Macula vessel density and its relationship with the central visual field mean sensitivity across different stages of exfoliation glaucoma.

CLINICAL RELEVANCE: Alterations in ocular microvasculature may contribute to pathogenesis of exfoliation glaucoma (XFG) and may improve monitoring this aggressive type of open angle glaucoma. BACKGROUND: This work aims to compare the macula vessel density and the relationship between macula vessel density and central visual field mean sensitivity between eyes with XFG and eyes with primary open-angle glaucoma (POAG) of different stages. METHODS: In this cross-sectional observational study, the macula vessel density values were compared among 52 POAG cases (26 early stage, 26 moderate to advanced stage) and 53 XFG cases (27 early stage, 26 moderate to advanced stage). The vessel density values were evaluated with optical coherence tomography angiography. Vasculature-function and structure-function relationships were analysed by comparing macula vessel density, inner macula thickness and visual field mean sensitivity in early and moderate to advanced stages of XFG and POAG eyes separately. RESULTS: The early stage XFG eyes had a significantly lower global macula vessel density compared with early stage POAG eyes (42.81 ± 3.85% and 46.56 ± 3.90%, respectively; p = 0.02). However, the tendency of XFG eyes for a lower vessel density compared with the POAG eyes did not exhibit any significance in moderate to advanced stages of glaucoma (37.39 ± 5.65% and 38.35 ± 4.67%, respectively; p = 0.9). The macula vessel density (%)-visual field mean sensitivity (1/Lambert) correlation was statistically significant in early stage XFG eyes (r = 0.464 p = 0.01), while no such correlation was notable for the early stage POAG eyes (r = -0.029 p = 0.89). CONCLUSION: The macula vessel density appears to be more severely affected in early stage XFG than POAG of similar severity, suggesting a relatively greater value of vascular insufficiency in XFG. The significant vasculature-function association in early stage XFG, which was absent in early stage POAG, may infer the importance of macula vessel density in monitoring functional loss in early stages of XFG.

Choroidal vascularity index and choroidal thickness assessment in vitiligo.

CLINICAL RELEVANCE: Vitiligo is a skin disease characterised by depigmentation and loss of melanocytes. Melanocyte loss may not be limited to the skin in vitiligo, and various abnormalities may occur in the choroid, which is dense in melanocytes. BACKGROUND: To evaluate structural changes in the choroid by measuring choroidal thickness and vascularity index using optical coherence tomography in patients with vitiligo and comparing them to healthy subjects. METHODS: This study included 168 participants: 84 with vitiligo (30 females, 54 males) and 84 controls (36 females, 48 males). Choroidal thickness and vascularity index were measured using the enhanced depth imaging mode in spectral-domain optical coherence tomography. The choroidal thickness was measured at the following five points; subfoveal (SF), 500 µm (NCT1) and 1000 µm (NCT2) nasal to the fovea; and 500 µm (TCT1) and 1000 µm (TCT2) temporal to the fovea. The choroidal vascularity index was calculated using the ImageJ software. RESULTS: SF (p < 0.001), NCT1 (p < 0.001), NCT2 (p = 0.021), TCT1 (p = 0.001), and TCT2 (p < 0.006) choroidal thicknesses were significantly smaller in the vitiligo group than in the control group. Total choroidal (p < 0.001) and stromal (p < 0.001) areas were significantly smaller in the vitiligo group than in the control group. Choroidal vascularity indices were significantly higher in the vitiligo group than in the control group (p < 0.001). However, luminal areas did not differ significantly between groups (p = 0.935). CONCLUSION: Patients with vitiligo should be regularly monitored for choroidal alterations and, if necessary, referred to an ophthalmologist.

Could Corneal Densitometry be a Progression Criterion for Subclinical Keratoconus?

Objectives: The objective of this study is to investigate the changes in topometry, tomography, and corneal densitometry in subclinical keratoconus (SK) at the 6-month interval. Methods: The clinical keratoconus and SK groups included 25 eyes; the control group included 22 eyes from 22 patients. Corneal topographic, tomographic, topometric, and densitometric values obtained using the Pentacam HR imaging system were analyzed. Results: Posterior elevation (PE), Keratoconus index (KI), index of height asymmetry (IHA), index of height decentration (IHD), Dp, Da, Final D, maximum pachymetric progression index (PPImax), and maximum Ambrósio relational thickness parameters showed significant changes between the baseline and the 6th-month follow-up in SK group (p<0.05 for all values). There were significant changes in all zones except a central layer of 6-10 zone, anterior, and central layer of 10-12 zone between the baseline and the 6th-month follow-up in the SK group (p<0.05, for all values). The changes in mean±standard deviation of KI, IHA, IHD, PPImax parameters, and corneal densitometry values of the posterior layer of 0-2 mm and 2-6 mm zones were significant in the SK group compared to the controls (p<0.05, for all values). Conclusion: PE, KI, IHA, IHD, and PPImax parameters as well as increasing corneal light backscatter of the posterior central layer might be useful for follow-up of progression of SK. New multimeric parameters created by combinations of topometric, tomographic, and corneal densitometry parameters could be the future of SK follow-up.

Evaluation of Retinal Layers and Choroidal Structures Using Optical Coherence Tomography in Alopecia Areata.

Objective: To evaluate the macula, retinal nerve fiber layer (RNFL), retinal layers, and choroidal thickness (CT) using spectral domain optical coherence tomography (SD-OCT) in patients with alopecia areata (AA). Methods: The right eyes of 42 AA patients (17 women, 25 men) and 42 controls (18 women, 24 men) were included in the study. Each subject underwent thorough ophthalmic examination and SD-OCT (Heidelberg Engineering) measurements. Central macular thickness (CMT), RNFL, the average thicknesses of the ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retinal layers (IRL), photoreceptor layers (PRL) as well as subfoveal, temporal and nasal CT were measured. Results: In all sectors, no significant difference was observed between the AA group and the control group with regard to the mean values for CMT and RNFL (p>0.05, for all). There was not a significant difference between the AA group and the control group with regard to the thickness of the GCL, IPL, INL, OPL, ONL, RPE, IRL, and PRL (p>0.05 for all). CT at the subfoveal, temporal, and nasal regions was significantly thicker in the AA group than in the control group (p<0.05 for all). Conclusions: Along with T-lymphocyte-mediated hair follicle damage, choroidal melanocyte damage and inflammation can also be observed in AA patients. CT may increase secondary to melanocyte inflammation in AA patients.

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.

Evaluation of Retinal Layer Thicknesses in Patients with Keratoconus Using Retinal Layer Segmentation Analysis.

OBJECTIVE: To conduct an evaluation of the effects of irregular astigmatism on the retinal nerve fiber layer (RNFL) and the retinal layers observed using spectral-domain optical coherence tomography (SD-OCT) in patients who had keratoconus (KC). MATERIALS AND METHODS: A total of 255 eyes from 255 individuals, comprising 72 eyes of KC patients, 70 eyes of patients with astigmia, and 113 eyes of healthy controls were included in the analysis. RNFL scan maps (comprising global, temporal, superotemporal, inferotemporal, nasal, inferonasal, and superonasal maps) and macular thickness (MT) maps of a standard from the Early Treatment Diabetic Retinopathy Study (ETDRS) grid were assessed. The measurements were segmented automatically using Spectralis software, and included the RNFL, inner and outer plexiform layers (IPL, OPL), inner and outer nuclear layers (INL, ONL), ganglion cell layer, retinal pigment epithelium (RPE) in the central 6-mm ETDRS subfield. RESULTS: The RNFL thickness in the KC group was lower when compared with the other two groups; however, statistically significant differences were noted in the global, temporal, superotemporal, and inferotemporal sectors (p < 0.05 for all). All of the central MT parameters showed significant variation among the groups, while a statistically significant decrease was noted in the KC group, except in the inferior outer sector (p = 0.741). In the segmentation analysis, the KC group had the significantly lowest IPL, ONL, RPE, and outer retinal layer (ORL) thickness among the groups (p < 0.05 for each). The astigmatic group was similar to the control group with regard to these parameters (p > 0.05 for each). CONCLUSION: The eyes in the KC group appeared to have a thinner RNFL and MT when compared to those in the astigmatic and control groups. The ORLs, especially the ONL and RPE, were the most affected component of the macula in the KC group.

Choroidal Vascular Index in Patients With Attention-Deficit/Hyperactivity Disorder and Methylphenidate.

PURPOSE: To investigate choroidal vascularity in children with attention-deficit/hyperactivity disorder (ADHD) who were not receiving therapy, children with ADHD who were regularly taking methylphenidate (MPH), and healthy controls. METHODS: The study included three groups: patients with newly diagnosed ADHD without treatment, patients diagnosed as having ADHD who were already being treated with oral MPH, and controls. Both choroidal vascularity index (CVI) and choroidal thickness were measured using an enhanced-depth imaging mode of spectral-domain optical coherence tomography (EDIOCT) (Spectralis; Heidelberg Engineering GmbH). RESULTS: There was a significant difference in CVI and stromal area between groups. Post-hoc univariate analysis showed that CVI was significantly lower in patients with ADHD treated with MPH compared with the other groups (P < .001, for each); however, there was no difference between the treatment-free ADHD group and controls (P = .305). In contrast, stromal area was significantly higher in patients with ADHD treated with MPH than the other groups (P < .001, for each group). The correlation of CVI with MPH treatment duration in patients with ADHD treated with MPH showed a significant, moderate negative correlation (P = .01, r = - 0.66). CONCLUSIONS: CVI is reduced in patients with ADHD treated with MPH, and the decrease in CVI becomes significant with increasing duration of MPH treatment. This result reflects an indirect effect of MPH treatment on choroidal vascular structures. [J Pediatr Ophthalmol Strabismus. 2023;60(6):411-416.].

Effects on Wavefront Aberration after Short-term Wear of Senofilcon A Photochromic Contact Lens.

BACKGROUND: To assess the variability in wavefront aberrations with short-term wear of photochromic senofilcon A contact lenses in both its activated and inactive states. METHODS AND MATERIAL: In this cross-sectional study, 20 participants who had previously used soft contact lenses were enrolled. Corneal aberrometry measurements were performed on each subject, without contact lenses, using Sirius Scheimpflug-Placido topography. The photochromic lenses were illuminated using a blue-violet light (λ max = 420 nm) so as to provoke an activated state, and measurements were taken with the lenses inserted, in both states. The root mean square (RMS) of the aberrations was calculated, and the higher- and lower-order aberrations, astigmatism, coma, spherical aberration, and trefoil measurements were evaluated using a 5.0-mm pupil diameter. RESULTS: The average contact lens sphere power was - 2.33 ± 1.07 D. The mean refractive errors with contact lens wear were 0.07 ± 0.18 D for the sphere and - 0.26 ± 0.15 D for the cylinder. The mean RMS values for all the corneal aberrations showed no statistically significant differences with and without contact lenses (p > 0.05). In a bivariate correlation analysis, there was a positive correlation between contact lens sphere power and coma (vertical and horizontal) in the activated state (r = 0.455, p = 0.44 and r = 0.495, p = 0.27, respectively). CONCLUSION: The photochromic contact lenses did not influence ocular aberration during short-term wear, even when the photochromatic additive was activated. This property may help to provide more comfortable vision with lens wear. This finding needs to be verified by further studies.

Objective assessment of corneal backscattered light in myopic, hyperopic, and emmetropic children.

BACKGROUND: To determine the corneal densitometry(CD) values by using Scheimpflug imaging in myopic and hyperopic children and to compare the results with emmetropic children. METHODS: The CD measurements of the subject were obtained with Scheimpflug tomography. The values were automatically measured in standardized grayscale units over an area 12mm in diameter, which was subdivided into 4 annular concentric zones(0-2mm, 2-6mm, 6-10mm, 10-12mm) and 3 corneal depths(anterior layer: anterior 120µm; central layer: from 120µm to the last 60µm; posterior layer: last 60µm). In addition, we evaluated the correlation between spherical equivalence and anterior corneal morphological parameters and the CD values. RESULTS: A total of 211 participants were included in this prospective cross-sectional study. The eyes were divided into three groups related to their spherical equivalent(SE) refractive error values as follows: 88(41.7%) hyperopic eyes, 62(29.4%) myopic eyes, and 61(28.9%) emmetropic control eyes. The hyperopic eyes were found to have lower corneal densitometry values in 4 annular zones and the total 0-12 diameter of all layers except the central layer. However, only the 6-10mm annular zone of the central and posterior layers of the myopic eyes had lower corneal densitometry values than emmetropic eyes. There was also a significant correlation between spherical equivalent and corneal densitometry values in the anterior layer(0-2mm, 2-6mm zones), central layer(0-2mm, 10-12mm zones), posterior layer(6-10mm, 10-12mm zones, and the total 0-12mm diameter), and total corneal thickness(0-2mm zone) of the hyperopic eyes. CONCLUSIONS: Backward scattering of light was lower in hyperopic eyes and this could indicate better visual quality.

Conjunctival Histopathological Changes in Children With Vitamin D Deficiency.

PURPOSE: The aim of this study was to investigate tear function-associated clinical findings and conjunctival histopathological changes in children with vitamin D (Vit-D) deficiency. METHODS: This study used a prospective case-control design. Group 1 (n=38) comprised pediatric patients with Vit-D deficiency, and group 2 (n=45) was the control group. Tear break-up times (TBUTs), Schirmer-1 test measurements, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (CIC) results of the groups were compared. RESULTS: The participant demographic characteristics, including the mean age and the male-to-female ratio, were similar (P>0.05). The median TBUT and Schirmer-1 test measurement were 10 s (5-15) and 12 mm (6-19) in group 1 and 11 s (6-16) and 15 mm (8-21) in group 2 (P=0.004 and P=0.013, respectively). The median OSDI scores were 16 (10-20) in group 1 and 17 (10-21) in group 2 (P=0.092). According to the CIC, 25 samples in group 1 and 40 samples in group 2 were categorized as grade 0, 11 samples in group 1 and 5 samples in group 2 were categorized as grade 1, and 2 samples in group 1 and no sample in group 2 were categorized as grade 2 (P=0.027). CONCLUSION: Significant conjunctival histopathological changes occur in children with Vit-D deficiency, and these changes have effects on some tear function-associated clinical findings including the Schirmer-1 test and TBUT measurements.

Comparison of Clinical Outcomes of Upper Eyelid Blepharoplasty Using Two Different Suture Techniques.

Objectives: To compare upper eyelid blepharoplasty patients' suture techniques with interrupted cutaneous in one eye and running cutaneous in the other in terms of edema, ecchymosis, and scar index. Methods: Among patients whose suture techniques with interrupted cutaneous in one eye and running cutaneous in the other, 34 patients in the vicryl group and 46 patients in the polypropylene group were included in the study. The patients' edema and ecchymosis levels on postoperative days 1, 7, and 30 days and 3 months were selected. The Manchester Scar Scale was used to evaluate the scar index at 30 days and 3 months after surgery. Suture material (either 6-0 polypropylene sutures or 6-0 vicryl sutures) were evaluated independently. Results: In vicryl group, there was significantly less ecchymosis and edema first week postoperatively in interrupted sutured eyelid than running sutured eyelid (p=0.001, p=0.011, respectively). In polypropylene group, there was significantly less ecchymosis at the first day and first week postoperatively in interrupted sutured eyelid than running sutured eyelid (p=0.025, p=0.001, respectively). The total scar index scores in both groups at first month and third month were significantly better at the interrupted sutured eyelid than running sutured eyelid (p<0.05, for all). Conclusion: In upper eyelid blepharoplasty, an interrupted suture technique yielded the lowest rates of edema, ecchymosis, and scar formation compared with a running suture technique.

Objective Assessment of Corneal and Lens Clarity in Patients with COVID-19.

SIGNIFICANCE: The severe acute respiratory syndrome coronavirus 2 virus, which causes the coronavirus disease 2019 (COVID-19) pandemic, can bind to epithelial cells in the human cornea and conjunctiva, which may result in changes of corneal and lenticular densitometry. PURPOSE: We aimed to report the corneal and lenticular clarity of patients who had been diagnosed previously with confirmed infection of COVID-19. METHODS: This was a prospective, cross-sectional study. Fifty-three patients who had recovered from COVID-19 and 51 healthy individuals who had not had COVID-19 (control) were included in this study. Measurement of the corneal (at a corneal diameter of 12 mm) and lens densitometry of participants was performed using a Pentacam HR Scheimpflug imaging system. Three different optimal depths as anterior, central, and posterior layers and four concentric zones, consisting of diameters of 0 to 2, 2 to 6, 6 to 10, and 10 to 12 mm, were chosen to perform the corneal densitometric measurements. The mean lenticular densitometric values were calculated in zone 1 at 2.0 mm, zone 2 at 4.0 mm, and zone 3 at 6.0 mm by taking the central part of the pupil as reference point. RESULTS: When compared with the individuals in the control group, the corneal densitometry measurements in the patients in the COVID-19 group were considerably higher in anterior 0 to 2 mm, 2 to 6 mm, 6 to 10 mm zones and total diameter; center 0 to 2 and 2 to 6 mm zones and total diameter; posterior 0 to 2 mm zone; and total corneal 0 to 2 and 2 to 6 mm zones and total diameter (P < .05, for each). When compared with the individuals in the control group, all of the lens densitometry measurements, except for those located in zone 1, were determined to be significantly higher among the patients in the COVID-19 group (P < .05, for each). CONCLUSIONS: Significant alterations were found in corneal and lenticular densitometric values in patients who had had COVID-19. The virus could adversely affect cornea and lens transparency.

The Impact of Coronavirus Disease 2019 (COVID-19) on Retinal Microcirculation in Human Subjects.

BACKGROUND: The aim of the study was to assess retinal microcirculation in patients with coronavirus disease 2019 (COVID-19) through the use of optical coherence tomography angiography (OCT-A) and compare the results with those obtained in healthy controls. METHODS: The study enrolled 39 patients who had fully recovered from COVID-19 and 40 healthy controls. OCT-A image acquisitions were obtained using AngioVue software (version 2017.1.0.151) and the RTVue XR Avanti imaging system (Optovue Inc., Fremont, CA, USA). Nonflow area in the superficial capillary plexus (SCP), foveal avascular zone (FAZ) area in the whole retinal vasculature, FAZ perimeter, acircularity index of FAZ, and foveal density were automatically obtained with the FAZ assessment tool. Vessel density (VD) at the SCP and deep capillary plexus were also measured. RESULTS: Compared to the control group, the nonflow area and the FAZ area in the whole retina was greater in the COVID-19 group; however no statistically significant difference was observed (p > 0.05 respectively). As for vessel densities, all superficial parafoveal VD parameters were considerably higher in the COVID-19 group compared to the control group (p < 0.05 respectively). Despite the fact that the vessel densities in the remaining zones were lower in the COVID-19 group, those differences were not statistically significant (p > 0.05 respectively). CONCLUSION: VD at the parafoveal area of the SCP was significantly higher among patients in the late post-recovery period of COVID-19 disease compared to healthy controls. These findings show the impact of COVID-19 on the retinal microvasculature and its possible role as a risk factor for the development of ocular diseases.

Quantitative assessment of retinal changes in COVID-19 patients.

CLINICAL RELEVANCE: The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina. BACKGROUND: To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT. RESULTS: The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were significantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all). CONCLUSION: In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.

Evaluation of topographic, tomographic, topometric, densitometric, and aberrometric features of cornea with pentacam HR system in subclinical keratoconus.

PURPOSE: To investigate topographic, tomographic, topometric, densitometric, and aberrometric parameters in subclinical keratoconus with the Pentacam HR imaging system. METHODS: Data of 3128 patients were evaluated, finding in 108 patients clinical keratoconus in one eye and subclinical keratoconus in the other. Corneal topographic, tomographic, topometric, densitometric, and aberrometric values obtained using the Pentacam HR imaging system were compared between clinical keratoconus, subclinical keratoconus, and normal eyes. RESULTS: Comparing eyes with subclinical keratoconus and the control group, while flat K, horizontal coma, horizontal trefoil, and vertical trefoil values were similar (p > 0.05 for each), all other parameters were significantly different (p < 0.05 for each). Densitometry values of eyes with subclinical keratoconus were significantly higher in all layers of the 0-2 mm annular area and in the anterior and central layers of the 2-6 mm annular area compared to the control group (p < 0.05 for each). According to the receiver operating characteristic curve analysis, the densitometry region with the largest area under the curve was the anterior layer of the 0-2 mm annular area. The sensitivity in this region was 79.4% and the specificity 73.2% in distinguishing eyes with subclinical keratoconus from normal eyes when 19.3 GSU was considered the threshold. CONCLUSION: Corneal densitometry values in the 0-2 and 2-6 mm annular areas, especially in the anterior layers, are parameters that can be used to predict and distinguish subclinical keratoconus from normal eyes.

Tomographic characteristics of focal choroidal excavation and its association with retinal disorders.

PURPOSE: To evaluate the morphological, clinical, and tomographic characteristics of focal choroidal excavation in the context of concomitant retinal pathologies. METHODS: This case series included 13 eyes of 13 patients with focal choroidal excavation diagnosed by spectral-domain optical coherence tomography. Morphologic characteristics of excavation and quantitative thicknesses of retinal layers and choroid were analyzed in excavation area, area adjacent to excavation, and fellow eye without focal choroidal excavation by spectral-domain optical coherence tomography. RESULTS: At the initial examinations, one eye had a history of blunt trauma, three eyes were diagnosed with choroidal neovascularization, one with choroidal osteoma, one with angioid streaks, one with retinal detachment, one with diabetic macular edema, one with optic pit, one with torpedo maculopathy, and the rest three with idiopathic focal choroidal excavation. The mean choroidal thickness in the area of focal choroidal excavation was statistically significantly thinner compared to in the area adjacent to focal choroidal excavation and fellow eye (p < 0.001) and total average outer nuclear layer thickness was statistically significantly thicker in the area of excavation compared with fellow eye (p = 0.007). CONCLUSION: This study confirmed the presence of focal choroidal excavation in various ocular diseases and the evaluation of focal choroidal excavation using the spectral-domain optical coherence tomography demonstrated choroidal thinning and outer nuclear layer thickening in the area of the excavation.

Evaluation of radial peripapillary capillary density in patients with newly diagnosed iron deficiency anemia.

PURPOSE: To investigate the effects of iron deficiency anemia (IDA) on radial peripapillary capillary vessel density (RPCvd) and retinal nerve fiber layer (RNFL) thickness. METHODS: Forty patients with IDA, and 46 healthy participants, were enrolled in this study. Optical coherence tomography angiography was used to determine RNFL thickness and RPCvd measurements. In addition, hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and ferritin laboratory values were evaluated. RESULTS: Analysis of retinal regions (whole images, peripapillary, superior-hemi, inferior-hemi, inferior-nasal, inferior-temporal, temporal-inferior, temporal-superior, superior-nasal) showed that RPCvd values were significantly lower in patients with IDA compared to the control group values (p < 0.05 for all). However, there were no significant differences in RNFL thickness values between the IDA patient group and the control group (p > 0.05 for all). In addition, there were significant positive correlations between RPCvd values and hematological values for Hb, HCT, MCV, MCH, MCHC, and ferritin. CONCLUSION: It is important to identify changes in retinal vascularity to prevent possible ocular problems in patients with IDA. Specifically, the significant positive correlations between RPCvd values and hematological values suggest that anemia treatment is important for optic nerve perfusion.

Evaluation of Corneal and Lenticular Parameters in Iron Deficiency Anemia.

OBJECTIVES: The aim of this study was to investigate the effects of iron deficiency anemia on corneal and lenticular densitometry. METHODS: Thirty-two patients with iron deficiency anemia and 38 healthy participants were enrolled. The Pentacam HR imaging system (Oculus Optikgeräte GmbH, Wetzlar, Germany) was used to record keratometry, corneal densitometry (12-mm corneal diameter), lens densitometry measurements. Endothelial parameters were evaluated using specular microscopy. RESULTS: The corneal densitometry values in the anterior 0-2 mm and 2-6 mm zone were significantly higher in the iron deficiency anemia group than in the control group (p=0.044 and p=0.021, respectively). There was a statistically significant difference in the mean values of the standard deviation and maximum lens densitometry measurements of the iron deficiency anemia group when compared with the control group (p=0.012 and p=0.011, respectively). There were statistically significant correlations between the anterior 2-6 mm zone corneal densitometry and ferritin, iron, and total iron binding capacity (r=-0.275, r=-0.243, r=0.240, respectively). However, ferritin, iron, and total iron binding capacity showed no significant correlation with the lens densitometry values (p>0.05 for all). CONCLUSION: Iron deficiency anemia had several effects on corneal and lenticular densitometry measurements. Evaluation of the corneal and lenticular changes at an ophthalmology clinic might be recommended for patients with iron deficiency anemia.

A Comparative Evaluation of Diffractive Trifocal and New Refractive/Extended Depth of Focus Intraocular Lenses for Refractive Lens Exchange.

PURPOSE: To evaluate and compare the visual performance and quality of life (QOL) associated with refractive/extended depth of focus (EDOF) intraocular lenses (IOLs) and diffractive trifocal IOLs in refractive lens exchange patients. MATERIALS AND METHODS: This was a comparative interventional study of patients undergoing implantation of Lucidis (Swiss Advanced Vision, SAV­IOL SA, Neuchâtel, Switzerland) or AT LISA tri 839MP (Carl Zeiss Meditec AG, Germany) IOLs. Near, intermediate, and distance best corrected and uncorrected visual acuities were collected at 1 and 3 months postoperatively. The vision-related QOL was evaluated 1 and 3 months after surgery, using the National Eye Institute Visual Function Questionnaire-14 (VF-14 QOL questionnaire). RESULTS: A total of 74 patients underwent refractive lens exchange and IOL implantation, with 38 patients in the EDOF group and 36 in the trifocal group. Among all visual acuities, uncorrected near visual acuity was statistically significantly better with the Lucidis IOL at the first month (p = .02) and diminished at the third-month visit (p = .16). When we compared the VF-14 QOL questionnaire scores, reading small print, reading a newspaper or book, and driving at night were statistically significantly better in the Lucidis group at the first month (p = .00, for each). That difference persisted only in driving at night at the third-month visit (p = .04). Reading small print, driving at night, and doing fine handwork were the most difficult tasks in the AT LISA group at the first month, and only driving at night remained so at the third-month visit. CONCLUSIONS: The refractive results and visual outcomes at all distances of EDOF and trifocal IOLs were highly satisfactory. However, the EDOF design in the Lucidis IOL achieves lower rates of glare in the early period after refractive lens exchange.