Evaluation of lamina cribrosa parameters, nerve fiber thickness, and macular thickness in primary open-angle glaucoma and pseudoexfoliation glaucoma using optical coherence tomography.

PURPOSE: To evaluate the lamina cribrosa, retinal nerve fiber layer (RNFL), and macula in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG) and healthy individuals using enhanced depth imaging (EDI) of spectral-domain optical coherence tomography (SD-OCT). METHODS: A total of 158 eyes were included in the study, comprising 58 eyes of 29 patients with POAG, 50 eyes of 25 patients with PEXG, and 50 eyes of 25 healthy individuals. The lamina cribrosa thickness (LCT) (at three locations), lamina cribrosa depth (LCD), RNFL thickness, and the macular thickness were measured using the EDI mode of the SD-OCT. The results were compared among the three groups. RESULTS: In both POAG and PEXG groups, the LCT was significantly thinner in the center, mid-superior, and mid-inferior areas in both eyes than in the control group (p < 0.001). However, no statistically significant difference was observed between the POAG and PEXG groups in terms of LCT at all three measurement locations in both eyes (p > 0.05). The LCD was significantly lower in the control group compared to the POAG and PEXG groups (p < 0.05), but there was no significant difference between the POAG and PEXG groups (p > 0.05). The RNFL thickness was significantly lower in both the POAG and PEXG groups compared to the control group in both eyes (p < 0.05). CONCLUSION: The LCT and LCD of patients with POAG and PEXG were thinner than those of healthy individuals, but there was no significant difference between the patients with POAG and PEXG.

Evaluation of lamina cribrosa thickness in patients diagnosed with central retinal vein occlusion.

PURPOSE: To evaluate the thickness of lamina cribrosa (LC) in both eyes of patients with unilateral central retinal vein occlusion (CRVO) and to compare with eyes of age-matched healthy control subjects. METHODS: This prospective case-control study included a total of 38 patients with unilateral CRVO and 42 healthy control subjects. The LC thickness was measured at the center of the optic disc using an enhanced depth imaging with the spectral domain optical coherence tomography in both eyes of patients with unilateral CRVO and eyes of healthy control subjects. The LC thickness of CRVO patients was evaluated one month after dexamethasone intravitreal implant (Ozurdex) injection. RESULTS: The mean LC thickness in affected eyes of patients with CRVO was significantly thinner than that of the healthy eyes (204.4 ± 8.8 and 228.0 ± 7.1 µm, p < 0.001, respectively). Also, the unaffected fellow eyes had significantly thinner LC compared with eyes of healthy subjects (205.3 ± 9.3 and 228.0 ± 7.1 µm, p < 0.001, respectively). There was no statistically significant difference in the thickness of LC between the affected and unaffected fellow eyes (p = 0.669). CONCLUSIONS: The LC thickness in both eyes of CRVO patients was thinner than that of the healthy eyes. This finding suggests that thin LC may contribute to the development of CRVO as an ocular risk factor in addition to systemic factors.

Corneal Sublayers Thickness in Patients With Mitral Valve Prolapse.

OBJECTIVES: The aim of this study was to compare the thickness of each corneal sublayer in patients with mitral valve prolapse (MVP) and healthy individuals. METHODS: A total of 38 eyes from 38 patients with MVP and 34 eyes from 34 age- and sex-matched healthy individuals were included in this study. The thickness of the corneal epithelium, Bowman layer, stroma, and Descemet membrane-endothelium complex were measured on the central cornea (i.e., corneal apex) and both the inferior and superior halves of the cornea with anterior segment module of spectral domain optical coherence tomography. RESULTS: No statistically significant differences emerged between the study and control groups in terms of Bowman layer thickness in the central cornea and the cornea's superior half (P=0.092 and P=0.128, respectively). However, in the inferior half of the cornea, Bowman layer thickness among patients with MVP was 11.95±2.34 µm (range 7-16 µm) and in the control group was 13.03±1.62 µm (range 10-16 µm), which made for a statistically significant difference (P=0.025). CONCLUSIONS: Our study revealed thinning of Bowman layer in the inferior half of the cornea in patients with MVP.

Assessing posterior ocular structures in ß-thalassemia minor.

PURPOSE: The aim of this study was to investigate the effect of ß-thalassemia minor on choroidal, macular, and peripapillary retinal nerve fiber layer thickness. METHODS: To form the sample, we recruited 40 patients with ß-thalassemia minor and 44 healthy participants. We used spectral-domain optical coherence tomography to take all measurements of ocular thickness, as well as measured intraocular pressure, axial length, and central corneal thickness. We later analyzed correlations of hemoglobin levels with ocular parameters. RESULTS: A statistically significant difference emerged between patients with ß-thalassemia minor and the healthy controls in terms of mean values of subfoveal, nasal, and temporal choroidal thickness (p = 0.001, p = 0.016, and p = 0.010, respectively). Except for central macular thickness, differences in paracentral macular thicknesses between the groups were also significant (superior: p < 0.001, inferior: p = 0.007, temporal: p = 0.001, and nasal: p = 0.005). Also, no statistically significant differences were noted for retinal nerve fiber layer thickness between two groups. CONCLUSION: Mean values of subfoveal, nasal, temporal choroidal, and macular thickness for the four quadrants were significantly lower in patients with ß-thalassemia minor than in healthy controls.

The Effect of Oral Contraceptive Pills on the Macula, the Retinal Nerve Fiber Layer, and Choroidal Thickness.

BACKGROUND The aim of this study was to evaluate the effect of oral contraceptive pills (OCP) on the macula, the retinal nerve fiber layer (RNFL), and choroidal thickness (CT). MATERIAL AND METHODS A total of 24 healthy women taking monophasic OCP (3 mg drospirenone and 0.03 mg ethinylestradiol) for contraception only for at least one year were compared with a control group of 24 healthy women who were not taking an OCP. Optical coherence tomography (OCT) was used to evaluate the posterior ocular segments, and measurements were taken in the follicular phase (day 3) of the cycle in all women. RESULTS No disparity in terms of age and body mass index between the groups was observed (p=0.436, p=0.538, respectively). In comparison of the macular region and CT between groups, we found that all variables except foveal center thickness and CT were significantly thinner in the OCP group. Nasal and temporal inferior parts of the RNFL and average RNFL were significantly slimmer in the study group versus the control group (p=0.013, p=0.018, and p<0.001, respectively). CONCLUSIONS OCP resulted in several structural changes in the posterior ocular segment. Thus, women using OCP for more than one year may have some eye problems. Therefore, it OCT should be performed for these women. Further clinical trials researching long-period effect of OCP on the eyes are needed.

Evaluation of foveal photoreceptor layer in eyes with macular edema associated with branch retinal vein occlusion after ozurdex treatment.

The aim of this study was to evaluate the central retinal thickness (CRT), outer nuclear layer thickness (ONLT), photoreceptor layer thickness (PLT), photoreceptor layer integrity, and the correlation between visual acuity and PLT in eyes with branch retinal vein occlusion (BRVO) 2 months after treatment with intravitreal dexamethasone implant (Ozurdex; Allergan, Inc, Irvine, CA). In this prospective study, 32 eyes of 32 patients were enrolled. A single injection of Ozurdex was administered to all the patients. CRT, ONLT, and PLT were measured using spectral-domain optical coherence tomography before and 2 months after the injection. Best-corrected visual acuity (BCVA [logMAR]) and photoreceptor cell integrity were also evaluated. The average CRT, ONLT, PLT, and BCVA values for the sample group before the treatment were as follows: 707 ± 261, 608 ± 288, 70 ± 25, and 0.96 ± 0.22 µm, respectively. The average CRT, ONLT, PLT, and BCVA values for the sample group 2 months after the Ozurdex injection were as follows: 299 ± 149, 211 ± 138, 77 ± 20, and 0.63 ± 0.30 µm, respectively (p < 0.05). Two months after the Ozurdex injection, BCVA correlated with ONLT and PLT (r = 0.365, p = 0.048 and r = -0.488, p = 0.021, respectively), whereas BCVA was not correlated with CRT (r = 0.239, p = 0.189). Photoreceptor layer is associated with the visual function of eyes with macular edema secondary to BRVO. Also, ONLT seems to be more closely related to visual acuity improvement than CRT decrement.

The assessment of choroidal thickness with spectral-domain optical coherence tomography during Valsalva maneuver.

PURPOSE: The purpose of the study was to evaluate the effect of Valsalva maneuver (VM) on choroidal thickness. METHODS: All the volunteers underwent a detailed opthalmic examination. Third-generation Spectralis OCT device (software version 5.6.3.0; Spectralis OCT, Heidelberg Engineering, Dossenheim, Germany) was used for assessment. Subfoveal and perifoveal CT of all volunteers were measured by using EDI-OCT technology. Perifoveal CT was measured 1500 µm nasally and 1500 µm temporally apart from the foveal center. The measurements were repeated while volunteers were performing VM. RESULTS: Sixty-four eyes of 32 healthy volunteers were assessed. The volunteers were aged 29-50. The mean age was 32.8 ± 6.6 years. Choroidal thickness measurements differed with statistical significance between resting position and VMin all regions (p < 0.001). While mean subfoveal CT was 350.64 ± 87.73 µm during resting position, it was 369.95 ± 90.12 µm during VM (p < 0.001). While mean nasal CT was 292.14 ± 81.67 µm during resting position, it was 305.46 ± 85.80 µm during VM (p < 0.001). While mean temporal CT was 325.93 ± 80.91 µm during resting position, it was 343.21 ± 81.53 µm during VM (p < 0.001). CONCLUSIONS: We found statistically significant increase in choroidal thickness during the VM in healthy volunteers. This result might be important for future studies researching autoregulation of choroidal and retinal blood flow in physiologic and pathologic conditions. Also, our study is noteworthy to stand out the errors in EDI-OCT measurements caused by unintentional breath holding of patients.

Systemic endothelial function in cases with wet-type age-related macular degeneration.

BACKGROUND: Choroidal endothelial dysfunction plays key role in wet-type age-related macular degeneration (AMD). Peripheral vascular endothelial function is not known in wet AMD. OBJECTIVE: We aimed to analyze peripheral vascular endothelial function in cases with wet-type age-related macular degeneration by measuring flow-mediated dilatation (FMD). MATERIALS AND METHODS: The study included 20 cases with wet AMD (Group 1, mean age 65.9 ± 7.2 years) and 24 healthy individuals (Group 2, mean age 62.0 ± 11.9 years). In all cases, a cardiologist assessed the responses of endothelial function by measuring the FMD following brachial artery occlusion. RESULTS: Mean FMD, an indicator of endothelial function was found to be 6.4 ± 2.7 % in Group 1 and 15.6 ± 7.3 % in Group 2 (p < 0.001). There was no significant difference between patient and control groups regarding age, sex, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, ESR and CRP. CONCLUSION: Reduced FMD is present in patients with wet AMD, suggesting that impaired peripheral endothelial function may be involved in its pathogenesis.

The assessment of changes in macular thickness in diabetic and non-diabetic patients: the effect of topical ketorolac on macular thickness change after ND:YAG laser capsulotomy.

PURPOSE: The purpose of our study is to assess the changes in macular thickness (MT) in diabetic and non-diabetic patients and to research effects of topical ketorolac (Acular®, Allergan, Irvine, CA) on MT change after neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy. MATERIAL AND METHODS: This study involved 88 eyes of 88 patients diagnosed as posterior capsule opacification (PCO). Patients were divided into four groups according to presence of diabetes mellitus (DM) and drugs used after capsulotomy. Group 1: Patients with DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy (22 patients). Group 2: Patients with DM using 0.5% ketorolac (Acular®) and 0.1 Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy (20 patients). Group 3: Patients without DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (22 patients). Group 4: Patients without DM using 0.5% ketorolac (Acular®) and 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (24 patients). A plus-shaped capsulotomy was performed using VISULAS® YAGIII (Carl Zeiss) laser microscope. MT measurement with Cirrus SD-OCT (Carl Zeiss Opthalmic System Inc., Model 400, Dublin, CA, Software 5) were done. Measurements were done before laser, and on the first day, first week, first month, third month and sixth month after laser capsulotomy. We compared the four groups for MT change during 6 months. RESULTS: Group 1 involving patients with DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy had increased MT at the first week, and the first, third, and sixth month after laser (p < 0.001). Group 3 involving patients without DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) had increased MT at the first week, and at the first and third month, there was no statistically significant difference at the sixth month (p > 0.05). There was no statistically significant increase in MT during the follow-up period in group 2 involving patients with DM using 0.5% ketorolac (Acular®) and 0.1 Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy and group 4 involving patients without DM using 0.5% ketorolac (Acular®) and 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (p > 0.05). CONCLUSION: An increase in MT can be observed after Nd:YAG laser capsulotomy, especially in diabetic patients. Adding topical ketorolac (Acular®, Allergan, Irvine, CA) to topical Fluorometholon (FML®, Allergan, Irvine, CA) therapy after YAG laser capsulotomy can prevent this increase.

The assessment of anterior and posterior ocular structures in hyperopic anisometropic amblyopia.

BACKGROUND: The aim of this study was to examine the relationship or differences in ocular structures of amblyopic eyes compared to fellow eyes in children and young adults with hyperopic anisometropic amblyopia. MATERIAL/METHODS: Hyperopic participants with anisometropic amblyopia, defined as the presence of best-corrected visual acuity differences of at least 2 Snellen lines and 1.5 diopters between amblyopic and fellow eyes, were studied. Using the IOL Master, Pentacam Scheimpflug imaging and Spectralis optical coherence tomography, the axial length, corneal curvature, and anterior chamber depth (ACD), as well as the thickness of the cornea, peripapillary retinal nerve fiber layer (RNFL), and macula, were compared between children and young adults and between their amblyopic and fellow eyes. RESULTS: In 53 participants with hyperopic anisometropic amblyopia, there were significant differences in the anterior corneal curvature, ACD and axial length between the amblyopic and fellow eyes of all the patients. The mean central macular thickness in the amblyopic eyes was significantly thicker (P=.001) in the group aged 5 to 12 years; however, this was not the case in the group aged 13 to 42 years. There was no significant difference in average RNFL thickness in either group. CONCLUSIONS: We found significantly greater mean central macular thickness in anisometropic amblyopic eyes among participants aged 5 to 12 years, but not among those who were older. Similarly, the interocular differences in axial length parameters seemed to be related to the central macular thickness differences between the amblyopic and fellow eyes in the younger group.

Assessment of Macular Peripapillary Nerve Fiber Layer and Choroidal Thickness Changes in Pregnant Women with Gestational Diabetes Mellitus, Healthy Pregnant Women, and Healthy Non-Pregnant Women.

BACKGROUND: Gestational diabetes mellitus (GDM) is a risk factor for the development of type II diabetes and it causes maternal and child morbidity. Screening for diabetic retinopathy (DR) is important because patients who develop DR have no symptoms until macular edema and/or proliferative diabetic retinopathy (PDR) are already present. The aim of this study was to determine the early retinal findings of GDM. MATERIAL AND METHODS: This study was conducted in a tertiary research center. We conducted a prospective cross-sectional study with 3 groups: Group 1 consisted of 36 pregnant women with GDM, Group 2 consisted of 24 healthy pregnant women, and Group 3 consisted of 38 healthy non-pregnant women of reproductive age. Spectralis optical coherence tomography (OCT) was used for the assessment. Macular, choroid, and retinal nerve fiber layer (RNFL) thicknesses were evaluated in patients with GDM and comparisons were made among pregnant women with GDM, healthy pregnant women, and healthy non-pregnant women for these parameters. RESULTS: The nasal part of the RNFL was significantly thinner in the GDM group than in the healthy pregnant group. None of the patients had retinopathy or macular edema at the time of examination. CONCLUSIONS: Decreased nasal part of RNFL thickness may be the first retinal change in patients with GDM. Our study suggests that OCT should be performed for the patients with GDM for detection of early retinal changes associated with GDM.

Evaluation of the macula, retinal nerve fiber layer and choroid thickness in postmenopausal women and reproductive-age women using spectral-domain optical coherence tomography.

OBJECTIVE: Menopause is a physiological life period that potentially affects various organs and systems. Therefore, a wide spectrum of signs and symptoms of eyes may be clinically observed in the postmenopausal period. AIM OF THE STUDY: To evaluate the macular, retinal nerve fiber layer (RNFL) and choroidal thickness alterations by using spectral-domain optical coherence tomography (SD-OCT) in postmenopausal women and compare with healthy reproductive-age women controls. MATERIAL AND METHODS: The study population included a healthy reproductive-age control group (n = 72) and postmenopausal study group (n = 72). Retinal thickness parameters were measured by SD-OCT. Peripapillary RNFL thickness parameters, macular thickness and choroidal thickness were evaluated. RESULTS: Superior inner macula, temporal inner macula, inferior inner macula, nasal inner macula, inferior outer macula and choroid thickness were significantly thinner in the postmenopausal study group than the healthy reproductive-age control group (p = 0.007, p = 0.037, p = 0.027, p = 0.006, p = 0.016, p < 0.001, respectively). After adjusting for age, only choroid thickness was significantly thinner in the postmenopausal study group than controls (p (†) = 0.005). CONCLUSIONS: This study revealed that choroidal thickness measured by SD-OCT was significantly thinner in postmenopausal women than healthy reproductive-age women. We can speculate that the decrease in choroidal thickness in postmenopausal women may indicate a reduced estrogen-dependent vasodilatory effect in ophthalmic artery secondary to menopausal estrogen deficiency.

The toxicity assessment of phosmet on development, reproduction, and gene expression in Daphnia magna.

The use of pesticides to control pests, weeds, and diseases or to regulate plant growth is indispensable in agricultural production. However, the excessive use of these chemicals has led to significant concern about their potential negative impacts on health and the environment. Phosmet is one such pesticide that is commonly used on plants and animals against cold moth, aphids, mites, suckers, and fruit flies. Here, we investigated the effects of phosmet on a model organism, Daphnia magna using acute and chronic toxicity endpoints such as lethality, mobility, genotoxicity, reproduction, and gene expression. We performed survival experiments in six-well plates at seven different concentrations (0.01, 0.1, 1, 10, 25, 50, 100 µM) as well as the control in three replicates. We observed statistically significant mortality rates at 25 µM and above upon 24 h of exposure, and at 1 µM and above following 48 h of exposure. Genotoxicity analysis, reproduction assay and qPCR analysis were carried out at concentrations of 0.01 and 0.1 µM phosmet as these concentrations did not show any lethality. Comet assay showed that exposure to phosmet resulted in significant DNA damage in the cells. Interestingly, 0.1 µM phosmet produced more offspring per adult compared to the control group indicating a hormetic response. Gene expression profiles demonstrated several genes involved in different physiological pathways, including oxidative stress, detoxification, immune system, hypoxia and iron homeostasis. Taken together, our results indicate that phosmet has negative effects on Daphnia magna in a dose- and time-dependent manner and could also induce lethal and physiological toxicities to other aquatic organisms.

Evaluation of the lamina cribrosa after topical latanoprost therapy in primary open-angle glaucoma or ocular hypertension.

PURPOSE: To investigate that the changes of lamina cribrosa (LC) thickness and depth after latanoprost therapy in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. METHODS: In this single-center prospective cross-sectional study, 35 eyes from 35 patients with POAG or OHT (study group) and 26 age- and gender- matched healthy individuals (control group) were included. All participants were examined by spectral domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode for LC thickness and depth measurements at the first visit before latanoprost therapy and at visits after 1 (second visit) and 3 (third visit) months of latanoprost therapy. RESULTS: The mean LC thickness in both horizontal and vertical scans of the study group were thinner than the control group (p < 0.001, for both). During latanoprost therapy in the study group, the LC thickness values in horizontal scans significantly differed over the three visits, gradually increased (p < 0.05). There was significantly decrease in LC depth in horizontal scans between the first and third visits, and the second and third visits (p = 0.003 and p = 0.008, respectively). The gradual decrease in LC depth in vertical scans was observed at all visits, but the statistically significant difference was between the first and third visits only (p = 0.048). CONCLUSION: POAG/OHT patients showed more LC thinning compared with healthy individuals. The significant increase in LC thickness and the significant decrease in LC depth were detected after IOP reduction therapy with latanoprost in ocular hypertensive/ glaucomatous eyes.

Short-term impact of intravitreal ranibizumab injection on axial ocular dimension and intraocular pressure.

OBJECTIVE: To evaluate the short-term impact of intravitreal ranibizumab injection on axial ocular dimension (AOD) and intraocular pressure (IOP). METHODS: A total of 31 patients who received 0.05 mL intravitreal ranibizumab injection (IRI) for age-related macular degeneration and 30 healthy volunteers were enrolled in the study. AODs i.e. anterior chamber depth and axial length were measured with IOL Master and IOP with noncontact tonometer before and 5 min, 30 min and 1 day after the injection. RESULTS: Five minutes after the injection, mean IOP increased to 24.8 ± 9.5 (13-46) mmHg from 14.5 ± 2.3 (10-18) mmHg (p < 0.001). Thirty minutes after the injection, IOP decreased a mean level of 17.3 ± 4.1 (11-26) mmHg. The change in axial length and anterior chamber depth measurements did not reach a statistical significance across the time points (p > 0.05, for all values). There was no correlation between biometric measurements and IOP before (r = 0.016, p = 0.948 for axial length and r = -0.48 p = 0.075 for anterior chamber depth) and 5 min after IRI (r = 0.049, p = 0.835 for axial length and r = -0.219 p = 0.367 for anterior chamber depth). Measurements of control group taken across same time points did not reveal statistically significant differences (p > 0.05, for all measurements). CONCLUSION: Although IOP increases transiently after the intravitreal injection of 0.05 mL ranibizumab, axial length and anterior chamber depth are not affected by this amount of injection, and the increase in IOP after the injection seems to be irrelevant to AL and anterior chamber depth. Therefore, it is postulated that ranibizumab can be used safely in patients with age-related macular degeneration who have shallow anterior chamber and/or short axial length simultaneously.

Retrospective analysis of the efficacy of early switching from bevacizumab to aflibercept or ranibizumab in diabetic macular edema.

PURPOSE: The study aimed to compare the anatomical and functional gains of switching to ranibizumab or aflibercept in eyes with treatment-naive diabetic macular edema (DME) which has an inadequate response to three consecutive bevacizumab injections. METHODS: This observational, retrospective, comparative study presented 12-month results of 80 patients with DME. One eye of each patient was enrolled, and bevacizumab was switched as aflibercept (40 eyes) or ranibizumab (40 eyes). DME was diagnosed based on a fundoscopic examination, fundus fluorescein angiography (FFA), central macular thickness (CMT), and best-corrected visual acuity (BCVA). RESULTS: Forty-one patients (51.2%) were male, and 39 (48.8%) were female, with a mean age of 62.3 ± 6.7 years. At the end of the study, the mean number of intravitreal injections was 8.1 ± 1.8 in the aflibercept group, whereas 8.9 ± 1.4 in the ranibizumab (p = 0.091). The mean CMT decreased from 449.2 ± 69.3 µm to 311.0 ± 48.9 µm in the aflibercept group, and from 444.9 ± 109.2 µm to 316.3 ± 54.5 µm in the ranibizumab group (for both, p < 0.0001). The mean BVCA increased from 49.2 ± 11.1 ETDRS letters to 62.5 ± 9.9 in the aflibercept group (p < 0.0001) and from 49.9 ± 12.0 ETDRS letters to 61.1 ± 9.1 in the ranibizumab group (p < 0.0001). Macular laser treatment was required in 17.5% of the aflibercept group and 22.5% of the ranibizumab group (p = 0.781). CONCLUSION: Significant improvement was observed with ranibizumab and aflibercept treatments in initial bevacizumab-resistant DME. Early switching therapy may contribute to better visual and anatomical outcomes.

Effect of pupil dilation on intraocular pressure in preterm and term infants.

PURPOSE: To evaluate the effect of pupil dilation on intraocular pressure in preterm and term newborns. METHODS: This prospective study involved 55 eyes of 28 preterm infants and 38 eyes of 20 term infants. The infants were divided into two groups according to their gestational ages at birth as follows: preterm group, <37 weeks and term group, ≥37 weeks. Pupil dilation was attained with tropicamide 0.5% and phenylephrine 2.5%. Intraocular pressure measurements were performed with Icare PRO (Icare Finland Oy, Helsinki, Finland) before and after pupil dilation. A paired t test was used to compare the measurements before and after pupil dilation. RESULTS: The mean intraocular pressure change was -1.04 ± 3.03 mmHg (6.20/-11.40 mmHg) in the preterm group and -0.39 ± 2.81 mmHg (4.60/-9.70 mmHg) in the term group. A statistically significant difference in intraocular pressure was observed only in the preterm group after pupil dilation (p=0.01). CONCLUSION: An unexpected alteration in intraocular pressure in newborns may occur after pupil dilation, especially in preterm infants.

Relationship between erythrocyte sedimentation rate and choroidal and retinal thickness in Behçet's disease.

PURPOSE: To compare retinal and choroidal thickness in patients with Behçet's disease with and without ocular involvement as well as to evaluate the correlation between erythrocyte sedimentation rate and choroidal thickness among patients with Behçet's disease. METHODS: This was a prospective interventional study investigating erythrocyte sedimentation as well as choroidal and retinal thickness among patients with Behçet's disease. Patients who were diagnosed based on The International Criteria for Behçet's Disease with (Group A) or without (Group B) ocular involvement and a matched control group (Group C) participated in the study. Optical coherence tomography measurements and blood tests were performed on the same day. Retinal and choroidal thickness were measured using spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany), and central macular thickness, central subfoveal choroidal thickness, and retinal nerve fiber layer thickness were measured using optical coherence tomography. RESULTS: Average erythrocyte sedimenta-tion values were 9.89 mm/h in Group A, 16.21 mm/h in Group B, and 3.89 mm/h in Group C; average central subfoveal choroidal thickness values were 350.66, 331.74, and 325.95 mm, respectively. Average central macular thickness and retinal nerve fiber layer thickness values of patients in Groups A, B and C were 226.39 and 225.97mm; 234.11 and 92.00 mm; and 97.58 and 99.84 mm, respectively. No significant difference was seen between Group A and B patients in central subfoveal choroidal thickness, central macular thickness, or retinal nerve fiber layer thickness values. Central macular thickness was statistically significantly thinner in Groups A and B than in Group C (p=0.016). Group A had thinning in the nasal quadrant of the retinal and general retinal nerve fiber layers when compared with those in Group C (p=0.010 and 0.041, respectively). A connection could not be established between the erythrocyte sedimentation, central subfoveal cho-roidal thickness, central macular thickness, and retinal nerve fiber layer thickness in the patients with Behçet's disease. CONCLUSION: The erythrocyte sedimentation rate is typically used to test for activation of Behçet's disease and assess treatment response. In our study, we could not establish a connection between the erythrocyte sedimentation rate and central subfoveal choroidal thickness, central macular thickness, and retinal nerve fiber layer thickness in patients with systematically active Behçet's disease without ocular involvement.

The Effect of Age on Dexamethasone Intravitreal Implant (Ozurdex®) Response in Macular Edema Secondary to Branch Retinal Vein Occlusion.

PURPOSE: To investigate the effect of age on dexamethasone intravitreal implant (Ozurdex®) response in macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: Seventy-three eyes of 73 patients with macular edema secondary to BRVO were recruited in the study. The patients in the study were divided into the following four groups according to their ages: group 1 (<60 years), group 2 (60-69 years), group 3 (70-79 years), and group 4 (≥80 years). Single-dose Ozurdex injection was applied to all patients. The effectiveness of Ozurdex treatment on macular edema is evaluated via optical coherence tomography (OCT) according to the age groups. RESULTS: Two months after Ozurdex injection, mean reduction of central retinal thickness in groups 1, 2, 3, and 4 were -466.4 ± 149.6, -379.7 ± 238.7, -280.1 ± 233.0, and -180.5 ± 81.4 µm, respectively. This reduction of central retinal thickness decreased with aging (p = 0.001). Also, ages of patients were negatively correlated with the mean reduction of central retinal thickness for the whole study group (r = -0.439, p < 0.001). CONCLUSION: Our study revealed that the effectiveness of Ozurdex treatment decreases with aging.

The Effect of Pseudoexfoliation Syndrome on the Retinal Nerve Fiber Layer and Choroid Thickness.

PURPOSE: To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers. METHODS: This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects. RESULTS: The RNFL thickness was higher in the PEX and control groups compared to the PXG group (p<0.001). The choroid thickness was significantly higher in the control group compared to the PXG and PEX groups (p<0.05). No significant difference was detected between the both groups. CONCLUSIONS: PEX might weaken choroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.