Assessment of macular choroidal thickness, central macular thickness and retinal nerve fiber layer in patients receiving oral isotretinoin treatment.

PURPOSE: To investigate the impact of oral isotretinoin therapy in choroidal thickness, central macular thickness (CMT), and retinal nerve fibre layer (RNFL) thickness using optical coherence tomography (OCT). PATIENTS AND METHODS: Choroidal thicknesses, CMT, and RNFL thickness of 64 eyes were evaluated at baseline and the end of the third month of isotretinoin therapy by spectral-domain OCT. For assessment of choroidal thickness, OCT measurements were obtained at the fovea with 6 additional measurements at adjacent locations (at 500-1000-1500 µm temporal to the fovea and 500-1000-1500 µm nasal to the fovea). RESULTS: There was not a statistically significant difference between the baseline and third-month follow-up measurements of choroidal thicknesses at seven distinct locations (p > 0.05). Similarly, RNFL thickness and CMT did not change with a mean dose of 30 (±6) mg per day isotretinoin therapy during follow-up (101.82 vs 102.24, p = 0.079; 217.77 vs 217.25, p = 0.731, respectively). CONCLUSION: After the use of oral isotretinoin for 3 months, no significant side effects have been observed in choroidal thickness, CMT, and RNFL thickness by OCT.

The change in intraocular pressure after pupillary dilation in eyes with pseudoexfoliation glaucoma, primary open angle glaucoma, and eyes of normal subjects.

To evaluate the change in intraocular pressure (IOP) after pharmacologic dilation in eyes with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and eyes of normal subjects. This cross-sectional study was conducted in a university hospital-based setting. Patients with PXG, POAG, and normal subjects were consecutively selected and included in the study. Of the 125 eyes of 125 subjects; 46 (25 female) had PXG, 42 (29 female) had POAG, and 37 (20 female) belonged to the control group. Pharmacologic dilation procedure consisted of instillation of topical phenylephrine HCL 10 % followed 5 min by tropicamide 1 %. Studied variables were pre- and post-dilation IOP and also baseline measurements of anterior chamber angle, central corneal thickness, and pupillary diameter by Pentacam HR (Oculus, Wetzlar, Germany). Clinically significant IOP change was defined as a change of ≥2 mmHg from baseline. Randomly selected single eye of each patient was included in the analysis. The mean pre:post-dilation IOP of eyes with PXG and POAG was 17.39 ± 3.89:17.54 ± 3.98 and 15.92 ± 2.37:16.07 ± 2.89 mmHg, respectively. The difference between the pre- and post-dilation IOP of eyes with PXG and POAG was not statistically significant. The eyes of control subjects, however, had a statistically significant reduction of IOP from 14.24 ± 2.88 to 13.54 ± 2.94 mmHg (P = 0.005). 28.3 % (13/46) of eyes with PXG, 16.7 % (7/42) of eyes with POAG, and 2.7 % (1/37) of control eyes showed a clinically significant IOP elevation from baseline after the dilation. In this study, glaucoma patients proportionally experienced a higher rate of clinically significant IOP elevation after pupillary dilation, when compared to normal subjects.

Comparison of the efficacies of patching and penalization therapies for the treatment of amblyopia patients.

AIM: To compare the efficacies of patching and penalization therapies for the treatment of amblyopia patients. METHODS: The records of 64 eyes of 50 patients 7 to 16y of age who had presented to our clinics with a diagnosis of amblyopia, were evaluated retrospectively. Forty eyes of 26 patients who had received patching therapy and 24 eyes of 24 patients who had received penalization therapy included in this study. The latencies and amplitudes of visual evoked potential (VEP) records and best corrected visual acuities (BCVA) of these two groups were compared before and six months after the treatment. RESULTS: In both patching and the penalization groups, the visual acuities increased significantly following the treatments (P<0.05). The latency measurements of the P100 wave obtained at 1.0°, 15 arc min. Patterns of both groups significantly decreased following the 6-months-treatment. However, the amplitude measurements increased (P<0.05). CONCLUSION: The patching and the penalization methods, which are the main methods used in the treatment of amblyopia, were also effective over the age of 7y, which has been accepted as the critical age for the treatment of amblyopia.

Long-term vision-threatening complications of phakic intraocular lens implantation for high myopia.

AIM: To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens (pIOLs) implantation for high myopia. METHODS: This study was designed from a consecutive series of phakic intraocular lens complication and corrective surgeries. Sixteen eyes of 13 patients had implantation of phakic intraocular lens for correction high myopia and developed serious complications have been included in this study. The mean age of patients was 38.6±6.35y (range 32-50y) and the mean time of history of pIOL implantation for high myopia was 6±2y (range 2-10y). Before corrective surgery, best spectacle-corrective visual acuity (BSCVA) ranged from perception to 20/200 in the eyes in which severe complications occurred. RESULTS: Corneal decompensation occurred in 12 eyes of 9 high myopic patients after anterior chamber pIOL implantation. Rhegmatogenous retinal detachment (RRD) occurred in 4 eyes of 4 high myopic patients following anterior chamber and posterior chamber pIOL implantation. Patients with corneal decompensation, had combined procedures consisting of pIOL removal and penetrating keratoplasty (PKP). Removals of pIOL, phacoemulsification and pars plana vitrectomy (PPV) with silicone oil tamponade were performed in patients with RRD. After corrective surgeries, all patients but one (P+, patient 2, right eye) achieved moderate BSCVA ranged from 20/200 to 20/50 at the last visit. CONCLUSION: Phakic IOLs may be effective for the correction of high myopia. Although these IOLs may have severe complications and it affects safety and efficacy of this surgery. As seen here, corneal decompensation and rhegmatogenous retinal detachment are possible postoperative vision-threatening complications of phakic IOLs. Patients must be carefully examined before and after surgery for possible endothelial cell loss and vitreoretinal problems.