The effect of obesity and insulin resistance on macular choroidal thickness in a pediatric population as assessed by enhanced depth imaging optical coherence tomography.

BACKGROUND: The purpose of this study was to evaluate the macular choroidal thickness in obese children with and without insulin resistance (IR). METHODS: Thirty-six patients with obesity and 26 healthy volunteers were included in this cross-sectional study. The choroidal thickness was measured with enhanced depth imaging optical coherence tomography (EDI-OCT) at the fovea and at positions 500 µm, 1000 µm, 1500 µm nasal and temporal to the fovea. The choroidal thickness measurements of the groups were compared and the correlation between the homeostasis model assessment of insulin resistance (HOMA-IR) and choroidal thickness values was evaluated. RESULTS: The average choroidal thickness in the obese group was significantly lower than that of controls at locations 1000 µm (303.31±58.52 vs. 340.58±69.47, p=0.026) and 1500 µm (284.14±65.06 vs. 336.85±71.37, p=0.004) temporal to the fovea. A subgroup analysis depending on the presence of IR revealed that the choroidal thickness measurements at all positions were thinner in obese children without IR compared to children with IR and healthy controls. This thinning reached a statistical significance at locations 500 µm temporal, 1000 µm temporal and 1500 µm temporal to the fovea (p=0.03, p=0.009 and p=0.006; respectively). There was a moderate correlation between the choroidal thickness measurements and HOMA-IR values (r-values between 0.37 and 0.48; p<0.05). CONCLUSIONS: Our results suggest that obesity and IR may have an influence on the choroidal thickness in children. Longitudinal studies will clarify whether these choroidal changes are progressive and are a sign of microvascular dysfunction in childhood obesity.

Retinal Nerve Fiber Layer Thickness in Children With ADHD.

OBJECTIVES: The current study aims to compare retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume between children with ADHD and a control group. METHOD: The study group included children with ADHD and the control group consisted of age- and gender-matched participants without any psychiatric disorder. In all participants, RNFL thickness, macular thickness, and macular volume were measured by using spectral domain-optical coherence tomography (SD-OCT). ADHD symptom severity was evaluated by using parent-report measures, including Conners' Parent Rating Scale-Revised: Short Form (CPRS-R: S) and the Strengths and Difficulties Questionnaire: Parent Form (SDQ: P). RESULTS: We compared 90 eyes of 45 children with ADHD and 90 eyes of 45 controls. ADHD group had significantly lower RNFL thickness only in nasal quadrant than the controls. The remaining RNFL quadrants, macular thickness, and volume were not significantly different between groups. There was a reverse correlation between RNFL thickness and ADHD symptom severity. CONCLUSION: This is the first study examining the RNFL thickness in ADHD. Our findings showed that nasal RNFL thickness was lower, indicating reduced unmyelinated axons in the retina of children with ADHD. The results of this study support the evidence that ADHD involves a lag in cortical maturation and this is measurable in the retina.

Ocular penetration of topically applied 1% tigecycline in a rabbit model.

AIM: To evaluate ocular penetration of topically applied 1% tigecycline. METHODS: Forty-two New Zealand White rabbits were divided into 3 groups. A 50 µL drop of 1% tigecycline was administered in group 1. In groups 2 and 3, the drop was administered every 15min for 60min (keratitis protocol). Aqueous humor samples in groups 1 and 2 were collected under general anesthesia at 15, 30, 45, 60, 120, and 180min after the last drop. All animals in group 3 were euthanatized. Cornea, vitreous and blood samples were collected 60 and 120min after the last drop. Tigecycline concentrations were measured using high performance liquid chromatography-mass spectrometry (LC-MS/MS). RESULTS: The peak aqueous humor tigecycline concentration [mean 0.73±0.14 mg/L (SD) and 2.41±0.14 mg/L, respectively] occurred 45min after topical drug application in groups 1 and 2. Group 3 mean values in the cornea, and vitreous, were 3.27±0.50 µg/g, and 0.17±0.10 mg/L at 60min and 3.17±0.77 µg/g and 0.20±0.07 mg/L at 120min, respectively. Tigecycline serum concentrations were negligible. CONCLUSION: Tigecycline levels in the aqueous humor in groups 1 and 2, and in the cornea in group 3 exceeded the minimum inhibitory concentrations of most gram-positive organisms that cause bacterial keratitis and endophthalmitis.

Effect of topical cyclopentolate on post-operative pain after pterygium surgery.

OBJECTIVES: The aim was to evaluate the effectiveness of topical cyclopentolate following pterygium surgery for post-operative ocular pain. METHODS: All participants had nasal pterygium and underwent pterygium excision and conjunctival autografting with fibrin glue. Participants were randomised into two groups. Participants in group 1 received one per cent cyclopentolate eye drops and artificial tears upon completing surgery and were prescribed self-administered drops three times daily for three days, while participants in group 2 received a control (artificial tears) in a manner identical to group 1. Data were gathered regarding post-operative pain intensity experienced during each of the three days. Pain was graded from zero to 10 according to a visual analogue scale, in which zero signified no pain and 10 signified severe, unbearable pain. RESULTS: This study analysed data regarding 38 participants in group 1 and 40 participants in group 2. Results were defined as median with interquartile range (IQR); median of the pain scores at days one, two and three were as follows, respectively: 4 (IQR 2), 2.5 (IQR 1) and 2 (IQR 1.25) for group 1 and 5 (IQR 1), 3 (IQR 1.75) and 3 (IQR 1) for group 2. Pain scores were significantly lower for group 1 compared with group 2 at days one, two and three (p < 0.05). CONCLUSIONS: Topical cyclopentolate seems to be effective and well tolerated following pterygium surgery for post-operative ocular pain.

Evaluation of the Corneal Layers in Meibomian-Gland-Dysfunction-Related Dry Eye by In Vivo Slit-Scanning Confocal Microscopy.

In the current study it was aimed to evaluate the findings of cornea in Dry Eye related Meibomian Gland Dysfunction through in vivo confocal microscopy. 30 patients of Dry Eye related Meibomian Gland Dysfunction (DEMGD) and 30 healty individuals were included. 46 eyes of 30 DEMGD patients (group 1) and 46 eyes of 30 healthy individuals (group 2) were formed as control group and images were captured from the centre of the cornea. 26 of the patients (%86,6) in Group 1 were male, and four of them (%13,4) were female and 25 of healthy individuals (% 83,3) were male and 5 of them(%16,7) were female. The ages of the patients in Group 1 were between 23-67 (51,58±13,4 on average). The ages of the healthy individuals in Group 2 were between 23-67 (51,45±10,4 on average). Tear film break-up time and Schirmer 1 values were significantly lower in the MGDDE group than the control group (p<0.001). There were statistically significant intergroup differences in basal epithelial cell density and area and stromal nerve thickness (p<0.05). Surface epithelium changes, anterior stromal hyperreflectivity and subepithelial nerve morphology changes were not observed in the control group. As a result, some of the effects on cornea tissue caused by Dry Eye related Meibomian Gland Dysfunction were able to be visualized with confocal microscopy at micro level.

Peripapillary choroidal thickness in patients with chronic obstructive pulmonary disease.

OBJECTIVE: To evaluate the peripapillary choroidal thickness of patients with chronic obstructive pulmonary disease (COPD) via enhanced depth imaging optical coherence tomography (EDI-OCT). MATERIALS AND METHODS: A total of 80 patients with COPD (80 eyes) and 50 control subjects (50 eyes) were enrolled. Choroidal scans and the retinal nerve fiber layer (RNFL) thickness were obtained for all eyes using OCT. RESULTS: The average peripapillary choroidal thickness measurements of the COPD group (147.58 ± 53.53 µm) were lower than the control group (160.84 ± 44.73 µm) (p = 0.068). Inferior segment thicknesses were significantly thinner than the other segments (p < 0.05). Subfoveal choroidal thickness and RNFL thickness measurements of the COPD group were also lower than those of the control group (p = 0.111). CONCLUSION: Hypoxia in COPD seems to affect the choroidal thickness. Thinning of the choroid may be attributed to increased vascular resistance and reduced blood flow in patients with COPD. The possible effects of the disease to the eye may be clarified through the role of the choroidal vasculature in the blood supply of the anterior optic nerve head.

New therapy option for treatment of methicillin-resistant Staphylococcus aureus keratitis: tigecycline.

PURPOSE: The aim of the present study was to evaluate the effectiveness of topically applied tigecycline for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in a rabbit model. METHODS: Experimental bacterial keratitis was induced in rabbits by a corneal intrastromal injection of 100 colony-forming units (CFUs) of MRSA bacteria. Sixteen hours after the injection, 28 rabbits were randomly divided into 4 treatment groups of 7 rabbits each. In each group, the rabbits' eyes were treated topically with 19 doses of topical tigecycline (10 or 50 mg/mL), vancomycin (50 mg/mL), or isotonic saline. Slit lamp examinations were performed before and after the inoculation by two observers masked to the study for the determination of clinical severity. Corneas were harvested for bacterial quantitation and histopathologic examination. RESULTS: No significant differences were observed in the clinical scores between pretreatment and posttreatment in the 4 groups (P>0.05). The mean difference between the pretreatment and posttreatment clinical scores from the 4 treatment groups was also not significant (P>0.05). All treatment groups had significantly lower CFUs compared with the control group. There were no significant differences in the bacterial load among the treatment groups. The minimum inhibitory concentration (MIC) for tigecycline was 0.12 µg/mL, whereas the MIC for vancomycin was 2.2 µg/mL. The tigecycline 10 mg/mL group had the lowest mean epithelial erosion values among the treatment groups. CONCLUSIONS: Topical tigecycline significantly reduced the bacterial load in infected rabbit corneas and may be as effective as vancomycin for the topical treatment of MRSA keratitis.

Clearance of intravitreal daptomycin in uveitis-induced rabbit model.

PURPOSE: To investigate the elimination rate of daptomycin after intravitreal injection in uveitis-induced rabbits. MATERIALS AND METHODS: Intravitreal injection of the single dose of 200 µg/0.05 mL daptomycin was administered to rabbits starting 24 h after induction of uveitis by an intravitreal endotoxin injection. Aqueous humor and vitreous humor samples of eight eyes per time point were collected at selected time intervals (1, 3, 6, 24, 48, 72 and 96 h), and the in vitreous half-life was calculated. Daptomycin concentrations in vitreous and aqueous humor were assayed with high-performance liquid chromatography. RESULTS: The vitreous concentration was noted to decline slowly with time. The mean vitreous concentration was 23.25 ± 10.99 µg/mL and 11.10 ± 3.33 µg/mL at 96 h in inflamed and normal eyes, respectively. The vitreous daptomycin concentration showed an exponential decay with a half-life of 25.67 h in normal eyes and 34.6 h in inflamed eyes. The aqueous levels of daptomycin in normal eyes were low but remained significantly higher than those of inflamed eyes. CONCLUSIONS: Given that the injected dose corresponds to several times the minimum inhibitory concentrations of organisms most involved in endophthalmitis, and that therapeutic levels are present up to 96 h after injection, intravitreal daptomycin should be considered for the treatment of endophthalmitis caused by Gram-positive bacteria.

Evaluation of peripapillary choroidal and retinal nerve fiber layer thickness in eyes with tilted optic disc / Avaliação espessura da camada de fibras nervosas peripapilares da retina e coroide em olhos com disco óptico inclinado

Purpose: This study was performed to evaluate the retinal nerve fiber layer (RNFL) and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT). Methods: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD)-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standar d protocol for RNFL assessment was performed. Results: SD-OCT indicated significantly lower superotemporal (p<0.001), superonasal (p=0.001), and global (p=0.005) RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001). Conclusion: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups. .

Objetivo: Avaliar camada de fibras nervosas da retina (RNFL) e a espessura da coroide peripapilar em olhos com disco óptico inclinado a fim de identificar as características da RNFL e os padrões de coroide peripapilar verificados pela tomografia de coerência óptica (OCT). Métodos: Vinte e nove olhos de 29 pacientes com discos ópticos inclinadas foram estudados prospectivamente com OCT de domínio espectral (SD) e comparados com controles pareados por sexo e idade. As imagens da RNFL foi obtidas por meio de varreduras circulares com um diâmetro de 3,4 mm em torno do disco óptico usando OCT. Para as medições de espessura da coroide peripapilar, o protocolo padrão para avaliação da RNFL foi realizado. Resultados: O OCT SD indicou diminuição das espessuras significativas da RNFL superotemporal (p<0,001), superonasal (p=0,001), e global (p=0,005) no grupo disco inclinado em relação aos do grupo controle. A coroide peripapilar foi significativamente mais espessa no local da borda elevada dos olhos com disco inclinado (p<0,001). Conclusões: Este estudo demonstrou que a caracterização clínica das principais morfologias disco inclinado pode ser útil na diferenciação entre um disco inclinado de outras alterações morfológicas de disco. Seria importante a comparação entre grupos com glaucoma e com discos inclinados, estudos futuros. .

Antiangiogenic effect of itraconazole on corneal neovascularization: a pilot experimental investigation.

PURPOSE: To investigate the antiangiogenic effect of itraconazole for the prevention of experimentally induced corneal neovascularization and whether the efficacy depends on the route of administration. MATERIALS AND METHODS: Thirty-six rats were randomly divided into 6 groups with 6 rats in each group. Chemical cauterization of the cornea was performed using silver nitrate/potassium nitrate sticks, and the rats were subsequently treated daily with topical (10 mg/ml), subconjunctival (10 mg/ml) or intraperitoneal (19 mg/kg) itraconazole for 7 days. Control rats received topical, subconjunctival or intraperitoneal 0.9% saline. On the 8th day of the experiment, the rat corneas were photographed to determine the percentage area of the cornea covered by neovascularization. The maximum density of corneal neovascularization was determined by microscopy. RESULTS: The median percentage of corneal neovascularization for group 1 was 31.5% (95% confidence interval, 27.5-35.5%); in group 3, it was 32% (23.5-39.8%); in group 5, it was 47% (36.3-60.0%). The percentages of corneal neovascularization in groups 2, 4 and 6 (the control groups) were 70% (95% confidence interval, 60.7-77.3%), 69% (63.0-77.7%) and 68% (56.5-78.5%), respectively. The area of neovascularization was smaller after itraconazole treatment as compared to saline treatment. Further, the area of neovascularization was smaller after topical and subconjunctival administration than after intraperitoneal administration. Histological evaluation of the corneas showed the most extensive corneal neovascularization in the control group. No local or systemic adverse effects were seen from either treatment group. CONCLUSION: Itraconazole reduces corneal neovascularization shortly after chemical burn. However, a larger experimental study is necessary to confirm the data of this investigation.

Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography.

PURPOSE: To investigate choroidal thickness in healthy pregnant women during different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: This prospective study included 90 healthy pregnant women in their first, second, or third trimester (groups 1, 2, and 3, respectively) and 30 non-pregnant healthy women (group 4). The age range for all groups was 18-40 years. Spectral domain optical coherence tomography scans were obtained to estimate the average choroidal thickness. Using EDI-OCT, we measured choroidal thickness manually from the outer border of the retinal pigment epithelium to the inner scleral border at the subfovea, 3 mm temporal, and 3 mm nasal to the fovea. Differences among groups were analyzed by one-way ANOVA. RESULTS: We found a statistically significant difference between groups 2 and group 4 for subfoveal, temporal, and nasal mean choroidal thickness (p=0.007, p<0.001, p=0.026, respectively). The mean choroidal thickness for group 2 was 395 ± 80 µm, 338 ± 74 µm, and 233 ± 61 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. In comparison, the mean choroidal thickness for group 4 was 335 ± 86 µm, 274 ± 54 µm, and 200 ± 53 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. No statistically significant differences were found for choroidal thickness among groups 1-4 (p=0.214, p=0.177, p=0.094, respectively) and between groups 3-4 (p=0.105, p=0.261, p=0.695, respectively) for all measured points. CONCLUSION: Our results suggest that choroidal thickening can occur at the regions subfoveal, temporal, and nasal to the fovea in the second trimester.

Inhibition of corneal neovascularization by topical and subconjunctival tigecycline.

Objective. To investigate the effects of topical and subconjunctival tigecycline on the prevention of corneal neovascularization. Materials and Methods. Following chemical burn, thirty-two rats were treated daily with topical instillation of 1 mg/mL tigecycline (group 1) or subconjunctival instillation of 1 mg/mL tigecycline (group 3) for 7 days. Control rats received topical (group 2) or subconjunctival (group 4) 0.9% saline. Digital photographs of the cornea were taken on the eighth day after treatment and analyzed to determine the percentage area of the cornea covered by neovascularization. Corneal sections were analyzed histopathologically. Results. The median percentages of corneal neovascularization in groups 1 and 3 were 48% (95% confidence interval (CI), 44.2-55.8%) and 33.5% (95% CI, 26.6-39.2%), respectively. The median percentages of corneal neovascularization of groups 1 and 3 were significantly lower than that of the control group (P = 0.03 and P < 0.001, resp.). Histologic examination of samples from groups 1 and 3 showed lower vascularity than that of control groups. Conclusion. Topical and subconjunctival administration of tigecycline seems to be showing promising therapeutic effects on the prevention of corneal neovascularization. Furthermore, subconjunctival administration of tigecycline is more potent than topical administration in the inhibition of corneal neovascularization.

Pharmacokinetics of intravenously administered tigecycline in eye compartments: an experimental study.

PURPOSE: The purpose of this study was to evaluate the ocular distribution of intravenously administered tigecycline in a rabbit uveitis model. METHODS: Tigecycline, which has a broad spectrum of activity against many gram-positive, gram-negative, and anaerobic organisms, was given intravenously to rabbits at 7 mg/kg of body weight starting 24 h after induction of uveitis by intravitreal endotoxin injection. Tigecycline concentrations were determined by high performance liquid chromatography-mass spectrometry (LC-MS/MS) assay in the aqueous humor, vitreous humor, and plasma 1, 3, 6, and 24 h after administration of a single dose. RESULTS: The maximum concentrations were found within 1 h after the end of the intravenously given tigecycline, and were 1,308.60 ± 301.76 ng/mL in plasma, 181.40 ± 51.32 ng/mL in vitreous humor and 145.00 ± 55.29 ng/mL in aqueous humor of the inflamed eye. After 24 h, no drug was detectable in the aqueous and vitreous of the normal eyes, whereas small amounts of drug were detectable in inflamed eyes and in plasma. CONCLUSIONS: Tigecycline did not reach therapeutically significant levels in the aqueous and the vitreous humor of rabbit eyes. The findings suggest a limited role for intravenously administered tigecycline in the treatment of bacterial endophthalmitis.

Ocular penetration of intravenously administered colistin in rabbit uveitis model.

PURPOSE: The purpose of this study was to evaluate the ocular distribution of intravenously administered colistin in a rabbit uveitis model. METHODS: Colistin, a polypeptide antibiotic against the multidrug-resistant (MDR) Gram-negative organisms, was given intravenously to rabbits at 5 mg/kg of body weight starting 24 h after induction of uveitis by intravitreal endotoxin injection. Colistin concentrations were determined by high-performance liquid chromatography-mass spectrometry assay in the aqueous humor, vitreous humor, and plasma 0.5, 3, 6, and 24 h after administration of a single dose. RESULTS: The maximum colistin concentrations (mean±standard deviation) were found 0.5 h after the end of the intravenous administration and were 9.48±2.0 µg/mL in plasma and 0.62±0.07 µg/mL in the aqueous humor of the inflamed eye. After 24 h, no drug was detectable in the aqueous of the inflamed eyes. Colistin was undetectable in the aqueous of contralateral normal eyes at all time points. Drug concentrations in all the vitreous samples from both inflamed and normal eyes were undetectable, except at the 3-h inflamed eye group, and a colistin concentration of 0.02±0.01 µg/mL was found. Plasma levels of colistin fell to 0.93±0.07 and 0.24±0.08 µg/mL, after 3 and 6 h, respectively, and were not detectable 24 h after the given dose. CONCLUSIONS: In our model, colistin did not reach therapeutically relevant levels in the aqueous and in the vitreous humor of rabbit eyes. The findings suggest a limited role for intravenously administered colistin in the treatment of Gram-negative bacterial endophthalmitis.

Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography / Medição da espessura da coroide em gestantes utilizando tomografia de coerência óptica com profundidade de imagem aprimorada

Purpose: To investigate choroidal thickness in healthy pregnant women during different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: This prospective study included 90 healthy pregnant women in their first, second, or third trimester (groups 1, 2, and 3, respectively) and 30 non-pregnant healthy women (group 4). The age range for all groups was 18-40 years. Spectral domain optical coherence tomography scans were obtained to estimate the average choroidal thickness. Using EDI-OCT, we measured choroidal thickness manually from the outer border of the retinal pigment epithelium to the inner scleral border at the subfovea, 3 mm temporal, and 3 mm nasal to the fovea. Differences among groups were analyzed by one-way ANOVA. Results: We found a statistically significant difference between groups 2 and group 4 for subfoveal, temporal, and nasal mean choroidal thickness (p=0.007, p<0.001, p=0.026, respectively). The mean choroidal thickness for group 2 was 395 ± 80 µm, 338 ± 74 µm, and 233 ± 61 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. In comparison, the mean choroidal thickness for group 4 was 335 ± 86 µm, 274 ± 54 µm, and 200 ± 53 µm at the regions subfoveal, temporal, and nasal to the fovea, respectively. No statistically significant differences were found for choroidal thickness among groups 1-4 (p=0.214, p=0.177, p=0.094, respectively) and between groups 3-4 (p=0.105, p=0.261, p=0.695, respectively) for all measured points. Conclusion: Our results suggest that choroidal thickening can occur at the regions subfoveal, temporal, and nasal to the fovea in the second trimester. .

Objetivo: Investigar a espessura da coroide em gestantes saudáveis durante os diferentes trimestres utilizando tomografia de coerência óptica com profundidade de imagem aprimorada (EDI-OCT). Métodos: Este estudo prospectivo incluiu 90 gestantes saudáveis nos primeiro, segundo e terceiro trimestres da gravidez (grupos 1, 2 e 3, respectivamente) e 30 mulheres saudáveis não-gestantes (grupo 4) com faixa etária de 18-40 anos de idade. Foi realizada tomografia de coerência óptica espectral para estimar a espessura média da coroide. A espessura da coroide foi medida manualmente da borda externa do epitélio pigmentar da retina até o limite interno da esclera nas regiões subfoveal, 3 mm temporal e 3 mm nasal à fóvea utilizando EDI-OCT. As diferenças entre os grupos foram analisadas com o teste ANOVA unicaudal. Resultados: Houve diferença estatística significativa na espessura média da coroide entre os grupos 2 e 4 nas regiões subfoveal, temporal e nasal à fóvea (p=0,007; p<0,001; p=0,026, respectivamente). A espessura média da coroide no grupo 2 foi: 395 ± 80 µm, 338 ± 77 µm e 233 ± 61 µm nas regiões subfoveal, temporal e nasal à fóvea, respectivamente. Em comparação, a espessura média da coroide no grupo 4 foi de: 335 ± 86 µm, 275 ± 54 µm e 200 ± 53 µm, nas regiões subfoveal, temporal e nasal à fóvea, respectivamente. Não foi encontrada diferença estatística significativa entre os grupos 1-4 (p=0,214, p=0,177, p=0,094, respectivamente) e os grupos 3-4 (p=0,105, p=0,261, p=0,695 respectivamente), para todas as medidas. Conclusão: Nossos resultados sugerem que há espessamento da coroide nas regiões subfoveal, temporal e nasal à fóvea no segundo trimestre gestacional. .

Choroidal thinning in pseudoexfoliation syndrome detected by enhanced depth imaging optical coherence tomography.

PURPOSE: To measure choroidal thickness in patients with pseudoexfoliation (PEX) syndrome and to compare the values with control eyes using enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS: Thirty-four patients with PEX syndrome and 30 age- and sex-matched healthy subjects were included in this study. Only one eye of each of the patients was included. Choroidal thickness was measured manually from the outer border of the retinal pigment epithelium to the inner scleral border at the subfovea, 3 mm temporal to the fovea, and 3 mm nasal to the fovea using EDI-OCT. RESULTS: A total of 34 eyes from 34 consecutive patients with PEX syndrome (19 women and 15 men; mean age 75.3 ± 6.6 years) were included in the analysis. The mean subfoveal, temporal, and nasal choroidal thickness was significantly thinner in the PEX syndrome group compared with the control group (p<0.05, at all points). The mean choroidal thickness in the PEX syndrome group was as follows: 259 ± 33 µm, 211 ± 29 µm, and 106 ± 24 µm, subfoveal, temporal, and nasal to the fovea, respectively. In comparison, the mean choroidal thickness in the control group was 274 ± 23 µm, 225 ± 17 µm, and 117 ± 17 µm, at the subfovea, 3 mm temporal to the fovea, and nasal to the fovea, respectively. CONCLUSIONS: In PEX syndrome, there is choroidal thinning subfoveal, temporal, and nasal to the fovea on EDI-OCT. Decreased choroidal thickness, probably due to increased vascular resistance, and reduced blood flow, is seen in PEX syndrome.

Evaluation of peripapillary choroidal and retinal nerve fiber layer thickness in eyes with tilted optic disc.

PURPOSE: This study was performed to evaluate the retinal nerve fiber layer (RNFL) and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT). METHODS: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD)-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standard protocol for RNFL assessment was performed. RESULTS: SD-OCT indicated significantly lower superotemporal (p<0.001), superonasal (p=0.001), and global (p=0.005) RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001). CONCLUSION: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups.