The effect of intravitreal dexamethasone implant on central foveal thickness and choroidal thickness in retinal vein occlusion.

AIM: To investigate the effect of intravitreal dexamethasone implant on central foveal thickness and choroidal thickness in retinal vein occlusion. MATERIALS AND METHODS: Clinical records and optical coherence tomography (OCT) scans of 41 naïve patients with retinal vein occlusion (RVO), who were initially treated with intravitreal dexamethasone (DEX) implant between 2016 and 2017 at Kocatepe University Faculty of Medicine, Department of Ophthalmology were investigated. Collected data included age and sex of the patients, crystalline lens status, baseline and final intraocular pressure, and OCT parameters including central foveal thickness and choroidal thickness. RESULTS: Twenty-two (53.7%) female and 19 (46.3%) male patients were enrolled in the study. There were 30 phakic and 11 pseudophakic patients. The intraocular pressure increased significantly from 15.19 mmHg to 17.8 mmHg (P = 0.005), and cataract extraction was performed in two patients who developed cataract after the treatment. There was a significant decrease in the central foveal thickness from 556 µm to 288 µm (P < 0.001). In addition, although there was no statistically significant change in choroidal thickness in the patients with branched retinal vein occlusion (P = 0.423), the patients with central retinal vein occlusion had statistically significant decrease in choroidal thickness measurements (P = 0.049). CONCLUSION: Therapeutic effect of the DEX implant not only influences retinal layer. Its influence may also extend further to the choroid layer, thereby leading to decrease in the choroidal thickness. Our results were mostly similar to the results of studies in literature which investigated the effects of the DEX implant therapy on the choroidal thickness of the patients with RVO.

Consequences of seasonal allergic conjunctivitis on ocular parameters of anterior and posterior segments: An up-to-date imaging approach.

AIMS: To investigate consequences of seasonal allergic conjunctivitis (SAC) on the ocular anterior and posterior segment parameters. MATERIALS AND METHODS: Forty healthy participants (mean age: 25.90 ± 5.7 years, 20 females, 20 males) and 40 patients with SAC (mean age: 26.20 ± 5.7 years, 20 females, 20 males) were included in this prospective study. The anterior segment parameters including central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by Scheimpflug imaging system. Axial length (AL) was measured by optical biometry. The posterior segment parameters, including retinal nerve fiber layer (RNFL), subfoveal choroidal thickness, and central macular thickness were measured by optical coherence tomography. RESULTS: Similar values of the ACD, AL, RNFL as well as central macular thickness between healthy participants and patients with SAC were revealed. Despite the CCT being thinner in SAC, there was no statistically significant difference between the two groups. On the other hand, SAC was found to be associated with an increase in subfoveal choroidal thickness, the condition of which may be attributed to the inflammatory nature of the disease. CONCLUSION: The present study has managed to demonstrate non-significant alterations in the ocular anterior and posterior segment parameters of patients with SAC. Yet, the increase in subfoveal choroidal thickness may be linked to the accompanying inflammation of both the conjunctiva and other ocular tissues, particularly the choroidal layer.

Results of the switch from intravitreal ranibizumab to intravitreal aflibercept therapy in patients with neovascular age-related macular degeneration: A 42-month retrospective real-world study.

AIM: The study aimed to evaluate the functional and anatomical results of patients treated with intravitreal ranibizumab (IVR) for neovascular age-related macular degeneration (n-AMD) but switched to intravitreal aflibercept (IVA) treatment due to insufficient response treatment. MATERIAL AND METHODS: At least six doses of n-AMD were administered IVR to 33 patients who were switched to IVA treatment due to insufficient response and were included in the study. The patients were evaluated at the beginning of the IVR treatment during the transition to IVA treatment and at 6, 12, 18, 24, 30, 36, and 42 months of IVA treatment. RESULTS: After an average of 10.1 ± 5.04 IVR injections, the patients who were accepted as insufficient response were treated with IVA. The central macular thickness of the patients was evaluated at the beginning of the treatment, immediately before, and after the initiation of IVA treatment at 6, 12, 18, 24, 30, 36, 42 months. It was as follows: 325.21 ± 123.04, 351.42 ± 126.09, 284.81 ± 112.65, 296.68 ± 89.17, 282.61 ± 81.58, 292.27 ± 109, 92,269.75 ± 97.14, 267.50 ± 87.56, and 266.82 ± 88.35 µm. According to the best-corrected visual acuity (BCVA), it was initially 0.89 ± 0.65; 1.08 ± 0.53 during the transition to IVA; 0.91 ± 0.46 6 months after IVA; 12th 1.14 ± 0.59; 0.94 ± 0.55 at 18th; 1.07 ± 0.49 at 24th; 1.15 ± 0.57 at 30th; 1.06 ± 0.45 at 36th, and 1.13 ± 0.46 LogMAR ( Logarithm of the Minimum Angle of Resolution) at the 42nd month. CONCLUSION: In conclusion, in n-AMD patients with inadequate response to intravitreal ranibizumab or with relapse, and therefore, switched to aflibercept treatment, the anatomical improvement and sustainment were observed, however, functional recovery could not be achieved.

Evaluation of thiol-disulfide homeostasis in pseudoexfoliation glaucoma and primary open-angle glaucoma.

AIMS: This study aimed to compare the serum thiol-disulfide homeostasis, total antioxidant status (TAS), and total oxidant status (TOS) in patients with pseudoexfoliation glaucoma (PEG) patients, primary open-angle glaucoma (POAG) patients, and healthy individuals (control). METHODS: Ninety subjects were included in this study. Three groups were separated as PEG, POAG, and control. All groups were chosen to be similar in terms of age and gender. Blood samples were obtained following an overnight fasting state and were collected on the ice at 4°C. The serum samples were separated from the cells by centrifugation at 3000 rpm for 15 min and were stored at -80°C. Serum samples analyzed for TAS and TOS, native thiol, total thiol, disulfide, and native thiol/disulfide ratio. RESULTS: TAS and TOS levels of PEG patients were 1.2892 ± 0.0905 mmol/L; 5.0191 ± 2.7722 µmol/L, respectively. TAS and TOS levels of POAG patients were 1.2741 ± 0.1252 mmol/L; 4.1674 ± 1.7723 µmol/L, respectively. TAS and TOS levels of the control group were 2.3414 ± 0.1409 mmol/L; 4.0931 ± 0.1107 µmol/L, respectively. The TAS level was significantly lower in PEG and POAG groups compared to control. TOS level showed no significant differ ¬ ence between PEG, POAG, and control groups (P > 0.05). The mean serum total thiol and native thiol levels were significantly lower in patients with PEG compared to POAG and control group; there was no significant difference between the POAG and control group (P > 0.05). The mean serum disulfide level was significantly lower in patients with PEG compared to POAG (P = 0.018). CONCLUSION: Low levels of TAS were observed in patients with glaucoma, which was likely a response to the increased oxidative stress observed in these patients. While total thiol and native thiol levels were higher in the PEG group, the disulfide level was higher in the POAG group. TAS and TOS levels showed no significant difference between POAG and PEG groups.

Analysis of corneal astigmatism with NIDEK axial length scan in caucasian cataract surgery candidates.

AIMS AND OBJECTIVES: The aim of the study was to analyze and quantify the pattern of corneal astigmatism in Caucasian cataract surgery patients using a new optical biometer (axial length [AL] Scan, NIDEK Co., Gamagori, Japan). PATIENTS AND METHODS: The datasets of cataract surgery patients acquired between March 1, 2014, and April 15, 2016, were collected and analyzed. The corneal power (flat keratometry, steep keratometry, and mean keratometry), negative cylinder power, and axis of astigmatism were recorded. Keratometry values were optically measured by optical low coherence interferometry (AL-Scan, NIDEK Co., Ltd.,) before cataract extraction. RESULTS: The study comprised 1233 eyes of 838 consecutive cataract candidates with a mean age of 66.8 ± 10.7 years (range 40-97 years). The mean keratometry value and corneal astigmatism were 43.69 ± 1.61 D and 0.84 ± 0.70 D, respectively. Corneal astigmatism of 1.00 D or greater was found in 344 eyes (27.9%), and 548 eyes (44.4%) had against-the-rule astigmatism. A trend toward decreasing J0 and J45 with age was found by linear regression models. The per-year increase in age was associated with a J0 and J45 decrease of 0.002 D and 0.001D, respectively. CONCLUSION: This study provides the distribution of astigmatism axis and power for cataract patients in age subsets from Turkey.

Do SGLT2 inhibitors prevent preclinical diabetic retinopathy? A Prospective Pilot Optical Coherence Tomography Angiography Study.

PURPOSE: To evaluate the effects of metformin alone and combined treatment with metformin and an SGLT2 inhibitor on retinal microvascular morphology using optical coherence tomography angiography (OCTA) in isolated type 2 diabetes mellitus (DM) patients with HbA1c above the expected target (>7%). METHODS: Fifty patients with isolated DM, 7%