THE EFFECT OF AGE ON AFLIBERCEPT (EYLEA) RESPONSE IN DIABETIC MACULAR EDEMA.

PURPOSE: To investigate the effect of age on aflibercept (Eylea) response in macular edema secondary to treatment-naive diabetic eyes. METHODS: Two hundred seventy-three eyes of 273 treatment-naive patients with macular edema secondary to diabetes mellitus were enrolled in this study. The patients in the study were divided into the following 4 groups according to their ages: Group 1 (40-50 years), Group 2 (51-60 years), Group 3 (61-70 years), and Group 4 (>70 years). Three consecutive injections at intervals of 1 month were applied to all diabetic patients. The efficacy of the aflibercept treatment on macular edema according to age groups was assessed by optical coherence tomography by comparing the central foveal thickness (CFT) values and mean visual acuity changes after initial and three loading dose injections. RESULTS: After three consecutive aflibercept injections, the mean reduction of CFT in Groups 1, 2, 3, and 4 were -256.4 ± 110.9, -197.4 ± 96.4, -189.4 ± 110.8, and -186.2 ± 118.9 µm, respectively. The changes of CFT was significantly different between age groups (P = 0.003, analysis of covariance). The improvement of visual acuity was significantly different in each group (P < 0.001 in all groups, paired-samples t-test), and changes of visual acuity was significantly different between age groups (P < 0.05, analysis of covariance). In addition, ages of patients were correlated with the mean reduction of CFT and mean improvement of visual acuity for the whole study group (r = -0.183, P = 0.002 for CFT; r = -0.682, P < 0.001 for visual acuity, Pearson correlation). CONCLUSION: In this study, it was observed that the efficacy of aflibercept treatment was found to be more effective in younger patients in treatment-naive diabetic macular edema patients.

Using Anterior Segment Optical Coherence Tomography to Assess Angle Anatomy in Patients with Neurofibromatosis Type 1.

SIGNIFICANCE: Lisch nodules have been identified in more than 90% of patients 16 years or older with neurofibromatosis type 1 (NF1). According to our hypothesis, the presence of Lisch nodules in patients with NF1 might affect the anterior chamber angle (ACA) parameters. PURPOSE: The aim of this study was to evaluate the anterior segment angle parameters using anterior segment optical coherence tomography in patients with NF1. METHODS: A total of 42 eyes from 21 patients with NF1 (study group) and 42 eyes from 21 age- and sex-matched healthy individuals (control group) were included in this study. Angle opening distance at 500 (AOD500) and 750 µm (AOD750) anterior to the scleral spur, ACA, and iris thickness (IT) values were measured in the temporal (T) and nasal (N) quadrants using anterior segment optical coherence tomography. RESULTS: The mean AOD500 and AOD750 values in both quadrants were significantly lower in the study group compared with the control group (T-AOD500: 548 ± 151 vs. 761 ± 288 [P < .001], T-AOD750: 705 ± 175 vs. 921 ± 334 [P < .001], N-AOD500: 599 ± 223 vs. 777 ± 292 [P = .002], and N-AOD750: 756 ± 268 vs. 948 ± 303 [P = .003], respectively). The mean ACA values in both quadrants were significantly narrower in the study group compared with the control group (T-ACA: 29.52 ± 6.36 vs. 40.83 ± 8.90 [P < .001] and N-ACA: 30.05 ± 7.11 vs. 41.29 ± 8.68 [P < .001], respectively). The IT values in both quadrants were significantly thicker compared with the control group (T-IT500: 406 ± 78 vs. 355 ± 59 [P = .001], T-IT750: 453 ± 103 vs. 362 ± 100 [P < .001], N-IT500: 416 ± 93 vs. 353 ± 54 [P < .001], and N-IT750: 437 ± 91 vs. 370 ± 95 [P = .002], respectively). CONCLUSIONS: We have revealed lower angle opening distance values in individuals with NF1 than in the healthy ones, as well as significantly narrower ACA values and significantly thicker IT values.

Preservative-free versus preserved brimonidine %0.15 preparations in the treatment of glaucoma and ocular hypertension: short term evaluation of efficacy, safety, and potential advantages.

Purpose: To compare the efficacy, safety, and potential advantages of the preservative-free versus preserved brimonidine %0.15 preparations in patients with primer open-angle glaucoma (POAG) or ocular hypertension (OHT).Methods: Forty-two eyes of the 21 treatment-naive patients with POAG or OHT were enrolled in this study. Eyes were randomly assigned to receive brimonidine-purite 0.15% or preservative-free brimonidine 0.15% two times daily. Efficacy of the two eye drops was assessed by measuring the intraocular pressure (IOP) at 9-10 am at baseline and week 4. Safety and potential advantages of the drops were evaluated at weeks 4 in terms of ocular symptoms and tear parameters. Ocular symptom values of the patients were evaluated with a scale of 0-4 (0 = no discomfort and 4 = severe discomfort).Results: Both of the brimonidine tartrate formulations resulted in statistically similar IOP reduction (preserved formulation; -5.2 mmHg [22.9% reduction] preservative-free formulation; -5.7 mmHg [24.1% reduction], p = 0.37). It was found that brimonidine tartrate formulations with and without topical preservatives did not produce a statistically significant difference in pain, stinging, and blurred vision at the upon instillation (p > 0.05). However, the burning sensation was significantly higher in the preservative-free formulation at the first instillation compared to the preserved formulation (p = 0.01). Also, there was no statistically significant difference between the two formulations in terms of symptoms (itching, burning, tearing, stinging, and photophobia) and tear parameters during the day (p > 0.05).Conclusions: Although topical preservative-free brimonidine tartrate treated eyes had a more burning sensation at the first drop, the two formulations were similar in terms of ocular tolerability in the short term period. Also, both formulations were found to reduce IOP at a similar rate.

Evaluation of retina nerve fiber layer, ganglion cell-inner plexiform layer and lamina cribrosa in clinically unilateral exfoliative glaucoma.

PURPOSE: To compare retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GC-IPL), the lamina cribrosa depth (LCD) and thickness (LCT) in unilateral exfoliative glaucoma (EXG) patients with their fellow eyes without exfoliation and control eyes. METHODS: This cross-sectional prospective single-center study consisted of 64 eyes of 32 patients with unilateral EXG and 35 eyes of controls. All subjects were examined with spectral domain optical coherence tomography for the RNFL and GC-IPL measurements. The LCD and LCT measurements were also obtained. RESULTS: The RNFL measurements at all quadrants were statistically thinner in EXG eyes than those in their eyes without EXG and control eyes (p < 0.001 for average, superior, temporal and inferior; p = 0.004 for nasal). The EXG group had deeper LCD than their eyes without EXG and control eyes (p < 0.001, for both). The fellow eyes of EXG group had also deeper LCD than control eyes, with no statistical significance (p = 0.058). The mean LCT was thinner in EXG eyes compared to those in the eyes without EXG and control eyes (p < 0.001, for both). The eyes without EXG and control eyes had similar LCT (p = 0.293). CONCLUSIONS: Recent developments in imaging technology give the clinician detailed structural information about optic nerve head and retina such as GC-IPL, LCD and LCT. In addition to follow-up of RNFL changes, these new parameters may be useful in recognizing progression in EXG patients.

Diurnal variation of anterior segment parameters handled with Scheimpflug imaging in keratoconus patients.

PURPOSE: To define diurnal changes in anterior segment parameters of keratoconus patients by using Scheimpflug imaging. METHODS: All keratoconus patients had corneal topography measurements 3 times a day (around 09:00 AM, 13:00 PM and 17:00 PM) by the same experienced operator. Three consecutive scans in each measurement session were obtained. The average of three measurements was used for analysis. A repeated measures analysis of variance with one within-subject factor (time of day) was carried out to assess diurnal variation. RESULTS: This study included 26 eyes of 26 patients with keratoconus. Significant diurnal variation was found in CCT and TCT measurements (P < 0.01, and P < 0.01, respectively). The mean amplitudes of change in CCT and TCT were 4.2 ± 1 µm (95% CI: 1.7-6.8 µm) and 4.1 ± 1.1 µm (95% CI: 1.2-8.0 µm), while the mean of CCT and TCT were 462.4 ± 34.5 µm (95% CI: 448.4-476.6 µm) and 452.9 ± 6.6 µm (95% CI: 439.3-466.5 µm), respectively. The maximum value and the lowest value were observed at 09:00 AM and at 17:00 PM, respectively. Other parameters except CCT and TCT did not show diurnal variation. CONCLUSION: Statistically significant but clinically insignificant diurnal variation in CCT and TCT measurements of the keratoconus patients were detected over an 8-hour period (09:00 AM-17:00 PM).

Evaluation of Corneal Morphology in Patients With Hemifacial Spasm.

PURPOSE: To determine whether the corneal topographic parameter values, individual corneal layer thicknesses, and its endothelial layer morphology are different in patients with hemifacial spasm (HFS) than in the control contralateral eye. METHODS: This study was designed as a prospective study. Among patients who applied to our hospital within the past 3-year period, those with HFS in one eye (study eyes) and a completely normal contralateral eye (control eyes) were included in this study. In addition to a complete ophthalmologic examination, all patients were scanned by the Pentacam Scheimpflug camera, and a corneal endothelium cell count was taken using a Topcon Specular Microscope. Also, the thickness of the corneal sublayers was measured on the central cornea with anterior segment module of spectral domain optical coherence tomography. Data entered using SPSS software were then evaluated by paired t test; P<0.05 value was considered statistically significant. RESULTS: Twenty-eight patients (16 women and 12 men) were evaluated. Steep K, Kmax, and astigmatism values were significantly higher in the study eyes of patients with HFS than in the control eyes (P<0.05, for all). In addition, the total corneal thickness and corneal stromal thickness measurements in the study eyes were statistically significantly thinner than the control eyes (P=0.04 and P<0.001, respectively). Specular microscopy parameters were not statistically significant between the study eyes and control eyes (P>0.05, for all). CONCLUSION: Corneal stromal thinning suggests that chronic exposure to hypoxia may induce this effect through extracellular matrix remodeling and losses in collagen framework content in patients with HFS.

The effect of voluntary fasting and dehydration on posterior ocular structures.

PURPOSE: Islamic Ramadan is the month of fasting, in which intake of food and drink is restricted from sunrise until sunset. The objective of the present study was to find out the effects of religious fasting on posterior ocular structures. MATERIALS AND METHODS: In this prospective study, 34 eyes of 34 healthy volunteers with a mean age of 34.09 ± 7.20 years were enrolled. Volunteers with any systemic disorder and eyes with pathology or previous surgery were excluded. One week before Ramadan (non-fasting period) and during Ramadan (fasting period) at the same hours (at 08:00 and 16:00 h), choroidal, macular, and retinal nerve fibre layer (RNFL) thicknesses were measured by spectral domain optical coherence tomography. Results were compared using paired sample t-test, and a p value <0.05 was accepted as statistically significant. RESULTS: The comparison of 16:00-h measurements significantly revealed lower values during fasting period when compared non-fasting period for choroidal thickness (non-fasting and fasting, respectively; subfoveal: 299.26 ± 41.3 and 280.03 ± 38.75 p < 0.001, nasal: 246.09 ± 53.59 and 227.06 ± 53.82 p < 0.001, and temporal: 273.56 ± 42.68 and 257.44 ± 45.06 p = 0.001) and paracentral macular thickness (superior: p = 0.002, inferior: p = 0.010, temporal: p = 0.013, and nasal: p = 0.016). By contrast, no significant differences were found in the central macular thickness between the fasting and non-fasting periods (p = 0.735). Also, no statistically significant difference was noted for RNFL thickness at the different periods and time points. CONCLUSION: Our results reveal that Islamic religious fasting is associated with statistically significant alterations in choroidal and paracentral macular thickness in healthy volunteers. However, more detailed investigations should be designed to evaluate whether fasting has a pivotal influence on pathological conditions.

Does using topical latanoprost affect subfoveal choroidal thickness?

Purpose: The aim of our prospective study was to investigate the effect of using latanoprost eye drops on subfoveal choroidal thickness in the macular area, as measured by using enhanced depth imaging optical coherence tomography (EDI-OCT). Materials and methods: A total of 39 eyes from 39 patients with bilateral glaucoma or ocular hypertension who had never received hypotensive therapy (study group) and 39 eyes from 39 age- and gender-matched healthy individuals (control group) were included in this study. The EDI-OCT measurements of subfoveal choroidal thickness were obtained during an initial visit before latanoprost therapy and at visits after 1 and 3 months of latanoprost therapy. Results: The mean subfoveal choroidal thickness was 309.5 ± 38.5 µm before latanoprost therapy in the study group and 307.3 ± 31.8 µm in the control group (p = .794). During latanorprost therapy in the study group, mean values of subfoveal choroidal thickness at the initial visit and at intervals of 1 and 3 months were 309.5 ± 38.5 µm, 314.2 ± 39.7 µm, and 318.3 ± 33.4 µm, respectively, which indicated a statistically significant difference between the initial and third visits only (p=.002). Conclusion: Subfoveal choroidal thickness increased after 3 months of topical latanoprost therapy.

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.

Does Valsalva Maneuver Affect Corneal Morphology in Eyes With Keratoconus?

OBJECTIVES: The aim of this study was to investigate the effect of the Valsalva maneuver on corneal morphology and anterior chamber parameters in patients with keratoconus. METHODS: A total of 39 eyes from 39 patients with keratoconus and 41 eyes from 41 age-matched and gender-matched healthy individuals were included in this cross-sectional study. Measurements of corneal front keratometry values (K-flat, K-steep, and K-max), central corneal thickness, corneal apex thickness, thinnest corneal thickness, corneal volume, anterior chamber volume (ACV), anterior chamber depth (ACD), and iridocorneal angle (ICA) were performed with a Pentacam Scheimpflug camera (Oculus, Germany) before and during the Valsalva maneuver. Changes in the anterior segment parameters from baseline and during the Valsalva maneuver and the differences in parameters between the keratoconus group and the control group were analyzed. A P value less than 0.05 was accepted as statistically significant. RESULTS: In the patients with keratoconus, the Valsalva maneuver did not have any significant influence on the corneal parameters (P>0.05). However, ACV, ACD, and ICA decreased markedly during the Valsalva maneuver (P=0.006, P=0.048, and P=0.025, respectively). Changes caused by the Valsalva maneuver were similar for all parameters when compared with those in healthy individuals (P>0.05). CONCLUSIONS: During corneal topography imaging, the Valsalva maneuver observed in patients with keratoconus does not typically cause any significant change in corneal morphology.

Analysis of multiple sclerosis patients with electrophysiological and structural tests.

We aimed to analyze the effects of progressive myelin loss and neurodegeneration seen in patients with multiple sclerosis (MS) on visual tract with electrophysiological and structural tests. Fifty-one patients diagnosed with MS in the Neurology Department were followed up in neuro-ophthalmology outpatient clinic irrespective of their visual symptoms, and were included in our study. The patients were classified as the ones with the history of optic neuritis (group II) and ones without the history (group I) of optic neuritis. The data, including clinical presentation, retinal nerve fiber layer thickness (RNFLT) measurements, pattern visual evoked potential (pVEP) and flash electro retino grams (ERG) test results, were recorded. In our study, comparison of pVEP test latencies of groups I and II with each other, and with those of healthy subjects revealed statistically significant differences (p < 0.05). The analysis of rod functions on ERG did not show any significant changes (p > 0.05). However, both groups showed significantly decreased cone b-wave amplitudes, elongation of latencies, and decreased flicker amplitudes on cone and flicker potentials obtained after light adaptation (p < 0.05). There was significant thinning in RNFLT of the both groups when compared to the normal standards. The difference between two groups was statistically significant (p < 0.05). Axon loss is seen in the optic nerve with subclinical or acute optic neuritis in patients with MS. RNFLT analysis and electrophysiological tests are of great importance in diagnosis of MS, as well as to determine progression and to direct neuroprotective therapy in patients diagnosed with MS. Objective analysis methods gain more importance in the diagnosis and follow-up of MS patients, parallel to technological advancements.

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.

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.

Comparison of the inhibitory effect of topical cyclosporine A 0.1% and topical anti-VEGF application in an experimental model of corneal neovascularization.

PURPOSE: The aim of this study was to compare the effects of topical cyclosporine 0.1% and bevacizumab on experimentally induced corneal neovascularization in a rat model. METHODS: A total of 30 adult Sprague-Dawley rats were used in this experimental study. The central cornea of the rats was cauterized chemically. The rats were randomly enrolled into three groups as follows: Group 1 received bevacizumab 1%, Group 2 received cyclosporine 0.1%, and Group 3 received isotonic saline twice a day for 28 days. Slit-lamp examination of all rats was performed at the 3rd and 28th day. The rats were then sacrificed, and the corneas were excised. The number of blood vessels, state of inflammation, and collagen formation were evaluated histopathologically in the corneal sections. RESULTS: Corneal opacity and edema grades were significantly lower in Group 2 than in Group 3 (p=0.04 and 0.00, respectively). In the histopathological examination, Group 2 demonstrated significantly lesser number of blood vessels than Group 3 (p=0.001). Regarding collagen formation, Group 2 exhibited more regular collagen formation than Groups 1 and 3 (p=0.03). Inflammation grades were significantly lower in Groups 1 and 2 than in Group 3 (p=0.014 and 0.001, respectively). CONCLUSION: Topical bevacizumab is effective in inhibiting newly formed corneal neovascularization. The topical cyclosporine 0.1% treatment appears to be more effective than the topical bevacizumab treatment.

Determination of Neurodegeneration in Polycystic Ovary Syndrome with Retinal Segmentation Analysis.

Purpose: To compare the thickness of each retinal layer in patients with polycystic ovary syndrome (PCOS) versus healthy, age-matched controls by using retinal segmentation analysis.Methods: In our cross-sectional study, 37 patients with PCOS (i.e., patient group) and 35 healthy individuals (i.e., control group) underwent spectral-domain optical coherence tomography imaging. Using built-in automatic retinal segmentation software to analyze the images collected, we compared the thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, photoreceptor layer (PRL), retinal pigment epithelium (RPE), inner retinal layers, and outer retinal layers between the groups. To analyze the measurements, we used a traditional Early Treatment Diabetic Retinopathy Study (ETDRS) grid.Results: In ETDRS subfields, 6-mm nasal RNFL thickness; 3- and 6-mm nasal GCL thickness; 3-mm superior and 6-mm nasal IPL thickness; 1-mm central, 3-mm nasal, superior, and inferior, and 6-mm nasal and inferior PRL thickness; and 6-mm inferior RPE thickness were significantly thinner in patients with PCOS than that of healthy controls.Conclusion: The results of our retinal segmentation analysis indicate that patients with PCOS tend to have thinner GCL, IPL, and PRL than healthy, age-matched controls due to neurodegeneration likely caused by insulin resistance, or subclinical retinal inflammation.

Comparison of ganglion cell-inner plexiform layer thickness in exfoliative glaucoma and primary open-angle glaucoma.

PURPOSE: To determine and compare the thickness of the ganglion cell-inner plexiform layer (GCIPL), the thickness of the retina nerve fiber layer (RNFL), and the parameters of the optic nerve head (ONH) in exfoliative glaucoma (XFG), primary open-angle glaucoma (POAG), and control eyes using optical coherence tomography (OCT). METHODS: The study was a retrospective observational cross-sectional study of 43 eyes of patients with XFG, 44 eyes of patients with POAG, and 37 eyes of healthy participants. Visual acuity, intraocular pressure, central corneal thickness, rim-area, disc-area, average cup/disc ratio, vertical cup/disc ratio, cup volume, average RNFL thickness, and GCIPL (average, minimum, superior, superotemporal, superonasal, inferior, inferotemporal, and inferonasal) thicknesses were determined. RESULTS: RNFL thicknesses were similar in the XFG and POAG groups (p = 0.065), and both glaucoma groups had significantly thinner RNFLs than the controls (p = 0.002). The XFG group had significantly thinner average and minimum GCIPLs compared to the POAG and control groups (p = 0.027, p < 0.001 for average thickness and p = 0.038, p < 0.001 for minimum thickness, respectively). No significant difference was found in the ONH parameters among the three groups except for rim-area and cup volume (p > 0.05 for all ONH parameters, p < 0.001 for rim-area, and p = 0.003 for cup volume). Mean visual field mean deviation was -11.6 ± 8.2 dB in the XFG group and -10.4 ± 9.3 dB in the POAG group (p = 0.453). CONCLUSION: Eyes with XFG were found to have a thinner GCIPL (minimum and average) than eyes with POAG or from healthy controls, although the RNFL measurements were similar to those of eyes with POAG. GCIPL thickness may be a more valuable indicator than RNFL thickness in patients with XFG for early detection of glaucoma and/or for glaucoma progression measurement. There is still some debate in the literature about whether decreases in GCIPL thickness and RNFL thickness (and/or ONH parameter change) are the best indicators for early detection and progress measurement of glaucoma.

Elevated Monocyte-to-High-Density Lipoprotein Ratio as an Indicator of Systemic Inflammation in Patients with Branch Retinal Vein Occlusion.

OBJECTIVES: This study was designed to assess the monocyte-to-high-density lipoprotein (HDL) ratio (MHR) as a possible marker of systemic inflammation in patients with branch retinal vein occlusion (BRVO). METHODS: A study group of 62 patients with BRVO and a control group of 60 age-matched, healthy individuals were enrolled in the study. The blood lipid profile, hematology profile, and C-reactive protein (CRP) level were measured. The MHR was calculated as the ratio of the monocyte count to the HDL level, and the neutrophil-to-lymphocyte ratio (NLR) was calculated as the ratio of the neutrophil count to the lymphocyte count. RESULTS: In patients with BRVO versus controls, the mean MHR was 14.1±5.1 vs 12.2±4.3 (p=.032), the mean NLR was 1.99±0.69 vs 2.01±0.86 (p=.889), and the mean CRP level was 3.44±2.53 mg/L vs 2.81±1.57 mg/L (p=.102). The area under the receiver operating characteristic curve for the MHR and the NLR was 0.621 and 0.519, respectively. The sensitivity and specificity of the MHR and the NLR to predict BRVO was 51% and 73% vs 79% and 35%, respectively. CONCLUSION: The MHR values were higher in patients with BRVO compared with those of the control group. BRVO seems to be associated with systemic inflammation.

Does wearing swimming goggles affect corneal morphology in keratoconic eyes?

PURPOSE: A significant transient increase in intraocular pressure in individuals wearing swimming goggles has been demonstrated in previous studies. These findings suggested that wearing swimming goggles could represent a significant risk factor for worsening of corneal parameters in patients with keratoconus who swim regularly. The aim of this study was to investigate corneal parameters in patients with keratoconus after wearing swimming goggles. METHODS: Comprehensive ocular examinations were performed on 74 eyes of 37 patients with keratoconus. Measurements of the corneal front keratometry values (Kflat, Ksteep, and Kmax), central corneal thickness, corneal apex thickness, thinnest corneal thickness, corneal volume, anterior chamber volume, anterior chamber depth, and iridocorneal angle were performed in outpatient clinics using a Pentacam® Scheimpflug camera (Oculus, Wetzlar, Germany) before the patients wore swimming goggles and after they wore swimming goggles for 1, 10, and 20 min. A p-value of <0.05 was regarded as statistically significant. RESULTS: The average values before and after wearing swimming goggles for 1, 10, and 20 min were 52.72 ± 5.36, 52.64 ± 5.52, 52.62 ± 5.38, and 52.22 ± 4.86, respectively (p=0.257). The average values before and after wearing swimming goggles for 1, 10, and 20 min were 46.01 ± 3.17, 46.09 ± 3.17, 46.06 ± 3.26, and 46.04 ± 3.17, respectively (p=0.426). The average values before and after wearing swimming goggles for 1, 10, and 20 min were 49.02 ± 3.56, 49.06 ± 3.61, 49.08 ± 3.62, and 49.07 ± 3.61, respectively (p=0.750). No other corneal parameters showed changes after wearing swimming goggles (p>0.05). However, the anterior chamber volume markedly decreased after wearing swimming goggles (p<0.001). CONCLUSIONS: These findings suggested that the short-term use of swimming goggles does not increase the risk of corneal parameter worsening in patients with keratoconus.

Effects of senofilcon A and lotrafilcon B bandage contact lenses on epithelial healing and pain management after bilateral photorefractive keratectomy.

PURPOSE: The purpose of this study was to compare postoperative epithelial healing time and ocular discomfort score in patients wearing two types of silicon hydrogel bandage contact lenses (BCLs) following bilateral photorefractive keratectomy (PRK). METHODS: For the study's contralateral eye comparison, 43 patients who underwent bilateral PRK were randomized to be fitted for a senofilcon a lens in one eye and a lotrafilcon B lens in the other. The patients were masked to the specific BCL in each eye. On the first 3 days after PRK, the epithelial defect size was calculated, and patients reported their level of ocular discomfort, including pain, epiphora, and photophobia, on a visual analog scale (0 = no pain or discomfort, 10 = highest level of pain and discomfort). RESULTS: Epithelial defect size (mm2) did not differ significantly between the BCLs on Day 1 (senofilcon A vs. lotrafilcon B: 14.15 ±â€¯5.59 vs. 14.93 ±â€¯5.72, p = .327), Day 2 (senofilcon A vs. lotrafilcon B: 7.43 ±â€¯4.67 vs. 7.04 ±â€¯3.82, p = .586), or Day 3 (senofilcon A vs. lotrafilcon B: 0.59 ±â€¯1.44 vs. 0.38 ±â€¯1.08, p = .348) postoperation. By Day 3, re-epithelialization was complete in 35 eyes (81.3%) with senofilcon A lenses and 36 eyes (83.7%) with lotrafilcon B lenses. Patients reported less pain in eyes with senofilcon A lenses during the first 3 days postoperation (for all, p < .001) and less epiphora during the first 2 days postoperation (Day 1: p =  .008, Day 2: p <  .001, Day 3: p = .267) than in eyes with lotrafilcon B lenses. No significant difference in photophobia emerged between the BCLs postoperatively (for all, p > .05). CONCLUSIONS: Although duration of corneal re-epithelialization after PRK between the two BCLs did not differ significantly, senofilcon A lenses caused significantly less pain and epiphora after PRK.