Effect of latanoprost on choroidal thickness in patients with newly diagnosed primary open-angle glaucoma.

OBJECTIVE: The purpose of this study was to assess the influence of latanoprost on choroidal thickness in patients with newly diagnosed primary open-angle glaucoma using Swept-Source Optical Coherence Tomography (SS-OCT). METHODS: The retrospective, non-randomized study comprised 40 newly diagnosed primary open-angle glaucoma patients receiving latanoprost therapy (Group 1). Additionally, 40 age- and sex-matched healthy subjects served as the control group (Group 2). Using SS-OCT, measurements of subfoveal, horizontal temporal, and horizontal nasal quadrants choroidal thickness, as well as intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness values, were collected at baseline and after 1 month for both groups. RESULTS: The mean age was 39.8±4.15 years (range: 18-45 years) in group 1 and 41.67±7.95 years (range: 18-45 years) in group 2 (p>0.05). The mean choroidal thickness in the subfoveal area, horizontal temporal quadrant, and horizontal nasal quadrant prior to latanoprost therapy were 263.57±84.23 µm, 233.05±80.08 µm, and 219.52±83.28 µm in the group 1 whereas 278.9±93.88 µm, 243.8±73.37 µm and 209.85±92.92 µm in the group 2. After latanoprost therapy, the mean choroidal thickness in the subfoveal area, horizontal temporal quadrant, and horizontal nasal quadrant changed significantly to 299.77±41.29 µm, 269.9±43.80 µm, and 261.32±45.60 µm in the group 1 (p=0.02, p=0.016, and p=0.012, respectively) (Table 1). However, the mean choroidal thickness in the subfoveal area, horizontal temporal quadrant and horizontal nasal quadrant in group 2 changed not significant and was 279.25±103.37 µm, 246.42±87.07 µm and 203.62±106.74 µm, respectively (p=0.4, p=0.5 and p=0.9, respectively). The mean IOP decreased significantly in group 1 (p=0.000) but did not change significantly in group 2 (p=0.153). There was no difference in RNFL thickness values at baseline and 1 st month in group 1 and group 2 (p>0.05). CONCLUSION: Topical latanoprost may increase choroidal thickness. Swept Source-OCT may contribute to our understanding of the actions of latanoprost on choroidal thickness.

New approach to AGV implantation with scleral tunnel method by prolene suture: Simsek Technique.

PURPOSE: To present the short-term outcomes of our novel technique, the suture-assisted method, in long scleral tunnel Ahmed Glaucoma Valve (AGV) implantation. METHODS: This retrospective study included glaucoma patients who underwent AGV implantation using the suture-assisted long scleral tunnel method and were fellowed for at least 6 months between January 2022 and November 2022. Preoperative and postoperative assessments included best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment examinations, anti-glaucomatous medications, and intraoperative and postoperative complications were also evaluated. RESULTS: Eight eyes of seven patients were included in the study. The mean age was 52.25 ± 29.38 years (r:8-76 years), and there were 5 female and 2 male patients. The mean follow-up duration period was 8.62 ± 2.50 months (r:6-12 months). The mean IOP was 27.12 ± 3.48 mmHg preoperatively and 11.62 ± 3.48 mmHg on postoperative on 1st day, 11.62 ± 3.20 mmHg at 1st week, 18.75 ± 8.94 mmHg at 1st month, 16.62 ± 2.72 mmHg at 3rd month, 16.12 ± 3.75 mmHg at 6th month. Postoperative hyphema was observed in one eye, and tenon cyst excision was performed in two eyes. No tube exposure was observed in any eye during the follow-up period. No hypotony-related complications were observed during follow-up. CONCLUSION: We believe that suture-asissted application of the long scleral tunnel method not only prevents tube exposure but also facilitates the passage of the AGV silicone tube through the scleral tunnel, reducing the surgical time contributing to a decreased the risk of infection.

A Case Report of Conjunctival Extranodal Marginal Zone Lymphoma Treated with Intralesional Rituximab Injection Therapy.

PURPOSE: To describe the safety and efficacy of intralesional rituximab (anti-CD 20 monoclonal antibody) therapy in a patient with conjunctival extranodal marginal zone lymphoma. METHODS: A single case report from a tertiary referral center. RESULTS: A 43 years old female patient with low-grade conjunctival extranodal marginal zone lymphoma who was completely and safely treated with intralesional rituximab therapy was presented. After four injections per week, intralesional rituximab injections were given monthly, and the treatment was completed in 6 months. Near-total regression was achieved at the end of the tenth cycle. No recurrence was observed during the 20-month follow-up period. CONCLUSION: The intralesional rituximab is a cost-effective and well-tolerated treatment for low-grade conjunctival lymphoma. The intralesional rituximab therapy may be prefer in the patients with low grade conjunctival lymphoma instead of radiotherapy. There will be needed further researches in this area.

The impact of celiac disease and duration of gluten free diet on anterior and posterior ocular structures: Ocular imaging based study.

PURPOSE: To evaluate the eyes of adult celiac disease (CD) patients and investigate the association between these ocular parameters with celiac specific antibodies and duration of gluten free diet (GFD). METHODS: This cross-sectional study included 72 eyes of 36 CD patients (18-51 years of age) and 70 eyes of 35 age- and sex-matched healthy controls. In addition to a complete ophthalmologic examination, all patients were scanned by a Scheimpflug camera, specular microscopy and spectral domain optical coherence tomography. RESULTS: Endothelial cell density (ECD), anterior chamber angle (ACA) degrees, anterior chamber depth (ACD), anterior chamber volume (ACV) and central macular thickness (CMT) values were lower in CD patients as compared with control group (p values = 0.038, 0.024, 0.002, 0.038 and 0.046 respectively). ECD and CMT were lower in celiac patients whom endomysial antibodies (EMA) IgA were positive (p = 0.001, p = 0.042 respectively). Tissue transglutaminase IgA antibody (anti tTG IgA) was weakly positively correlated (p > 0.05) with ACD, and positively (r = 0.319; p < 0.05) correlated with ACV. As the duration of compliance to the diet increased in the celiac group the mean and inferior retinal nerve fiber layer (RNFL) thickness decreased (p = 0.035, p = 0.008 respectively). Mean, inferior and temporal RNFL thicknesses were lower in celiac patients whose duration of GFD was longer than 5 years (p < 0.05). CONCLUSIONS: Decreases in ECD, ACA degree, ACD, ACV and CMT can occur in CD patients. In adult celiac patients; ECD, CMT might be effected in the presence of positive EMA, and ACD, ACV might be effected in the presence of higher anti tTG IgA titer. Adult celiac patients who had longer duration of GFD may have thinner RNFL. RNFL may be thinner in celiac patients who comply with GFD for more than 5 years.

Sutureless Scleral-Fixated Intraocular Lens Implantation in the Treatment of Congenital Lens Subluxation Related to Marfan Syndrome.

PURPOSE: To evaluate the efficacy and safety of bimanual capsulorhexis combined with sutureless scleral-fixated intraocular lens (IOL) implantation in children diagnosed as having Marfan syndrome. METHODS: The study included 14 eyes with subluxated lenses of 7 children who were diagnosed as having Marfan syndrome and underwent bimanual capsulorhexis combined with sutureless scleral-fixated IOL implantation by the same surgeon between 2015 and 2019 at the University of Health Sciences, Kartal Dr. Lütfi Kirdar City Hospital's Eye Department. RESULTS: The mean preoperative and postoperative uncorrected visual acuity was 1.47 ± 0.41 and 0.42 ± 0.15 logarithm of the minimum angle of resolution (logMAR), respectively (P = .001). The preoperative best corrected visual acuity (BCVA) ranged from 1.30 to 0.40 logMAR with a mean value of 0.81 ± 0.30 logMAR. Postoperatively, all patients had an increase in the BCVA with a mean value of 0.20 ± 0.11 logMAR, which was statistically significant (P = .001). The mean preoperative and postoperative spherical equivalent was -9.69 ± 4.59 and -0.27 ± 1.21 diopters, respectively. CONCLUSIONS: Despite the small number of patients in this study, good visual results and a low complication rate were obtained in patients with ectopic lens. The long-term IOL status in patients who have undergone sutureless scleral-fixated IOL implantation will make it possible to better evaluate the safety and applicability of the technique. [J Pediatr Ophthalmol Strabismus. 2021;58(6):401-406.].