Comparison of HIF-1α and survivin levels in patients with diabetes and retinopathy of varying severity.

PURPOSE: This study measured serum hypoxia--inducible factor-1 (HIF-1α) and survivin levels in patients with diabetes and investigated their association with the severity of retinopathy. METHODS: This study included 88 patients with type 2 diabetes mellitus who underwent routine eye examinations. Three groups were created. Group 1 consisted of patients without diabetic retinopathy. Group 2 included patients with non-proliferative diabetic retinopathy. Group 3 included patients with proliferative diabetic retinopathy. To measure serum HIF-1α and survivin levels, venous blood samples were collected from patients. RESULTS: The mean HIF-1α levels in groups 1, 2, and 3 were 17.30 ± 2.19, 17.79 ± 2.34, and 14.19 ± 2.94 pg/ml, respectively. Significant differences were detected between groups 1 and 3 (p=0.01) and between groups 2 and 3 (p=0.01). The mean survivin levels in groups 1, 2, and 3 were 42.65 ± 5.37, 54.92 ± 5.55, and 37.46 ± 8.09 pg/ml, respectively. A significant difference was only detected between groups 2 and 3 (p=0.002). CONCLUSION: The present study revealed that serum HIF-1α and survivin levels are increased in patients with non-proliferative diabetic retinopathy compared to those in patients without diabetic retinopathy.

Assessment of Tear Meniscus Dimensions Using Anterior Segment Optical Coherence Tomography in Vitamin D Deficiency in a Pediatric Population.

BACKGROUND: To investigate of the effect of vitamin D (Vit-D) deficiency on the tear film in children and compare it with that of healthy subjects. METHODS: This prospective and cross-sectional study comprised 75 eyes of children who had Vit-D deficiency (Group 1) and 85 eyes of age- and gender-matched healthy children (Group 2). The tear-film break-up time (TF-BUT) and Schirmer test values, as well as the Ocular Surface Disease Index (OSDI) scores, were recorded for the participants in all groups. Measurement of the tear meniscus area (TMA) and tear meniscus height (TMH) was performed 2 times in the same day via the use of anterior segment-optical coherence tomography (AS-OCT). RESULTS: The mean age of the participants in Group 1 was 12.42 ± 3.40 years, while in Group 2, it was 12.59 ± 2.32 years (p = 0.758). Group 1 comprised 43 females and 32 males, while Group 2 comprised 44 females and 41 males (p = 0.250). The mean TMH, TMA, and Schirmer test values were found to be significantly lower in children with Vit-D deficiency (Group 1) than in healthy children (Group 2), with p < 0.05 for all the values. It was concluded that there was no significant difference in the values for the mean TF-BUT and OSDI scores (p = 0.029 and p = 0.596, respectively). CONCLUSION: The children with Vit-D deficiency exhibited lower TMH, TMA, and Schirmer test values. The alterations that were observed in these parameters were more prominent in the participants who had lower Vit-D levels.

Expression of Vitamin D Receptor and Vitamin D Receptor Gene Polymorphisms (BsmI, FokI, and TaqI) in Patients with Pterygium / Expressão do gene do receptor da vitamina D e de seus polimorfismos (BsmI, FokI e TaqI) em pacientes com pterígio

ABSTRACT Purpose: This study aimed to determine the role of vitamin D receptor in the pathogenesis of pterygium. The vitamin D receptor eexpression levels in pterygium tissue, blood vitamin D levels, and frequency of selected vitamin D receptor gene polymorphisms (BsmI, FokI, and TaqI) were compared between patients with pterygium and healthy participants. Methods: The study included patients with pterygiumeee (n=50) and healthy volunteers (n=50). The serum vitamin D levels were measured for both groups. Immunohistochemical staining for vitamin D receptor ewas performed on sections obtained from the pterygium and adjacent healthy conjunctival tissues of the same individuals. The genomic existence of vitamin D receptor epolymorphisms (BsmI, FokI, and TaqI) were analyzed in DNA obtained from venous blood of participants using polymerase chain reaction and restriction fragment length polymorphism methods. Results: There was no difference found between the serum vitamin D levels of patients with pterygium and healthy controls. However, tissue expression of vitamin D receptor was higher in the pterygium endothelial cells of micro-vessels (p=0.002), subepithelial stromal (p=0.04), and intravascular inflammatory cells (p=0.0001), in comparison with the adjacent healthy conjunctival tissue. Moreover, while the BBtt haplotype was 2-fold higher, the bbTt haplotype was 2.5-fold lower, and the BbTT haplotype was 2.25-fold lower in the control group than in the pterygium group (p<0.001). Conclusions: Vitamin D serum levels did not differ between the healthy and pterygium groups. Vitamin D receptor expression was increased in the pterygium tissue versus the adjacent healthy tissue. However, vitamin D receptor polymorphism analysis in patients with pterygium did not reveal any significant difference in BsmI, FokI, or TaqI polymorphisms in comparison with the healthy volunteers.(AU)

RESUMO Objetivo: Determinar o papel do receptor da vitamina D na patogênese do pterígio. Os níveis de expressão do receptor da vitamina D no tecido do pterígio, os níveis sanguíneos de vitamina D e a frequência de alguns polimorfismos do gene do receptor da vitamina D (BsmI, FokI e TaqI) foram comparados entre pacientes com pterígio e participantes saudáveis. Métodos: Foram incluídos pacientes com pterígio (n=50) e voluntários saudáveis (n=50). Os níveis séricos de vitamina D foram medidos em ambos os grupos. Foi feita uma coloração imuno-histoquímica para o receptor da vitamina D em cortes obtidos do pterígio e dos tecidos conjuntivais saudáveis adjacentes dos mesmos indivíduos. A existência de polimorfismos do receptor da vitamina D (BsmI, FokI e TaqI) no genoma foi analisada em DNA obtido do sangue venoso dos participantes, usando métodos de Polymerase chain reaction (PCR) e RFLP. Resultados: Não foi observada nenhuma diferença entre os níveis séricos de vitamina D dos pacientes com pterígio e os dos controles saudáveis. Entretanto, a expressão tissular do receptor da vitamina D foi maior nas células endoteliais dos microvasos do pterígio (p=0,002), nas células estromais sub-epiteliais (p=0,04) e nas células inflamatórias intravasculares (p=0,0001), quando comparada à expressão no tecido conjuntival saudável adjacente. Além disso, embora o haplótipo BBtt tenha sido duas vezes mais frequente, o haplótipo bbTt foi 2,5 vezes menos frequente e o haplótipo BbTT foi 2,25 vezes menos frequente no grupo de controle do que no grupo com pterígio (p<0,001). Conclusões: Os níveis séricos de vitamina D não apresentaram diferenças entre o grupo de pessoas saudáveis e o com pterígio. A expressão do receptor da vitamina D mostrou-se maior no grupo com pterígio do que no tecido saudável adjacente. Entretanto, a análise dos polimorfismos do receptor da vitamina D nos pacientes com pterígio não revelou qualquer diferença significativa nos polimorfismos BsmI, FokI ou TaqI em comparação com os voluntários saudáveis.(AU)

Comparison of vitamin D levels between patients with pterygium and healthy subjects.

PURPOSE: The purpose of this study was to compare vitamin D (VD) deficiency frequency among patients with pterygium to that of healthy subjects and to investigate the VD deficiency among patients with pterygium. METHODS: One-hundred eight pterygium patients and 94 healthy subjects were included in the study. Blood samples were collected from groups during the same time interval and the samples were saved. Serum 25-hydroxyvitamin D (25(OH)D) and parathormone (PTH) levels were measured and analyzed. RESULTS: The pterygium group consisted of 57 female and 51 male patients, while the control group consisted of 47 female and 47 male patients. The mean age, sex and mean BMI were similar in the two groups (p > 0.05). The percentage of time that individuals spent outdoors was higher in the pterygium group (p = 0.02). The percentage of VD deficiency was 83.3% in the pterygium group and 61.7% in the control group (p = 0.001). There was a positive correlation between VD and time spent outdoors (p < 0.05). CONCLUSIONS: VD deficiency can play a role in pterygium etiopathogenesis. Wide population-based studies in different regions are needed to evaluate this result.

Expression of Vitamin D Receptor and Vitamin D Receptor Gene Polymorphisms (BsmI, FokI, and TaqI) in Patients with Pterygium.

PURPOSE: This study aimed to determine the role of vitamin D receptor in the pathogenesis of pterygium. The vitamin D receptor eexpression levels in pterygium tissue, blood vitamin D levels, and frequency of selected vitamin D receptor gene polymorphisms (BsmI, FokI, and TaqI) were compared between patients with pterygium and healthy participants. METHODS: The study included patients with pterygiumeee (n=50) and healthy volunteers (n=50). The serum vitamin D levels were measured for both groups. Immunohistochemical staining for vitamin D receptor ewas performed on sections obtained from the pterygium and adjacent healthy conjunctival tissues of the same individuals. The genomic existence of vitamin D receptor epolymorphisms (BsmI, FokI, and TaqI) were analyzed in DNA obtained from venous blood of participants using polymerase chain reaction and restriction fragment length polymorphism methods. RESULTS: There was no difference found between the serum vitamin D levels of patients with pterygium and healthy controls. However, tissue expression of vitamin D receptor was higher in the pterygium endothelial cells of micro-vessels (p=0.002), subepithelial stromal (p=0.04), and intravascular inflammatory cells (p=0.0001), in comparison with the adjacent healthy conjunctival tissue. Moreover, while the BBtt haplotype was 2-fold higher, the bbTt haplotype was 2.5-fold lower, and the BbTT haplotype was 2.25-fold lower in the control group than in the pterygium group (p<0.001). CONCLUSIONS: Vitamin D serum levels did not differ between the healthy and pterygium groups. Vitamin D receptor expression was increased in the pterygium tissue versus the adjacent healthy tissue. However, vitamin D receptor polymorphism analysis in patients with pterygium did not reveal any significant difference in BsmI, FokI, or TaqI polymorphisms in comparison with the healthy volunteers.

Evaluation Using Spectral-Domain Optical Coherence Tomography of the Effects of Malnutrition on Ocular Parameters in Pediatric Patients.

SIGNIFICANCE: We determined decreases in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in all quadrants. Our findings show that the choroid and RNFL are affected before the emergence of ocular symptoms in malnourished children. PURPOSE: We aimed to determine whether the RNFL, a component of the neuronal structure, and the choroid, supplying the retina, are affected in children with malnutrition using spectral-domain optical coherence tomography. METHODS: One hundred twenty-six malnourished patients without ocular symptoms, aged between 5 and 10 years, and 116 healthy children were included in the study. Age, sex, weight-for-age (WFA) z score, height-for-age z score, body mass index-for-age z score, and spectral-domain optical coherence tomography data were recorded. RESULTS: Average RNFL thickness was 96.5 µm (82.0 to 128.0 µm) in the malnutrition group and 111.0 µm (95.0 to 128.0 µm) in the control group (P < .001). Retinal nerve fiber layer thickness was statistically significantly lower in all quadrants in malnourished patients compared with the control group. Median choroidal thickness in the foveal center was 304.0 µm (250.0 to 375.0 µm) in the malnutrition group and 345.0 µm (280.0 to 403.0 µm) in the control group (P < .001). Choroidal thickness in all quadrants was also statistically significantly lower in malnourished patients. Positive correlation was determined between average RNFL thicknesses and WFA z score. Average RNFL thickness decreased as WFA z score decreased (r = 0.730 and P < .001). Positive correlation was also observed between choroidal thickness in the foveal center and WFA z score. Foveal center choroidal thickness decreased in line with WFA z score (r = 0.786 and P < .001). CONCLUSIONS: Our results show that the retinal nerve fiber layer and choroidal thickness decreased in malnourished children without clinically reported ocular symptoms. A decreased retinal nerve fiber layer and choroidal thickness may be an important clue to the prevention of retinal pathologies that may develop at later ages if the malnutrition is not addressed.

Assessment of Patient Pain Experience During Intravitreal Ranibizumab and Aflibercept Injection.

PURPOSE: The aim of this study was to compare the pain scores of the patients during intravitreal injection of ranibizumab and aflibercept based on patient feedback. MATERIALS AND METHODS: Seventy-two eyes of 72 patients, who had not previously undergone any intravitreal injection procedures, were included in this study. Thirty-eight patients received ranibizumab, and 34 patients received aflibercept injections. The pain was measured by visual analog scale (VAS). Patients were asked to rate their pain experienced during the injection between 0 (no pain) and 10 (worst pain ever felt) on VAS just after the injection. RESULTS: VAS pain scores in ranibizumab and aflibercept groups were 3.28 ± 2.45 and 4.20 ± 2.30, respectively. There was a significant difference in average VAS pain scores between groups (P = 0.04). CONCLUSION: VAS pain scores in aflibercept group were found to be significantly higher than the scores in the ranibizumab group.

Evaluation of white matter hyperintensities and retinal fiber layer, ganglion cell layer, inner-plexiform layer, and choroidal layer in migraine patients.

The aim of our study is to assess retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), inner-plexiform layer (IPL), and choroidal layer in migraine patients with white matter lesion (WML) or without WML, using spectral domain optical coherence tomography (OCT). To our study, 77 migraine patients who are diagnosed with migraine in accordance to the International Classification of Headache Disorders (ICHD)-3 beta and 43 healthy control are included. In accordance to cranial MRI, migraine patients are divided into two groups as those who have white matter lesions (39 patients), and those who do not have a lesion (38 patients). OCT was performed for participants. The average age of participants was comparable. The RNFL average thickness parameter in the migraine group was significantly lower than in the control group (p < 0.01). However, no significant difference was detected among those migraine patients who have WML, and those who do not have. No significant difference is detected among all groups in terms of IPL, GCL, and choroidal layer measuring scales. The proofs showing that affected retinal nerve fiber layer are increased in migraine patients. However, it is not known whether this may affect other layers of retina, or whether there is a correlation between affected retinal structures and white matter lesions. In our study, we found thinner RNFL in migraine patients when we compared with controls but IPL, GCL, and choroid layer values were similar between each patient groups and controls. Also, all parameters were similar between patients with WML and without WML. Studies in this regard are required.

Evaluation of Anterior Segment Parameter Changes Using the Sirius after Uneventful Phacoemulsification.

PURPOSE: To investigate changes in anterior chamber depth (ACD), corneal volume (CV), anterior chamber angle (ACA), anterior chamber volume (ACV), central corneal thickness (CCT), horizontal visible iris diameter (HVID), pupil diameter (PD), and intraocular pressure (IOP) after uneventful phacoemulsification cataract surgery with intraocular lens implantation. METHODS: A total of 132 eyes of 132 patients (87 men and 45 women) that underwent uneventful phacoemulsification cataract surgery and intraocular lens implantation were prospectively studied. The mean age of the patients was 63.68 ± 12.51 years. All patients were evaluated preoperatively and at 1 month postoperatively with the Sirius 3D Rotating Scheimpflug camera topography system. The ACD, CV, ACA, ACV, CCT, HVID, and PD measurements were recorded. IOP was measured using the Goldmann applanation tonometer, which was corrected for CCT of the Sirius device using Ehlers' formula. RESULTS: The preoperative mean ACD, ACV, ACA, CCT, CV, PD, HVID, and IOP were 2.79 ± 0.45 mm, 124.73 ± 25.72 mm(3), 42.09 ± 7.49(0), 523.87 ± 41.97 microns, 55.37 ± 4.89 mm(3), 3.98 ± 1.23 mm, 11.72 ± 0.67 mm, and 14.74 ± 2.59 mmHg, respectively. Three months postoperatively, the mean ACD, ACV, ACA, CCT, CV, PD, HVID, and IOP were 3.45 ± 0.6 mm, 162.52 ± 23.79 mm(3), 51.46 ± 5.63(0), 526.21 ± 44.45 microns, 56.23 ± 5.12 mm(3), 2.87 ± 0.45 mm, 11.91 ± 0.75 mm, and 12.02 ± 1.83 mmHg, respectively. There was a statistically significant increase in mean postoperative ACD, ACV, ACA, CV, and HVID compared with the corresponding preoperative values (p < 0.05). CCT remained stable after surgery. Postoperative PD and IOP were significantly decreased compared to corresponding preoperative values (p < 0.05). CONCLUSIONS: Preoperative measurements by the Sirius 3D Rotating Scheimpflug camera topography system might help surgeons to predict postoperative changes resulting from phacoemulsification and intraocular lens implantation. This is a noncontact, noninvasive, and comfortable system for patients that is highly reliable and repeatable for anterior segment measurements.

Choroidal Thickness in Children with Beta Thalassemia Major.

PURPOSE: The purpose of this study was to determine whether there are differences in choroidal thickness in children with beta thalassemia major (ß-TM). METHODS: Thirty-five patients with ß-TM and 38 healthy children aged between 3 and 16 years participated in the study. After complete eye examinations were conducted on the participants, choroidal thickness measurements were performed using optical coherence tomography. Correlations between choroidal thickness and laboratory and clinical parameters, such as age, sex, hemoglobin and ferritin levels, duration of disease, type and duration of chelating therapy, visual acuity, intraocular pressure, central corneal thickness, and axial length were also evaluated. RESULTS: The mean ages for the study group and for the control group were 8.2 ± 2.7 and 7.9 ± 2.4 years, respectively. There were no statistical differences between groups in terms of visual acuity, intraocular pressure, central corneal thickness, or axial length (p > 0.05). Choroidal thicknesses at the foveal center were 286 ± 33 µm in ß-TM patients and 335 ± 423 µm in the healthy control children. Choroidal thicknesses at each point within the horizontal nasal and temporal quadrants were thinner in the ß-TM group. There was a positive correlation between choroidal thickness and hemoglobin levels and a negative correlation between choroidal thickness and ferritin levels (r = 0.924, p < 0.001 and r = -0.947, p < 0.001, respectively). There was no correlation between clinical or ocular characteristics and choroidal thickness. CONCLUSIONS: Choroidal thickness was significantly thinner in all quadrants in children with ß-TM. This thinning of the choroid may be the reason for the development of eye disorders in older patients with ß-TM.

Comparison of Central Corneal Thickness Measurements Obtained by RTVue OCT, Lenstar, Sirius Topography, and Ultrasound Pachymetry in Healthy Subjects.

PURPOSE: To compare central corneal thickness (CCT) measurement results obtained by RTVue OCT, Lenstar, Sirius topography, and ultrasound pachymetry (UP) (OcuScan RxP Ophthalmic Ultrasound System, Alcon Laboratories) in healthy subjects. MATERIALS AND METHODS: 256 eyes of 128 healthy subjects were included in the study. CCT measurements were obtained from the eyes for each subject using the UP, Lenstar, Sirius topography, and RTVue OCT instruments. Ultrasound pachymetry measurements were performed after the eyes were anesthetized with one drop of 0.5% proparacaine hydrochloride and were performed at the same day after 15 minutes after previous measurements. RESULTS: Of 128 participants, 84 were male and 44 were female with a mean age of 33.15 ± 12.95 years (ranging from 18 to 75 years). The mean CCTs for UP, Lenstar, Sirius topography, and RTVue OCT were 535.60 ± 35.15 (440,00-668,00); 532.63 ± 34.44 (449,00-650,00); 526.05 ± 36.45 (314,00-640,00); 525.89 ± 33.21 (437,00-646,00) µm, respectively. The mean CCT measurements were statistically different among the three groups (p = 0.002). CCT measurements obtained using RTVue-OCT were significantly thinner than those obtained using UP (p = 0.009). Sirius CCT measurements were also thinner than UP (p = 0.011). Mean CCT measurements between UP and Lenstar were similar (p = 0.769). Measurements with Lenstar (r = 0.849), Sirius topography (r = 0.883), and RTVue OCT (0.949) were highly correlated with UP measurements. CONCLUSION: RTVue OCT and Sirius topography significantly underestimated the CCT compared with UP. Although highly correlated, the measurement values with these devices are not directly interchangeable in clinical practice.

Conservative Surgical Management of a Grade III Corneal Dermoid.

PURPOSE: To present a rare, unique, grade III corneal dermoid treated with conservative surgical management. METHODS: An 8-month-old boy was admitted to our clinic with a lesion on the central cornea of the right eye and a corneal mass in the left eye. The mass had a skin-like surface and protruded to the outside of the palpebral fissure. MRI (magnetic resonance imaging) of the orbits showed a large cyst covering most of the cornea and the absence of the anterior chamber and lens. The dermoid was excised and sent for histopathological examination. The cornea was reconstructed using the partial thickness scleral graft. RESULTS: The histopathology report confirmed the diagnosis of a grade III corneal dermoid. On examination 1 year after the surgery, the orbital and globe volumes were the same, and the intraocular pressure was normal. CONCLUSIONS: This is likely the first report of an unusual case in which a grade III corneal dermoid with an anterior staphyloma was treated by anterior segment reconstruction using an autologous partial thickness scleral graft. We believe that this technique has the advantage that it stimulates orbital and facial development and has good cosmetic results.

Assessment of patient pain experience during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection.

PURPOSE: To compare pain scores of patients during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection procedures. METHODS: Seventy eyes of 70 patients who had not previously undergone intravitreal anti-vascular endothelial growth factor therapy were included in this study. Thirty-five patients received ranibizumab and 35 patients received bevacizumab. The diagnoses of the patients were: 27 age related macular degeneration, 15 diabetic macular edema, 9 diabetic vitreous hemorrhage, 6 central retinal vein occlusion, 11 branch retinal vein occlusion and 2 central serous chorioretinopathy. Bevacizumab (1.25 mg/0.05 mL) was injected into the vitreous cavity using a 27-gauge needle, and ranibizumab (0.5 mg/0.05 mL) was injected with 30-gauge needle. Patients were asked just after the injection to rate their perceived pain during the injection using the visual analogue scale (VAS) of 0 (no pain) to 10 (unbearable/worst pain). The average of these scores was used as the primary outcome. RESULTS: The VAS pain scores in the ranibizumab and bevacizumab groups were 1.06 ± 0.91 (range, 0 to 3) and 1.94 ± 1.55 (range, 0 to 7), respectively, a significant difference (p = 0.005). Patients <65 and ≥65 years of age in both the ranibizumab and bevacizumab groups were then compared. For patients <65, there was a significant difference in the average VAS pain scores between groups (p = 0.003). However, for patients ≥65 years, there was not a significant difference in the average VAS pain scores between groups (p = 0.238). Female and male patients in both ranibizumab and bevacizumab groups were also compared. For female patients, there was a significant difference in the average VAS pain scores between groups (p = 0.016), although not for male patients (p = 0.078). CONCLUSIONS: Thirty-gauge intravitreal injection is more comfortable than 27-gauge injection. Injection of bevacizumab with 30-gauge needle syringes may be more tolerable for patients.

Biometric and intraocular pressure change after cataract surgery.

PURPOSE: To evaluate changes in ocular biometric parameters with optical biometry and intraocular pressure (IOP) by Goldmann tonometry after uneventful phacoemulsification in normotensive eyes. METHODS: This prospective study was composed of 117 eyes of 117 patients who had undergone uncomplicated phacoemulsification and foldable intraocular lens implantation. The measurements were obtained preoperatively and 1 month postoperatively. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), pupil diameter (PD), and lens thickness were measured by the LenStar optical biometer, and IOP was measured by Goldmann applanation tonometry. The relationships between IOP change and ocular biometric parameters were evaluated. RESULTS: Mean age was 64.73 ± 10.83 years; 45 patients were women (38.46%) and 72 patients were men (61.54%). Comparing preoperative and postoperative 1-month measurements, the mean AL, PD, and IOP decreased (p < 0.01), whereas ACD (p < 0.01) and CCT (p > 0.05) increased. Intraocular pressure change correlated positively with AL change (p < 0.05) and PD change (p < 0.05) and preoperative IOP (p < 0.01) and preoperative CCT (p < 0.05). Anterior chamber depth change correlated positively with preoperative ACD (p < 0.01) and negatively with preoperative PD (p < 0.05). Pupil diameter change positively correlated with preoperative PD (p < 0.01). Regression analyses showed that preoperative IOP significantly associated with postoperative IOP reduction according to the standardized coefficient beta (-0.649). CONCLUSIONS: Anterior segment morphometry changed and IOP decreased after phacoemulsification. The preoperative IOP may be the best parameter for estimating postoperative IOP reduction.

Comparison of Intraocular Pressure Measurements Obtained by Icare PRO Rebound Tonometer, Tomey FT-1000 Noncontact Tonometer, and Goldmann Applanation Tonometer in Healthy Subjects.

PURPOSE: To compare intraocular pressure (IOP) measurements obtained by Icare PRO rebound tonometer (RT), Tomey FT-1000 noncontact tonometer (NCT), and Goldmann applanation tonometer (GAT) in healthy subjects, and to investigate the influence of central corneal thickness (CCT) on IOP measurements. METHODS: A total of 132 eyes of 66 healthy subjects were included in the study. All IOP measurements were applied in a sitting position and always in the same order (RT, NCT, and GAT). CCT was measured by noncontact anterior segment optical coherence tomography. RESULTS: The mean CCT was 523.5±31.2 µm. The mean IOPs with GAT, NCT, and RT measurements were 14.56±2.77, 13.42±2.99, 14.18±2.55 mm Hg, respectively. A significantly good agreement was found between RT and GAT measurements (P=0.515). The mean difference between RT and GAT measurements was -0.38 mm Hg. An underestimation was found in NCT measurements compared with GAT ones as defined from paired comparisons (P=0.003). The mean difference between NCT and GAT measurements was -1.14 mm Hg. There was no significant difference between NCT and RT readings (P=0.069). The mean difference between NCT and RT measurements was -0.76 mm Hg. There was a significant correlation between GAT-NCT (r=0.740, P<0.001), GAT-RT (r=0.743, P<0.001), NCT-RT (r=0.729, P<0.001) measurement methods. The increment in measured IOP for a 10 µm increase in CCT was 0.16, 0.33, and 0.18 mm Hg for the GAT, NCT, and RT, respectively. CONCLUSIONS: The IOP readings with the new Icare PRO RT showed good correlation with those obtained by GAT. Tomey FT-1000 NCT underestimated the IOP compared with GAT.

Short-term effects of intravitreal bevacizumab on cornea and anterior chamber.

PURPOSE: To determine the short-term effects of single-dose intravitreal bevacizumab injection on central corneal thickness (CCT), simulated keratometry (Sim K), anterior chamber depth (ACD), iridocorneal angle (ICA) and intraocular pressure (IOP) measurements. DESIGN: Prospective, nonrandomized, interventional clinical trial. MATERIALS AND METHODS: Forty-three eyes of 43 patients aged between 41 and 78 years (average 62 ± 13 years) received an intravitreal injection of 2.5 mg/0.1 mL bevacizumab. Patients who had not undergone additional intravitreal anti-vascular endothelial growth factor therapy within 6 months were included in the study. CCT, Sim K, ACD and ICA measurements were obtained with Sirius Topographer. IOP measurements were taken after topographic measurements with Goldmann applanation tonometer. The CCT, ACD, ICA and IOP measurements were taken before and after 3rd, 15th days and 1st month of intravitreal bevacizumab injection. RESULTS: Pre- and postinjection of 3rd, 15th days and 1st month CCT (p = 0.999), Sim K (p = 0.746), ACD (p = 0.996), ICA (p = 0.632) and IOP (p = 0.707) measurements were not statistically different. Mean CCT (p = 1.000), Sim K (0.972), ACD (p = 0.998), ICA (0.667) and IOP (0.951) values were similar before and after 3rd day of bevacizumab injection. Mean CCT (p = 0.999), Sim K (p = 0.994), ACD (p = 1.000), ICA (p = 0.999) and IOP (p = 1.000) measurements were also similar before and after 15th day of injection. Preinjection and 1st month of postinjection CCT (p = 0.999), Sim K (p = 0.932), ACD (p = 0.998), ICA (p = 1.000) and IOP (p = 0.741) measurements did not change significantly. CONCLUSIONS: Single-dose intravitreal bevacizumab injection does not affect CCT, Sim K, ACD, ICA and IOP in short-term period.

What is the importance of Demodex folliculorum in Behçet's disease?

Demodex folliculorum is an obligate parasite and commonly detected in patients with immune system deprivation. This study is planned to document the Demodex folliculorum prevalence among patients with Behçet's disease (BD). The patients who referred to the ophthalmology clinic were included in the study. Fourty patients with BD and 131 patients with refractive errors without any ocular and systemic disease were included. For parasite detection, 3 eyelashes from each inferior eyelid were epilated. Standardized skin surface biopsy (SSSB) was performed for detection of parasite at cheeks of patients. Samples were prepared with Hoyer's solution and investigated under the light microscope. There were 15 female and 25 male in BD group and 61 female and 70 male patients ine control group. Mean ages were 37.62 and 38.38 for BD and control groups, respectively. Demodex folliculorum prevalence at eyelashes was 65% for BD and 10% for control group. SSSB of cheek revealed 7.5% positivity for BD and 10% for control group patients. Statistical analysis documented a significant difference for eyelashes (p < 0.05) which could not be detected for skin results. Investigation of Demodex folliculorum in BD may be useful, even in patients without any complaint, for the treatment of ocular and eyelid discomforts of these patients.