Based on the Real-Life Data of Türkiye; Comparison of Anatomical and Functional Outcomes of Phakic and Pseudophakic Patients in Wet Type Age-Related Macular Degeneration.

Objectives: The aim of the study was comparison of wet-type age-related macular degeneration in phakic and pseudophakic patients in terms of anatomical and functional success based on the real-life data of Türkiye. Methods: The multicenter retrospective real-life study data of the. retinal study group were used in this study. Among 867 eyes of 867 patients were included in the study. Patients were divided into two groups according to the status of the lens; phakic group and pseudophakic group. The follow-up period of the two groups, the number of injections at the 1st, 2nd, and 3rd years, and changes in the central macular thickness (CMT, µ) and visual acuity (VA, logMAR) of the patients at the beginning, 6th, 12th, 24th, and 36th months were examined. Results: In our study, the number of injections in the 1st, 2nd, and 3rd years, respectively, was 4.2±2.0, 1.8±1.9, and 1.0±1.7 in the phakic group, and 3.9±2.0, 1.7±1.9, and 0.8±1.4 in the pseudophakic group. When the two groups were compared in terms of the number of injections, there was a statistically significant difference in the 1st year, but there was no significant difference in the 2nd and 3rd years (p=0.001, p=0.350, and p=0.288, respectively). There was no statistically significant difference between the groups in terms of CMT in the baseline, 6th, 12th, 24th, and 36th months (p=0.991, p=0.327, p=0.652, p=0.599, and p=0.873, respectively). Although there was no difference in VA between groups at the beginning (p=0.052), the phakic group showed statistically better VA in controls at 3rd, 6th, 12th, 24th, and 36th months (p=0.001, p=0.001, p=0.000, p=0.000, and p=0.003, respectively). Conclusion: Differences in the number of injections and visual results between phakic and pseudophakic patients in wet type AMD may necessitate the creation of different treatment and follow-up protocols.

Results of anti-VEGF treatment for neovascular AMD in eyes with different baseline visual acuity in Turkish population-based on real life data-Bosphorus retina study group.

BACKGROUND: To investigate the anatomical and visual outcomes of the patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (anti-VEGF), according to the baseline best-corrected visual acuity (BCVA) based on the multicenter real-life data. METHODS: Five-hundred-ninety patients who had taken the Pro Re Nata (PRN) treatment regimen with three loading doses and at least one year of follow-up were included. The patients were divided into three groups according to the baseline BCVA: Group 1 (BCVA ≥ 1.3 Logmar), Group 2 (1.3 Logmar > BCVA ≥ 0.3 Logmar), and Group 3 (BCVA ≤ 0.2 Logmar). BCVA, central macular thickness (CMT), and the number of injections and visits were evaluated. RESULTS: There were 175, 322, and 93 patients in Group 1, Group 2, and Group 3, respectively. The number of visits and injections in the 1st year was not different between the groups (p = 0.58 and p = 0.08) and was 7.09 and 4.41 (Group 1), 6.59 and 5.58 (Group 2), 6.77 and 4.08 (Group 3). There was a significant difference in CMT between the baseline and 12th month in Group 1 and Group 2 (p < 0.001, p < 0.001, respectively) but not in Group 3 (p = 0.84). BCVA was significantly better in the 12th month in Group 1 (p < 0.001), slightly worse in Group 2 (p = 0.79), and significantly worse in Group 3 (p < 0.001). CONCLUSION: This study provides evidence that an inadequate number of injections cannot protect vision. Moreover, it can cause vision loss, especially in the eyes with good vision.

Improving effectiveness of different deep learning-based models for detecting COVID-19 from computed tomography (CT) images.

COVID-19 has caused a pandemic crisis that threatens the world in many areas, especially in public health. For the diagnosis of COVID-19, computed tomography has a prognostic role in the early diagnosis of COVID-19 as it provides both rapid and accurate results. This is crucial to assist clinicians in making decisions for rapid isolation and appropriate patient treatment. Therefore, many researchers have shown that the accuracy of COVID-19 patient detection from chest CT images using various deep learning systems is extremely optimistic. Deep learning networks such as convolutional neural networks (CNNs) require substantial training data. One of the biggest problems for researchers is accessing a significant amount of training data. In this work, we combine methods such as segmentation, data augmentation and generative adversarial network (GAN) to increase the effectiveness of deep learning models. We propose a method that generates synthetic chest CT images using the GAN method from a limited number of CT images. We test the performance of experiments (with and without GAN) on internal and external dataset. When the CNN is trained on real images and synthetic images, a slight increase in accuracy and other results are observed in the internal dataset, but between 3 % and 9 % in the external dataset. It is promising according to the performance results that the proposed method will accelerate the detection of COVID-19 and lead to more robust systems.

Comparison of two different treatment regimens' efficacy in neovascular age-related macular degeneration in Turkish population-based on real life data-Bosphorus RWE Study Group.

AIM: To compare two different anti-vascular endothelial growth factor (anti-VEGF) treatment regimens'-a priori pro re nata (PRN) and PRN regimen following the loading phase-anatomical and functional results in neovascular age-related macular degeneration (nAMD) patients. METHODS: Totally 544 nAMD patients followed and treated with aflibercept (n=135) and ranibizumab (n=409) at 9 different centers between 2013 and 2015 were enrolled into this retrospective multicenter study. Patients with initial best corrected visual acuity (BCVA) interval of 1.3-0.3 (logMAR) and a minimum follow-up of 12mo were included. Patients under two different regimens-a priori pro re nata (1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen (3+PRN)-were compared in BCVA at 3th, 6th and 12th months, and in central macular thickness (CMT) at 6th and 12th months. The total study group, intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in the 1+PRN (n=101) regimen from 407 to 358 and 340 µm and in the 3+PRN (n=443) group from 398 to 318 and finally to 310 µm at months 6 and 12, respectively. Anatomically, the CMT reduction at 6th month (48.5 vs 76.4; P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75; in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3th month (-0.01 vs 0.12; P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6th (44 vs 72) and 12th month (61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3th month (-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction (61 vs 89, 6th month; 85 vs 97, 12th month) and visual gain (0.02 vs 0.16; 0.02 vs 0.14; 0.05 vs 0.11) was found in favor of 3+PRN group at all visits. CONCLUSION: The loading dose of anti-VEGF treatments in nAMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.

Optical Coherence Tomography Angiography: Are There Any Changes in Measurements After Strabismus Surgery?

PURPOSE: To evaluate the possible hemodynamic changes following strabismus surgery via optical coherence tomography angiography. METHODS: Thirty-two eyes of 16 patients who underwent strabismus surgery in one eye were included in the study. Fellow eyes were used as a control group. The vessel densities of the superficial and deep capillary plexus and superficial and deep foveal avascular zones were measured preoperatively and 3 months postoperatively. RESULTS: The mean superficial and deep foveal avascular zones measurements were 0.84 ± 0.09 and 0.76 ± 1.13 mm2, respectively. The mean vessel density of the superficial capillary plexus was 1.23 ± 0.12 and 11.13 ± 1.04 mm2 preoperatively in the 1- and 3-mm zones, respectively, whereas the mean vessel density of the deep capillary plexus was 1.13 ± 0.16 and 10.11 ± 1.28 mm2 preoperatively. Postoperatively, the mean superficial and deep foveal avascular zones changed to 0.20 ± 0.13 and 0.23 ± 0.12 mm2, respectively. Postoperatively, the mean vessel density of the superficial capillary plexus changed to 1.47 ± 0.11 and 12.75 ± 1.10 mm2, and the mean vessel density of the deep capillary plexus changed to 1.56 ± 0.12 and 13.91 ± 1.35 mm2 in 1- and 3-mm zones, respectively. There was a statistically significant increase in vessel density measurements of the superficial and deep capillary plexus, and a statistically significant decrease in measurements of the superficial and deep foveal avascular zone postoperatively (P < .05). In the fellow eyes, there was no statistically significant change in any of the measurements (P > .05). CONCLUSIONS: Following strabismus surgery, vessel density of the fovea may increase and the foveal avascular zone may decrease according to optical coherence tomography angiography measurements. [J Pediatr Ophthalmol Strabismus. 2019;56(2):95-100.].

Measurement of extraocular horizontal muscle insertion distance via anterior segment optical coherence tomography of healthy children and comparison with healthy adults.

PURPOSE: The aim of the study was to determine the corneal limbus-extraocular muscle insertion distance (LID), via anterior segment optical coherence tomography, in healthy children and healthy adults and to compare the results of the measurements of the two groups. METHODS: Muscle limbus distances were measured using AS-OCT in 60 healthy cases in two groups. Children aged 8-13 years were evaluated as group 1, and healthy adults aged 25-30 years were evaluated as group 2. Measurements of 120 horizontal muscles were taken by one doctor (OBO). The values were compared according to age and gender groups, and correlation between LID measurements and spherical equivalent. Statistical evaluation was performed using SPSS 16® for Windows with the Student's t test and Pearson correlation coefficient test. RESULTS: LID measurements for MR and for lateral rectus (LR) were 5.74 ± 0.75 and 6.74 ± 1.11 mm, in the pediatric age-group, and 5.73 ± 0.75 and 6.84 ± 1.15 mm, in the adult age-group, respectively. There was no statistically significant difference between the two groups in terms of MR distances. There was a slight increase in the adult values, for the LR distance. There was no significant difference in terms of gender. Correlation was found 0.62 for MR and 0.46 for LR between LID measurements and spherical equivalent in the pediatric age-group. CONCLUSIONS: In healthy individuals, different imaging modalities can be used to measure LID, but AS-OCT can be used in pediatric age-groups as a preferred imaging method because it is easy and noninvasive.

Real-World Outcomes of Anti-VEGF Treatment for Neovascular Age-Related Macular Degeneration in Turkey: A Multicenter Retrospective Study, Bosphorus Retina Study Group Report No: 1.

OBJECTIVES: To evaluate the real-world outcomes of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in neovascular age-related macular degeneration (nAMD) patients. MATERIALS AND METHODS: Multicenter, retrospective, interventional, non-comparative study. The records of nAMD patients treated with an anti-VEGF agent on a pro re nata treatment regimen basis between January 2013 and December 2015 were reviewed. The patients who completed a follow-up period of 12 months were included. Primary outcome measures of this study were the visit and injection numbers during the first year. RESULTS: Eight hundred eighty eyes of 783 patients met the inclusion criteria for the study. Mean number of visits at month 12 was 6.9±2.5 (range: 1-15). Mean number of injections at month 12 was 4.1±1.9 (range: 1-11). Mean visual acuity at baseline and months 3, 6, and 12 was 0.90±0.63 LogMAR (range: 0.0-3.0), 0.79±0.57 LogMAR (range: 0.0-3.0), 0.76±0.57 LogMAR (range: 0.0-3.0), and 0.79±0.59 LogMAR (range: 0.0-3.0), respectively. Mean central retinal thickness at baseline and months 6 and 12 was 395±153 µm (range: 91-1582), 330±115 µm (range: 99-975), and 332±114 µm (range: 106-1191), respectively. CONCLUSION: The numbers of visits and injections were much lower than ideal and were insufficient with the pro re nata treatment regimen.

Assessment of the macula and choroid in pediatric keratoconus patients.

PURPOSE: To present choroidal and macular thickness measurements in pediatric patients with keratoconus and to evaluate a possible correlation between anterior and posterior segment parameters. METHODS: 50 eyes of 50 patients and 50 eyes of 50 age-matched controls were included in this cross-sectional comparative study. The participants underwent ophthalmologic examination including; refraction, visual acuity, biomicroscopy, corneal topography and optical coherence tomography. The choroidal thickness (CT) was measured at subfoveal area and at 500 microns intervals to the nasal and temporal to the fovea up to 1500 microns. RESULTS: The mean age of the patients and controls were 12.4 ±â€¯1.9 and 12.0 ±â€¯2.1 years. The mean thinnest corneal pachimetry was 456 ±â€¯57 µm, the mean central macular thickness (CMT) was 258 ±â€¯24 µm and the mean subfoveal choroidal thickness was 342 ±â€¯30 µm for the patients. There was no significant difference between the patients and controls in regards of CMT and CT at any measured points (p > 0.05 for all). There was no correlation between anterior segment parameters and CMT. There was no correlation between anterior segment parameters and subfoveal choroidal thickness. CONCLUSIONS: We may conclude that keratoconus does not affect the CMT and CT of pediatric keratoconus patients, and we may propose that we do not need a correction for this group of patients when we need to evaluate the CMT and CT.

Comparison of visual acuity measurements via three different methods in preschool children: Lea symbols, crowded Lea symbols, Snellen E chart.

PURPOSE: The aim of this study was to compare three different methods to measure visual acuity (VA) in healthy and amblyopic preschool children: a Snellen E chart (SE), a single Lea symbols (SLS), and a crowded Lea symbols (CLS). METHODS: Seventy-eight eyes of 54 patients (28 females, 26 males) were included in this cross-sectional, comparative study. The control group consisted of 30 healthy cases, and the amblyopic group consisted of 24 patients with amblyopia. Best-corrected VA (BCVA) measurements with SLS, CLS, and SE were compared in control eyes (CE), amblyopic eyes (AE), and fellow eyes (FE) separately. RESULTS: The mean age of the cohort was 5.7 ± 0.7 years (range 5-7 years). The mean refractive error was +1.02 ± 0.36 D (diopter, spherical equivalent) in CE, +5.59 ± 2.45 D in AE, and +3.96 ± 2.38 D in FE. The median BCVA (logMAR) was (in order of SLS, CLS, and SE) 0.00 [interquartile range (IQR) 0.10], 0.10 (IQR 0.10), 0.00 (IQR 0.10) in CE, 0.25 (IQR 0.33), 0.35 (IQR 0.30), 0.25 (IQR 0.38) in AE, and 0.10 (IQR 0.08), 0.10 (IQR 0.00), 0.10 (IQR 0.10) in FE. There was no statistically significant difference between the three methods in terms of the CE or FE (p > 0.05). In contrast, there was a statistically significant difference in AE (p < 0.05). The mean VA measurement with SLS was higher compared with CLS in AE. A positive and strong correlation between the three charts was found in all of the groups (p < 0.001). CONCLUSION: We found SLS, CLS, and SE to be consistent: all three methods can be used to obtain measurements of VA in healthy and amblyopic preschool children.

Efficacy of Intravitreal Bevacizumab in Treatment of Proliferative Type 2 Idiopathic Juxtafoveal Telangiectasia.

OBJECTIVES: To evaluate the effectiveness of intravitreal bevacizumab (IVB) in patients with subretinal neovascularization secondary to type 2 juxtafoveal telangiectasia. MATERIALS AND METHODS: Ten eyes of 10 patients were included in this retrospective study. All cases were treated with IVB (1.25 mg bevacizumab). Visual acuity and slit-lamp anterior and posterior segment examinations were performed at each visit. Central macular thickness (CMT) and intraretinal/subretinal fluid were evaluated via spectral domain optical coherence tomography (OCT). Loss of a line in visual acuity chart and presence of fluid on OCT were defined as criteria for repeated treatment. RESULTS: The mean age of patients was 66.0±7.0 years (56-75). The mean follow-up time was 54.7±16.0 month (24-72). The mean BCVA was 0.62±0.35 (0.00-1.00) logMAR at baseline and 0.54±0.35 (0.00-1.00) logMAR at final exam (p=0.03). The mean CMT was 251±25.4 µm at baseline and 239±39.3 µm at final exam (p=0.01). Patients received an average of 1.7±1.0 IVB injections during follow-up. At baseline, all cases had intraretinal/subretinal fluid. There was no fluid at final examination of all cases. CONCLUSION: IVB treatment may be effective in the treatment of subretinal neovascularization secondary to type 2 juxtafoveal telangiectasia.

Comparison of quantitative measurement of foveal avascular zone and macular vessel density in eyes of children with amblyopia and healthy controls: an optical coherence tomography angiography study.

PURPOSE: To quantify vessel density of superficial capillary plexus (SCP), deep capillary plexus (DCP), and the foveal avascular zone (FAZ) of children's amblyopic eyes and to compare the measurements with those of companion eyes and age-matched controls. METHODS: Fifteen patients with strabismic amblyopia, and 15 age-matched controls were included in this cross-sectional study. SCP, DCP, and FAZ were measured via optical coherence tomographic angiography (OCTA). RESULTS: Mean subject age was 8.2 ± 2.3 years in the amblyopia group and 8.6 ± 2.2 years in the control group. The mean SCP at 1 mm, 2 mm, and 3 mm zones were (in the order amblyopic eye, companion eye, control) 1.399 ± 0.088, 5.854 ± 0.195, 12.866 ± 0.346; 1.467 ± 0.084, 5.979 ± 0.182, 12.965 ± 0.321; and 1.559 ± 0.052, 6.343 ± 0.190, 13.819 ± 0.423. SCP was significantly lower in amblyopic eyes than in companion eyes and controls (P < 0.05). The mean DCP at 1 mm, 2 mm, and 3 mm zones were 1.425 ± 0.069, 6.038 ± 0.186, 13.522 ± 0.336; 1.525 ± 0.072, 6.427 ± 0.190, 14.286 ± 0.322; and 1.685 ± 0.074, 6.895 ± 0.198, 15.355 ± 0.356. DCP was significantly lower in amblyopic eyes than companion eyes and controls (P < 0.05). The mean superficial FAZ were 0.287 ± 0.091, 0.262 ± 0.092, and 0.280 ± 0.097. The mean deep FAZ were 0.382 ± 0.092, 0.335 ± 0.080, and 0.329 ± 0.085. There was no significant difference in FAZ among groups (P > 0.05). CONCLUSIONS: Vessel density of SCP and DCP of eyes with amblyopia is lower than that of the companion eye and the age-matched controls.

Ocular Pulse Amplitude and Retinal Vessel Caliber Changes after Intravitreal Dexamethasone Implant.

PURPOSE: The purpose of this study is to evaluate possible changes in ocular pulse amplitude (OPA), retinal arteriole caliber (RAC), and retinal venule caliber (RVC), following the intravitreal injection of dexamethasone implants (DIs). METHODS: Thirty-four eyes of 34 patients with macular edema were included. All participants received a full ophthalmologic examination at baseline. RAC and RVC were measured via optical coherence tomography; OPA and intraocular pressure (IOP) were measured via dynamic contour tonometry at baseline, month 1, and month 3. Statistical analysis was performed for before-after comparison of OPA, IOP, RAC, and RVC measurements. RESULTS: The mean OPA (in order to baseline, month 1, month 3) was 2.8 ± 0.8, 2.9 ± 1.0, 2.9 ± 0.9. The mean IOP was 16.8 ± 2.9, 17.3 ± 2.7, 18.4 ± 2.9 mmHg. The mean RAC was 97.8 ± 9.2, 97.2 ± 9.0, 97.6 ± 9.4. The mean RVC was 124.4 ± 8.2, 124.8 ± 8.8, 123.8 ± 8.2. There were no statistically significant changes in RAC (P = 0.688), RVC (P = 0.714), OPA (P = 0.348), and IOP (P = 0.115). There was also no correlation between RAC and OPA (r = 0.12, P = 0.62) or RVC and OPA (r = 0.16, P = 0.68) at the last visit. CONCLUSION: The intravitreal injection of DI does not significantly affect RAC, RVC, or OPA, which indicates that the treatment does not alter overall retinal-choroidal vasculature or hemodynamics.

Intravitreal ranibizumab in the treatment of choroidal neovascularization secondary to morning glory syndrome in a child.

Congenital optic nerve abnormalities may rarely cause choroidal neovascularization (CNV). This case report summarizes the clinical and therapeutic outcomes of a 7-year-old boy with unilateral CNV secondary to morning glory syndrome associated with acute visual acuity loss. The patient was successfully treated with a single intravitreal ranibizumab injection. One month after the injection the visual acuity increased and optic coherence tomography (OCT) showed a decrease in the intraretinal fluid around the CNV. The patient was then called for monthly follow-up visits. No further treatment was needed for the next 12 months after the first treatment. There was no complication related to the injection.

Clinical Performance of Toris K Contact Lens in Patients with Moderate to Advanced Keratoconus: A Real Life Retrospective Analysis.

Objectives. To evaluate the visual performance of Toris K soft contact lenses in patients with moderate-to-advanced keratoconus and also to compare the results according to cone types, cone location, and severity of keratoconus. Materials and Methods. Sixty eyes of 40 participants were included in this retrospective study. Uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BCVA), best-contact lens corrected visual acuity (BCLCVA), and comfort rating via visual analogue scales (VAS) were measured. Results. The mean age was 27.3 ± 8.6 years (range: 18 to 54). The mean logMAR UCVA, BCVA, and BCLCVA were 0.85 ± 0.38 (range: 0.30-1.30), 0.47 ± 0.27 (range: 0.10-1.30), and 0.16 ± 0.20 (range: 0-1.00). There were significant increases in visual acuities with contact lenses (p < .05). BCLCVA was significantly better in oval type than globus type (p = .022). UCVA and BCLCVA were significantly better in moderate keratoconus group (p = .015, p = .018). The mean line gain in Snellen was 3.6 ± 1.8 lines (range: 0-7 lines). The mean line gain was higher in central cone group than paracentral cone group and oval group than globus group (p = .014, p = .045). The mean VAS score was 8.14 ± 1.88 (range: 6-10). Conclusions. Toris K can improve visual acuity of patients with keratoconus. Toris K is successful even in the moderate and advanced form of the disease.

Anti-Vascular Endothelial Growth Factor Treatment for Proliferative Macular Telangiectasia Type 2.

Idiopathic macular telangiectasia type 2 (IMT 2), is the most common type of a heterogeneous group of disorders, characterized by telangiectatic alterations of the juxtafoveolar capillary network. Vision loss is due to retinal atrophy and subretinal neovascularization (SRN). Here, we report the outcomes of intravitreal anti-vascular endothelial growth factor injections, bevacizumab or ranibizumab, in four cases with proliferative IMT 2. Baseline best corrected visual acuity (VA) ranged from 20/50 to 20/100. Follow-up time ranged from 12 months to 24 months. One of four patients received one injection, two patients received three injections, and one patient received seven injections. VA improved in three eyes (≥1 line improvement) and decreased in one eye (≥1 line decrease) over time. Final acuity ranged from 20/30 to 20/100. There were no cases of leakage after the cessation of treatment. SRN, which is a complication of IMT 2, should be recognized and treated accordingly.

Long-Term Changes in Subfoveal Choroidal Thickness After Cataract Surgery.

BACKGROUND Cataract surgery is associated with the development of late-onset age-related macular degeneration (AMD). The pathogenic mechanism is still not fully established. The purpose of this study was to evaluate the possible changes in central macula thickness (CMT) and subfoveal choroid thickness (SCT) after uneventful cataract surgery. MATERIAL AND METHODS A total of 65 eyes of 65 patients who underwent phacoemulsification and intracapsular lens implantation were included in this prospective study. Patients had not undergone previous ocular surgery and had no other ocular abnormality. CMT and SCT were measured at baseline and postoperatively at week 1 and months 1, 3, 6 and 12 via spectral domain optical cohorence tomography (SD-OCT). RESULTS CMT was 252.4±27.6 µm (mean ±SD) preoperatively, then 253.5±29.8, 256.1±28.7, 257.4±27.2, 253.18±23.7, and 252.8±21.7 µm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. There were insignificant changes in CMT, and it returned to baseline at six months after surgery (all p>0.05). SCT was 237.4±21.6 µm preoperatively, and 240.5±24.8, 241.2±25.7, 242.7±26.3, 243.1±24.2, and 244.2±21.4 µm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. Although there was an increase in SCT during follow-up, the difference between preoperative and postoperative values was not significant (p>0.05). CONCLUSIONS Uncomplicated phacoemulsification induces subclinical changes in CMT, probably due to the inflammatory insult of surgery, and CMT returns to baseline value. There were slight, insignificant increases in choroid thickness during follow-up, and this did not return to baseline during follow-up. Changes in the choroid after cataract surgery may provide clues to the development of late-onset AMD.

Immediate Intraocular Pressure Changes Following Intravitreal Dexamethasone Implant.

PURPOSE: To evaluate the immediate intraocular pressure (IOP) changes following intravitreal dexamethasone implantation. METHODS: Thirty-four eyes of 34 consecutive patients (16 females and 18 males; mean age, 59.9 ± 9.0 years) with diagnosis of macular edema secondary to diabetic retinopathy (20 eyes) or retinal vein occlusion (14 eyes) scheduled for intravitreal dexamethasone implantation (Ozurdex) were included in the study. IOP at baseline, minute 1, minute 10, hour 1, and day 1 was measured using Tono-Pen XL. As a subgroup, the eyes with visible reflux after the implantation were analyzed separately for IOP change. RESULTS: Overall, the only significant change in relation to baseline was observed immediately after the implantation (16.5 ± 3.4 mmHg at baseline vs. 13.5 ± 5.7 mmHg at minute 1, P = 0.004). In eyes with reflux (N = 9), the mean IOP was 15.4 ± 2.4, 6.3 ± 4.2, 10.1 ± 4.4, 15.8 ± 2.9, and 15.6 ± 2.2 mmHg at baseline, minute 1, minute 10, hour 1, and day 1, respectively. The mean IOP was significantly lower at minute 1 (P = 0.008) and minute 10 (P = 0.013). In eyes without reflux (N = 25), the mean IOP was not significantly altered at any time point (for all P > 0.05). The rate of hypotony (IOP <6 mmHg) at minute 1, minute 10, hour 1, and day 1 was 8.8%, 2.9%, 0%, and 0%, respectively. Wound leakage and choroidal detachment were not observed in any of the eyes. CONCLUSIONS: The injection procedure of the Ozurdex implant itself does not affect IOP, except in the case of observable reflux, in which case the IOP temporarily decreases.