Outcomes after corneal crosslinking treatment in paediatric patients with keratoconus.

PURPOSE: This study aims to determine the efficacy and safety of accelerated corneal crosslinking in children with keratoconus. METHODS: The study enrolled 64 patients aged 16 years or younger, each contributing one eye for a total of 64 eyes for analysis. Participants underwent an accelerated form of corneal cross-linking with 15 min of ultraviolet A irradiation at a rate of 7 mW/cm2, resulting in a cumulative energy dose of 5.4 J/cm2. The primary outcome measures were best corrected visual acuity (BCVA) and corneal tomography at 6 and 12 months post-intervention. Parameters assessed included BCVA, spherical and cylindrical refraction, keratometry (K1 and K2), maximum keratometry (Kmax) and thinnest corneal thickness (TCT). These metrics were documented preoperatively and then again at 6 and 12 months postoperatively. In addition, any ocular or systemic conditions related to keratoconus were recorded for each participant. RESULTS: The results showed an improvement in BCVA at 12 months after surgery. K1 showed a decrease at both post-operative follow-ups while K2 remained constant throughout the observation period. Kmax showed a notable decrease at the 12 month postoperative follow-up. Although the TCT showed an initial decrease, it reached a stable state after 12 months of crosslinking. Refractive values remained stable at all subsequent examinations. Notably, no complications such as corneal opacity, non-healing epithelial defects or corneal infections occurred during the follow-up period. The most common ocular comorbidity was allergic conjunctivitis (34.4%). CONCLUSION: The findings suggest that accelerated corneal crosslinking treatment is effective in slowing or halting the progression of keratoconus. Furthermore, there were no persistent overt complications observed at 12 months after the procedure.

Pars plana vitrectomy combined with pan-retinal photocoagulation, Ahmed glaucoma valve implantation, and/or phacoemulsification for complicated neovascular glaucoma treatment / Vitrectomia pars plana combinada com fotocoagulação panretiniana, implantação da válvula Ahmed para glaucoma e/ou facoemulsificação para tratamento de glaucoma neovascular complicado

ABSTRACT Purpose: To present long-term results of pars plana vitrectomy combined with pan-retinal endolaser photocoagulation, Ahmed glaucoma valve implantation, and/or phacoemulsification in patients with complicated neovascular glaucoma. Methods: The study comprised 15 eyes from 15 patients with neovascular glaucoma as a complication of diabetic retinopathy and owing to ischemic central retinal vein occlusion. There was a vitreous hemorrhage n all of the patients. Furthermore, 8 of the cases showed varying degrees of hyphema. All subjects received an intravitreal injection of bevacizumab three days before surgery. In 12 phakic patients, phacoemulsification, pars plana vitrectomy, and Ahmed glaucoma valve implantation were performed. Pars plana vitrectomy and Ahmed glaucoma valve implantation were performed in 3 pseudophakic patients. Perioperative and postoperative complications, intraocular pressure values, and best-corrected visual acuity scores were also recorded. Results: The mean follow-up was 24.4 ± 14.56 months. The mean preoperative intraocular pressure was 50.06 ± 7.6 mmHg. At 1 day, 7 days, and 1-, 3-, 6-, 12-month, and last visit following surgery, the mean intraocular pressure was 11.06 ± 8.22, 12.66 ± 7.27, 13.8 ± 7.73, 18.64 ± 7.05, 19.28 ± 4.61, 16.28 ± 1.68, and 16.92 ± 2.12 mmHg, respectively (p=0.001 for every follow-up visit). The mean visual acuity on the most recent appointment was 1.18 ± 0.42 logMar (p=0.001 for each subsequent visit). As postoperative early complications, varying degrees of hyphema and fibrin reactions were recorded. During follow-up, one patient developed phthisis bulbi. In 4 cases, Ahmed glaucoma valve revision surgery was required. Conclusions: In patients with complicated neovascular glaucoma, combined surgical procedures are safe, effective, and preferable both in terms of controlling high intraocular pressure and providing reasonable visual abilities.

RESUMO Objetivo: Apresentar nossos resultados de longo período de vitrectomia pars plana combinada com fotocoagulação panretiniana com endolaser, implantação da válvula Ahmed para glaucoma e/ou facoemulsificação em pacientes com glaucoma neovascular complicado. Métodos: Foram incluídos no estudo 15 olhos de 15 pacientes com glaucoma neovascular como complicação da retinopatia diabética e devido à oclusão isquêmica da veia central da retina. Todos os casos tiveram hemorragia vítrea. Além disso, 8 dos casos apresentaram diferentes graus de hifema. A injeção intravítrea de bevacizumabe foi administrada em todos os casos 3 dias antes da cirurgia. Facoemulsificação, vitrectomia pars plana e implantação da válvula Ahmed para glaucoma foram realizadas em 12 pacientes fáquicos. A vitrectomia pars plana e a implantação da válvula Ahmed para glaucoma foram realizadas em 3 pacientes pseudofáquicos. Complicações perioperatórias e pós-operatórias, valores de pressão intraocular e valores de melhor acuidade visual corrigida pré-operatório e pós-operatório foram registrados. Resultados: O acompanhamento médio foi de 24,4 ± 14,56 meses. A média da pressão intraocular pré-operatória foi de 50,06 ± 7,6 mmHg. Em 1 dia, 7 dias e 1,3,6,12 meses, e última visita após cirurgia, a média da pressão intraocular foi de 11,06 ± 8,22, 12,66 ± 7,27, 13,8 ± 7,73, 18,64 ± 7,05, 19,28 ± 4,61, 16,28 ± 1,68 e 16,92 ± 2,12 mmHg, respectivamente (p=0,001 para cada visita de acompanhamento). A média da acuidade visual na última visita foi de 1,18 ± 0,42 logMar (p=0,001 para cada visita de acompanhamento). Vários graus de reações de hifema e fibrina foram registrados como complicações precoces pós-operatórias. Phthisis bulbi foi desenvolvido em um caso durante o acompanhamento. A cirurgia de revisão da válvula Ahmed para glaucoma foi necessária em 4 casos. Conclusões: Os procedimentos cirúrgicos combinados que realizamos são seguros, eficazes e preferenciais, tanto em termos de controle da alta pressão intraocular quanto fornecimento de habilidades visuais razoáveis em pacientes com glaucoma neovascular complicado.

Pars plana vitrectomy combined with pan-retinal photocoagulation, Ahmed glaucoma valve implantation, and/or phacoemulsification for complicated neovascular glaucoma treatment.

PURPOSE: To present long-term results of pars plana vitrectomy combined with pan-retinal endolaser photocoagulation, Ahmed glaucoma valve implantation, and/or phacoemulsification in patients with complicated neovascular glaucoma. METHODS: The study comprised 15 eyes from 15 patients with neovascular glaucoma as a complication of diabetic retinopathy and owing to ischemic central retinal vein occlusion. There was a vitreous hemorrhage n all of the patients. Furthermore, 8 of the cases showed varying degrees of hyphema. All subjects received an intravitreal injection of bevacizumab three days before surgery. In 12 phakic patients, phacoemulsification, pars plana vitrectomy, and Ahmed glaucoma valve implantation were performed. Pars plana vitrectomy and Ahmed glaucoma valve implantation were performed in 3 pseudophakic patients. Perioperative and postoperative complications, intraocular pressure values, and best-corrected visual acuity scores were also recorded. RESULTS: The mean follow-up was 24.4 ± 14.56 months. The mean preoperative intraocular pressure was 50.06 ± 7.6 mmHg. At 1 day, 7 days, and 1-, 3-, 6-, 12-month, and last visit following surgery, the mean intraocular pressure was 11.06 ± 8.22, 12.66 ± 7.27, 13.8 ± 7.73, 18.64 ± 7.05, 19.28 ± 4.61, 16.28 ± 1.68, and 16.92 ± 2.12 mmHg, respectively (p=0.001 for every follow-up visit). The mean visual acuity on the most recent appointment was 1.18 ± 0.42 logMar (p=0.001 for each subsequent visit). As postoperative early complications, varying degrees of hyphema and fibrin reactions were recorded. During follow-up, one patient developed phthisis bulbi. In 4 cases, Ahmed glaucoma valve revision surgery was required. CONCLUSIONS: In patients with complicated neovascular glaucoma, combined surgical procedures are safe, effective, and preferable both in terms of controlling high intraocular pressure and providing reasonable visual abilities.

Prediction of Pentacam image after corneal cross-linking by linear interpolation technique and U-NET based 2D regression model.

Keratoconus is a common corneal disease that causes vision loss. In order to prevent the progression of the disease, the corneal cross-linking (CXL) treatment is applied. The follow-up of keratoconus after treatment is essential to predict the course of the disease and possible changes in the treatment. In this paper, a deep learning-based 2D regression method is proposed to predict the postoperative Pentacam map images of CXL-treated patients. New images are obtained by the linear interpolation augmentation method from the Pentacam images obtained before and after the CXL treatment. Augmented images and preoperative Pentacam images are given as input to U-Net-based 2D regression architecture. The output of the regression layer, the last layer of the U-Net architecture, provides a predicted Pentacam image of the later stage of the disease. The similarity of the predicted image in the final layer output to the Pentacam image in the postoperative period is evaluated by image similarity algorithms. As a result of the evaluation, the mean SSIM (The structural similarity index measure), PSNR (peak signal-to-noise ratio), and RMSE (root mean square error) similarity values are calculated as 0.8266, 65.85, and 0.134, respectively. These results show that our method successfully predicts the postoperative images of patients treated with CXL.

Is contrast sensitivity a physiological marker in attention-deficit hyperactivity disorder?

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset psychiatric disorders. Although the etiology is complex and has not yet been clarified, dopamine is thought to play a role in the etiology. Methylphenidate (MPH) is a psychostimulant drug used as first-line treatment for ADHD and it inhibits dopamine and norepinephrine reuptake transporters. Dopamine also has an effect on retina and contrast sensitivity. Despite evidence indicating the effects of dopamine on contrast sensitivity, the results of studies examining contrast sensitivity in ADHD patients are inconsistent. Also, no studies have been encountered examining the possible effect of MPH on contrast sensitivity. The hypotheses of this study are that children with ADHD who have not used MPH will have lower contrast sensitivity levels than the members of the control group, that contrast sensitivity levels increase after the use of MPH, and that contrast sensitivity is a potential physiological marker for ADHD. The study was conducted with 30 children with ADHD and 30 children without ADHD. Psychiatric evaluations of the participants were conducted with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime-Turkish version, Conner's Parent Rating Scale-Revised Short form and the Turgay DSM-IV-based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Photopic contrast sensitivity was measured using the Functional Acuity Contrast Test (FACT). Results showed that FACT mean values of the control group were significantly higher than those of the ADHD group (pre-treatment) in all spatial frequencies. In four spatial frequencies (CPD 1.5, 3, 12 and 18), the FACT mean values of the control group were significantly higher than the ADHD group (during the OROS-MPH treatment). At all spatial frequencies, the mean values of the ADHD group during the OROS-MPH treatment were significantly higher than before the OROS-MPH treatment. In conclusion, the present study showed that contrast sensitivity is low in children with ADHD and increases significantly after OROS-MPH medication, but still did not reach the levels of the children without ADHD. Our findings suggest that contrast sensitivity may be a potential physiological marker in ADHD.

Effect of Vitamin D Deficiency on Contrast Sensitivity Function.

PURPOSE: The purpose of this study is to investigate the effects of vitamin D (vit D) deficiency on contrast sensitivity (CS) function and retinal layers. MATERIALS AND METHODS: Group 1 consisted of 42 patients aged between 18 and 50 years with vit D deficiency and Group 2 consisted of sex- and age-matched 34 healthy subjects with normal vit D levels. Functional acuity contrast testing (FACT) was performed using the Optec 6500 vision testing system. The average retinal nerve fiber layer (RNFL) thickness and macular thickness (MT) obtained from nine macular areas in the Early Treatment Diabetic Retinopathy Study were evaluated using SD-OCT (RS-3000; Nidek Inc., Fremont, CA, USA) following a detailed ophthalmologic examination. Measurements were performed on both eyes. RESULTS: A lower CS was found in Group 1 compared to Group 2 in all spatial frequencies. A statistically significant difference was observed between the groups in 6, 12 and 18 cpd spatial frequencies, respectively. (p = .004, p = .001, p = .042, respectively). There was no statistically significant difference between groups in terms of RNFL thicknesses (p = .200). There was an increase in MT in Group 1. However, this increase was statistically significant in the inferior inner area in the right eye, and in the inferior inner, temporal inner and outer macular areas in the left eye (p = .018, p = .003, p = .033, p = .040, respectively). CONCLUSION: It was observed that vit D deficiency had negative effects on CS function and also caused thickness difference in certain segments of retinal layers.

Corneal tattooing for esthetic purposes in patients with corneal opacities.

Purpose: This study evaluated corneal tattooing for esthetic purposes in patients with corneal opacification. Methods: Eight eyes of eight patients were included in the study (four males and four females). Corneal tattooing was achieved by stromal puncture in five patients, femtosecond laser-assisted corneal tattooing in two patients, and femtosecond laser-assisted corneal tattooing and stromal needling (combined procedure) in one patient. In six of the patients, the entire cornea was stained black; in one patient, the center of the cornea (3 mm) was stained black and the periphery was stained dark brown; and in the last patient, the corneal periphery was stained dark brown. Patient satisfaction was evaluated on the first day after surgery and at the last visit as follows: Very satisfied (4), satisfied (3), moderately satisfied (3), and not satisfied (1). Results: The patients ranged in age from 11-80 years. The mean satisfaction score of the patients was 4 and 3.5 on the first postoperative day and at the last visit, respectively. No complication occurred during or after surgery. Conclusion: Corneal tattooing for esthetic purposes was successful in both blind eyes and seeing eyes.

Surgical Management of Primary Inferior Oblique Muscle Overaction: A Subgroup-Specific Surgical Approach.

OBJECTIVES: The aim of this research was to assess the surgical results of recession and myectomy procedures in a subgroup of patients who had primary inferior oblique muscle overaction. METHODS: The records of 94 patients who had been treated due to primary inferior oblique muscle overaction were retrospectively analyzed. The patients were classified into 2 groups according to the severity of the inferior oblique hyperfunction. Recession was performed for patients with a low grade (+1 or +2) inferior oblique hyperfunction, and patients with high grade (+3 or +4) hyperfunction underwent myectomy surgery. Patients demonstrating a horizontal misalignment underwent conventional horizontal muscle surgery along with an inferior oblique weakening procedure. RESULTS: A total of 134 eyes fulfilled the inclusion criteria. Recession was performed in 95 eyes and myectomy in 39. Surgical success was obtained in 96.8% of the eyes that underwent recession and 97.4% of the eyes that underwent myectomy. Residual inferior oblique hyperfunction was observed in 3 eyes after recession and in 1 eye after myectomy. After surgery, about one-quarter of the patients with unilateral inferior oblique overaction subsequently developed a contralateral inferior oblique overaction. CONCLUSION: The results of this study demonstrated that both recession and myectomy procedures are effective for treating primary inferior oblique hyperfunction with minimal complications when applied in the appropriate patient.

Increased frequency of Demodex blepharitis in rosacea and facial demodicosis patients.

BACKGROUND: Rosacea is an inflammatory disease with 50% of ocular involvement rate. Primary demodicosis is an eruption caused by Demodex mites, and there is no data about the rate of ocular involvement in primary demodicosis. AIMS: In this cross-sectional study, it is aimed to reveal the frequency of Demodex blepharitis in rosacea and primary demodicosis patients. METHODS: In total, 58 rosacea, 33 primary demodicosis patients, and 31 healthy volunteers were included in the study. Four samples were obtained from eyelashes with a forceps and from facial skin by standardized skin surface biopsy. A positive result is described as detecting at least one Demodex mite on an eyelash or at five mites in the face. The patients were also examined by an ophthalmologist in terms of ocular involvement. RESULTS: Both rosacea and primary demodicosis patients had significantly more complaints like burning and stinging in the eyes compared to the control patients (P = .001). Primary demodicosis and papulopustular rosacea patients had the highest numbers of eyelash mites, respectively, and significantly a higher rate of blepharitis than the control group. CONCLUSION: As a result, the Demodex count was significantly higher in the primary demodicosis and rosacea patients than the control group. We think that every Demodex-positive patients should be evaluated for also eyelash mites to prevent a possible chronic blepharitis.

Estimation of angle kappa and pupil barycentre configuration in myopic tilted disc syndrome.

BACKGROUND: To evaluate the angle kappa and pupil barycentre configuration in patients with myopic tilted disc syndrome (TDS). METHODS: Thirty-five eyes of 35 patients with TDS were included in the study. Thirty-five eyes of 35 age- and sex-matched healthy subjects were enrolled in the control group. All measurements were performed with the Lenstar LS 900. Angle kappa was calculated according to Pythagorean theorem using the x and y co-ordinates of the pupil centre. Pupil dx and pupil dy values (pupil dx: x co-ordinate of pupil centre relative to corneal apex, pupil dy: y co-ordinate of pupil centre relative to corneal apex) were used to evaluate the pupil barycentre configuration. Central corneal thickness, white to white (cornea diameter), pupil diameter, anterior chamber depth, lens thickness, and axial length were also measured. RESULTS: The calculated mean angle kappa distance was 0.27 ± 0.15 mm in the TDS group and 0.29 ± 0.23 mm in the control group (p = 0.42). The mean pupil dx was -0.01 ± 0.24 mm in the TDS group and -0.17 ± 0.14 mm in the control group (p = 0.006). The mean pupil dy was -0.02 ± 0.13 mm in the TDS group and -0.05 ± 0.22 mm in the control group (p = 0.65). CONCLUSIONS: The pupil barycentre in TDS cases was statistically significantly closer to the corneal vertex on the horizontal plane compared to the control group. However, there was no statistically significant differences in terms of angle kappa and pupil dy values between the groups. According to our results, refractive surgery can be performed safely with respect to complications related to decentration of ablation zone and decentration of multifocal intraocular lenses in these groups of patients.

Effect of Fasting on Contrast Sensitivity in Healthy Males.

PURPOSE: To evaluate the effect of fasting on contrast sensitivity (CS) in healthy male individuals during the month of Ramadan. METHODS: This study included 45 healthy male individuals, aged between 20 and 40 years, working in the same environment. Functional acuity contrast testing (F.A.C.T) was performed using the Optec 6500 vision testing system. Measurements taken during a state of satiety one week before Ramadan were compared with those taken a minimum of 12 hours after the start of fasting in the first and fourth weeks of Ramadan. RESULTS: Contrast sensitivity (CS) was increased at the spatial frequency of three cycles per degree (cpd) at the end of the first week of Ramadan in comparison to the CS measured before Ramadan ( P = 0.03). The mean CS values were increased at the spatial frequencies of 3 and 12 cpd at the end of the last week of Ramadan in comparison to the mean values measured before Ramadan ( P = 0.01 for both). CONCLUSION: Although we found statistically significant increases in CS at certain frequencies, we can conclude that Ramadan fasting has no negative effects on CS.

Familial association of keratoconus and granular corneal dystrophy: The familial case series.

OBJECTIVE: The aim of the present study was to evaluate the coexistence of bilateral keratoconus and granular corneal dystrophy (GCD) in the members of a family. METHODS: A total of 22 patients were examined in four generations of the family tree in this family screening study. Visual acuity test, biomicroscopic examination, and fundus examination were performed in all patients. The diagnosis of granular dystrophy was based on biomicroscopic examination findings. Corneal topography was performed on the patients diagnosed with granular dystrophy and other family members aged >5 years with normal examination findings. Corneal photographs were obtained from all patients with granular dystrophy except one case. RESULTS: Keratoconus or subclinical keratoconus was detected in seven cases. In addition, GCD type 1 was found in six of the seven cases. All patients diagnosed with keratoconus and granular dystrophy were females. On the other hand, there was no ophthalmologic problem in the men of the family tree. Although an autosomal dominant inheritance was found, the onset of the disease only in women suggests that there may be a variant expression. CONCLUSION: The present study showed an association of GCD and keratoconus in four generations of a family. More research is required to further explain this association.

Measurement of Contrast Sensitivity in Patients with Behçet's Disease without Ocular Involvement.

PURPOSE: To evaluate contrast sensitivity in patients with Behçet's disease (BD) without ocular involvement. METHODS: The study group was composed of 47 BD patients (20 to 50 years of age) who did not have ocular involvement. The control group was composed of 47 normal volunteers who were similar to the study group in terms of age and gender. No participants in this study had any ocular or systemic pathologies except for BD. The contrast sensitivity measurements were performed using the Functional Acuity Contrast Test under photopic conditions, and the results were compared between the two groups. RESULTS: The mean age of the BD patients and control subjects was 34.5 ± 9.7 and 33.2 ± 7.6 years, respectively. The mean disease duration of the BD patients was 5.5 ± 6.4 years. There was a statistically significant decrease at five spatial frequencies (A, 1.5; B, 3; C, 6; D, 2; and E, 18 cycles per degree) in patients with BD compared with control subjects (p < 0.001, p = 0.004, p = 0.002, p < 0.001, and p = 0.001, respectively). CONCLUSIONS: The contrast sensitivity of BD patients without ocular involvement was lower than that of the control group. Further studies seem mandatory to confirm our results.

Effect of inferior oblique anterior transposition in correcting vertical hyperdeviation in primary position.

OBJECTIVE: To evaluate the effect of inferior oblique anterior transposition (IOAT) on improvement of vertical hyperdeviation in primary position. METHODS: This study was a retrospective review and included 35 eyes of 33 patients (18 males and 15 females). Patients with dissociated vertical deviation were not included in the study. Preoperative and postoperative average follow-up was 11.46 ± 11.73 and 11.43 ± 9.73 months, respectively. The eyes were divided into 5 groups according to the amount of transposition. Inferior oblique muscle was transpositioned 2 mm posterior to the inferior rectus insertion in group 1; 1 mm posterior to the inferior rectus insertion in group 2; parallel to the inferior rectus insertion in group 3; 1 mm anterior to the inferior rectus insertion in group 4; and 2 mm anterior to the inferior rectus insertion in group 5. RESULTS: The mean preoperative and postoperative vertical hyperdeviation were 16.52 ± 5.54 and 0.97 ± 2.34 prism diopters (PD), respectively. The mean preoperative vertical hyperdeviation in group 1, group 2, group 3, group 4, and group 5 was 11.0 ± 4.24, 12.88 ± 4.26, 16.63 ±3.50, 19.83 ± 2.71, and 25.5 ± 3.00 PD, respectively. Postoperatively, improvement in vertical hyperdeviation in group 1, group 2, group 3, group 4, and group 5 was 11.0 ± 4.24, 11.63 ± 3.20, 15.46 ± 3.19, 18.17 ± 2.23, and 25.5 ± 3.00 PD, respectively. The vertical hyperdeviation had improved 100% in group 1; 90.2% in group 2; 92.9% in group 3; 91.59% in group 4; and 100% in group 5. CONCLUSION: IOAT surgery planned according to hyperdeviation amount has effective and predictable results in correcting vertical hyperdeviation in primary position.

Anti-Saccharomyces Cerevisiae as Unusual Antibody in Autoimmune Polyglandular Syndrome Type III: A Case Report.

Backgraund and Objective: Anti-Saccharomyces Cerevisiae Antibodies (ASCA) that are considered to reflect immune response against increased intestinal permeability due to mucosal damage are among the serological markers of Crohn's Disease. METHODS: This microbial seromarker was recently shown to be elevated in several autoimmune disorders such as celiac disease, autoimmune liver diseases, type 1 diabetes, and Graves' disease. Despite that fact, ASCA seropositivity in Autoimmune Polyglandular Syndrome (APS) has never been reported before. RESULTS: Herein, we present a 46-year-old woman who has uveitis, autoimmune thyroiditis, and primary ovarian failure. CONCLUSION: Based on the coexistence of these diseases, the patient was diagnosed with APS type III. Moreover, ASCA seropositivity was detected although she has no overt intestinal disease.

Conjunctival Limbal Autograft Combined with Amniotic Membrane Transplantation to Treat a Moderate Chemical Eye Injury.

A 25-year-old male patient presented at the clinic with chemical trauma to the left eye. His visual acuity according to Snellen chart measurement was 0.05/10 in the left eye and 10/10 in the right eye. On slit lamp examination, conjunctival hyperemia and limbal ischemia were observed between the 1 o'clock and 6 o'clock hours (approximately 5 clock hours). The cornea was edematous in this area, and a corneal epithelial defect adjacent to the limbal ischemia area was present. The anterior chamber, iris, and lens were normal; the fundus could not be concurrently evaluated. Conjunctivalization and excessive neovascularization were observed in the limbal ischemic area at the end of the fourth week of medical treatment. Visual acuity in the left eye was 0.3 and the epithelial defect had healed. At the end of the sixth week, a conjunctival limbal autograft (CLAU) combined with amniotic membrane (AM) transplantation surgery was performed. Subsequently, the corneal neovascularization was noted to have completely vanished in the ischemic area where the CLAU and AM transplantation were performed. Visual acuity improved to 0.7 and the symptoms of the patient decreased.

Corneal endothelial changes in patients with vitamin D deficiency.

Purpose: The purpose of this study is to evaluate the effect of vitamin D deficiency on corneal endothelial layer using specular microscopy. Methods: Fifty-eight eyes of 58 patients whose vitamin D level was below 15 ng/ml and who had no ocular pathology were included in the study (Group 1). Forty eyes of 40 age-and sex-matched subjects were enrolled as control group (Group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical Inc., Nishinomiya, Japan). The obtained data were compared between the groups. Results: There was no significant difference between the groups in terms of age and gender (P = 0.344, P = 0.399, respectively). The mean CD value was 2772.79 ± 202.21 cells/mm2 in Group 1 and 2954.97 ± 116.89 cells/mm2 in Group 2 (P = 0.001). The mean CV value was 30.31 ± 3.65 in Group 1 and 28.20 ± 2.71 in Group 2 (P = 0.003). The mean HEX value was 46.56 ± 6.32 in Group 1 and 51.07 ± 5.28 in Group 2 (P = 0.001). The mean CCT value was 555.87 ± 36.90 µ in group 1 and 549.0 ± 37.39 µ in Group 2 (P = 0.96). Conclusion: Vitamin D deficiency may affect the corneal endothelial layer. Patients with vitamin D deficiency should be evaluated for endothelial parameters in particular before an intraocular surgery. Further studies are needed to confirm our results.

Corneal Endothelial Changes in Behçet's Patients with Inactive Ocular Involvement.

PURPOSE: The purpose of this article is to evaluate alterations in the corneal endothelial layer in Behçet's disease (BD) with inactive ocular involvement using specular microscopy. MATERIALS AND METHODS: Thirty-three eyes of 33 BD patients who had at least one anterior segment involvement and no active inflammation in the last 3 months were included in the study (group 1). Twenty-seven of the 33 BD patients had an anterior uveitis attack and six of them had a panuveitis (both anterior and posterior involvement) attack. Thirty-three eyes of 33 age- and sex-matched healthy subjects were enrolled in the control group (group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical, Nishinomiya, Japan), and the results were compared between groups. RESULTS: The mean CD was 2739 ± 164.18 cells/mm2 in group 1 and 2922 ± 107.60 cells/mm2 in group 2 (p = 0.001). The mean CV was 32.9 ± 4.76 in group 1 and 28.5 ± 3.06 in group 2 (p = 0.001). The mean HEX was 44.7 ± 6.51 in group 1 and 49.7 ± 6.10 in group 2 (p = 0.019). The mean CCT was 545.75 ± 40.89 µ in group 1 and 545.66 ± 30.09 µ in group 2 (p > 0.05). CONCLUSIONS: Ocular attacks in our BD patients may have caused permanent changes in the corneal endothelial layer. However, these changes did not lead to corneal decompensation, but further studies are necessary to confirm these results.

Foveal Thickness Alterations in Patients with Migraine.

AIM: To investigate the alterations in foveal retinal thickness (FT) values in patients with migraine and to reveal the correlations between FT and clinical characteristics of migraine disease. METHODS: This study included sixty-eight eyes of 34 migraine patients [twenty-eight eyes of 14 patients with aura (group 1), and forty eyes of 20 patients without aura (group 2)] and forty eyes of 20 healthy volunteer who served as the control group (group 3). FT values were measured by optical coherence tomography (OCT) in each group. RESULTS: Mean age of patients in group 1, 2, and 3 was 34.0± 6.82, 35.2±10.12, and 35.1± 6.85 years, respectively (p=0.84). Mean FT was 211.07±7.36, 220.0±12.01, and 221.85±12.27 in groups 1, 2, and 3, respectively. There was statistically significance among the group 1-2 and 1-3 (p=0.002 and p< 0.001). There was no statistically significance between group 2-3 (p=0.88). CONCLUSION: This study suggests that in particular migraine with aura may lead to a reduction in FT values. This finding can be explained by the blood flow decrease theory in migraine; however larger studies seem mandatory.

Corneal Biomechanical Characteristics in Patients with Behçet Disease.

AIM: To examine corneal biomechanical properties, intraocular pressure, and central corneal thickness in uveitic eyes with Behçet disease (BD) and to compare them with healthy controls. METHODS: This study included 40 eyes of 34 patients with ocular BD and 20 eyes of 20 healthy controls. Eyes with ocular BD were subdivided into active and inactive groups. Ocular response analyzer (ORA) measurements were performed on the 20 eyes of 16 patients with active BD (group 1), 20 eyes of 18 patients with inactive BD (group 2), and 20 eyes of 20 healthy volunteers who served as the control group (group 3). Corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (Goldmann correlated [IOPg], and corneal compensated [IOPcc]) and central corneal thickness (CCT) values were recorded. RESULTS: Mean age of patients in groups 1, 2, and 3 was 33.81 ± 9.36, 32.38 ± 9.08, and 31.05 ± 5.85 years, respectively (p = 0.76). Mean CH, CRF, IOPg, IOPcc, and CCT values in groups 1, 2, and 3 were [8.51 ± 1.88, 9.72 ± 2.11, 19.87 ± 2.92, 16.13 ± 3.29, and 592.50 ± 39.95], [8.46 ± 1.82, 8.45 ± 1.98, 15.89 ± 2.68, 15.35 ± 2.91, and 528.35 ± 19.18], and [8.47 ± 1.48, 8.43 ± 1.58, 15.59 ± 2.74, 15.42 ± 3.19, and 526.30 ± 18.21], respectively [(p1 = 0.040, 0.904, <0.001, 0.495 and <0.001 for CRF, CH, IOPg, IOPcc and CCT in group 1, respectively), (p2 = 0.989, 0.904, 0.659, 0.989, and 0.989 for CRF, CH, IOPg, IOPcc and CCT in group 2, respectively), (p3 = 0.989, 0.904, 0.660, 0.989, and 0.989 for CRF, CH, IOPg, IOPcc and CCT in group 3, respectively)]. CONCLUSION: CRF, IOPg, and CCT values altered in active BD group when compared with inactive BD and control group (p < 0.005). Further studies are required to establish the effects of BD on corneal biomechanical properties.