Success Rate Comparis on of External Dacryocystorhinostomy with 5-FU Application or Silicone Tube Intubation.

Aims: To compare anatomical and functional success rates in patients with primary acquired nasolacrimal duct obstruction undergoing external dacryocystorhinostomy (EX-DCR) either with adjunctive 5-fluorouracil (5-FU) or silicone tube intubation. Methods: In this retrospective comparative study, 37 eyes in 32 patients who underwent EX-DCR with adjunctive 5-FU (5-FU group) and 43 eyes in 40 patients who underwent EX-DCR with silicone intubation (controls) between 2018 and 2019 were included. Results: The mean age of patients in 5-FU and control groups was 59.8 ± 9.4 and 57.0 ± 15.3 years, respectively. The mean follow-up was 18.70 ± 3.47 months in the 5-FU group and 21.38 ± 7.76 months in the control group. Anatomical success was determined based on patency rates at the time of irrigation and recurrence, while subjective symptoms (improvement in tearing) were used to evaluate the functional success. Lacrimal patency rates in 5-FU and control groups were 83.3% and 86.0%, respectively, while recurrence was observed in 16.2% of 5-FU and 14.0% of control subjects. The two groups were comparable in terms of patency and recurrence rates (p=0.777) as well as rates of epiphora (p=0.212). Conclusion: Both EX-DCR procedures were effective in the management of nasolacrimal duct obstruction. Our results suggest that EX-DCR augmented with 5-FU may represent a more feasible and cost-effective therapeutic option as compared to silicone tube placement in these patients.

Optical Coherence Tomography Angiography for Evaluation of Retinal Vascular Changes in Patients with Psoriasis according to Disease Severity.

OBJECTIVES: To investigate foveal avascular zone (FAZ) area and retinal vascular density (VD) in patients with psoriasis according to disease severity using optical coherence tomography angiography (OCTA). METHODS: Twenty-seven patients with mild psoriasis (Group 1), 28 with moderate to severe psoriasis (Group 2) and 30 healthy controls (Group 3) were evaluated with OCTA. Foveal and parafoveal VD and FAZ area were measured and compared. RESULTS: FAZ values were significantly higher in Group 2 (0.20 ± 0.1, 0.31 ± 0.07, 0.20 ± 0.09; P < .001, respectively.). The mean VD value were significantly lower in the deep capillary plexus in parafoveal area in Group 2 (35.5 ± 8.7, 28.7 ± 4.6, 35.0 ± 3.5; P < .001, respectively.). These changes showed significant correlation with Psoriasis Area and Severity Index (PASI) scores of patients. CONCLUSIONS: Our results suggest that OCTA may have a future role as alert of potentially more severe disease in cases clinically classified as mild disease.

Retinochoroidal vascular plexuses in patients with iron deficiency anaemia.

CLINICAL RELEVANCE: Optical coherence tomography angiography (OCT-A) may enable the identification of alteration in the retinochoroidal microvasculature in patients with iron deficiency anaemia. BACKGROUND: To investigate the presence of macular microvascular alterations in females with IDA by using OCT-A. METHODS: This is a cross-sectional comparative study. Forty patients with IDA and 35 age-matched healthy women underwent a complete ophthalmologic examination and OCT-A imaging. Foveal avascular zone parameters and the vessel density in the superficial (SCP) and deep capillary plexus (DCP) were calculated using automated software. All measurements were compared between groups. Correlations between the OCT-A metrics and haematological laboratory parameters were evaluated. RESULTS: Compared to healthy subjects, IDA patients revealed significantly decreased vessel density of the SCP in all parafoveal quadrants (p < 0.05). In contrast, vessel density analysis in DCP has shown no statistically significant difference in all parafoveal quadrants (p > 0.05). Although foveal vessel density in both SCP and DCP were higher in the IDA group, only the foveal vessel density in DCP was significantly higher than controls (p = 0.001). The mean values of the foveal avascular zone area and perimeter and choriocapillaris flow area were significantly lower in the IDA group (p < 0.05). The parafoveal vessel density in SCP, foveal avascular zone area, and choriocapillaris flow area were positively correlated with haematological parameters including haemoglobin, haematocrit, mean corpuscular haemoglobin, and mean corpuscular volume (p < 0.01). CONCLUSION: Patients with IDA had decreased parafoveal vessel density in the SCP, but not the DCP. Foveal avascular zone metrics and choriocapillaris flow area measurements were significantly lower in IDA.

Optical coherence tomography findings and choroidal neovascular membrane detectability with optical coherence tomography angiography in different subtypes of pattern dystrophy.

CLINICAL RELEVANCE: Optical coherence tomography angiography (OCTA) is a useful method for determining choroidal neovascular membranes (CNVM) in different subtypes of pattern dystrophy. BACKGROUND: We aimed to evaluate the optical coherence tomography (OCT) findings in different subtypes of pattern dystrophy and to detect CNVM not detectable by conventional method using OCTA. METHODS: Of 55 eyes included in this retrospective, cross-sectional study, adult onset vitelliform macular dystrophy was present in 42 eyes (32 eyes vitelliform stage-10 eyes vitelliruptive stage), butterfly-shaped pattern dystrophy in 8 eyes, and multifocal pattern dystrophy simulating fundus flavimaculatus in 5 eyes. Fluorescein angiography (FA), fundus autofluorescence, OCT and OCTA imaging were performed in all cases. RESULTS: The study included 55 eyes of 29 patients, of which 21 were female and 8 were male. On OCT, 25 eyes had hyperreflective dots, 14 eyes had a disruption in the ellipsoid zone (EZ), and 6 eyes had atrophy in the outer retinal layers, and these findings were detected in all subtypes. Findings consistent with CNVM were detected in 1 eye using FA, 3 eyes using OCT and 5 eyes in OCTA. CONCLUSION: In this study, we demonstrated that in different subtypes of pattern dystrophies OCT findings such as hyperreflective dots, disruption in the EZ, atrophy in the outer retinal layers and CNVM can be seen, and that a quiescent CNVM lesion, which cannot be detected by conventional methods, can be detected by OCTA, a new imaging method.

Subfoveal choroidal thickness and peripapillary retinal nerve fiber layer thickness in young obese males.

OBJECTIVE: Regarding the effect of obesity on subfoveal choroidal thickness (CT) and peripapillary retinal nerve fiber layer (RNFL) thickness, controversial results have been reported in different patient groups. This study aimed to evaluate the effect of obesity on these parameters among young male subjects in comparison with age-matched non-obese healthy males. METHODS: This prospective, cross-sectional study included both eyes of 50 obese young males and 50 healthy non-obese young males. The obese and the non-obese groups included subjects with a BMI of ⩾30 and ⩽25 kg/m², respectively. Subfoveal choroidal thickness and RNFL analyses were conducted by spectral domain optical coherence tomography (SD-OCT). RESULTS: Subfoveal choroidal thickness (321.0 ± 46.7 vs 338.4±35.3, p = 0.002) and RNFL thickness at temporal quadrant (73.4 ± 9.9 vs 76.4 ± 9.3, p = 0.008) was significantly lower in the obese group when compared to the non-obese group. The groups did not differ regarding peripapillary RNFL thickness at other quadrants (superior, inferior, or nasal) or regarding mean peripapillary RNFL thickness. CONCLUSION: Findings of this study demonstrated a negative correlation of obesity with subfoveal choroidal thickness and temporal quadrant peripapillary RNFL thickness. Larger studies on different patient groups with longer-term follow-up are warranted to better elucidate the ophthalmological effects of obesity.

Optical coherence tomography angiography of central serous chorioretinopathy patients' response to breath-holding manoeuvre.

PURPOSE: To demonstrate through the use of optical coherence tomography angiography (OCTA) that normal vasoreactivity cannot be monitored in central serous chorioretinopathy (CSR) patients in the presence of vasoactive stimuli owing to hypoxia caused by the breath-holding manoeuvre (BHM). METHODS: This cross-sectional study included a total of 210 eyes, including 70 CSR patients (70 symptomatic eyes, 70 asymptomatic eyes) and 70 control group. Images of the macula (3 × 3 mm) and the optic disc (4.5 × 4.5 mm) were obtained at the baseline and after BHM using OCTA. The change in vascular parameters in the OCTA after BHM was evaluated in CSR patients and the control group. RESULTS: In the symptomatic eyes of CSR patients, the mean whole image vessel density (VD) in the superficial capillary plexus decreased from 48.0 ± 3.5% under baseline conditions to 46.0 ± 4.5% after BHM (p < 0.01), and the mean whole VD in the deep capillary plexus decreased from 47.9 ± 8.0% under baseline conditions to 46.9 ± 6.7% after BHM (p < 0.01). The OCTA after BHM revealed a decrease in the mean whole image VD of the optic disc in both symptomatic (50.4 ± 2.1% to 49.6 ± 2.0%, p < 0.05) and asymptomatic (50.9 ± 1.8% to 50.4 ± 1.9%, p < 0.05) eyes of CSR patients. No difference for any mean VD of the control group was seen between the baseline and after BHM. Outer retinal flow areas increased significantly after BHM compared with the baseline in both eyes of CSR patients. CONCLUSION: These results suggest that CSR pathogenesis is related to an imbalance in local vascular regulation and the sympathetic activity of the autonomic nervous system. This technique constitutes a new way of studying retinal vascular changes and may be applied to CSR patients.