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.

The effects of chalazion surgery on intraocular pressure and corneal topography.

PURPOSE: To evaluate the effects of chalazion surgery on intraocular pressure (IOP) and the biomechanical, topographic, and topometric properties of the cornea. METHODS: A total of 29 patients with upper eyelid chalazion were included in this study. All patients underwent preoperative and postoperative detailed ophthalmological examinations including scale of chalazion size; IOP (IOPcc and IOPg), corneal hysteresis, and corneal resistance factor measurements using ocular response analyser (ORA; Reichert Instruments, Depew, NY, USA); topographic and topometric properties of the cornea using Pentacam HR (Oculus GmbH, Wetzlar, HE, Germany). Preoperative and postoperative measurements were compared. RESULTS: The mean age of the patients was 29.07 ± 13.74 years (18-54 years). The mean IOPcc was 15.82 ± 4.20 mmHg preoperatively and 14.72 ± 3.96 mmHg postoperatively, and the mean IOPg was 15.21 ± 3.91 mmHg preoperatively and 14.21 ± 4.02 mmHg postoperatively (p = 0.020, p = 0.007, respectively). The mean central keratoconus index (CKI) was 1.006 ± 0.01 preoperatively and 1.002 ± 0.01 postoperatively (p = 0.035). Other biomechanical, keratometric, topographic, and topometric parameters were similar before and after the surgery (all p > 0.05). CONCLUSION: To the best of our knowledge, this is the first report to suggest that IOP and CKI are decreased after the removal of upper eyelid chalazion.

Initial trabeculectomy with 5-fluorouracil with or without subconjunctival bevacizumab in the management of pseudoexfoliation glaucoma.

PURPOSE: To investigate the outcomes of trabeculectomy with 5-fluorouracil (5-FU) with or without subconjunctival bevacizumab in the surgical management of pseudoexfoliation glaucoma (PXG). METHODS: This retrospective study consisted of 49 cases with PXG who underwent initial trabeculectomy with 5-FU. The cases were divided into two age- and sex-matched groups. In 23 cases, subconjunctival bevacizumab was injected (1.25 mg/0.05 mL) at the end of the surgery and in 26 of them the surgery was performed without bevacizumab. The groups were evaluated for the postoperative differences of the intraocular pressure (IOP) and the number of the anti-glaucomatous medications. Independent t, Kolmogorov-Smirnov and Chi square tests were used for statistical analysis. RESULTS: The mean preoperative IOP was 30.91 ± 4.50 mmHg under the mean number of 2.4 ± 0.7 drops in bevacizumab group. The IOP decreased to 10.22 ± 2.63 mmHg (first week), 10.91 ± 1.88 mmHg (first month), 12.35 ± 2.5 mmHg (3rd month), 12.65 ± 2.35 mmHg (sixth month) and 12.7 ± 1.9 mmHg at the final visit. The mean preoperative IOP was 31.27 ± 5.60 mmHg under the mean number of 2.3 ± 0.7 drops in without bevacizumab group. The IOP decreased to 10.08 ± 2.59 mmHg (first week), 11.00 ± 1.87 mmHg (first month), 12.81 ± 2.04 (3rd month), 13.62 ± 2.21 mmHg (sixth month) and 12.9 ± 2.4 mmHg at the final visit. In both groups, IOP reduced significantly postoperatively. There were no significant differences between the preoperative and the postoperative IOP values. CONCLUSION: The additional benefit of single dose of intraoperative bevacizumab was not observed in trabeculectomy with 5-FU in PXG.

Contrast sensitivity of patients with congenital color vision deficiency.

PURPOSE: To investigate the static and dynamic contrast sensitivity (CS) of patients with congenital red-green color vision deficiency (CVD) and to compare these values with those of healthy control subjects. METHODS: The study included 25 subjects with congenital CVD (10 with strong protan defect and 15 with strong deutan defect) and 20 age- and gender-matched healthy subjects. Following detailed ophthalmological examination, monocular static and dynamic CS measurements were taken with the Monpack3 device (Metrovision, Perenchies, France) on all subjects. The data from the right eyes of all the subjects were used for statistical analysis. RESULTS: The mean age of the groups was similar (deutan group: 25.3 ± 11.3 years, protan group: 27.1 ± 12.2 years, control group: 26.7 ± 8.8 years, p = 0.98). The mean static and dynamic CS values in the protan and deutan groups were higher compared to those of the healthy control subjects, but not at a statistically significant level (all p > 0.017). CONCLUSION: The static and dynamic CS values of patients with congenital red-green CVD were similar to those of healthy control subjects.

Comparison of anterior segment parameters and axial lengths of myopic, emmetropic, and hyperopic children.

PURPOSE: To compare the anterior segment parameters of myopic, hyperopic, and emmetropic children by using optical biometry. METHODS: This prospective cross-sectional study included 150 eyes of 150 children between 6 and 16 years old. The eyes were divided into three groups according to their spherical equivalent (SE) refractive error values as myopic [between - 1.0 and - 6.0 diopter (D)], emmetropic (between + 0.50 and - 0.50 D), and hyperopic (between + 1. 0 and + 3.0 D). Axial length (AL), central corneal thickness, anterior chamber depth (ACD), lens thickness (LT), and mean keratometry (K mean) measurements were obtained by an optical biometry (LenStar LS 900, Haag Streit Diagnostics) were compared between the groups. RESULTS: There were no statistically significant differences regarding the ages and genders of the participants between the groups (p > 0.05). The mean SE refractive error values were - 2.20 ± 0.71 D in myopic, - 0.08 ± 0.49 D in emmetropic, and + 2.06 ± 0.53 D in hyperopic eyes. The mean AL values were 24.50 ± 0.69, 23.41 ± 0.61, and 22.33 ± 0.61 mm, respectively, in myopic, emmetropic, and hyperopic eyes (p < 0.001). The mean ACD values were 3.94 ± 0.22, 3.78 ± 0.23, and 3.45 ± 0.20 mm, respectively, in myopic, emmetropic, and hyperopic eyes (p < 0.001). The mean LT values were 3.56 ± 0.20, 3.43 ± 0.17, and 3.31 ± 0.12 mm, respectively, in myopic, emmetropic, and hyperopic eyes (p < 0.001). There were no significant differences in the other parameters between the groups. CONCLUSIONS: Refractive errors are the main factors those affect anterior segment parameters and AL in children and the most severely affected parameters were found to be the AL, ACD, and LT values.

The ultrastructural alterations in the lens capsule and epithelium in eyes with traumatic white cataract.

PURPOSE: To demonstrate the morphological and physiological characteristics of lens epithelial cells (LECs) in patients with traumatic cataract using transmission electron microscopy (TEM) to further understand penetrating ocular injury-induced cataract morphology and epithelial repair mechanisms involved at a cellular level. METHODS: This is a prospective international study. Sixteen eyes of 16 consecutive patients who were diagnosed as traumatic white cataracts following the anterior lens capsule perforation and 13 eyes of 13 patients with idiopathic posterior subcapsular cataract were included to the study. The anterior lens capsules (aLCs: basement membrane and associated LECs) were obtained from cataract surgery and prepared for TEM. RESULTS: Two prominent cell types were observed in all aLCs of the traumatic cases: degenerated type LECs having variable sized intraepithelial vacuoles close to injury site and normal appearing LECs having an euchromatic nucleus distant from the injury site. In control group, the LECs and all their elements were in normal ultrastructural pattern except some small intraepithelial vacuoles, which were fewer and smaller than the vacuoles in the degenerated LECs of the traumatic group. CONCLUSIONS: The ultrastructural findings of our cases support that traumatically induced dysfunction of the lens epithelium may lead to an edema in superficial cortical lens fibers that subsequently undergo degeneration and produce a localized zone of vacuolization.

Could corneal densitometry be used as a diagnostic and screening tool for ocular involvement in patients with gout?

PURPOSE: To evaluate the corneal and tear film characteristics in patients with gout and compare these data with those of healthy subjects and to investigate the correlation of corneal densitometry with uric acid value and duration of disease. METHODS: Forty-one eyes of 41 patients with gout (group 1) and 40 eyes of 40 healthy subjects (group 2) were included in this study. Detailed ophthalmologic examinations were performed on all participants. Corneal tomographic analyses were performed with the Pentacam HR Scheimpflug imaging system (Oculus, Wetzlar, Germany). Maximum keratometry (Kmax), central corneal thickness (CCT), corneal volume (CV), and corneal densitometric values were compared between groups. Tear function tests including Schirmer, tear breakup time, and fluorescein staining were performed and compared between groups. RESULTS: Groups were similar in terms of age and gender. Kmax, CCT, and CV values were similar between groups. The outcomes of tear function tests were similar between groups. Corneal densitometric values for the 0-2 and 2-6 mm zones of the anterior and center layers were significantly higher in group 1 compared to group 2. This densitometric increase was positively correlated with uric acid levels and gout duration. CONCLUSIONS: Corneal densitometry values of the 0-2 and 2-6 mm zones of the anterior and central layers were higher in patients with gout than those of the control subjects, and the densitometric values increased as uric acid level and disease duration increased.

Aqueous humor IL-8, IL-10, and VEGF levels in Fuchs' uveitis syndrome and Behçet's uveitis.

PURPOSE: This study investigated the levels of interleukin (IL)-8, IL-10, and vascular endothelial growth factor (VEGF) in the aqueous humor (AqH) of patients with Behçet's uveitis (BU) and Fuchs' uveitis syndrome (FUS) during an inactive period and compared these levels with those in the AqH of noninflammatory healthy control subjects. METHODS: This prospective and case-control study included 33 patients (16 patients with BU and 17 patients with FUS) and 35 control subjects. IL-8, IL-10, and VEGF levels in the AqH were quantified by performing sandwich enzyme-linked immunosorbent assay. Kruskal-Wallis test was used to compare the cytokine levels in the different groups, and statistical significance was set at p < 0.05. RESULTS: IL-8 levels were significantly higher in the AqH of patients with BU and FUS than in the AqH of control subjects (p < 0.001 and p < 0.001, respectively). IL-10 levels were significantly lower in the AqH of patients with BU than in the AqH of patients with FUS and of control subjects (p = 0.001 and p < 0.001, respectively). Although VEGF levels were higher in the AqH of patients with FUS than in the AqH of patients with BU and of control subjects, the difference was significant only between patients with FUS and control subjects (p < 0.001). CONCLUSIONS: We observed a significant decrease in IL-10 levels in the AqH of patients with BU and a significant increase in VEGF levels in the AqH of patients with FUS compared to controls. IL-8 and VEGF levels showed no significant difference among uveitis patients.

The effect of trabeculectomy on serum brain-derived neurotrophic factor levels in primary open-angle glaucoma.

PURPOSE: We aimed to investigate the effect of trabeculectomy on serum brain-derived neurotrophic factor (BDNF) levels. Our secondary goal was to compare serum and aqueous humor (AH) BDNF levels in primary open-angle glaucoma (POAG) and control subjects. METHODS: This prospective, cross-sectional study consists of 20 eyes of with advanced-stage POAG who had trabeculectomy and 19 eyes of age- and sex-matched control healthy subjects who had cataract surgery. Serum and AH samples were obtained preoperatively in trabeculectomy group and control subjects. Serum samples were obtained at the third postoperative month in both groups. RESULTS: The aqueous humor and serum levels of BDNF at the surgery day were found to be strongly positive correlated (r = 0.868; p < 0.001). Serum and AH BDNF levels of POAG cases were significantly lower than control subjects at the surgery day (respectively p = 0.038, p = 0.011). In POAG cases, serum BDNF levels significantly increased at the third month after trabeculectomy while there was not a significant difference in control subjects with cataract surgery (p < 0.001; p = 0.717 respectively). CONCLUSION: Trabeculectomy was found to have a positive effect on serum BDNF levels in POAG cases.

The significance of thiol/disulfide homeostasis and ischemia-modified albumin levels to assess the oxidative stress in patients with different stages of diabetes mellitus.

This study investigated the value of Thiol/Disulfide homeostasis and ischemia-modified albumin (IMA) levels in discriminating diabetic cases with different stages of retinopathy and without retinopathy. In total, 122 patients with type 2 diabetes mellitus (DM) were enrolled in this prospective cross-sectional study. These patients were separated into three subgroups: Group 1 included 42 patients with DM and no diabetic retinopathy (DR), Group 2 included 40 patients with DM having non-proliferative DR and the Group 3 had 40 patients with DM having proliferative DR. The native thiol, total thiol, and disulfide levels and disulfide-native thiol, disulfide-total thiol, and native thiol-total thiol ratios as well as the IMA levels were analyzed and compared among the groups. There were no statistically significant differences regarding the ages and genders of the patients between the groups. The native thiol level, the total thiol level and the native thiol-total thiol ratio showed a statistically significantly reduction, while the disulfide level, the disulfide-native thiol ratio, and the disulfide-total thiol ratio showed a statistically significantly elevation in the Group 3 compared with the Group 1 and Group 2. Additionally, the mean IMA levels were statistically significantly higher in Group 3 when compared to Group 1 and Group 2 (p = .003 and p = .014, respectively). In conclusion, both Thiol/Disulfide homeostasis parameters and IMA levels increase with the progression of DR. Thiol/Disuldife homeostasis balance and IMA levels may be used a biomarker to monitor the tissue ischemia in DM and to discriminate the different stages of DR, in the future.

Interocular Comparison of Anterior and Posterior Segment Findings and Laterality in Hyperopic Anisometropia.

OBJECTIVES: To investigate the laterality and the differences in anterior and posterior segment findings in hyperopic patients with anisometropia between their eyes using spectral domain optical coherence tomography and LenStar LS-900 device. METHODS: This prospective institutional study included hyperopic anisometropic patients with and without amblyopia, aged between 6 and 40 years. The refractive error and the values of keratometry, axial length (AL), central corneal thickness (CCT), peripapillary retinal nerve fiber layer (RNFL) thickness, and central macular thickness (CMT) obtained using the RK-F1 autorefractor, LenStar LS-900, and Spectralis optical coherence tomography were compared between the higher hyperopic and fellow eyes. RESULTS: Eighty of the patients had hyperopic anisometropia with amblyopia and 30 of them had hyperopic anisometropia without amblyopia. The left eyes of the patients in this series were significantly more commonly affected. Axial length and CCT were significantly different between the higher hyperopic and the fellow eyes of all patients. In addition, the mean CMT and RNFL thickness of the higher hyperopic eyes were significantly higher than that of the fellow eyes. CONCLUSIONS: During the process of emmetropization and development of the retina, higher hyperopic eyes in hyperopic patients with anisometropia and amblyopic eyes may have blurred and abnormal vision, leading to under-development of vision, significantly higher CCT, CMT, and RNFL thickness, more hyperopic refraction, and shorter AL in the affected eye.

Stabilization Time of Anterior Segment Parameters After Trabeculectomy Surgery.

OBJECTIVES: To investigate the postoperative changes in the anterior segment parameters by Scheimpflug imaging method in patients undergoing trabeculectomy surgery. METHODS: This prospective study included 38 phakic eyes of 38 patients with primary open-angle glaucoma who underwent trabeculectomy. Anterior chamber angle (ACA), anterior chamber depth (ACD), anterior chamber volume (ACV), and central corneal thickness (CCT) of the eyes were measured by performing Scheimpflug imaging in preoperative (baseline) and postoperative periods (1st week and 1st, 3rd, and 6th months after the surgery). RESULTS: Significant differences were observed in all the anterior segment parameters during the postoperative period (P<0.001 for ACA, ACD, and CCT; P=0.001 for ACV). Compared with preoperative values, ACA, ACD, and ACV values decreased and CCT value increased in the 1st postoperative week (P<0.001 for all the parameters). Compared with the 1st postoperative-week values, ACA, ACD, and ACV values significantly increased and CCT value significantly decreased in the 1st postoperative month (P=0.002 for ACV; P<0.001 for ACA, ACD, and CCT). However, no significant differences were observed between the baseline and 1st postoperative-month values (P>0.05 for all the parameters). Moreover, the changes in the anterior segment parameters were not statistically significant after the 1st postoperative month. CONCLUSIONS: Our results showed that the changes in the anterior segment parameters observed in the early postoperative period after trabeculectomy returned to their baseline values after approximately 1 month after the surgery and remained stable thereafter.

Comparison of anterior segment measurements with LenStar and Pentacam in patients with newly diagnosed glaucoma.

PURPOSE: To compare anterior segment measurements obtained using the Pentacam; Oculus, HR and the LenStar LS 900 in patients with newly diagnosed glaucoma. METHODS: Patients with ocular hypertension and primary open-angle glaucoma who had been treated with PGA were included in the study. Anterior segment measurements including central corneal thickness (CCT), keratometry, anterior chamber depth (ACD) and white-to-white (WTW) corneal diameter obtained with the optic low-coherent reflectometer (LenStar LS-900, Haag-Streit AG, Switzerland) and with the Scheimpflug system (Pentacam; Oculus, HR) were compared. In order to compare LenStar and Pentacam measurements, paired sample t test and 'Bland-Altman' plot were used in the statistical analysis. RESULTS: Twenty-two female (59.5%) and 15 male (40.5%) totally 37 cases with newly diagnosed glaucoma were included in the study. Anterior segment parameter measurements obtained with both the LenStar and the Pentacam were significantly correlated for right and left eyes, so the right eye values were used in statistical analysis. WTW and ACD values measured with LenStar were statistically significantly higher than those measured with Pentacam (p: 0.0001, p: 0.0001, respectively). There was no statistically significant difference between the CCT values measured by the two devices (p: 0.217). CONCLUSION: There was a statistically significant difference between the mean values of ACD and WTW measured with the LenStar and Pentacam. These biometric devices should not be used interchangeably. It should be appropriate to use the same device on follow-up of glaucoma patients.

Evaluation of corneal topographic changes and surgically induced astigmatism after transconjunctival 27-gauge microincision vitrectomy surgery.

PURPOSE: To evaluate the corneal topographic changes and postvitrectomy astigmatism after 27-gauge (g) microincision vitrectomy surgery (MIVS) by using Pentacam HR-Scheimpflug imaging system. METHODS: This prospective descriptive study included 30 eyes of 30 patients who underwent 27-g MIVS. All eyes underwent a Pentacam HR examination preoperatively and on the first week, first month and third month postoperatively. The power of the corneal astigmatism, mean keratometry (K m), K 1 and K 2 values and corneal asphericity (Q value) values for the both front and back surfaces of the cornea, index of surface variance (ISV), index of vertical asymmetry (IVA), index of height asymmetry (IHA), index of height decentration (IHD) and higher-order aberrations including coma, trefoil, spherical aberration, higher-order root-mean-square and total RMS were recorded. Additionally, the mean induced astigmatism was estimated by vector analysis. RESULTS: No statistically significant changes were observed in the mean power of corneal astigmatism, mean keratometry, K 1 and K 2 values, corneal asphericity values, ISV, IVA, IHA, IHD and higher-order aberrations on the first week, first month and third month after the operation. The mean surgically induced astigmatism was calculated as 0.23 ± 0.11 D on the first week, 0.19 ± 0.10 D on the first month and 0.19 ± 0.08 D on the third month postoperatively. CONCLUSION: Minor corneal surface and induced astigmatic changes are expected to result in rapid visual rehabilitation after pars plana vitrectomy with the 27-g MIVS system.

Analysis of clinical features and visual outcomes of pars planitis.

PURPOSE: To evaluate the demographic characteristics, clinical features, treatment and outcomes of patients with pars planitis in a tertiary referral center in Turkey. METHODS: Medical records of patients with pars planitis were retrospectively reviewed. The data including demographic and ocular features and treatment outcomes were recorded. The distribution of clinical findings and complications were evaluated according to age and gender groups. The changes in final BCVA compared to the initial BCVA were noted. Statistical analysis was performed using SPSS software (Version 18.0, SPSS Inc., Chicago, USA). RESULTS: Twenty-seven patients (54 eyes) were included in this study. 16 patients were male (59.3%), and 11 were female (40.7%). Mean age at diagnosis was 12.84 ± 8.26 (range 4-36) years. Mean follow-up period was 61.3 ± 52.15 (range 9-172) months. Mean BCVA was 0.58 ± 0.36 (range 0.03-1.00) (0.40 ± 0.45 logMAR) at presentation, and 0.81 ± 0.28 (range 0.10-1.00) (0.14 ± 0.27 logMAR) at final visit (P = 0.001). Vitreous inflammation (100%), vitreous haze (92.6%), snowballs (74.1%), snowbanks (66.7%), anterior chamber cells (66.7%) and peripheral retinal vascular sheathing (48.1%) were the most common presentations. Ocular complications included vitreous condensation (51.9%), cystoid macular edema (22.2%), cataract (18.5%), inferior peripheral retinal detachment (11.1%), glaucoma (5.6%) and vitreous hemorrhage (3.7%). Treatments included topical, periocular, intravitreal and systemic corticosteroids, immunosuppressives, peripheral laser photocoagulation and pars plana vitrectomy when needed. CONCLUSIONS: Pars planitis is an idiopathic chronic intermediate uveitis mostly affecting children and adolescents. In spite of its chronic nature with high potential of causing ocular complications, adequate treatment and close follow-up lead to favorable visual outcomes.

Electron microscopic evaluation of anterior lens epithelium in patients with idiopathic congenital cataract.

PURPOSE: To investigate the ultrastructure of the lens epithelial cells (LECs) in patients with idiopathic congenital cataract. METHODS: This is a prospective interventional study. The anterior lens capsules (aLC: basement membrane and associated LECs) were taken from 16 eyes of 12 consecutive patients who were diagnosed as having idiopathic congenital cataracts. The aLCs were obtained from cataract surgery and prepared for transmission electron microscopy (TEM). RESULTS: Some significant ultrastructural changes were observed in all aLCs of the participants. The anterior LECs showed alterations in different areas which were partly cuboidal and partly squamous in shape. The LECs had euchromatic nucleus and included some vacuoles in the cytoplasms as a remarkable alteration. The sizes of these intraepithelial cell vacuoles were changeable. CONCLUSIONS: We identified remarkable changes in LECs of the eyes with idiopathic congenital cataract by TEM. It can be assumed that oxidative damage may be associated with these ultrastructural changes in LECs of the eyes with idiopathic congenital cataracts.

Could Platelet Indices and Neutrophil to Lymphocyte Ratio Be New Biomarkers for Differentiation of Arteritic Anterior Ischemic Neuropathy from Non-Arteritic Type?

The aim of this study was to assess the possible relationship between AAION (arteritic anterior ischemic optic neuropathy) and NAION (non-arteritic anterior ischemic optic neuropathy) with blood platelet parameters and NLR (neutrophil-to-lymphocyte ratio). The medical records of 12 patients with AAION, 33 patients with NAION, and 35 healthy subjects were examined. MPV, PDW, and PCT values showed marked elevation in AAION and NAION groups compared with control group. The mean NLR was statistically significantly higher only in AAION group compared to the NAION and control groups, suggesting that platelet function plays an important role in AIONs and NLR might be used to differentiate AAION from NAION.

Are optic nerve heads of patients with helicobacter pylori infection more susceptible to glaucomatous damage?

BACKGROUND: To compare retinal nerve fiber layer thicknesses (RNFLT) of patients with or without Helicobacter pylori infection and to reveal the possible RNFLT changes after H. pylori eradication. MATERIALS AND METHODS: Sixty-five eyes of 65 patients that tested positive for H. pylori (Group 1) and 48 eyes of 48 patients that tested negative for H. pylori (Group 2) were included. RNFLT analyses were performed with spectral-domain (SD) optical coherence tomography (OCT) in a total of five regions: the superior, inferior, nasal, and temporal quadrants and the average. Then, a comparison was made between groups. After H. pylori eradication in 38 patients, RNFLTs were compared with both pre-eradication values and Group 2. RESULTS: The groups were similar in terms of age and gender. Temporal quadrant RNFLT was thinner in Group 1 than in Group 2 (P=.02). After H. pylori eradication, RNFLTs did not differ from pre-eradication values in Group 1 (P>.05 for all), whereas temporal quadrant RNFLT after H. pylori eradication was thinner compared to Group 2 (P=.03). CONCLUSIONS: H. pylori may cause the localized defects on RNFL that are the early signs of glaucoma.

Effect of myopic anisometropia on anterior and posterior ocular segment parameters.

The purpose of this study is to investigate the differences in anterior and posterior segment parameters of more myopic eyes compared to fellow eyes using spectral domain optical coherence tomography and optical biometer device in patients with myopic anisometropia. This prospective cross-sectional study included 42 myopic anisometropic patients with and without amblyopia, aged between 7 and 40 years old. The refractive error and keratometry values, axial length (AL), central corneal thickness (CCT), peripapillary retinal nerve fiber layer thickness (RNFLT), and central macular thickness (CMT) were evaluated. Eighteen of the patients had myopic anisometropia with amblyopia, and the remaining 24 had myopic anisometropia without amblyopia. There were 23 female and 19 male patients with a mean age as 23.67 ± 10.12 years (range 7-40). The right eyes of the subjects significantly had a higher degree of myopia. There was a significant difference in mean best-corrected visual acuity (0.195 ± 0.234 vs. 0.011 ± 0.025 logMAR, p < 0.001), spherical equivalent refraction (-3.95 ± 1.38 vs. -1.04 ± 0.99 D, p < 0.001), AL (25.06 ± 1.27 vs. 23.99 ± 0.98 mm, p < 0.001), and RNFLT (89.24 ± 12.84 vs. 94.57 ± 10.81 µm, p < 0.001) between the more myopic and fellow eyes in all patients. On the contrary, there was no significant difference in CMT and anterior segment parameters including mean keratometry and CCT in all patients and either group. During the development of the myopic anisometropia, more myopic eyes have significantly more myopic refraction, longer AL and thinner RNFLT compared to the fellow eyes.

Does the intraocular pressure-lowering effect of prostaglandin analogues continue over the long term?

The purpose of the study is to assess the changes in the long-term effects of prostaglandin analogues (PGAs) on intraocular pressure (IOP) reduction in patients with primary open-angle glaucoma (POAG). Data of POAG patients treated with latanoprost (0.005 %), travoprost (0.004 %), or bimatoprost (0.03 %) as the first line treatment for 5 years or more were retrospectively evaluated. Baseline ophthalmic assessment values were recorded together with the IOP at the 6th month, 1st year, and then annually. The 79 patients included 33 (41.8 %) men and 46 (58.2 %) women. There were 34 (43.0 %) patients using latanoprost (0.005 %), 23 (29.1 %) patients using bimatoprost (0.03 %), and 22 (27.8 %) patients using travoprost (0.004 %). There was no difference between the groups in terms of age, gender, or baseline IOP levels. IOP levels at the 6th month were significantly lower than baseline IOP levels in all groups (p < 0.01, Friedman test). The IOP decrease was maintained after the 6th month in all three group with no statistically significant difference compared to the 6th month IOP value (p > 0.05, Friedman test) and no statistically significant difference between the groups during follow-up (Kruskal-Wallis test, p > 0.05). IOP reductions with PGAs were adequate and stable in the 5-year follow-up period with no decrease in effectiveness over time.