[Seroprevalence and Risk Factors of Hepatitis B, C and D in Adults in Trabzon, Türkiye]. / Trabzon'da 20 Yas Üstü Eriskinlerde Hepatit B, Hepatit C ve Hepatit D Seroprevalansi ve Risk Faktörleri.

Viral hepatitis are infections that can cause liver damage, become chronic, lead to cirrhosis, hepatocellular carcinoma and ultimately result in death due to their ability to spread in the community through blood and infected body fluids. The aim of this study was to determine the seroprevalence of hepatitis B (HBV), hepatitis C (HCV), and hepatitis D (HDV) transmitted through blood among individuals living in Trabzon province and to examine the factors potentially associated with seroprevalence. This cross-sectional study was conducted in Trabzon province, located in the northeast of Türkiye, including a total of 10 districts, including the central district. Since seroprevalence was calculated for HBV, HCV, and HDV in the study, the sample size was separately calculated for each, and the calculated maximum sample size of 1116 was accepted as the minimum sample size for the study. The study was completed with 1502 participants. Serological tests for HBV included HBsAg, anti-HBs, and anti-HBc IgG; for HCV, anti-HCV; and for HDV, anti-HDV were analysed. Data were evaluated for HBV risk factors using univariate analyses with Chi-square test and for multiple analyses using enter model logistic regression analysis. The mean age of the participants was 45.7 ± 16.6 years, with 767 (51.1%) being female. The prevalence of HBV seropositivity, indicating vaccination, was 23.0%, while the seroprevalence of HBV among unvaccinated adults was 27.4%. HBsAg positivity was 5.1%, and isolated anti-HBc IgG positivity was 4.2%. The proportion of individuals with HBsAg in the gray zone was 0.5%, while the positivity rates for anti-HBs and anti-HBc IgG (indicating past infection) were 17.6%. The prevalence of anti-HCV was six per thousand, while anti-HDV was not detected in the analyses. HBsAg positivity and co-infection with HCV were found in one person, and among the nine individuals positive for anti-HCV, isolated anti-HBc IgG positivity was detected in three. Increasing age, presence of a person with jaundice in the family, presence of diabetes mellitus, alcohol use and cupping therapy were identified as risk factors for HBV in the logistic regression analysis. Risk factors for HCV in univariate analyses were being over 40 years old, presence of hepatic steatosis and receiving dialysis treatment. The results of the study indicate that despite being included in our vaccination schedule and the administration of vaccines to high-risk adults, HBV still requires intensive attention as a public health problem. HCV, lacking a vaccine has been evaluated as an infectious agent that needs to be taken into consideration due to its potential risks and requires the complete implementation of individual and social precautions.

Evaluation of the cytotoxic and genotoxic/antigenotoxic effects of resveratrol in human limbal explant cultures.

PURPOSE: Resveratrol (RSV) is a natural polyphenol phytoalexin compound and has long been considered to possess antioxidant and anti-inflammatory effects. In order to exploit the protective potential of RSV in anterior segment diseases, we investigated the possible cytotoxic, genotoxic/antigenotoxic effects of human limbal explant cultures to RSV and MMC or H2O2 alone and in combination. METHODS: A total of 18 limbal explant tissues obtained from three corneal donors were placed on the 12 well tissue culture polystyrene plates and cultured for 14 days. Cell growth from limbal explants was observed by inverted phase contrast microscopy. The cytotoxic effects of RSV was studied by neutral red uptake assay. For the assessment of the genotoxic and antigenotoxic effects, basic alkaline technique of comet assay was performed. RESULTS: It was found that the concentrations of RSV up to 100 µM did not significantly affect the viability of outgrowth cells of limbal explant during 24 h exposure. When compared to negative control, all concentrations of RSV alone caused an increase in DNA strand breakage. Interestingly, 10 µg/mL MMC alone caused similar tail intensity and tail moment values with RSV alone. On the other hand, RSV treatment in all doses seemed to decrease the DNA damage induced by either H2O2 or MMC. CONCLUSION: RSV is an attractive natural compound for the purpose of oxidative stress reduction in ocular surface and can be utilized as a supplement to promote ocular surface regeneration in vivo.

Topographic and specular microscopic evaluation of cornea and meibomian gland morphology in children with isolated growth hormone deficiency.

PURPOSE: To evaluate whether the anterior segment topographic measurements, meibomian gland (MG), and non-invasive tear film break-up time (NITFBUT) differ between healthy children and children with isolated growth hormone deficiency (GHD). METHODS: A total of 74 eyes of 37 children with GHD and 84 eyes of 42 age- and sex-matched healthy children were included in the study. The spherical equivalence (SE), mean keratometry (Km), corneal thickness, corneal volume (CV), anterior chamber depth (ACD), topographic NITFBUT, qualitative and quantitative MG measurements, corneal endothelial cell density (CD), and proportion of hexagonal cells (HG) were analysed. RESULTS: The mean SE level of GHD group was similar between groups (p = 0.017). Back Km values were insignificantly steep in children with GHD (p = 0.004, with Bonferroni correction). Specular microscopy analysis was not different between groups. MG loss of GHD group were higher than control group (p < 0.001). The MG morphology analysis and distortion grade were not different between groups (p > 0.05). CONCLUSIONS: Our results showed that the growth hormone (GH) may have an important role on the anterior segment parameters; however, it is not clear that this misregulation leads to a clinical scenario in childhood. Future studies investigating GHD and/or GH therapy on the ocular surface system are required to clearly demonstrate basic mechanism of GH action.

Quantitative analysis of macular and peripapillary microvasculature in adults with anisometropic amblyopia.

INTRODUCTION: The aim of this study was to compare the macular and peripapillary capillary vessel density (CVD) and foveal avascular zone (FAZ) in amblyopic eyes of adults with their fellow eyes and with eyes of healthy controls using optical coherence tomography-angiography (OCT-A). METHODS: A total of 34 eyes of 17 patients with anisometropic amblyopia and 80 eyes of 40 age- and gender-matched healthy controls were included. CVD in superficial (SCP) and deep retinal capillary plexuses (DCP), peripapillary region, and FAZ were analyzed by OCT-A. RESULTS: The median ages were 31 years (range 20-64) in patients with amblyopia and 34.5 years (range 24-65) in healthy controls (p = 0.242). The mean FAZ area measured was 0.329 ± 0.024 mm2 in amblyopic eyes, 0.332 ± 0.025 mm2 in fellow eyes, and 0.269 ± 0.015 mm2 in control eyes (p < 0.05). The amblyopic eye of participants showed a decrease in CVD of SCP and DCP (p < 0.001, for all). The inside optic disk CVD measurements were lower in the amblyopic eyes than in the fellow eyes (p = 0.001) and healthy subjects (p = 0.015). CONCLUSION: Significant differences in macular and peripapillary microvasculature were found in anisometropic amblyopic patients. The clinical significance of the results requires further investigation.

A simple and efficient method for cultivation of limbal explant stem cells with clinically safe potential.

BACKGROUND: Several methods to cultivate limbal epithelial stem cells (LESCs) in vitro with the support of feeder layers and different growth medium formulations have been established for several years. The initial green medium consists of various ingredients that exhibit a non-optimal level of biosafety, therefore, different modifications have been made to suit it to safe clinical applications. However, the question of which formulation is the most appropriate remains to be answered. AIMS: This study evaluated the outgrowth kinetics and stemness of cells cultured from human limbal explants with the aim of preserving LESC characteristics in the human-derived platelet-rich fibrin (HPRF)-conditioned medium with no feeder cell layer or carrier for the first time. The final composition of the cell culture system included only human-derived products without any xenobiotic or chemical substances to minimize the potential risk for human health, which will be useful for clinical purposes. METHODS: To test our hypothesis, limbal explants were incubated with either Dulbecco's Modified Eagle's Medium (DMEM)/F12-10% human serum (HS), human-derived amniotic membrane (HAM)-conditioned DMEM/F12-10% HS or HPRF-conditioned DMEM/F12-10% HS to determine whether outgrowth kinetics and stemness of cells show any differences among groups. RESULTS: The results showed that the HPRF-conditioned medium showed higher concentration levels of growth factors, which may be involved in the promotion of LESC expansion while preserving the stem cell characteristics. HPRF-conditioned medium had significantly superior capacity to enhance the cell growth rate, the stem/progenitor cell phenotype and the expressions of putative stem cell markers. CONCLUSION: This novel xeno-feeder-chemical-free, completely human-derived and biologically safe culture system including HPRF and HS would be of interest to replace conventional cell culture strategies to meet safety requirements mandatory for clinical use in humans.

An assessment of ocular elasticity using real time ultrasound and ocular response analyzer in active or remission rheumatoid arthritis.

PURPOSE: To investigate the elasticity of ocular structures in patients with rheumatoid arthritis (RA) without ocular involvement. METHODS: The study included 56 RA patients (study group) and 24 healthy volunteers as the control group. The rheumatoid arthritis patients were divided into two subgroups as those in active phase (Group 1, n = 25) or in remission phase (Group 2, n = 31) according to the disease activity index (DAS 28) score. The elastography values of the ratio of orbital fat-sclera (ROF/S) were measured with real-time US elastography, and corneal mechanical values were measured with the Reichert Ocular Response Analyzer in each eye. RESULTS: The mean ROF/S value was 5.2 ± 1.8 in Group 1, 0.7 ± 0.4 Group 2, and 0.6 ± 0.1 in the control group. There was a significant difference between the Group 1 and control group with regard to ROF/S (p < 0.001), but no significant difference was determined between Group 2 and control group (p > 0.05). The mean ROF/S value was a significant difference between the Group 1 and 2 (p < 0.001). ROF/S was significantly correlated with DAS-28 and C-reactive protein (CRP) (r = 0.816, p < 0.001 and r = 0.259, p = 0.006). CONCLUSIONS: ROF/S was significantly increased in patients in the active phase of RA. Findings revealed that ocular tissue structural changes may occur in the active phase and these could be related to ocular complications as a prognostic factor.

A completely human-derived biomaterial mimicking limbal niche: Platelet-rich fibrin gel.

Platelet-rich fibrin (PRF) is a natural biomaterial and has excellent biochemical and physical properties with a history of proven biocompatibility in the field of tissue engineering and regenerative medicine. Recent reports of fibrin-based matrices have offered new opportunities to apply PRF as a supplement for in vitro cell culture. Here, custom-modified human-derived PRF (HPRF) was produced via different centrifugation protocols, then, characterized by morphologically and chemically and utilized as a substrate and as a conditioned medium for limbal explant culture for the first time. It was found that the HPRF released significantly higher levels of growth factors which are essential for epithelial cell growth. The enhanced physicochemical properties of the HPRF were also proven in the limbal explant cultures in terms of cell growth, migration, viability, and stemness in comparison with the conventional limbal explant culture on human-derived amniotic membrane. Consequently, HPRF hydrogels are appealing natural biomaterials for the purpose of mimicking limbal niche and the discovery elucidates this new, xeno-chemical-free, completely human-derived biomaterial can be utilized as a supplement to promote epithelial cell behaviour in vitro.

Outcomes of corneal collagen crosslinking using a customized epithelial debridement technique in keratoconic eyes with thin corneas.

The purpose of the study was to evaluate the outcomes and possible complications of CXL performed with customized epithelial debridement technique to keratoconic corneas with the thinnest pachymetry values less than 400 µm. Nineteen eyes of 19 patients were included. The uncorrected (UCVA) and best corrected visual acuity (BCVA), flattest and steepest keratometric (K) readings, central corneal thickness at the thinnest point (t-CCT), endothelial cell density (ECD) were assessed before and 12 months after CXL. The mean UCVA was increased (p = 0.001), while the mean BCVA did not show any difference (p > 0.05). The mean flattest and steepest K readings were decreased (p = 0.001). No change was observed in the mean t-CCT (p > 0.05). The mean ECD was decreased (p = 0.001). The mean pre-CXL and post-CXL percentages of polymegathism and pleomorphism did not show any significant difference (p > 0.05). CXL performed with customized epithelial debridement technique is successful in halting the progression of keratoconus in corneas thinner than 400 µm after 12 months of treatment. However, significant endothelial cell loss can occur after this procedure.

Corneal Biomechanical Properties in Rheumatoid Arthritis.

PURPOSE: To investigate the variations in biomechanical properties of the cornea in rheumatoid arthritis (RA) patients. METHODS: A total of 53 RA patients, and 25 healthy individuals (control group) were enrolled. Rheumatoid arthritis patients were classified as in active phase (group 1; n=24) or in remission phase (group 2; n=29). Corneal biomechanical parameters including corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Reichert Ocular Response Analyzer. Topographical measurements, including central corneal thickness (CCT), anterior chamber depth, iridocorneal angle, and corneal volume were measured using a Sirius corneal topographer. RESULTS: The mean CH was 9.43±1.17 mm Hg in group 1, 9.42±1.84 mm Hg in group 2, and 10.47±1.68 mm Hg in the control group (P=0.03). The mean IOPcc was 17.85±3.2 mm Hg in group 1, 17.95±3.49 mm Hg in group 2, and 15.36±3.11 mm Hg in the control group (P=0.008). The CH showed a significant positive correlation with CRF (P=0.000, r=0.809) and CCT (P=0.000, r=0.461), and a significant negative correlation with IOPcc (P=0.000, r=-0.469). CONCLUSIONS: Decrease in the mean CH measurements indicates that ultrastructural changes in the cornea may occur in the active phase, and these changes persist in the remission period. In addition, IOPcc is significantly affected by the corneal biomechanical properties. In RA patients, it is important to control the corneal parameters and IOP measurements against the irreversible changes on the optic nerve.

The effect of antihypertensive therapy on dry eye disease.

CONTEXT: There is a generalization that "antihypertensive (antiHT) therapy causes Dry Eye Syndrome", which has been claimed for years however most of the publications are epidemiological studies. We performed a clinical study to investigate the effects of antiHT agents on tear function. OBJECTIVE: The aim of this article is to evaluate the effects of different classes of antiHT medications on tear osmolarity, ocular surface problems and dry eye symptoms. MATERIALS AND METHODS: Prospective, non-randomized a clinical study. A total of 71 patients who would be initiated antiHT medication due to elevated systemic blood pressure were included in the study. Thirty of these patients were given antiHT drugs containing diuretic (diuretic +), and 41 of them were given diuretic-free drugs (diuretic -). While the number of the patients medicated in the group that received Angiotensin Converting Enzyme inhibitors (ACE inh)/Angiotensin receptor blockers (ARB) (ACE/ARB +) was 29, the number of those medicated in the ACE/ARB-free group (ACE/ARB -) was 42. Ocular surface disease index scores, tear osmolarity, Schirmer I test, tear film break-up time (TBUT), fluorescein (FL) and rose bengal corneal staining patterns of the patients were analyzed. The patients were examined through the repetition of all the tests in the 1st and the 3rd month. RESULTS: The participants (n = 71) comprised 38 males and 33 females with a mean age of 51.8 ± 10.4. When the first (0-1st month) and the third month (0-3rd months) control measurements between diuretics (+) and diuretics (-) groups before and after antiHT therapies were compared, a statistically significant difference was not found in any of the tests applied. When the 0-1st month measurements of ACE/ARB (+) and ACE/ARB (-) groups were compared, it was observed that staining with FL in ACE/ARB (+) group decreased in a statistically significant manner (p = 0.035) and there was a significant increase in TBUT values (p = 0.022). DISCUSSION AND CONCLUSION: The use of antiHT drugs containing diuretic had no adverse effect on the tear function tests, but using drugs that contain ACE/ARB could have a positive impact.

Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status.

OBJECTIVES: The aim of the study was to assess seasonal prevalence of vitamin D deficiency according to sex and to determine the relations between serum levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) and sociodemographic characteristics in otherwise healthy schoolchildren during spring and autumn. METHODS: In a cross-sectional study, 746 healthy students aged between 11 and 18 years were recruited during spring (n = 375) and autumn (n = 371). Sociodemographic data were collected by a questionnaire. Serum 25(OH)D, PTH, calcium, phosphate, and alkaline phosphatase were measured. Serum 25(OH)D levels were categorized as <50 nmol/L (vitamin D deficiency) and <25 nmol/L (severe deficiency). RESULTS: Mean ± standard deviation 25(OH)D levels were 22.3 ± 10.5 nmol/L in girls and 28.5 ± 17.0 nmol/L in boys during spring (P < 0.001) and 36.5 ± 20.3 nmol/L in girls and 45.0 ± 18.5 nmol/L in boys during autumn (P < 0.001). The prevalence of vitamin D deficiency was 93% during spring and 71% during autumn. There was a negative correlation between 25(OH)D and PTH levels (P < 0.01). We determined a cutoff point of serum 25(OH)D in which the mean serum PTH concentration began to increase as 35.8 nmol/L (P < 0.0001). The age, sex, and calcium level were found to be independent predictors for vitamin D deficiency. CONCLUSIONS: Vitamin D deficiency is prevalent among healthy schoolchildren. It is noteworthy that 25(OH)D levels were significantly lower in girls and during autumn. We recommend vitamin D supplementation for children in addition to more time spent for outdoor activities for sensible sunlight exposure.

Factors associated with early hospital arrival in acute ischemic stroke patients.

Early diagnosis and treatment in acute ischemic stroke are crucial in terms of survival and disability. Many stroke patients remain disabled because of the treatment delay. The purpose of this study was to investigate the factors associated with the early hospital arrival in acute ischemic stroke patients. 113 patients diagnosed with acute ischemic stroke were included in this prospective study performed at the Karadeniz Technical University Medical Faculty Hospital. Patients' characteristics and patients' and relatives' emotional and behavioral reactions were compared between early (within 3 h) and late (after 3 h) arrival groups. 72.6 % of patients arrived at hospital within 3 h from symptoms onset. Univariate analysis revealed that history of atrial fibrillation (p = 0.04) and coronary heart disease (p = 0.02), sudden onset of symptoms (p = 0.001), loss of consciousness (p = 0.03), recognizing symptoms as stroke (p = 0.01), seeking immediate medical attention (p < 0.001), feelings of fear and panic (p = 0.001), arriving at hospital by ambulance having called the emergency medical services (p = 0.04) and National Institute of Health Stroke Scale (NIHSS) score (p = 0.001) were associated with hospital arrival within 3 h. A multivariate regression model demonstrated that recognizing symptoms as stroke (OR, 3.4; 95 % CI, 1.2-9.3) and atrial fibrillation (OR, 4.3; 95 % CI, 1.1-15.7) were independent factors associated with early arrival. The role in early arrival at hospital of recognizing symptoms as stroke and seeking immediate medical attention with transportation by ambulance emphasize the importance of public awareness concerning recognizing the symptoms of stroke and accessing emergency medical assistance.

Energy drink use in university students and associated factors.

The use of energy drinks is common among adolescents and young age groups. The purpose of this study was to determine energy drink consumption status in students at the Karadeniz Technical University in Turkey and the factors affecting this. The research was performed at the Karadeniz Technical University among a total of 2001 students attending the Administration Department, the Physical Education Department, the Psychological Counseling and Guidance Department and the Faculty of Medicine. The research data were collected using the supervised questionnaire method. The 53.5 % (n = 1070) of students had never tried energy drinks, 22.5 % (n = 450) had tried them once only, 1.5 % (n = 30) had used them for a time and then gave up, 21.1 % (n = 422) consumed occasionally and 1.4 % (n = 29) regularly. The risks of regular energy drink consuming were male gender [2.4 (1.8-3.2)] [OR (95 %CI)], studying at night [1.6 (1.2-2.2)], having friends consuming energy drinks [3.6 (2.6-5.0)], regular physical activity [1.9 (1.4-2.5)], being an alcohol drinker [2.4 (1.7-3.2)]. This study revealed that almost half of university students had experience of energy drinks and that approximately one-fourth still used them. It will be useful for these factors listed above to be borne in mind in the development of policies aimed at protecting young people from the health impacts of energy drinks.

[Fungal keratitis caused by Scedosporium apiospermum: first report from Turkey]. / Scedosporium apiospermum'a Bagli Fungal Keratit: Ülkemizden Ilk Olgu.

Fungal keratitis, an eye infection with poor prognosis, is difficult to treat and can lead to loss of vision. Among filamentous fungi Scedosporium spp. rarely lead to fungal keratitis. Here we present a case of keratitis caused by Scedosporium apiospermum. A 61-year-old female patient was admitted to our hospital with the complaints of right eye pain and decreased vision after a foreign body trauma to the right eye. The patient was diagnosed as keratitis by biomicroscopic examination. Conjunctival swabs collected from both eyes were inoculated onto sheep blood agar, chocolate agar, eosin methylene blue agar and Sabouraud dextrose agar. Corneal scrapings from the right eye were inoculated onto the same solid media by "C-streak" method, and in brain-heart-infusion broth by immersion. While gram-stained smears of conjunctival swabs showed no significant finding, smears of corneal scrapings revealed abundant neutrophils and profuse septate hyphae. Fungal keratitis was diagnosed and topical enhanced amphotericin B (0.5 mg/ml) therapy was initiated with netilmicin sulfate and oxytetracycline HCl plus polymyxin B sulfate. At the 10th day of therapy a mold growth was detected in corneal scraping cultures and was identified microscopically as S.apiospermum. Based on the relevant literature, therapy was changed to enhanced topical voriconazole (2 mg/ml) applied hourly, plus systemic voriconazole administration. At the third day of treatment, reduction of epithelial defect and decline in the focus of keratitis were observed. In the following days, however, a progression occurred in the focus of keratitis and 5% natamycin ophthalmic suspension was added to the therapy. Since the patient did not respond to any of the medical treatments, therapeutic penetrating keratoplasty was planned; yet, the patient refused the operation and was discharged with her own request. As far as the local literature was concerned, this is the first report of keratitis caused by S.apiospermum in Turkey. Though a very rare causative agent of keratitis, S.apiospermum is generally resistant to antifungal therapy and often require surgical treatment. Especially in patients with predisposing factors, this organism should be kept in mind as a potential causative agent and relevant microbiological examinations should be performed.

The Relationship between Visual-Evoked Potential and Optic Coherence Tomography and Clinical Findings in Parkinson Patients.

Background: In Parkinson's disease (PD), dopamine deficiency is present not only in the nigrostriatal pathway but also in the retinal and visual pathways. Optic coherence tomography (OCT) can be used as morphological evidence of visual influence from early nonmotor symptoms. The aim of this study was to investigate the relationship of OCT and visual evoked potentials (VEPs) of eyes with the severity of clinical findings and ocular findings in PD. Methods: A group of 42 patients diagnosed with idiopathic PD and a control group of 29 people between the ages of 45-85 were included in our study. VEP was recorded in the patient and control groups. OCT measurement was made with the Optovue spectral-domain device. Foveal thickness and macular volume were measured in the foveal region and in the parafoveal and perifoveal regions in the temporal, superior, nasal, and inferior quadrants. RNFL (retinal nerve fiber layer) was measured in temporal, superior, nasal, and inferior quadrants. Ganglion cell complex (GCC) was evaluated in the superior and inferior quadrants. Using the UPDRS clinical scale, the relationship between measurements and the differences between the control group and the patient group were evaluated. Results: Among the OCT values in our study, foveal, parafoveal, perifoveal thickness, macular volume, RNFL, and GCC measurements were performed for the right and left eyes, and no difference was found between the patient group and the control group. There was no difference in VEP amplitude and latency values between the patient and control groups. The relationships between UPDRS and modified Hoehn Yahr staging and OCT and VEP measurements in the patient revealed no correlation. Conclusions: Studies on whether OCT measurements can functionally be a marker or which segments are more valuable for disease progression in patients with PD are needed. Visual dysfunction in PD cannot be attributed only to retinal pathology; however, the retina may provide monitoring of the status of dopaminergic neurodegeneration and axonal loss in PD.

Evaluation of Retinal Vessel Density and Foveal Avascular Zone in Unilateral Exudative Choroidal Neovascularization by Optical Coherence Tomography Angiography.

Objectives: To evaluate treatment-naïve patients with neovascular-exudative age-related macular degeneration (eARMD) in one eye and early-/intermediate-stage nonexudative ARMD (neARMD) in the fellow eye by optical coherence tomography-angiography (OCTA). Methods: A total of 70 eyes of 35 patients (17 females) with first diagnosis of eARMD in one eye and early/intermediate-stage neARMD in the fellow eye were included in this study. The eARMD diagnosis was confirmed by fluorescein angiography. Each subject underwent OCTA imaging by RTVue XR Avanti OCT device. Capillary vessel density (VD) of superficial (SCP) and deep (DCP) retinal capillary plexuses and foveal avascular zone (FAZ) parameters were measured. Results: The mean age was 72.0±8.9 years (range 59-87). The mean visual acuity was 0.7±0.5 logMar for the eARMD eyes and 0.4±0.3 logMar for the fellow eyes (p=0.012). Nineteen patients (54.3%) had occult choroidal neovascularization (CNV), and 16 patients (45.7%) had classical CNV. The mean FAZ area was measured 0.30 ± 0.11 mm2 in the eARMD eyes and 0.27±0.11 mm2 in the fellow eyes (p=0.387). The FAZ circularity index measurement was 1.15±0.03 in eARMD eyes and 1.11±0.05 in the fellow eyes (p=0.014). There was no statistically significant difference in any measure of the macular SCP and DCP's VD between eARMD eyes and their fellow eyes. Conclusion: Potential retinal vascular alterations will be important in ARMD pathogenesis.

The Psychosocial Effects of Noise Level in Hydroelectric Power Plants on Employees.

Background: This cross-sectional study was conducted to investigate the psychosocial effects of noise on employees in Hydroelectric Power Plants in Turkey. Methods: The study was conducted in 2018, in operating Hydroelectric Power Plants located in the city of Artvin in Turkey with 110 employees. Data were collected by performing noise measurement, blood pressure measurement and using descriptive characteristics form and Depression, Anxiety and Stress Scale. Results: The average personal noise of the sample was 72.3±0.8 dB(A). The blood pressure of the employees were within normal limits. There was no significant difference between the noise levels and the sub-dimensions of the scales used. Conclusion: The measured mean noise of the sample was within normal limits as per the regulations regarding the protection of employees from noise. Measured BP means of employees during working and resting hours were within normal limits. DASS-42 subscale scores exhibited no difference depending on the noise level.