Anti-Demodex Effect of Commercial Eyelid Hygiene Products.

PURPOSE: To investigate in vitro effects of active ingredients in eye cleansing wipes and solutions on the life span of Demodex. METHODS: Demodex mites were extracted by eyelash epilation method from volunteers who were found to have chronic demodex blepharitis during an ophthalmological examination. Preparations with three or more motile, live adult Demodex parasites were included in the study. Two drops of the test solution were dropped on the samples: saline, 2% tea tree oil (TTO; Osto®, AKD Medical products, Turkey), 7.5% TTO (Blefaritto®, Jeomed, Turkey), and 0.5% terpinen-4-ol (T4O; Blefastop plus®, NTC, Italy). Under light microscopy at 100× and 400× magnification, samples were examined and followed. The average killing time of Demodex was noted for each preparation. RESULTS: The study was analyzed on 120 patient samples. In the control group with saline, the average killing time of Demodex had an average of 323.5 ± 21.1 min. In other groups, an average mean of 95.9 ± 25.2 min in the 2% TTO group, 67.1 ± 21.8 min in the 7.5% TTO group, and 27.3 ± 6.0 min in the 0.5% T4O group was observed. It was found that the 0.5% T4O group was significantly more effective than the other groups. CONCLUSION: Chronic Demodex blepharitis treatment is quite difficult in ophthalmology practice. It appears that, even at very low concentrations, T4O has an effective anti-Demodex effect.

Transcanalicular Multidiode Laser Versus External Dacryocystorhinostomy in the Treatment of Acquired Nasolacrimal Duct Obstruction.

OBJECTIVES: This study was a comparison of the outcomes of transcanalicular multidiode laser dacryocystorhinostomy (TCLDCR) and external dacryocystorhinostomy (EXDCR) treatment for patients with acquired nasolacrimal duct obstruction. METHODS: Thirty-one consecutive patients who underwent TCLDCR (TCLDCR group) and 68 consecutive patients who underwent EXDCR (EXDCR group) due to acquired nasolacrimal duct obstruction were enrolled in the study. Follow-up visits were performed on the first day, and at the first week, first month, third month, sixth month, and every six months thereafter. Surgical success was defined as achievement of a patent osteotomy and a successful bicanalicular silicone intubation during the procedure. Anatomical success was defined by observation of a patent osteotomy on lacrimal irrigation, regardless of epiphora. The surgery time and intra- and postoperative complications were noted for each patient. RESULTS: The TCLDCR group had a significantly shorter mean surgery time (27.9±5.5 minutes) compared with the EXDCR group (58.5±12.0 minutes) (p<0.001). However, the mean anatomical and functional rates of TCLDCR (58.0% and 54.8%, respectively) were significantly lower than those of the EXDCR group (94.1% and 91.1%, respectively) (both p<0.001). Two patients had "cheese wiring" damage of the lower canaliculus and 1 patient in the TCLDCR group had a full-thickness skin defect in the medial canthal region. No serious intra- or postoperative complication occurred in the EXDCR group. CONCLUSION: Although a TCLDCR procedure decreased the surgical time, it had a significantly lower success rate in the treatment of acquired nasolacrimal duct obstruction compared to EXDCR. The decision of the type of surgery should be made based on the cosmetic and success expectations of the patients and the presence of systemic problems.

Does the treatment of amblyopia normalise subfoveal choroidal thickness in amblyopic children?

PURPOSE: Recent studies have found a choroidal thickening in amblyopic eyes and suggested that there might be a relationship between the choroid and amblyopia. The present study aimed to evaluate the effect of a six-month treatment of amblyopia on choroidal thickness in anisometropic hyperopic amblyopic children. METHODS: Thirty-two anisometropic hyperopic children with unilateral amblyopia were included in this prospective study. Subfoveal choroidal thickness was measured as the distance between the retinal pigment epithelium and the chorioscleral edge, by using spectral domain enhanced depth imaging optical coherence tomography. The treatment of amblyopia was performed based on the full correction of the refractive error with eyeglasses, a refractive adaptation phase and occlusion by patching the fellow eye. RESULTS: The mean visual acuity of the amblyopic eyes significantly increased from 0.35 ± 0.3 to 0.16 ± 0.2 logMAR after the treatment (p < 0.001). The mean initial choroidal thickness was significantly higher in the amblyopic eyes than in the fellow eyes (p = 0.019). There were no significant differences between the pre- and post-treatment mean choroidal thickness in the amblyopic eyes (p = 0.428) and in the fellow eyes (p = 0.343). The mean choroidal thickness was still higher in the amblyopic eyes than in the fellow eyes after the treatment (p = 0.006). CONCLUSIONS: Although a six-month treatment of amblyopia increased the visual acuity of the anisometropic hyperopic amblyopic eyes, it could not significantly change choroidal thickness. Our results were in accordance with the conventional explanation, which suggests visual cortex and lateral geniculate nucleus abnormalities in the pathophysiology of amblyopia.

Neutrophil-to-Lymphocyte Ratio Increases in Patients With Dry Eye.

PURPOSE: To assess the neutrophil-to-lymphocyte ratio (NLR) as an indicator of inflammation in patients with non-Sjögren dry eye disease. METHODS: Serum NLR and C-reactive protein values were determined in 33 patients with dry eye and in 32 controls. The NLR was calculated by dividing the neutrophil count by the lymphocyte count. RESULTS: Characteristics of the dry eye and control groups were similar. The mean NLR value was 2.8 ± 1.4 (range: 1.1-6.1) in the dry eye group and 1.6 ± 0.7 (range: 0.8-2.8) in the control group (P = 0.002, t test). The mean C-reactive protein value was 0.6 ± 0.7 mg/dL (range: 0-2.3 mg/dL) in the dry eye group and 0.5 ± 0.6 mg/dL (range: 0-1.9 mg/dL) in the control group (P = 0.307, t test). CONCLUSIONS: The NLR values were found to be higher in patients with non-Sjögren dry eye than in controls. This result suggests that non-Sjögren dry eye disease may be associated with systemic inflammation or the NLR values may increase in local inflammatory ocular diseases.

Associations between choroidal thickness, axial length and spherical equivalent in a paediatric population.

BACKGROUND: The aim was to compare the choroidal thickness (ChT) of myopic children's eyes with that of emmetropes to determine whether there are associations between ChT, axial length and spherical equivalent (SE) in a paediatric population. METHODS: A total of 117 eyes of 117 children including 53 myopic eyes (myopic group) and 64 emmetropic eyes (emmetropic group) were enrolled in this cross-sectional comparative study. ChT was analysed by using the HD 5 Line Raster scan protocol of spectral domain enhanced depth imaging optical coherence tomography. Subfoveal ChT was measured manually as the distance between the retinal pigment epithelium and the chorioscleral border and three additional measurements were carried out every 750 µm temporal (T1, T2 and T3) and nasal (N1, N2 and N3) to the fovea. RESULTS: The mean age was 11.7 ± 2.7 years (range five to 17 years) in the myopic group and 10.9 ± 3.4 years (range 5 to 17 years) in the emmetropic group. There were no significant differences between the groups concerning age and sex (both p > 0.05). The myopic eyes had significantly thinner subfoveal, T1, T2, T3, N1, N2, N3 and average choroid than the emmetropic eyes (all p < 0.05). In addition, correlation analyses among all the study subjects showed that all subfoveal, T1, T2, T3, N1, N2, N3 and average ChT had negative correlations with axial length and positive correlations with the SE. CONCLUSION: The present study showed that the myopic children's eyes had significantly thinner subfoveal choroid than the emmetropic control eyes. Further, ChT was negatively correlated with axial length and positively correlated with SE in the population that included myopic and emmetropic children.

Influence of hyperopia and amblyopia on choroidal thickness in children.

PURPOSE: To compare subfoveal choroidal thicknesses (ChTs) of anisometropic hyperopic amblyopic, hyperopic nonamblyopic, and emmetropic control eyes and to investigate the associations between ChT and ambylopia, spherical equivalent (SE), and axial length in the pediatric population. METHODS: Forty-six hyperopic nonamblyopic (hyperopic group), 33 anisometropic hyperopic amblyopic (amblyopic group), and 42 emmetropic (emmetropic group) eyes were enrolled in this cross-sectional comparative study. Enhanced depth imaging spectral-domain optical coherence tomography was used for quantitative analysis of subfoveal ChT. ChT was quantified manually as the distance between the hyperreflective line corresponding to the retinal pigment epithelium and the chorioscleral interface at the subfoveal area. RESULTS: The mean age was 10.6 ± 3.3 years (range 5-17) in the hyperopic group, 10.7 ± 3.3 years (range 5-17) in the amblyopic group, and 11.2 ± 3.3 years (range 5-17 years) in the emmetropic group (p = 0.627). The hyperopic and amblyopic groups had significantly thicker choroid compared to the emmetropic group (p1 = 0.005 and p2 = 0.006, respectively). However, there was no significant difference between the hyperopic and amblyopic groups concerning subfoveal ChT (p = 0.857). In addition, covariance analysis showed that although SE was independently associated with subfoveal ChT (p = 0.014), amblyopia had no significant independent effect on subfoveal ChT (p = 0.671). Further, subfoveal ChT had weak correlations with the axial length (r = -0.297, p = 0.001) and SE (r = 0.274, p = 0.002). CONCLUSIONS: Hyperopia was associated with subfoveal ChT, whereas amblyopia had no independent significant effect on subfoveal ChT in our study population.

Influence of indoor and outdoor activities on progression of myopia during puberty.

The purpose of this study was to investigate whether time spent on indoor and outdoor activities or the other possible risk factors including age, gender, parental history, and initial refraction was associated with progression of myopia, during puberty. Fifty eyes of 50 myopic children aged 9-14 years were enrolled in the study. The parents were interviewed to determine the amounts of time in hours per day spent on reading and writing, using computer, watching TV, and outdoor activities (i.e., sports, games, or being outdoor with no activities) on an average day. The annual myopia progression rate (diopters per year) was calculated for each subject and was used in the statistical analyses. The mean initial age of the subjects was 10.9 ± 1.5 (ranging from 9 to 14) years. The mean follow-up period was 33.3 ± 10.3 (ranging from 17 to 55) months. There was a significant increase in the mean myopia value of the subjects after follow-up period (p < 0.001). The mean daily time spent on reading and writing and initial refraction value were independently associated with annual myopic progression rate. On the other hand, age, gender, parental myopia, and the mean daily times spent on computer use, watching TV, and outdoor activities had no correlations with annual myopia progression rate. The present study showed that myopia progression was associated with time spent on reading and writing and initial refraction value, during puberty. However, myopia progression was not associated with parental myopia, age, gender, and daily times spent on using computer, watching TV, and outdoor activities.

Influence of Pterygium on Corneal Biomechanical Properties.

PURPOSE: To evaluate the influence of pterygium on corneal biomechanical properties as measured by the ocular response analyzer (ORA). METHODS: ORA measurements of 48 eyes with primary nasal pterygium were compared with those of healthy fellow eyes. The mean age of the patients was 46.6 ± 18.9 years. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) were obtained for each subject by using the ORA (Reichert Ophthalmic Instruments, Depew, NY). RESULTS: CH and CRF were significantly lower in the eyes with pterygium than in the healthy fellow eyes (p1 = 0.011, p2 = 0.014, respectively). On the other hand, there were no significant differences between the eyes with pterygium and healthy fellow eyes concerning IOPg and IOPcc (p1 = 0.948, p2 = 0.129, respectively). CONCLUSIONS: The present study showed that biomechanical properties measured by ORA were affected by pterygium. The eyes with primary nasal pterygium had lower CH and CRF than healthy fellow eyes. Therefore, the effect of pterygium should be taken into account in order to make correct diagnoses by ORA.