Retinal and choroidal microvascular changes during pregnancy detected with OCTA.

OBJECTIVE: To investigate choroidal and retinal blood flow and thickness changes using optical coherence tomography and optical coherence tomography angiography during pregnancy. DESIGN: Prospective and case-control study between June 2020 and June 2021. METHODS: This prospective study included 41 eyes of 41 pregnant females and 45 eyes of 45 healthy nonpregnant females. Ocular perfusion pressure, retinal thickness, choroidal thickness, foveal avascular zone (FAZ) area, superficial and deep capillary plexuses (SCP and DCP, respectively), vessel density (VD), and choriocapillaris (CC) VD measurements were evaluated with optical coherence tomography and optical coherence tomography angiography. RESULTS: There was no significant difference in ocular perfusion pressure, retinal thickness, and choroidal thickness during pregnancy. The FAZ area increased as the gestational weeks progressed (p = 0.011). The FAZ area in the first trimester was significantly smaller than that in the control group (p = 0,029). A decrease in the central SCP and DCP VD in the third trimester and an increase in the CC VD during pregnancy were detected (p = 0.01, p < 0.001, and p < 0.001, respectively). We observed an increase in mean VD for both the SCP and DCP in the second trimester (p = 0.02 and p = 0.027, respectively). In the second and third trimesters, the SCP and DCP VD values were found to be significantly higher than in the control group. During the pregnancy, a significant increase in CC VD was detected. CONCLUSION: This is the first prospective study in the literature that evaluates the measurements in all trimesters of pregnancy with optical coherence tomography angiography. We observed significant retinal and choroidal microvascular changes between trimesters of pregnancy and when compared with healthy females.

Comparison of Efficacy and Safety of Loteprednol Etabonate 0.5% and Topical Dexamethasone 1% in Post-Vitrectomy Inflammation.

PURPOSE: To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV). METHODS: A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups. RESULTS: The mean IOP was higher in the patients treated with DEX (p > 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p < 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005). CONCLUSIONS: Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.

Pars plana vitrectomy with or without intraoperative 360° peripheral endolaser for rhegmatogenous retinal detachment treatment.

PURPOSE: The aim of this study was to investigate whether intraoperative 360° prophylactic endolaser photocoagulation is necessary for the treatment of uncomplicated retinal detachment. METHODS: This prospective, randomized, comparative and interventional study includes 50 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who were treated by pars plana vitrectomy. The patients were divided into two groups: in Group A endolaser applied to all existing breaks as well as a 360° laser retinopexy, while Group B received endolaser only to the retinal breaks. Primary anatomical success rate, a final best-corrected visual acuity (BCVA) and postoperative complications were analyzed and compared between the groups at 1 and 3 months. RESULTS: After the primary procedure, the retina was reattached in 96% (24 of 25) of patients in Group A and in 88% (22 of 25) of patients in Group B at 1 and 3 months. The mean final BCVA (logarithm of the minimum angle of resolution) improved from 1.26 to 0.52 in Group A with 17 cases (68%) macula-off and 1.19 to 0.77 in Group B with 18 cases (72%) macula-off at preoperative and final follow-up visit. Epiretinal membranes were seen in four cases in Group A and four cases in Group B at 3 months. No statistically significant difference in the anatomical, functional and complication outcomes between the two groups was recorded. CONCLUSIONS: Pars plana vitrectomy without the 360° peripheral endolaser can provide successful anatomic outcomes and functional improvement in uncomplicated primary RRDs.

The Expression of GDF-15 in the Human Vitreous in the Presence of Retinal Pathologies with an Inflammatory Component.

PURPOSE: The presence of growth differentiation factor-15 (GDF-15), a protein implicated in the regulation of the inflammatory response, was investigated in the vitreous of patients with vitreoretinal disorders. METHODS: Vitreous and plasma samples were collected from patients with idiopathic epiretinal membrane (IERM), macular hole (MH), rhegmatogenous retinal detachment (RRD), nucleus drop (ND), or proliferative diabetic retinopathy (PDR). GDF-15 concentrations were measured using ELISA. RESULTS: The vitreous levels of GDF-15 were higher in ND (5) and PDR (14) patients (1494 ± 243 and 904 ± 138 pg/mL, respectively) than RRD (3), MH (3), and IERM (8) patients (302 ± 160, 288 ± 24, and 254 ± 91 pg/mL, respectively). The vitreous levels of GDF-15 were significantly higher in patients with inflammatory vitreoretinal disorders (p < 0.0001). CONCLUSIONS: This is the first report showing that GDF-15 appears to be expressed in the vitreous, and that its expression is significantly higher in the presence of a vitreoretinal disorder in which there is an inflammatory component.

An uncommon ocular manifestation of Sweet syndrome: peripheral ulcerative keratitis and nodular scleritis.

Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by fever, neutrophilic leukocytosis, and abrupt appearance of painful erythematous nodules and plaques, particularly on the face, neck, and limbs. In this study, we report a very rare case of Sweet syndrome in which the patient presented nodular scleritis and peripheral ulcerative keratitis during the dermatologically inactive period of the disease.

An uncommon ocular manifestation of Sweet syndrome: peripheral ulcerative keratitis and nodular scleritis / Uma manifestação ocular rara de síndrome de Sweet: ceratite ulcerativa periférica e esclerite nodular

Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by fever, neutrophilic leukocytosis, and abrupt appearance of painful erythematous nodules and plaques, particularly on the face, neck, and limbs. In this study, we report a very rare case of Sweet syndrome in which the patient presented nodular scleritis and peripheral ulcerative keratitis during the dermatologically inactive period of the disease.

A síndrome de Sweet (dermatose neutrofílica febril aguda) é caracterizada por febre, leucocitose neutrofílica, aparecimento abrupto de nódulos eritematosos dolorosos e placas, principalmente na face, pescoço e membros. Neste artigo, relatamos um caso muito raro de síndrome de Sweet, que tinha esclerite nodular e ceratite ulcerativa periférica no período dermatologicamente inativo da doença.

Is Smoking a Risk Factor in Ocular Behçet Disease?

PURPOSE: To investigate the association between smoking and prognosis of ocular Behçet disease. MATERIAL/METHODS: Medical records of 202 patients with Behçet uveitis were collected retrospectively. Patients were assigned to two groups according to smoking habits. In group I, 72 patients were current smokers. In group II, 130 were nonsmokers. The localization of uveitis, time to resolution of uveitis, time to recurrences, visual acuities, and presence of cystoid macular edema were compared between groups. RESULTS: The demographic characteristics were similar in both groups. Smoking was not associated with types of uveitis with OR of 1.01 (95% CI, 0.99-1.04; p = 0.21) for anterior uveitis, 0.96 (95%CI, 0.90-1.02; p = 0.18) for posterior uveitis, and 1.80 (95% CI, 0.75-2.77; p = 0.24) for panuveitis. The average times to inflammation resolution were 48 ± 10.1 days in group I and 51 ± 14 days in group II (p = 0.82). The average times to recurrence were 8.6 ± 5 months for smokers and 9.1 ± 7 months for nonsmokers (p = 0.43). Patients with CME in groups were 18 (25%) and 42 (32.3%), respectively (p = 0.08). CONCLUSIONS: Our findings suggest that smoking does not have a negative effect on the clinical findings and prognosis of uveitis in Behçet disease.

A case report of bilateral choroidal metastases of epithelial carcinoma of pancreas.

A 49-year-old woman with acute loss of vision in her left eye was examined in our clinic. Two months before arriving at out clinic, she was diagnosed with pancreatic endothelial carcinoma. Her visual acuities were 20/20 for the right and 20/200 for the left eye. Fundus examination and fundus fluorescein angiography showed bilateral subretinal solitary mass. Multiple metastases to lung, pleura, liver, spleen, and abdominal lymph nodes were detected during the initial diagnosis. The patient underwent chemotherapy during the period when the visual symptoms were observed. No additional treatment was offered because of the extent of the disease and poor general health. Although pancreatic endothelial carcinoma usually spreads to the abdominal visceral organs and lungs, choroidal metastases are rarely observed.

A case report of bilateral choroidal metastases of epithelial carcinoma of pancreas / Um relato de caso de metástases de coroide bilaterais de carcinoma epitelial de pâncreas

A 49-year-old woman with acute loss of vision in her left eye was examined in our clinic. Two months before arriving at out clinic, she was diagnosed with pancreatic endothelial carcinoma. Her visual acuities were 20/20 for the right and 20/200 for the left eye. Fundus examination and fundus fluorescein angiography showed bilateral subretinal solitary mass. Multiple metastases to lung, pleura, liver, spleen, and abdominal lymph nodes were detected during the initial diagnosis. The patient underwent chemotherapy during the period when the visual symptoms were observed. No additional treatment was offered because of the extent of the disease and poor general health. Although pancreatic endothelial carcinoma usually spreads to the abdominal visceral organs and lungs, choroidal metastases are rarely observed.

Uma mulher de 49 anos de idade, com perda visual aguda de seu olho esquerdo, que teve diagnóstico de carcinoma endotelial de pâncreas há dois meses, foi examinada em nossa clínica. Suas acuidades visuais eram 20/20 no olho direito e 20/200 no olho esquerdo. O exame de fundo de olho e a angiofluoresceinografia mostraram massa solitária sub-retiniana bilateral. Múltiplas metástases do pulmão, pleura, fígado, baço e nódulos linfáticos abdominais foram detectados no diagnóstico inicial. A paciente foi submetida a quimioterapia durante o tempo que os sintomas visuais foram observados. Nenhum tratamento adicional foi oferecido por causa da extensão da doença e problemas de saúde em geral. Embora o carcinoma endotelial de pâncreas normalmente se espalhe para órgãos abdominais e pulmões, este pode ser uma causa rara de metástases de coroide.