Evaluation of Dry Eye Disease Characteristics of Children With Type 1 and Type 2 Diabetes Mellitus and MODY.

PURPOSE: To assess dry eye disease characteristics of pediatric patients with diabetes. METHODS: Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed. RESULTS: In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group. CONCLUSIONS: Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.

Development of posttraumatic stress disorder and depression after open globe injury in adults.

PURPOSE: To investigate the prevalence of posttraumatic stress disorder (PTSD) and depression after open globe injury in adults. METHODS: A total of 95 participants, 43 adult patients with open globe injury and 52 age-sex similar subjects (control group), were included in this cross-sectional study. Age, gender, education level, occupation, accident history, psychiatric history, trauma type, cause of trauma, and visual acuity were recorded. One to six months after trauma, PTSD and depression symptoms of the participants were evaluated with the Posttraumatic Stress Disorder Questionnaire-Civil Version Scale (PTSD-S) and Beck Depression Inventory (BDI), respectively. RESULTS: Patients with open globe injury had a higher PTSD-S total score than the control group, but not significant (23.67 ± 20.41 vs. 18.56 ± 13.13, p = 0.580). Patients with eye trauma exhibited a much higher prevalence of PTSD compared to the control group (20.9% vs. 3.8%, p = 0.010). Patients with trauma had a significantly higher BDI total score than the control group (12.47 ± 10.08 vs. 7.69 ± 6.10, p = 0.015). Also, patients had a higher rate of depression symptoms than controls (25.6% vs. 7.7%, p = 0.017). A significant positive correlation was observed between PTSD-S and BDI scores in the trauma group (r = 0.720, p < 0.001). CONCLUSION: An increased prevalence of PTSD and depression was observed in adults after open globe injury. The significant relationship between PTSD-S and BDI scores indicates that patients with open globe injuries should be questioned in terms of both symptoms. For patients with open globe trauma, a holistic approach with psychosocial assessment in addition to physical intervention would be beneficial.

Changes in the macular choroidal thickness of children who have type-1 diabetes mellitus, with and without vitamin D deficiency.

PURPOSE: To assess the peripapillary retinal nerve fiber layer (RNFL) and macular choroidal thickness (CT) of children who have Type 1 diabetes mellitus (DM), both with and without vitamin D deficiency (VDD). METHODS: The prospective, case-control study herein comprised that included 46 children with DM and VDD (Group 1), 42 children with DM and normal vitamin D levels (Group 2), and 73 healthy children (Control group). The peripapillary RNFL thickness and macular CT were measured at three different points (subfoveal, 1500 µm nasal, and 1500 µm temporal from the fovea) and compared. RESULTS: The subfoveal, 1500 µm nasal, and 1500 µm temporal CT values were determined to be lower in the patients in Group 1 and Group 2 when compared to those in the Control group (P < 0.001). The same parameters were determined to be lower in the patients in Group 1 when compared to those in Group 2, although this difference was not found to be statistically significant (P > 0.05). In all of the quadrants, the RNFL thickness was determined to be similar between the groups, with P > 0.05 for all of the groups, except for the nasal quadrant (P = 0.031). In the correlation analysis of the patients in Group 1, it was revealed that a positive correlation existed between the CT and the vitamin D levels (P < 0.05). CONCLUSION: The choroids of pediatric diabetic children were thinner when compared to those of healthy children. The alterations in these parameters were more prominent in subjects who were determined to have lower levels of vitamin D.

Additive Effect of Topical Nepafenac on Mydriasis in Patients With Diabetes Mellitus.

OBJECTIVES: To evaluate the additive effect of topical nepafenac on pupil diameter (PD) in patients with diabetes mellitus (DM) and cataract. METHODS: This prospective comparative study included the patients having cataract surgery with and without DM. Two consecutive PD measurements were taken using an automatic quantitative pupillometry system (MonPack One, Metrovision). A baseline measurement was taken, then one drop of nepafenac % 0.1 (Nevanac; Alcon, Fort Worth, TX) was instilled only to the eye that will be operated on (study eye). Cyclopentolate 1.0% (Sikloplejin; Abdi Ibrahim, Istanbul, Turkey) was instilled to both eyes (study eye/fellow eye) 5 minutes later. The second measurement was taken at 1 hour after this application. RESULTS: The DM group consisted of 43 patients, and the control group consisted of 39 participants. The baseline PDs of both eyes were similar in the DM group (P=0.070) and the control group (P=0.345). The change in pupil size from baseline to mydriasis was statistically significantly greater in the study eyes (2.69±0.53) than fellow eyes (2.54±0.61) in the DM group (P=0.009), but there was no statistically significant difference in the control group (2.94±0.63 vs. 2.86±0.58). When the groups were compared, the PD changes were similar in the study eyes between groups (P=0.065), while the PD changes in the fellow eyes were lower in the DM group (P=0.017). CONCLUSIONS: Nepafenac has been shown additive effect on pupil dilation in diabetic patients before cataract surgery.

Postoperative eccentric macular holes after surgery for vitreomacular interface diseases.

PURPOSE: To assess the incidence, clinical characteristics, and outcome of postoperative eccentric macular hole (ECMH) after epiretinal membrane (ERM), macular hole (MH), and idiopathic vitreomacular traction (VMT) surgery and discuss the underlying possible mechanisms. METHODS: A retrospective study was carried out for 711 eyes of 711 consecutive patients who underwent 25-gauge pars plana vitrectomy (PPV) with ERM (396 eyes), MH (268 eyes), and VMT (47 eyes) surgery between 2010 and 2016. Mean follow-up time was 19 months. RESULTS: Eight patients developed ECMH (1.12%). Four of the patients were ERM, three patients were idiopathic full thickness MH, and one patient was ERM and lamellar pseudohole. There was no ECMH in patients with VMT. The average time of hole formation after vitrectomy was 7.25 weeks with a range from 2 to 15 weeks. Three patients developed 2 ECMH, and others had 1 ECMH. The location of the ECMH was mostly in the temporal of fovea. All patients were asymptomatic. No retinal detachment or choroidal neovascularization occurred in any patient and no additional intervention was attempted in the postoperative period in any case. CONCLUSION: Postoperative ECMH may be seen after vitreomacular interface surgery. They are mostly asymptomatic, usually do not require additional intervention and often located in the parafoveal area. ILM peeling-induced muller cell damage, residual ILM contraction, and iatrogenic trauma may play a role as the underlying cause in our case series.

Static and Dynamic Pupillary Responses in Patients with Different Stages of Diabetic Retinopathy.

This study aimed to investigate pupillary involvement in patients with type 2 diabetes mellitus (DM) and to evaluate whether there is a relationship between severity of diabetic retinopathy (DR) and pupillary responses. The study included 133 individuals in four groups: proliferative DR, non-proliferative DR, DM group without retinal involvement and a control group. Static pupillometry measurements including scotopic pupil diameter (PD), mesopic PD, low photopic PD, high photopic PD, and dynamic pupillometry measurements, including resting diameter, amplitude, latency, velocity, duration of pupil contraction and latency, duration, and velocity of pupil dilatation were taken using an automated quantitative pupillometry system. The correlations between glycosylated haemoglobin values and duration of DM with these parameters were also investigated. The study showed that patients with DR may also have diabetic autonomic neuropathy and pupillometry can be a useful screening tool for detecting diabetic autonomic neuropathy.

Intravitreal aflibercept for the treatment of choroidal neovascularization associated with rubella retinopathy.

PURPOSE: To report a case of choroidal neovascularization (CNV) associated with rubella retinopathy (RR) treated with intravitreal aflibercept. CASE PRESENTATION: A 15-year-old girl presented a complaint of visual decrease in her left eye. She had a history of hearing decrease since she was 1 year old in addition to patent ductus arteriosus. On ocular examination, the best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Dilated fundus examinations revealed a classic salt-and-pepper appearance in both eyes and a whitish subretinal lesion with retinal hemorrhages in the left macula. Fundus fluorescein angiography (FFA) of the left eye illustrated a pattern of diffuse spotty fluorescence with an active subfoveal CNV lesion, that hyperfluoresces in the early phases of the FFA, maintains well-demarcated borders, and leaks. Spectral domain optical coherence tomography (SD-OCT) revealed thickened and elevated retinal layers at the macula due to the subretinal and intraretinal fluid with foveal and extrafoveal protruding hyper-reflective lesion in the left eye. Single dose of intravitreal aflibercept was performed to the left eye and at the first month after the injection, the BCVA improved to 20/100 and the OCT revealed scar formation. At the follow-up visits, the macula was similar to those at the first month post-injection, and the BCVA was preserved. No additional injections were needed. CONCLUSION: Intravitreal aflibercept may be a treatment alternative, which provides satisfactory anatomical and functional results and leads to a better visual acuity in cases with RR complicated by CNV.

Quantification of macular perfusion following panretinal photocoagulation for diabetic retinopathy: An optical coherence tomography angiography study.

PURPOSE: To assess the effects of panretinal photocoagulation (PRP) on the microvascular structure of the macula and central thickness of the macula and choroid via optical coherence tomography angiography (OCTA). METHODS: In this prospective clinical study, 43 eyes of 31 patients with severe non-proliferative diabetic retinopathy or early proliferative diabetic retinopathy were included. Before and at the third and sixth months after PRP, the foveal avascular zone (FAZ) area, acircularity index (AI), foveal density (FD), and vascular density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were evaluated using OCTA. The central macular thickness (CMT) and subfoveal choroidal thickness (SCT) were also measured after PRP. RESULTS: There was no difference between the FAZ area, AI, FD, and vessel density of the SCP and DCP before and at the third and sixth months after PRP (all p>0.05). The CMT value was higher at the third and sixth months than at baseline (p = 0.002 and p = 0.001, respectively). The SCT value was lower at the third and sixth months than at baseline (p = 0.002 and p = 0.001, respectively). CONCLUSION: PRP is a beneficial and reliable method that supports the integrity of the macular microvascular structure. After PRP, the CMT increases, and the SCT decreases.

Evaluation of Choroidal Vascular Structure in Hyperopic Anisometropic Amblyopia.

Objectives: The aim of the study was to investigate the choroidal structure of patients with anisohypermetropic amblyopia compared to that of healthy eyes in controls of the same age. Methods: The study comprises three groups: One group was the amblyopic eyes of patients with anisometropic hypermetropia (AE group), another group was the fellow eyes of patients with anisometropic hypermetropia (FE group), and a final group of healthy controls. Both the choroidal thickness (CT) and choroidal vascularity index (CVI) values were obtained using the spectral-domain optical coherence tomography (OCT) method of improved depth imaging (EDI-OCT; Heidelberg Engineering GmbH, Spectralis, Germany, Heidelberg). Results: This study included 28 anisometropic amblyopic patients (AE and FE groups) and 35 healthy controls. Regarding the distribution of ages and sexes (p=0.813 and p=0.745), the groups were the same. The mean best-corrected visual acuity in AE, FE, and the control group was 0.58±0.76, 0.008±1.30, and 0.004±1.20 logMAR units, respectively. There was a significant difference in terms of CVI, luminal area (LA), and all the CT values between groups. Post hoc univariate analyses indicated that CVI and LA were significantly higher in AE compared to FE and the control group (p<0.05, for each). The temporal, nasal, and subfoveal CT values were considerably higher in AE compared to FE and the control groups (p<0.05, for each). However, there was no difference between FE and the control group (p>0.05, for each). Conclusion: The AE group had larger LA, CVI, and CT values compared to the FE and control groups. These results show that choroidal changes in amblyopic eyes in children are permanent in adulthood if untreated and are involved in the pathogenesis of amblyopia.

Comparison of radial peripapillary capillary density results of individuals with and without Helicobacter pylori infection.

PURPOSE: To evaluate the radial peripapillary capillary density using optical coherence tomography angiography in patients with and without Helicobacter pylori infection. METHODS: This prospective, cross-sectional study comprised 52 patients (52 eyes: Group 1) and 38 patients (38 eyes: Group 2) with and without H. pylori infections, respectively. The radial peripapillary capillary density and retinal nerve fiber layer thickness in 4 equal quadrants and 2 equal hemispheres in the peripapillary region were calculated using optical coherence tomography angiography. The optic nerve head parameters of the patients were also assessed. RESULTS: The groups were similar in terms of age, gender, and the optic nerve head parameters. The radial peripapillary capillary densities in the superior hemisphere and quadrant were significantly lower in Group 1 than in Group 2 (p=0.039 and p=0.028, respectively) and were positively correlated with the superior hemisphere's retinal nerve fiber layer thickness (p<0.001 and p<0.001, respectively). Similarly, the radial peripapillary capillary densities in the inferior hemisphere and quadrant were also significantly lower in Group 1 compared to Group 2 (p=0.03 and p=0.017, respectively) and were positively correlated with the inferior hemisphere's retinal nerve fiber layer thickness (p<0.001 and p<0.001, respectively). The retinal nerve fiber layer thickness in the nasal and temporal quadrants were significantly decreased in Group 1 when compared to Group 2 (p=0.013 and p=0.022) and were positively correlated with the corresponding radial peripapillary capillary densities of the 2 quadrants (p=0.002 and p=0.022). CONCLUSION: The decreased radial peripapillary capillary density in the H. pylori-positive patients suggests that H. pylori may play a role in the etiopathogenesis of glaucoma.

Association between ocular trauma and attention-deficit/hyperactivity disorder in adult patients.

Purpose: To investigate the potential relationship between ocular trauma and attention-deficit/hyperactivity disorder (ADHD)-related clinical outcomes in adults. Methods: This prospective case-control study included 108 ocular trauma patients and 90 age-sex-matched healthy control. The ocular trauma group was separated into the subgroups home accident, outdoor activity, and work related in terms of the reasons for ocular trauma, and as ocular surface problems, blunt trauma-related, and open globe injury in terms of the clinical findings. The ADHD-related clinical outcomes were evaluated using the Wender-Utah Rating Scale (WURS). The outcomes were compared between ocular trauma and control groups, and ocular trauma subgroups. Results: The demographic characteristics of ocular trauma groups and controls were similar (P > 0.05, for all). In comparison to the control group, the ocular trauma group had higher total WURS score and WURS subscale scores, but not significantly (P > 0.05, for all). According to comparisons of the subgroups separated by the reasons, there was significant difference in the mean behavioral problems/impulsivity scores in favor of outdoor activities (P = 0.015). On the other hand, the mean scores for WURS subscales of the subgroups separated by the clinical findings were similar (P > 0.05, for all). Conclusion: WURS scores in ocular trauma patients are similar to control; however, the score in behavioral problems/impulsivity subscales is higher for ocular trauma caused by outdoor activities.

Evaluation of pupil responses and anterior chamber parameters in overactive bladder syndrome before and after antimuscarinic treatment.

PURPOSE: To evaluate the static and dynamic pupillometric responses and anterior chamber parameters in overactive bladder (OAB) patients before and after solifenacin succinate treatment and to compare these results with those of healthy control subjects. MATERIALS AND METHODS: Forty OAB patients who were planned to be treated with solifenacin succinate and 40 control subjects without any systemic or ocular diseases were included in the study. Following detailed ophthalmological examination, Pentacam imaging in order to detect anterior chamber angle, depth and volume; and static and dynamic pupillometry measurement in order to detect high-photopic (100 cd/m2), low-photopic (10 cd/m2), mesopic (1 cd/m2) and scotopic (0.1 cd/m2) pupil diameters, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation and velocity of pupil dilation were performed at baseline and at the first month of treatment. Data from the right eyes of the participants were used for statistical analysis. RESULTS: Baseline low- and high-photopic pupil diameters, duration of pupil contraction, latency of pupil dilatation and velocity of pupil dilatation values were significantly higher; and velocity of pupil contraction and duration of pupil dilation values were lower in the OAB group compared to the control group (P < 0.05 for all). One-month treatment with oral solifenacin succinate revealed higher scotopic and mesopic pupil diameters (P = 0.042, P = 0.031, respectively). Also, latency of pupil contraction was found to be increased and velocity of pupil dilatation was found to be decreased compared to pretreatment (P = 0.003, P < 0.001, respectively). We did not find any significant change in anterior chamber angle, depth and volume measured with Pentacam HR compared to pretreatment. CONCLUSIONS: Patients with OAB also have pupil abnormalities which probably reflect an underlying autonomic disorder that affects the bladder and pupils. One-month treatment of solifenacin succinate may lead to enlargement of pupil diameters under low illumination conditions and may lead to changes in dynamic pupillometric responses compatible with antimuscarinic treatment. Systemic antimuscarinic therapy has no effect on anterior chamber depth and intraocular pressure.

Evaluation of Densitometric Analysis for Early Detection of Corneal Blood Staining in Hyphema.

PURPOSE: To investigate the possibility of detecting presumed corneal blood staining after traumatic hyphema with corneal densitometry and to evaluate corneal transparency after hyphema resolution. METHODS: Twenty-eight patients with uniocular nonpenetrating ocular trauma with hyphema were included in the study. Corneal densitometry measurements were performed at the first week and the first month after full resolution of blood in the anterior chamber and discontinuation of medication. The uninjured eyes were accepted as the control group. RESULTS: The corneal densitometry values at all zones of the posterior layer in the study eyes were significantly higher at the first week compared with the first month (P < 0.05 for all). Comparison of the corneal densitometry values of the study eyes at the first week with the fellow eyes showed significantly higher values at all zones of the posterior corneal layer (P < 0.05 for all). Comparison of the study eyes at the first month with the fellow eyes was significantly higher at the posterior 0- to 2-, 2- to 6-, and 6- to 10-mm zones (P = 0.030, P = 0.044, and P = 0.035, respectively). Although corneal densitometry values at the posterior 10- to 12-mm and posterior total zones were higher at the first month compared with those of the fellow eyes, these differences were not statistically significant (P = 0.197 and P = 0.085, respectively). CONCLUSIONS: Corneal densitometry at all zones of the posterior corneal layer significantly changed after traumatic hyphema. Corneal densitometry analysis could be used in clinically normal cases for possible early corneal blood staining detection.

Static and Dynamic Pupil Characteristics in Myopic Anisometropic Amblyopia.

OBJECTIVES: The purpose of this study was to compare static and dynamic pupillometry measurements in patients with myopic anisometropic amblyopia with those of age-matched, healthy subjects. METHODS: This prospective, cross-sectional study consisted of 29 patients with myopic anisometropic amblyopia and 83 control subjects. While both the amblyopic eye and the fellow eye of patients with myopic anisometropic amblyopia were examined, data were only recorded for the right eye of the subjects in the control group. Static pupillometry measurements determined included the scotopic pupil diameter (PD), mesopic PD, low photopic PD, and high photopic PD. Subsequently, dynamic pupillometry measurements were obtained, including the resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation. RESULTS: In the myopic anisometropia patients, there was a statistically significant difference in the low photopic PD and high photopic PD values of the amblyopic eyes and the corresponding fellow eyes compared with the healthy subjects (p<0.05 for each). These parameters of low photopic PD and high photopic PD were similar between the highly myopic eyes and the fellow eyes. There was no statistically significant difference in the mesopic or scotopic PD values between any of the groups (p>0.05 for each). There were no significant differences in the dynamic pupillometric measurements between the study and control eyes. CONCLUSION: These results confirm that amblyopia is a binocular disorder. The dynamic pupillary responses were similar in the highly myopic and fellow eyes, indicating that evaluation of relative afferent pupillary defects may not be a useful test to differentiate amblyopic eyes from healthy corresponding eyes.

Static and dynamic pupil characteristics in pseudoexfoliation syndrome and glaucoma.

BACKGROUND: To compare the static and dynamic pupillometry measurements in patients with pseudoexfoliation syndrome (PES), patients with pseudoexfoliation glaucoma (PEG) and age-matched healthy subjects using an automatic quantitative pupillometry system. METHODS: This prospective, cross-sectional study consisted of 40 patients with PES, 30 patients with PEG and 43 control subjects. Static pupillometry measurements including scotopic pupil diameter, mesopic pupil diameter, low photopic pupil diameter, and high photopic pupil diameter were undertaken. Subsequently, dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were undertaken. These measurements were compared between the groups. RESULTS: The scotopic, mesopic, and low photopic pupil diameter values were statistically significantly lower in patients with PES and PEG compared with controls (p < 0.001). However, these parameters were similar between the patients with PES and PEG (p > 0.05). The mean values of high photopic pupil diameter were similar within all groups (p = 0.54). The amplitude of pupil contraction values of the patients with PEG was statistically significantly lower than the patients with PES and the controls (p < 0.05). Patients with PES also had significantly lower amplitude of pupil contraction values compared with controls (p < 0.001). Additionally, the velocity of pupil contraction values was statistically significantly higher in control subjects when compared to the patients with PES and PEG (p < 0.05). CONCLUSION: This study demonstrated that accumulation of pseudoexfoliative material can cause alterations in static and dynamic pupillary characteristics and the progression from PES to PEG may be associated with reduced amplitude of pupil contraction values.

Effects of Topical Nepafenac and Fluorometholone on Macular Thickness After Posterior Capsulotomy Using Neodymium-doped Yttrium-Aluminum-Garnet Laser.

OBJECTIVES: The aim of this study was to assess the effects of topical 0.1% nepafenac and 0.1% fluorometholone on macular thickness (MT) after a neodymium: yttrium-aluminum-garnet (Nd: YAG) laser posterior capsulotomy and to compare the findings with those of untreated patients. METHODS: This prospective study included 75 eyes of 75 patients with posterior capsule opacification. The patients were divided into 3 groups according to the medications administered after a capsulotomy procedure. Group 1 comprised 25 patients who were prescribed 0.1% nepafenac for a week, Group 2 consisted of 25 patients who were prescribed 0.1% fluorometholone for a week, and Group 3 consisted of 25 patients who were not prescribed any medication. A circular-shaped capsulotomy was performed in all cases. MT was measured before the capsulotomy and at the first day, first week, and first month after the procedure using spectral domain-optical coherence tomography and the change values were compared within and between groups. RESULTS: In Group 1, the superior and nasal parafoveal MT, temporal, and nasal perifoveal MT values at the first month were statistically significantly greater than those observed in the first week (p<0.05 for all values). In Group 2, the superior and nasal parafoveal MT and inferior perifoveal MT measurements in the first month were greater than those recorded the first week (p<0.05 for all values). In Group 3, there was a gradual increase seen in the first day, first week, and first month in the superior and temporal parafoveal MT value (p<0.05 for all). The change value in the parafoveal temporal quadrant was significant between groups, indicating a greater increase in the untreated group compared with the nepafenac and fluorometholone groups (p=0.04). CONCLUSION: An increase in MT can occur after an Nd: YAG laser posterior capsulotomy. Both topical 0.1% nepafenac and 0.1% fluorometholone can prevent this increase. The 2 drugs were comparable; neither demonstrated apparent superiority to the other.

Direct and crossover effects of Phenylephrine and Cyclopentolate on foveal avascular zone and vessel density of macular capillary plexuses: an optical coherence tomography angiography study.

Purpose: To determine the influence of phenylephrine and cyclopentolate on foveal avascular zone (FAZ) and vessel density of macular capillary plexus measurements via optical coherence tomography angiography (OCTA). Materials and Methods: The participants were separated into 2 groups according to the administration of drops. One drop of phenylephrine 2.5% was administered on one eye of each subject in the phenylephrine group (n=30) and one drop of cyclopentolate 1% in the cyclopentolate group (n=30). FAZ parameters and vessel density values of both superficial (SCP) and deep capillary plexuses (DCP) were calculated via OCTA priorly and at 45 min following the drop administration in both eyes. Vessel density, acircularity index of FAZ, FAZ area, perimeter of FAZ and foveal density-300 were evaluated via OCTA. Results: The vessel density values of fovea in SCP and DCP was 18.51±7.14% and 36.05±8.76% and significantly decreased to 16.16±6.26% and 33.29±9.47% respectively after drop instillation in dilated eyes in phenylephrine group (p=0.041 and p=0.032). Likewise, the vessel density values in SCP and DCP were 21.56±7.74% and 39.27±8.76% and significantly decreased to 18.89±7.32% and 35.36±5.75% respectively, after drop instillation in dilated eyes in cyclopentolate group (p=0.035 and p=0.028). However, there was no significant difference between before and after instillation of drops in terms of foveal density-300 value via FAZ assessment tool in both dilated and nondilated contralateral eyes in both groups (p>0.05 for all). Conclusions: Mydriasis with phenylephrine and/ or cyclopentolate did not affect the foveal density-300 values while analyzing the perfusion of macula. Vessel density in foveal region should be evaluated via FAZ evaluation software of the OCTA.

Evaluation of static and dynamic pupil characteristics in hyperopic anisometropic amblyopia.

PURPOSE: The aim of this study is to perform a comparison of static and dynamic pupillometry measurements in patients with hyperopic anisometropic amblyopia and age-matched controls. METHODS: This prospective cross-sectional study consisted of 38 patients with hyperopic anisometropic amblyopia and 80 control subjects. A quantitative pupillometry system was used to evaluate the pupil characteristics of higher hyperopic eyes (Group 1), the fellow eyes (Group 2), and healthy eyes (Group 3). Static pupillometry measurements were taken including scotopic pupil diameter, mesopic pupil diameter, low-photopic pupil diameter, and high-photopic pupil diameter. Subsequently, dynamic pupillometry measurements were taken including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation. RESULTS: Groups 1 and 2 had statistically significantly lower scotopic and high-photopic pupil diameter values compared with Group 3 (p < 0.05). The amplitude of pupil contraction values were also statistically significantly lower in Groups 1 and 2 compared with Group 3 (p = 0.001 and p = 0.003). However, there were no significant differences between the study and the control eyes with respect to mesopic and high-photopic pupil diameter, resting diameter, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation values (p > 0.05, for all). CONCLUSION: Static and dynamic pupil characteristics of higher hyperopic eyes and their fellow eyes are similar. This may support that amblyopia is not a monocular disorder, but can affect both eyes.

The Validity of Optical Coherence Tomography Angiography as a Screening Test for the Early Detection of Retinal Changes in Patients with Hydroxychloroquine Therapy.

PURPOSE: The aim of this study was to quantitatively compare both the vessel density of macular capillary plexuses and the foveal avascular zone (FAZ) areas of patients receiving hydroxychloroquine (HCQ) therapy for more than 5 years while using age- and sex-matched controls. METHODS: The patients undergoing HCQ who were screened for toxic effects were evaluated. The FAZ parameters included the area, perimeter, and the acircularity index. The foveal density and vessel density values of both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured using optical coherence tomography angiography (OCTA). RESULTS: This study included 80 eyes of 40 subjects: 20 subjects in the HCQ group and 20 subjects in the control group. The FAZ perimeter and the FAZ area in the SCP and full retinal vasculature were significantly larger in the HCQ group than in the control group (p < 0.05 for all). Additionally, the vessel density of fovea in the SCP and DCP was significantly lower in the HCQ group than in the control group (p < 0.05 for all). CONCLUSIONS: OCTA provides objective documentation about FAZ and vessel density features in patients using long-term HCQ therapy before toxicity begins, and it can be used as a screening tool for detecting early changes in the macula.

Static and Dynamic Pupillary Characteristics in Clinically Unilateral Pseudoexfoliation Syndrome.

PURPOSE: The purpose of this study was to perform a comparison of static and dynamic pupillometry measurements in patients with clinically unilateral pseudoexfoliation syndrome (PES) and age-matched controls. METHODS: This prospective cross-sectional study consisted of 38 patients with unilateral PES and 40 control participants. A quantitative pupillometry system was used to evaluate the pupil characteristics of eyes with PES (group 1), clinically unaffected fellow eyes (group 2), and healthy eyes (group 3). Static pupillometry measurements including scotopic pupil diameter (PD), mesopic PD, low photopic PD, and high photopic PD were undertaken. Subsequently, dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were undertaken. RESULTS: There were statistically significant differences between the groups with regard to scotopic PD, mesopic PD, and low photopic PD (P<0.001). The pairwise comparisons exhibited that group 1 shows significantly lower PD values compared with groups 2 and 3. Group 2 also had significantly lower PD values compared with group 3. In addition, groups 1 and 2 had statistically significantly lower values of amplitude of pupil contraction, velocity of pupil contraction, duration of pupil dilatation, and velocity of pupil dilatation values compared with group 3. Moreover, group 1 and 2 demonstrated statistically significantly prolonged latency of pupil dilatation compared with group 3. CONCLUSIONS: Static and dynamic pupil characteristics of affected eyes and their fellow eyes of cases with unilateral PES are different from the healthy subjects.