Efficacy of pneumatic retinopexy in young adults with rhegmatogenous retinal detachment.

Background: In young adults with rhegmatogenous retinal detachment, pneumatic retinopexy can be a cost-effective and minimally invasive highly effective method in suitable cases. Objectives: To evaluate the role of pneumatic retinopexy in the treatment of young adults with rhegmatogenous retinal detachment (RRD) and the factors that may affect the success of pneumatic retinopexy. Design: Retrospective study. Methods: The study included 67 eyes of 67 patients aged between 21 and 40 who underwent pneumatic retinopexy (PR) between January 2015 and June 2021 for primary RRD. We retrospectively analyzed the prognostic factors that may affect the success of PR, such as preoperative age, best corrected visual acuity, tear site, lens condition, and axial length. Results: PR was successful in 61.2% of the patients, whereas 38.8% required secondary surgery. Between the group that had a single surgery (Group 1) and the group that required secondary surgery (Group 2) the tear location, axial length, and volumes of gases used were statistically different (p = 0.04, p < 0.001, and p = 0.02, respectively). There was a significant difference in visual acuity before and after surgery in the group that was successful with a single surgery (Friedman χ2 = 40.051, p < 0.001). There was no significant difference between the two groups in terms of intraocular pressure (p > 0.05), and glaucoma was not observed in the postoperative period. Conclusion: Since it is a minimally invasive and cost-effective method that provides rapid visual rehabilitation, it can be considered as first-line therapy in young adults who are suitable for PR.

Comparison of anatomical and functional outcomes of different surgical techniques in myopic macular hole without retinal detachment.

AIM: To define the anatomic and functional outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole (MH) without retinal detachment. METHODS: Sixty-four eyes of 64 patients who underwent PPV for myopic MH were included. Group 1 consists of patients underwent ILM peeling (n=26), and Groups 2 and 3 consists of patient underwent free ILM patch graft (n=20) and inverted ILM flap procedure (n=18) respectively. Outcomes following surgery were MH closure and best corrected visual acuity (BCVA) in logMAR at 6mo. RESULTS: Closure of MH was obtained in 20 eyes (76.9%) of the Group 1, in 16 eyes (80%) of the Group 2 and in 16 eyes (88.9%) of the Group 3. The mean preoperative and postoperative BCVA was 1.60±0.53 logMAR and 1.27±0.58 logMAR, respectively (P<0.05). There was no significant difference in the postoperative BCVA and anatomical closure rates in the three groups. Although the anatomical closure rate did not differ significantly in the groups, closure of MH tended to be better in the inverted ILM flap technique group at 6mo. CONCLUSION: Different surgical techniques may provide favorable visual and anatomical results for myopic MH surgery. ILM flap techniques offer higher closure rates compared to ILM peeling technique. However, in terms of visual outcomes, the study reveals no difference in three surgical techniques.

Effect of ILM Peeling on Anatomical and Visual Outcomes in Diabetic Tractional Retinal Detachment.

Objectives: The objcetive is to compare the anatomic and functional outcomes of vitrectomy between internal limiting membrane (ILM) peeling and non-ILM peeling in diabetic tractional retinal detachment (TRD). Methods: Twenty-three eyes with diabetic TRD with ILM peeling were compared with twenty-four eyes with non-ILM peeling. Best-corrected visual acuity (BCVA) was recorded at baseline and 3, 6, 9, 12 months, and end of follow-up. The mean retinal thickness across nine different regions that defined in the Early Treatment Diabetic Retinopathy Study (ETDRS) were obtained. The ETDRS grid was used to determine the extent of macular involvement. Results: In the 1st month postoperatively, the mean BCVA of eyes with ILM peeling (1.08±0.63 LogMAR) was significantly better than eyes with ILM non-peeling (1.69±0.75 LogMAR, p=0.003). There was also a significant difference at 9 and 12 months between groups in BCVA, in favor of ILM peeling (p=0.012 and p=0.047, respectively). Seven patients (29.2%) developed epiretinal membrane (ERM), and one patient (4.1%) had ERM with the lamellar macular hole in the ILM non-peeling group, while only one patient developed ERM in ILM peeling group during the follow-up. Conclusion: ILM removal may be considered in diabetic TRD surgery, as it can provide rapid visual recovery. Moreover, post-operative ERM formation was less frequent in ILM peeled eyes within 1 year after surgery.

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.

Single Layered Free ILM Graft Technique in Large Macular Holes with Associated ERM.

PURPOSE: We aimed to describe single layered free ILM graft technique (FIGT) and present results of this technique in the primary surgery of large macular holes (MHs). METHODS: In this retrospective study, we identified MHs with a minimum hole diameter >400 µm that underwent FIGT by a single surgeon. Nineteen eyes were found to have an associated epiretinal membrane (ERM) and four eyes demonstrated a patchy ILM staining intraoperatively. A single layered FIGT was performed first by peeling the ILM around the hole and then creating a free ILM flap and transplanting it to cover the hole. All cases were evaluated for anatomical closure and visual improvement. RESULTS: Twenty-three eyes of 22 patients (mean age 68.7 ± 7.4 years) were included in the study. The mean follow-up was 9.6 ± 4.9 months. Flap closure was observed in two eyes (8.6%) at week 1, while all eyes (100%) showed a complete closure at month 1. Mean preoperative visual acuity of 1.42 ± 0.66 LogMAR increased to 1.11 ± 0.51, 0.99 ± 0.34, 0.92 ± 0.38, 0.74 ± 0.37, 0.52 ± 0.28, 0.64 ± 0.39 respectively at week 1, month 1, month 3, month 6, year 1 and final follow-up postoperatively (p < .05 for all). In none of the eyes ERM recurred, nor flap contraction developed. CONCLUSION: The study showed encouraging results using free ILM graft in the primary surgery of large MHs. This technique might be considered in large MHs that are associated with ERM or demonstrate patchy ILM staining. Further studies are needed to prove the effectiveness also in the long-term.

Repeat Surgery following Temporal Inverted ILM Flap Technique: Next Step after Primary Failure.

PURPOSE: We aimed to report our surgical experience with repeat surgery as the next step after an unsuccessful hole closure with the primary single-layered temporal inverted flap technique (IFT). METHODS: We identified cases with persistent macular holes by reviewing the records of eyes that underwent IFT between October 2018 and October 2021. These cases were evaluated for hole features, anatomical closure, and visual improvement before and after the first and second surgeries. In addition, the technique applied in repeat surgery was recorded. Optical coherence tomography (OCT) images at follow-up were used to evaluate the flap position. RESULTS: A persistent hole was identified in 11 (6.4%) of 172 patients who underwent IFT. An inferotemporal displacement was observed in seven eyes, while no flap could be identified in the OCT images of the other four eyes. In the second surgery, the old flap was reinverted in one eye, and a new flap was created from the superior region in five eyes and the nasal region in the other five eyes and was stabilized under perfluorocarbon liquid. A gas tamponade (C3F8/SF6) was used in all patients at the end of surgery. The minimum hole diameter was > 400 µm in all eyes and 100% closure was achieved after the second surgery. Visual acuity gain of ≥ 3 lines was observed in 9 of the 11 eyes (81.8%). The mean visual acuity increase at the last follow-up was significant (p = 0.008). CONCLUSION: With single-layer temporal IFT in the primary surgery of macular holes, unsuccessful results may be observed due to the flap displacement in the early period. In our series, IFT was applied again with the use of the old flap or the creation of a new flap in the second surgery of the persistent holes, and successful results were obtained.

The Role of Oxidative Status in the Pathogenesis of Primary Open-Angle Glaucoma, Pseudoexfolyation Syndrome and Glaucoma.

PURPOSE: To investigate the role of oxidative stress and antioxidant system in the etiopathogenesis of pseudoexfoliation and progression of pseudoexfoliation syndrome to glaucoma. MATERIAL AND METHOD: A total of 20 patients with pseudoexfoliation syndrome, 20 with pseudoexfoliation glaucoma, 20 with primary open-angle glaucoma, and 20 without pseudoexfoliation and glaucoma as a control group, who underwent cataract or glaucoma surgery between December 2020 and March 2021 in the Health Sciences University Beyoglu Eye Training and Research Hospital, 80 patients were included in the study. Best corrected visual acuity (BCVA), intraocular pressure with applanation tonometry, detailed anterior and posterior segment examinations with biomicroscopy were performed in all patients included in the study. Approximately 0.1 cc of anterior chamber fluid was taken from all patients at the beginning of surgery. Total Oxidant Status (TOS) and Total Antioxidant Status (TAS) levels were measured by keeping the samples taken in the deep freezer of the cornea bank at -80 degrees, transferring them with cold chain transport rules, and examining them with automatic measurement method in the laboratories of the Medical Biochemistry Department of the University of Health Sciences. Oxidative Stress Index (OSI) value was calculated to measure the degree of oxidative stress. RESULTS: TAS averages of the control and POAG groups were found to be statistically significantly higher than the PES and PEG groups (p = 0.0001, p = 0.0001). No significant difference was observed between the other groups (p > 0.05). The TOS averages of the control and POAG groups were found to be statistically significantly lower than the PES and PEG groups (p = 0.003, p = 0.0001; p = 0.01, p = 0.001), no statistically significant difference was observed between the other groups (p > 0.05). The OSI mean of the control and POAG groups was found to be statistically significantly lower than the PES and PEG groups (p = 0.001, p = 0.0001; p = 0.002, p = 0.0001), no statistically significant difference was observed between the other groups (p > 0.05). CONCLUSION: Increased TOS and OSI and decreased TAS levels in the aqueous humour of patients with PES and PEG suggest that increased oxidative stress and decreased antioxidative defense system play a role in the etiopathogenesis of the disease.

A full thickness macular hole following severe preeclampsia: a case report / Buraco macular de espessura total após pré-eclâmpsia severa

ABSTRACT We report a case of a young woman presenting with decreased vision in the right eye. One month earlier, she developed severe preeclampsia at 22 weeks of gestation and the pregnancy was terminated. Fundus examination revealed cotton wool spots and hard exudates in the macula bilaterally, with a yellow spot at the center of the fovea in the right eye. Optic coherence tomography showed a full thickness macular hole with elevated cystoid edges in the right eye. The patient was diagnosed with macular hole secondary to preeclampsia and followed up for spontaneous closure. One month after the first visit, surgical intervention was suggested due to declining vision. Three months later, the patient agreed to surgery. She underwent pars plana vitrectomy with a temporal inverted internal limiting membrane flap and C3F8 endotamponade, which provided anatomic and visual improvement.

RESUMO Relatamos o caso de uma jovem com diminuição da visão do olho direito. Um mês antes do primeiro atendimento, a paciente desenvolveu pré-eclâmpsia grave com 22 semanas de gestação e interrompeu a gravidez. O exame de fundo revelou manchas algodonosas e exsudatos duros na mácula em ambos os olhos, com uma mancha amarela no centro da fóvea do olho direito. A tomografia de coerência óptica mostrou um buraco macular de espessura total com bordas cistoides elevadas no olho direito. A paciente foi diagnosticada com buraco macular secundário a pré-eclâmpsia e acompanhada para fechamento espontâneo. Um mês após a primeira visita, foi-lhe sugerida a intervenção cirúrgica, devido a um declínio em sua visão. Três meses depois, o paciente aprovou a cirurgia e foi submetida a uma vitrectomia via pars plana com retalho invertido de membrana limitante interna e tampão interno C3F8, o que proporcionou uma melhora anatômica e visual.

Retinal and choroidal microvasculature is altered after strabismus surgery.

PURPOSE: To evaluate the retinal and choroidal microvasculature after strabismus surgery using swept-source optical coherence tomography angiography (OCTA). METHODS: Thirty-three eyes of 33 patients who underwent horizontal rectus surgery for strabismus were included in this retrospective study. The unoperated fellow eyes were used as the control group. The macular microvasculature was assessed using a 3 × 3 scan pattern centred on the fovea preoperatively, and one week and one month postoperatively. The vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) were automatically analyzed. The foveal avascular zone (FAZ) was calculated manually using the tool of the device. RESULTS: The VD in SCP demonstrated a significant difference between operated and fellow eyes at one week (p = 0.017). Moreover, a significant increase was observed in the mean VD values in SCP of operated eyes after surgery (p = 0.037). The VD in DCP exhibited no significant differences between operated and fellow eyes before and after strabismus surgery. However, there was a significant difference in VD was observed between operated and fellow eyes one week after surgery (p = 0.001). The mean VD in CC was significantly increased in the operated eyes one week after surgery compared to preoperative values (p = 0.006). CONCLUSION: This study revealed that strabismus surgery may cause transient alterations both in retinal and choroidal microcirculation in the early postoperative period.

The outcomes of primary pars plana vitrectomy alone as a first surgical procedure in pediatric rhegmatogenous retinal detachment.

PURPOSE: To evaluate the characteristics and analyze the results of patients who underwent pars plana vitrectomy (PPV) as the first surgery due to rhegmatogenous retinal detachment (RRD) in pediatric age. METHODS: The records of pediatric patients who underwent PPV alone due to RRD were reviewed retrospectively. The best corrected visual acuity (BCVA) values were recorded before and after the surgery. Complications during and after the operation, postoperative recurrences were followed-up. RESULTS: One hundred and six patients included in the study were followed-up for an average of 24.20 ± 11.38 months. The final mean BCVA showed a statistically significant improvement compared to the initial mean BCVA (p < 0.001). During the postoperative follow-up period, recurrent retinal detachment was seen in 31.1% of patients. Anatomical success was achieved at a rate of 68.9% after the first surgery and increased to 95.3% after repeated operations (in 78.3% without any tamponade). Both anatomical and functional success of patients with proliferative vitreoretinopathy (PVR) grade C or worse and patients with macula-off retinal status were poorer (each p value < 0.05). The effect of the etiological factor on anatomical and functional success was not significant (each p value > 0.05). CONCLUSION: Satisfactory results can be obtained with PPV alone in pediatric RRD. However, it should be noted that postoperative complications and recurrences occur at a high rate and that repeated surgeries are often required. The presence of PVR and macular involvement are seen as negative prognostic factors to the success of surgery.

A full thickness macular hole following severe preeclampsia: a case report.

We report a case of a young woman presenting with decreased vision in the right eye. One month earlier, she developed severe preeclampsia at 22 weeks of gestation and the pregnancy was terminated. Fundus examination revealed cotton wool spots and hard exudates in the macula bilaterally, with a yellow spot at the center of the fovea in the right eye. Optic coherence tomography showed a full thickness macular hole with elevated cystoid edges in the right eye. The patient was diagnosed with macular hole secondary to preeclampsia and followed up for spontaneous closure. One month after the first visit, surgical intervention was suggested due to declining vision. Three months later, the patient agreed to surgery. She underwent pars plana vitrectomy with a temporal inverted internal limiting membrane flap and C3F8 endotamponade, which provided anatomic and visual improvement.

Macular and peripapillary microvasculature after dexamethasone injection in diabetic macular edema.

PURPOSE: To evaluate the microvascular changes in the macular and peripapillary area after intravitreal dexamethasone implant in diabetic macular edema (DME). MATERIAL AND METHODS: We included 31 eyes of 31 patients treated with a single dose dexamethasone implant for DME. All subjects underwent swept-source optical coherence tomography (OCT) and OCT angiography imaging before (T0), and one month (T1), two months (T2), and four months (T4) after dexamethasone injection. The foveal avascular zone (FAZ) area of superficial and deep capillary plexus (SCP and DCP) was calculated by delineating the FAZ border using the measurement tool of the device. The vessel density (VD) of SCP and DCP and choriocapillaris (CC) in the macular and peripapillary area were automatically calculated. RESULTS: There was an insignificant reduction in FAZ area measurements of SCP after dexamethasone injection in DME patients (p = 0.846). The FAZ area of DCP were significantly smaller compared to T0 measurements at T1, T2, and T4 (p = 0.013, p = 0.031, and p = 0.029, respectively). The mean average parafoveal VD measurements were significantly decreased after dexamethasone injection in SCP and DCP (p = 0.004, p = 0.005). The peripapillary VD in retinal capillary plexuses and choriocapillaris showed no significant difference after dexamethasone injection. CONCLUSION: Intravitreal dexamethasone leads to a significant FAZ area decrease in DCP with a reduction in parafoveal VD measurements. In addition, no significant VD changes were observed in the peripapillary area after dexamethasone. These findings indicate that dexamethasone may improve macular ischemia with no significant effects on peripapillary microvasculature in DME patients.

Comparison of quantitative measurement of macular vessel density before and after inferior oblique muscle-weakening surgery: An optical coherence tomography angiography study.

PURPOSE: To investigate hemodynamic changes in retinal and choroidal vasculature after surgical inferior oblique (IO) weakening through optical coherence tomography angiography (OCTA). METHODS: The medical records of patients who underwent unilateral IO-weakening surgery at a single institution were retrospectively reviewed. Patients who had OCTA measurements before surgery and on postoperative days 7 and 30 were included. Vessel density was determined for the superficial capillary plexus (SCP), deep capillary plexus (DCP), the choriocapillaris (CCP) and the foveal avascular zone (FAZ). RESULTS: The study included 72 eyes of 36 patients. Fellow eyes were used as a control group. The preoperative and postoperative week 1 and month 1 mean central vessel densities of the SCP were 20.48% ± 3.52%, 20.68% ± 3.83%, and 23.56% ± 5.65%, respectively, in the operated eye; those of the DCP were 16.72% ± 3.33%, 16.08% ± 4.65%, and 20.85% ± 7.09%, respectively. The mean FAZ areas were 341.29 ± 88.04 µm2, 341.30 ± 98.25 µm2, and 316.02 ± 74.61 µm2, respectively. We detected no significant changes in SCP, DCP, and FAZ in the postoperative period. The mean central vessel density of the CCP increased significantly from the preoperative level of 54.06% ± 2.86% to 55.55% ± 2.63% at postoperative week 1, but there was no significant difference between baseline and postoperative month 1 (P = 0.001 and P = 0.515, resp.). CONCLUSIONS: IO muscle surgery does not seem to cause alterations in retinal hemodynamics, although it can transiently increase the central vessel density of the CCP during the early postoperative period.

Effect of Optical Coherence Tomography Patterns on One-year Outcomes of Aflibercept Therapy for Diabetic Macular Edema.

OBJECTIVE: To evaluate the outcomes of aflibercept based on different morphologic patterns on optical coherence tomography (OCT) for diabetic macular edema (DME). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Beyoglu Eye Training and Research Hospital, Turkey from February 2016 to March 2018. METHODOLOGY: Records of 115 eyes of 115 patients who were treated with aflibercept for DME were reviewed. Eyes were classified based on OCT features as diffuse retinal thickening (DRT, n=37), cystoid macular edema (CME, n=40), and serous retinal detachment (SRD, n=38). Best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) at baseline and after three doses of aflibercept at months 3, 6, 12 were recorded. Primary outcome measures were the changes in BCVA and CST at follow-up visits compared with baseline. RESULTS: At month 3, mean BCVA was improved in all groups. Although the increase in BCVA at month 3 was significant in DRT and CME groups, it was not significant in SRD group (p=0.03, p<0.01, and p=0.22, respectively). At month 12, BCVA significantly improved compared to baseline values in DRT, CME, and SRD groups (p=0.01, p=0.01 and p<0.01, respectively). There was no significant difference between groups in terms of BCVA at baseline and months 3, 6, 12 (p=0.13, p=0.67, p=0.54, and p=0.28, respectively). Mean CST significantly decreased compared to baseline values at the end of month 12 (all p<0.01). CONCLUSION: Aflibercept therapy provided an improvement in visual acuity and decreased CST in different morphological DME types for one year. The number of injections that could achieve this efficacy was least in DRT group, and more injections were required in SRD group.

Lamina cribrosa surface position in idiopathic intracranial hypertension with swept-source optical coherence tomography.

Purpose: The purpose of this study is to compare the thickness and depth measurements of the lamina cribrosa (LC) obtained using a swept-source optical coherence tomography (SS-OCT) device in idiopathic intracranial hypertension (IIH) patients and healthy subjects. Methods: This retrospective, cross-sectional observational study included 16 eyes with IIH and 20 control eyes. The LC measurements with serial horizontal B scans of the optic nerve head were obtained using SS-OCT (Topcon 3D DRI OCT Triton). The anterior lamina surface (ALS) depth, posterior lamina surface (PLS) depth, and LC thickness measurements were evaluated. Results: In patients with IIH, the mean ALS depth was 225.00 ± 58.57 µm and the mean PLS depth was 449.75 ± 63.50 µm. In the IIH control group, the corresponding values were 359.40 ± 105.38 and 570.10 ± 99.41 µm (P < 0.05). The difference in LC thickness between the IIH and control subjects was not statistically significant. Conclusion: LC can be evaluated using an SS-OCT device. LC was displaced anteriorly in patients with IIH compared with normal controls. The assessment of LC level with SS-OCT in IIH cases is a valuable and reproducible adjunctive imaging method in terms of diagnosis and follow-up.

Treatment of intravitreal bevacizumab combined with focal laser photocoagulation in the case of macular telangiectasia type 2 with retinal arterial macroaneurysm.

Macular telangiectasia type 2 (Mac Tel 2) is a bilateral disease of unknown cause with characteristic changes of the retinal vasculature. To the best of our knowledge, we could not find any reported cases of Mac Tel 2 with retinal arterial macroaneurysm (RAM). Our aim is to report a case of Mac Tel 2 with RAM.

Evaluation of the effect of combined intravitreal ranibizumab injection and sub-tenon steroid injection in the treatment of resistant diabetic macular edema.

PURPOSE: To compare sub-tenon steroid plus anti-VEGF injection with anti-VEGF injection solely in the treatment of resistant diabetic macular edema (DME). METHOD: Patients who exhibited insufficient anatomic [over 350 µm central macular thickness (CMT)] and less than 3 lines of visual gain at least six anti-VEGF injections, were randomly divided into two groups. In group I, the anti-VEGF injection was performed 10 days after the sub-tenon steroid injection [Triamcinolone acetonide (Sinakort-A®)]. And anti-VEGF was performed when needed during the follow-up period. In group II, treatment was continued with anti-VEGF only. All patients' visual acuity and CMT were followed up for 6 months. RESULTS: The baseline BCVA in group I and group II was 0.51 ± 0.667 logMAR and 0.47 ± 0.60 logMAR, respectively (p = 0.52). In group I and II, at the end of 6-month follow-up, BCVA improved to 0.38 ± 0.60 logMAR (p < 0.001) and 0.43 ± 0.60 logMAR (p = 0.20), respectively. The baseline CMT in group I and group II was 494 ± 118.32 and 438.20 ± 90.99 µm, respectively (p = 0.029). In group I and II, at the end of 6 months, CMT decreased to 302.57 ± 69.89 µm (p < 0.001) and 439.20 ± 107.6 µm (p = 0.96), respectively. CONCLUSION: Adding steroid to routine anti-VEGF treatment is an effective way of treatment method for resistant DME.

Treatment of intravitreal bevacizumab combined with focal laser photocoagulation in the case of macular telangiectasia type 2 with retinal arterial macroaneurysm.

Macular telangiectasia type 2 (Mac Tel 2) is a bilateral disease of unknown cause with characteristic changes of the retinal vasculature. To the best of our knowledge, we could not find any reported cases of Mac Tel 2 with retinal arterial macroaneurysm (RAM). Our aim is to report a case of Mac Tel 2 with RAM.

Pharmacogenetic Aspect of Intravitreal Ranibizumab Treatment in Neovascular Age-Related Macular Degeneration: A Five-Year Follow-Up.

PURPOSE: This study aims to evaluate the role of complement factor H (CFH) in response to intravitreal ranibizumab (IVR) treatment, which is administered to patients with neovascular age-related macular degeneration (nAMD). METHODS: In this retrospective study, 90 nAMD patients' 90 eyes were evaluated. IVR was injected once a month for three consecutive months, and then, patients were followed up for five years by using pro re nata method. RESULTS: Average visual acuity (BCVA) values in TT group for the third, fourth and fifth years were found to be significantly higher than those in TC and CC groups, while average BCVA values in TC group were significantly higher than those in CC group (all p = .000 < .0167). CONCLUSION: Patients with CFH TT genotype responded significantly better to treatment after third year, while patients with CC genotype had a poorer response to IVR.

Effect of Upper Eyelid Blepharoplasty on Vision and Corneal Tomographic Changes Measured By Pentacam.

PURPOSE: The aim of this study is to determine whether any change occurs in corneal astigmatic values measured by a pentacam and any subjective visual acuity changes occurs following the upper eyelid blepharoplasty. METHODS: This is a prospective study; 43 eyes of 23 patients with dermatochalasis underwent pentacam and surveyed for blurred vision before, 1 and 3 months after blepharoplasty surgery. In the course of those 3 measurements, both refractive and keratometric data were recorded and analyzed. The changes in refractive sphere, cylinder and cylindrical axis from both preoperative and postoperative readings were compared statistically. RESULTS: Compared to preoperative measurements, 26 eyes (60%) had a measurable increase in corneal astigmatism after the surgery. Increased astigmatism observed by pentacam in the first and the third month after surgery, showed statistically significant results according to Wilcoxon test with (p = 0.028 < 0.05) and (p = 0.048 < 0.05) values, respectively. The mean change in astigmatism was reported as 0.15D. Regarding the astigmatism axis, no significant change was detected; in the 1 month (p = 0.435 > 0.05) and 3 months (p = 0.560 > 0.05) postoperative measurements compared to preoperative values. Two patients (4.34%) reported visual acuity change 3 months after the surgery. CONCLUSION: We discovered statistically significant astigmatic changes; however, these were clinically insignificant visual acuity changes in compatibility with prior studies. Patients undergoing blepharoplasty surgery should be advised that this procedure may potentially alter vision. It is also very important to advise the patients to undergo cataract and/or refractive surgery after having upper eyelid surgery that this procedure may induce vision changes.