in patients who had neurological manifestations of COVID-19.

Impact of unilateral trigeminal neuralgia on bilateral ocular surface alterations.

OBJECTIVE: To evaluate ocular surface alterations in both eyes of patients with unilateral trigeminal neuralgia (TN) compared with controls. BACKGROUND: Corneal nerves mainly originate from the trigeminal nerve, and neurosensory abnormalities are important factors in ocular surface alterations and dry eye etiopathogenesis. METHODS: Twenty-four patients with idiopathic unilateral TN and 24 healthy controls with similar sex and age distributions were included in this cross-sectional study conducted from February 15 to September 15, 2021. The eyes on the affected sides of the patients with TN were treated as Group 1, their contralateral eyes as Group 2, and the right eyes of the controls as Group 3. All participants were evaluated for tear film and ocular surface using the Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and conjunctival impression cytology grading. RESULTS: The mean (SD) ages of the patients with TN (17 of 24 females, 70.8%) and controls (15 of 24 females, 62.5%) were 49.7 (11.7) and 48.5 (9. 6) years, respectively. The median [25th, 75th percentile] Schirmer 1 test results in Groups 1, 2, and 3 were 5.0 [4.0, 14.0], 7.0 [3.2, 11.7], and 10.0 [6.0, 15.7] mm, respectively, with no statistically significant differences between Groups 1 and 2 (p = 0.697), Groups 1 and 3 (p = 0.133), or Groups 2 and 3 (p = 0.129). The median TBUT scores in Groups 1, 2, and 3 were 7.0 [5.0, 10.0], 8.0 [5.2, 10.0], and 12.5 [8.0, 13.0] s, respectively, showing reduced times for both Groups 1 and 2 versus Group 3 (median difference = -3.0 [95% CI: -5.0, -1.0], p = 0.001, and median difference = -3.0 [95% CI: -5.0, -2.0], p = 0.001, respectively). Conjunctival impression cytology grades were significantly higher in Groups 1 and 2 versus Group 3 (median difference = 2.0 [95% CI: 1.0, 2.0], p < 0.001, and median difference = 1.0 [95% CI: 1.0, 2.0], p < 0.001, respectively). The median OSDI score in TN patients (30.2 [25.0, 34.9]) was significantly higher than in the controls (8.3 [0.0, 18.7]), with a median difference of 20.8 (95% CI: 14.7, 27.1), p < 0.001. CONCLUSION: Even if pain is unilateral in patients with TN, there are significant abnormalities in conjunctival cytology and tear functions in both eyes. There seem to be various pathophysiological mechanisms of TN that affect the bilateral ocular surface and lead to significant alterations.

Dry eye disease and ocular surface characteristics in patients with keratoconus.

PURPOSE: The purpose of this study is to investigate the ocular surface alterations in patients with mild or severe keratoconus (KC). METHODS: A total of 80 participants were included in the study. The corneal topography was performed on each participant using Pentacam and the grouping was done accordingly. The patients with Kmax ≥52.0 D (severe KC) were considered Group 1 (n = 28), the patients with Kmax ≥47.2 and <52.0 D (mild KC) were considered Group 2 (n = 30). Healthy control participants with Kmax <47.2 D were considered Group 3 (n = 22). Tear breakup time (TBUT), Schirmer-I test, ocular surface disease index (OSDI) questionnaire, and conjunctival impression cytology (CIC) were evaluated among the groups. RESULTS: The mean values of TBUT and Schirmer-I test were significantly lower (P = 0.012, P = 0.012) and the mean scores of OSDI and CIC were significantly higher (P = 0.006, P < 0.001) in Group 1 and Group 2 than in Group 3. The mean values of TBUT and Schirmer-I test were lower and the mean scores of OSDI and CIC were higher in Group 1 than in Group 2 but the differences were insignificant (P > 0.05 for all). CONCLUSION: These results indicated that the tests associated with dry eye disease are correlated with KC. Tear film alterations and goblet cell loss are higher in severe KC.

The outcomes of intravitreal C3F8 gas tamponade combined with laser photocoagulation treatment for optic disc pit maculopathy.

PURPOSE: To share the anatomical results and visual outcomes of intravitreal gas tamponade combined with laser photocoagulation treatment for optic disc pit maculopathy (ODPM). METHODS: Intravitreal gas tamponade combined with laser photocoagulation treatment was performed on six consecutive patients with ODPM. A 0.3 mL of 100% perfluoropropane (C3F8) gas was injected intravitreally. The patients were then asked to maintain prone position until the C3F8 gas disappeared. Laser photocoagulation was performed the day after the procedure. The outcomes were determined by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA). RESULTS: In the present study, visual improvement and reduction in serous macular detachment were observed in 83% of the ODPM patients. Complete retinal reattachment was achieved in 66% of the ODPM patients. In one patient, no regression was observed after the repeated treatment, and pars plana vitrectomy was performed. The final BCVA improved in five eyes and unchanged in one eye. No postoperative complications were observed during the follow-up period in any patient. CONCLUSIONS: Intravitreal C3F8 gas tamponade combined with laser photocoagulation procedure is an effective, minimally invasive, and cost-effective treatment method for ODPM.

Conjunctival impression cytology and tear film parameters in patients with multiple sclerosis.

PURPOSE: To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls. METHODS: Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed. RESULTS: Mean CIC grade was higher in the MS group than in the control group (1.48 ± 0.71 and 0.39 ± 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2-3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 ± 3.16, 13.06 ± 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 ± 5.75, 17.36 ± 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 ± 19.19, 13.70 ± 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group. CONCLUSION: In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease.

Ganglion cell complex thickness changes in patients with different states of bipolar disorder.

OBJECTIVES: Neuroimaging studies in patients with bipolar disorder have suggested that a neuropathological process may be effective in this disease. Neurodegenerative changes in the retina can be followed by optical coherence tomography, a non-invasive imaging method that allows in vivo visualization of the retinal layers. The aim of this study was to investigate the possible differences in optical coherence tomography parameters during euthymic, manic, and depressive episodes in patients diagnosed with bipolar disorder. METHODS: A total of 150 patients with bipolar disorder were included in the study, divided into three groups (50 patients in a euthymic state, 50 patients in a manic state, and 50 patients in a depressive state) and compared with 50 healthy controls. Ganglion cell complex thickness was measured with automated macular segmentation software of spectral-domain optical coherence tomography. RESULTS: Ganglion cell complex thicknesses were thicker in all quadrants in patient groups than the control group but the differences were significant in perifoveal superior and perifoveal inferior quadrants (p < 0.001, p < 0.001). There were no differences in ganglion cell complex thickness among the patient groups (p > 0.05). CONCLUSION: The evaluation of ganglion cell complex thickness by spectral-domain optical coherence tomography may give a clue for monitoring neurodegenerative changes in patients with bipolar disorder.

Evaluation of inflammatory biomarkers in patients with keratoconus.

OBJECTIVE: To investigate the monocyte-to-HDL-cholesterol ratio (MHR), neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), eosinophil-to-lymphocytes ratio (ELR), platelet distribution width (PDW), red blood cell distribution width (RDW), mean platelet volume (MPV), MPV to platelet count ratio (MPV/PC), and RDW to platelet ratio (RPR) that are accepted as inflammatory markers in patients with keratoconus. METHODS: In this study, 43 patients with keratoconus and 43 healthy individuals as the control group were retrospectively evaluated. High density lipoprotein cholesterol (HDL-c), lymphocyte, neutrophil, eosinophil, monocyte, platelet, MPV, PDW, and RDW values were obtained with complete blood count performed on the peripheral blood samples. RESULTS: Absolute monocyte (593 ± 182 vs 492 ± 177; p < 0.05) and neutrophil (4860 ± 1553 vs 3954 ± 1297; p < 0.01) counts were statistically significantly higher in the keratoconus groups compared to the control group. MHR (13.18 ± 5.02 vs 9.88 ± 4.45; p < 0.01) and NLR (2.30 ± 0.87 vs 1.77 ± 0.61; p < 0.01) were statistically significantly higher and LMR (4.07 ± 1.67 vs 5.18 ± 2.06; p < 0.01) was significantly lower in the keratoconus group. As a result of univariate logistic regression analysis, it was observed that MHR and NLR were statistically significant relationship with keratoconus (p = 0.02 and p = 0.021) (Odds ratio = 5.41 (95% CI: 1.169-6.669) and Odds ratio:5.28 (95% CI: 1.024-6.321); respectively). No statistically significant difference was found between the groups in terms of PLR, ELR, RDW, MPV, PDW, MPV/PC, and RPR. Adjusting for age and gender, multivariate regression analysis revealed that MHR was the most significant parameter to demonstrate relationship with keratoconus (p = 0.025) (Odds ratio = 4.99 (95% CI: 1.019-6.332)). CONCLUSION: MHR and NLR values considered as inflammatory markers were statistically significantly higher and LMR value was significantly lower in the keratoconus group. Among these values, MHR was the most reliable parameter.

The ocular surface findings in alopecia areata patients: clinical parameters and impression cytology.

PURPOSE: The objective of this study was to examine the effects of alopecia areata (AA) on the ocular surface and conjunctival cytology. METHODS: A total of 48 subjects were included in the present study. Twenty-three subjects were assigned to group 1 as the patient group, and 25 healthy individuals were included in group 2 as the control group. The ocular surface examination was performed, and the right eyes of all participants were included in the analysis. Both groups underwent the following tests for evaluation of ocular surface: tear break-up time (TBUT), Schirmer I test, Ocular Surface Disease Index (OSDI), and conjunctival impression cytology (CIC). Results obtained from the tests were then analyzed and compared between the groups. RESULTS: The mean TBUT value was significantly lower in Group 1 compared to Group 2 (4.96 ± 3.4 vs 10.52 ± 4.8 s) (p < 0.001). There was no significant difference between Group 1 and Group 2 in terms of the mean Schirmer I test score (p = 0.129). The mean OSDI score was higher in Group 1 compared to Group 2 (15.48 ± 10.4 vs 9.61 ± 13.4), but the difference between both groups was not statistically significant (p = 0.1). The mean CIC score was statistically significantly higher in Group 1 than in Group 2 (1.65 ± 0.7 vs 0.52 ± 0.5) (p < 0.001). CONCLUSION: The results of this study showed that AA was correlated with significant disturbances in conjunctival cytology and the tear function.

The Causes and Frequency of Monocular and Binocular Blindness in Adults Applying to the Health Committee of a University Hospital in Central Anatolia

Objectives: The aim of this study was to investigate the frequency of blindness and the pathologies that cause blindness in the Konya province of Turkey. Materials and Methods: The records of individuals over 18 years of age who applied to the health committee of Meram School of Medicine Hospital between January 2015 and December 2018 were evaluated retrospectively. Results: After reviewing the records of 4,268 applicants, a total of 222 applicants were included in the study (159 patients with monocular blindness, 63 patients with binocular blindness). The most common causes of monocular blindness were optic atrophy (13%), amblyopia (11%), and phthisis bulbi (10%). The most common causes of binocular blindness were retinitis pigmentosa (28%), proliferative diabetic retinopathy (13%), and unoperated cataract (11%). The frequency of monocular blindness was 3.7% (95% confidence interval [CI]: 3.2-4.3%) and binocular blindness was 1.5% (95% CI: 1.1-1.9%) in the sample. The frequency of blindness increased with age, with a positive correlation between mean age and blindness (p=0.002). Monocular blind applicants had a significantly lower mean age than binocular blind applicants (48.8±13.3 vs. 55.0±13.1 years, p=0.002) and binocular blind women had a significantly higher mean age than binocular blind men (62.7±16.0 vs. 53.2±11.7 years, p=0.023). The prevalence of monocular and binocular blindness was significantly higher in men than women (p=0.032). Conclusion: The results of this study show that many of the pathologies that cause blindness are preventable or treatable, and that blindness is associated with age.

Tear Function Alterations and Conjunctival Impression Cytology Findings in Patients With Gout.

OBJECTIVES: The aim of this study was to evaluate the tear functions and conjunctival impression cytology (CIC) findings of patients with gout and compare them with healthy controls. METHODS: Thirty-four patients with gout (group 1) and 32 age-matched and gender-matched healthy individuals (group 2) were included in this cross-sectional study. Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and CIC grade were evaluated and compared between the groups. RESULTS: There was no significant difference between the groups in gender and age (P=0.923 and P=0.078, respectively). The mean of Schirmer 1 test result was significantly lower in group 1 (9.74±6.03 mm) than that in group 2 (17.16±9.33 mm) (P<0.001). The TBUT was also significantly lower in group 1 (7.00±2.09 seconds) than that in group 2 (12.75±5.25 seconds) (P<0.001). The OSDI score (20.04±12.92) was significantly higher in group 1 than that in group 2 (6.19±10.07) (P<0.001). Although 10 patients (29.4%) in group 1 had the CIC grade of 2 to 3, none of the controls had CIC grade 2 to 3. The mean CIC grade in group 1 (1.15±0.89) was significantly higher than that in group 2 (0.47±0.51) (P<0.001). CONCLUSIONS: The results of this study suggest that ocular surface alterations assessed by CIC and tear function abnormalities are more common in patients with gout.

Ocular-symptoms-related Google Search Trends during the COVID-19 Pandemic in Europe.

PURPOSE: To investigate the correlation between the daily relative search volume (RSV) of keywords related to coronavirus and ocular symptoms, and the numbers of the daily coronavirus disease 2019 (COVID-19) new cases and new deaths in Europe using Google Trends (GT). METHODS: The RSVs of the selected keywords related to coronavirus and ocular symptoms between 24 January and 1 June 2020 in the United Kingdom, Spain, Italy, Germany and Turkey were accessed from GT. The numbers of daily COVID-19 new cases and new deaths in the same time interval in the aforementioned countries were compared with the RSVs of the keywords and terms. RESULTS: The United Kingdom, Spain, Italy, Germany, and Turkey were the most affected countries from the COVID-19 pandemic in Europe. In these countries, statistically significant and strong correlations were found between the daily RSVs of most keywords related to coronavirus and ocular symptoms, and the daily numbers of COVID-19 new cases and new deaths ranging from 0.175 to 0.807. CONCLUSIONS: Ocular symptoms are not the frequent signs of COVID-19, but the ocular surface is a possible route for the transmission of COVID-19. The preliminary outcomes of this study demonstrated that there are significant correlations with the ocular symptoms and COVID-19. The news about the relation of eye and COVID-19 in the mass media may have influenced the Google internet search activity of the public for ocular symptoms.

Evaluation of the Systemic Inflammation in Patients with Pterygium: Monocyte-to- High-Density Lipoprotein Cholesterol Ratio and Hematologic Indexes of Inflammation.

PURPOSE: The purpose of this study is to evaluate systemic inflammation in patients with pterygium using the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and hematologic indexes of inflammation. METHODS: Thirty-one patients with primary pterygium and 31 age-and sex-matched healthy participants were enrolled in this retrospective study. The MHR, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, monocyte-to-eosinophil ratio, mean platelet volume-to-platelet count ratio, platelet distribution width, and red cell distribution width were compared between the two groups. RESULTS: There was not a statistically significant difference in terms of the MHR between the pterygium group and the control group (P = 0.693). The NLR was higher in the pterygium group than in the control group (P = 0.028). In the other hematologic indexes, there were no statistically significant differences between the two groups (P > 0.05 for all). CONCLUSION: The MHR is not associated with the presence of pterygium. An increased NLR in patients with pterygium may be an indicator of systemic inflammation.

Subclinical inner retinal layer thickness changes in the fellow eyes of patients with unilateral central retinal artery occlusion: a pilot study.

PURPOSE: To investigate microstructural changes in the macular inner retinal layers over time in the fellow eyes of patients with unilateral central retinal artery occlusion (CRAO). METHODS: Spectral-domain optical coherence tomography scans of 16 patients with CRAO were performed at initial examination (1st day), at 1st month, at 3rd month, at 6th month, and the central macular thickness (CMT) and inner retinal layer thicknesses in the fellow eyes of the patients were compared between each visit. The thicknesses of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL) were calculated in 9 quadrants according to the definition by the Early Treatment Diabetic Retinopathy Study. RESULTS: CMT decreased over a 6-month period, but the difference was insignificant among visits (p = 0.072). Also, there were no significant differences in the thicknesses of RNFL and GCL among visits (p > 0.05 for all quadrants). But there was thinning in the parafoveal superior and perifoveal superior quadrants of the IPL (p = 0.007, p = 0.01) and in the parafoveal temporal quadrant of the INL (p = 0.033) within 6 months of follow-up in the fellow eyes of the patients with CRAO. CONCLUSION: This study demonstrated subclinical alterations of the macular inner retinal layers over time in the fellow eyes of CRAO patients.

Monocyte/HDL Ratio and Lymphocyte/Monocyte Ratio in Patients with Pseudoexfoliation Syndrome.

Purpose: To evaluate the association between monocyte count/high-density lipoprotein (HDL) ratio (MHR) and lymphocyte count/monocyte count ratio (LMR) with pseudoexfoliation syndrome (PEXS) and pseudoexfoliation glaucoma (PEXG).Materials and Methods: A total of 63 participants included in the study. Participants were divided into three groups. Twenty-one patients with PEXS regarded as group 1, 21 patients with PEXG regarded as group 2 and 21 participants without PEXS or PEXG regarded as the control group. Blood parameters were accessed from file records and database retrospectively.Results: The mean MHRs were significantly higher in group 1 and group 2 (p = 0.003, p = 0.036) than the control group, whereas there was no difference between group 1 and group 2 (p = 0.686). The mean LMRs were lower in group 1 and group 2 than the control group but the difference was insignificant (p = 0.232).Conclusion: We found that there is an association between higher MHR and lower LMR with PEXS.

Assessment of Monocyte/HDL Ratio in Branch Retinal Vein Occlusion.

Purpose: The purpose of this article was to evaluate monocyte count and high-density lipoprotein (HDL) cholesterol levels and their ratio (monocyte/HDL ratio [MHR]) in patients with branch retinal vein occlusion (BRVO).Materials and Methods: A total of 50 participants were included in the study. Participants were divided into two groups: Twenty-five patients diagnosed with BRVO and 25 participants as the control group. Ocular examination findings and hematologic parameters were accessed from the file records and database, retrospectively.Results: The mean MHR was significantly higher in BRVO group compared to the control group (13.4 ± 5.2 vs. 8.1 ± 2.2, p < 0.001). In receiver operating characteristics analysis, the area under the curve for MHR was 0.862, and an MHR of >9.5 predicted BRVO with a sensitivity of 76% and specificity of 70.8%.Conclusion: The present study showed that elevated MHR is significantly associated with BRVO. Therefore, MHR may be a useful marker for the emergence of BRVO.

May Monocyte/HDL Cholesterol Ratio (MHR) and Neutrophil/Lymphocyte Ratio (NLR) Be an Indicator of Inflammation and Oxidative Stress in Patients with Keratoconus?

OBJECTIVE: To evaluate monocyte/high-density lipoprotein cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) in patients with keratoconus (KC). METHODS: Thirty-one patients with KC (group 1) and 31 healthy control subjects (group 2) were included in the study. All participants' ocular examination findings, clinical and laboratory parameters were obtained from file records and laboratory archives. RESULTS: When group 1 was compared with group 2, MHR (13.7 ± 5.0 vs. 9.1 ± 3.7; p < .001) and NLR (2.3 ± 0.8 vs. 1.7 ± 0.6; p < .001) were statistically significantly higher in group 1. Optimal MHR cutoff value for KC was calculated as 10.2 with 77.4% sensitivity and 64.5% specificity, and optimal NLR cut-off value for KC was found as 1.9 with 71.4% sensitivity and 55% specificity. CONCLUSION: MHR and NLR values recognized as indicators of oxidative stress and systemic inflammation were significantly higher in patients with KC compared to the control group.

The Frequency and Causes of Blindness in a Rural Region of Central Anatolia of Turkey.

OBJECTIVE: This study aimed to evaluate the frequency and primary causes of blindness in adults aged 18 years and more in Sarikaya rural region of Yozgat, Turkey, to contribute to the epidemiologic information about blindness in our country. MATERIALS AND METHODS: Patients who were examined between October 2016 and March 2017 in Sarikaya State Hospital, Clinic of Ophthalmology, were prospectively investigated. Demographic and ophthalmic examination data, presented visual acuities (VA), primary causes of blindness, and monocular blindness were recorded. Blindness was defined as presented visual acuities (VA) definition of World Health Organization criteria. RESULTS: A total of 3423 participants, aged 18-96 years, were examined. Among them, 1887 participants (55%) were female and 1536 (45%) were male. The frequency of blindness was 1.5% (95% CI: 1.1%-2.0%); and cataract was the primary cause of blindness (42%). Age-related macular degeneration (21%) and uncorrected refractive error (13%) were the next main causes of blindness. The frequency of monocular blindness was 4% (95% CI: 3.8%-5.2%), and cataract (27%) followed by phthisis bulbi/evisceration (13%) and glaucoma (12%) were the leading causes of monocular blindness. CONCLUSION: In this rural region of Central Anatolia, the primary cause of blindness and monocular blindness was an unoperated cataract. The patterns of age-specific causes of blindness are variable, but most of them are avoidable or treatable. Thus, awareness should be increased in societies, and people should be prevented from blindness with health-care programs in rural regions of developing countries.

Atherogenic indices in pseudoexfoliation syndrome.

OBJECTIVES: Evaluation of atherogenic indices in patients with pseudoexfoliation syndrome (PEXS) by traditional serum lipid profiles [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and non-HDL-c] and non-traditional serum lipid ratios [TC/HDL-c, TG/HDL-c, LDL-c/HDL-c and non-HDL-c/HDL-c]. METHODS: A total of 100 patients were included in the study. Fifty patients diagnosed with PEXS were regarded as group 1 and 50 patients without PEXS were regarded as group 2, respectively. RESULTS: The median TC, TG, LDL-c, HDL-c and non-HDL-c values were significantly higher in group 1 compared to group 2 (p = 0.007, p = 0.025, p = 0.016, p = 0.015 and p = 0.042, respectively). But there were no significant differences in the TC/HDL-c, TG/HDL-c, LDL-c/HDL-c and non-HDL-c/HDL-c ratios among the two groups (p = 0.581, p = 0.617, p = 0.292 and p = 0.583, respectively). CONCLUSIONS: Non-traditional serum lipid ratios are superior to traditional serum lipid profiles for identifying the risk of vascular disease and this study did not demonstrate a complete relationship between PEXS and increased risk of vascular disease.