Evaluation of the 24-hour intraocular pressure and systemic blood pressure at the same time.

PURPOSE: To obtain simultaneous 24-hour contact lens voltage and systemic arterial blood pressure values with the Sensimed Triggerfish system and Holter monitoring device. METHODS: Ten primary open-angle glaucoma (POAG) and 8 pseudoexfoliation glaucoma (PXG) patients were included in the study. The Sensimed Triggerfish contact lens device was used to calculate the 24-hour IOP, and a Holter sphygmomanometer device was used for simultaneous 24-hour blood pressure measurements. We define the 8:00 am-11:00 pm period measurements as diurnal values and the other measurements as nocturnal values. RESULTS: The mean nocturnal systolic values (nocturnal SBP 120.5±3.4 for POAG and 122.8±5.3mmHg for PXG) and diastolic BP (nocturnal DBP 70.2±1.9 for POAG and 68.1±1.2mmHg for PXG) were lower than the diurnal (diurnal SBP 134.6±5.3 for POAG, 145.9±41.7mmHg for PXG, diurnal DBP 79.4±5.8 for POAG and 78.6±5.1mmHg for PXG) values, and these differences were statistically significant in both groups (P=0.001 in DBP in PXG and P<0.001 for other values). In addition, nocturnal CL voltage values (228.8±41.1 for POAG and 214.3±47.0mVEq for PXG) were higher than the diurnal values (55.8±77.2 for POAG and 145.9±41.7mVEq for PXG) in the POAG and PXG groups, and these were statistically significant as well (P<0.001 for all). In the POAG and PXG groups, CL voltage had a statistically significant negative correlation with systolic (respectively, r: -0.248, P=0.001 and r: -0.272, P˂0.001) and diastolic (respectively, r: -0.115, P=0.036 and r: -0.160, P=0.028) BP values. CONCLUSION: We observed that CL voltage values rose during the nocturnal period, with a concomitant decrease in systolic and diastolic BP.

Comparison of the h-indices of the editorial board members of seven ophthalmic subspecialty journals.

PURPOSE: To investigate and compare the h-indices of the editorial board members of ophthalmic subspecialty journals. STUDY DESIGN: Descriptive Cross Sectional Research. METHODS: Bibliometric indices were calculated for the editorial board members of seven ophthalmic subspecialty journals. Correlations between the median h-indexes and journal impact factors (JIF), average citations per article and JIF, and publication count and JIF were analyzed. RESULTS: The median h-indices of the board members of Retina, Journal of Glaucoma, Journal of Cataract and Refractive Surgery, Cornea, Ophthalmic Plastic and Reconstructive Surgery, Journal of Neuroophthalmology and Journal of the American Academy of Pediatric Ophthalmology and Strabismus (J AAPOS) were 34, 26, 23, 17, 15, 14 and 13, respectively. H-indices and publication count were correlated with JIF (P<0.05, for each). CONCLUSION: The board members of Retina have the highest h-index and average citations per article, and J AAPOS have the least. These data provide useful benchmarks for comparison of the various subspecialty areas in ophthalmology.

Corneal sensitivity and subjective complaints of ocular pain in patients with fibromyalgia.

PurposeFibromyalgia (FM) is a chronic pain disorder associated with pain and hypersensitivity in various parts of the body. The aim of this study was to understand whether changes in corneal sensitivity were associated with the subjective complaints of these patients.Patients and methodsIn this study, we included 36 patients with FM (30 female, 6 male, mean age: 46.7±9.2 years) and 39 healthy control subjects (33 females, 6 males, mean age: 44.3±7.6 years). We performed a detailed ophthalmological examination, measured tear film breakup time (TBUT), and performed Schirmer I test without anesthetic (SIT). Only patients that did not have any eye disease were included in this study. Subjective complaints of the patients were evaluated with ocular surface disease index (OSDI) scores and the corneal sensation was evaluated with Cochet-Bonnet esthesiometer.ResultsThere was no significant difference between the groups for age, sex, and visual acuity. Both SIT (16.1 mm vs 15.3 mm, P=0.36) and TBUT results (17.8 s vs 18.8 s, P=0.40) were similar in FM group and the controls subjects. However, corneal sensations in central (60.0 mm vs 55.0 mm, P=0.03), superior (57.5 mm vs 50.0 mm, P=0.005), and inferior (53.89 mm vs 46.03 mm, P<0.001) regions were significantly increased in FM patients. There was a significant positive correlation between corneal sensation and OSDI scores.ConclusionIn this study, we have demonstrated that the patients with FM have increased corneal sensitivity and have related ocular surface complaints similar to dry eye disease in the absence of it.

A co-occurrence of familial isolated cherry red spot and multiple lens opacities.

PURPOSE: To present a co-occurrence of familial isolated cherry red spot (CRS) and multiple lens opacities in all siblings from the same family without any other systemic or ocular diseases. METHODS: Four siblings from the same family had bilateral punctate lens opacities and bilateral CRS at the macula. RESULTS: The oldest one had left eye exotropia and amblyopia, otherwise the other siblings had no additional ocular findings. Systemic investigation, physical examination, and laboratory tests were within normal limits. CONCLUSION: Bilateral isolated CRS along with punctate lens opacities were seen in all siblings from the same family without any systemic and ocular diseases.

GAPO syndrome associated with pyoderma vegetans: an unreported co-existence.

GAPO syndrome is a rare autosomal recessive disease and an acronym composed of growth retardation, alopecia, pseudoanodontia, optic atrophy. Approximately 38 cases have been reported in literature until now. Pyoderma vegetans is a chronic inflammatory disease characterized with vesicopustular, exudative and vegetative lesions usually localized on face, scalp, axilla and genitalia. Pyoderma vegetans is attributed to a bacterial infection frequently occurring in individuals with an underlying immunosuppressive condition. A 30-year-old female patient was admitted to our clinic with complaint of a hemorrhagic, crusted, exudative vegetative two plaques on the scalp. On her physical examination, she had a prematurely aged face, predominant lower lips, total tooth loss, frontal bossing, enlarged anterior fontanelle, marked scalp veins, micrognatia, depressed nasal bridge, short stature, growth retardation. She was diagnosed as GAPO syndrome as the result of her physical examination. Result of the biopsy taken from scalp was evaluated as pyoderma vegetans. And the diagnosis of pyoderma vegetans was established based on the correlate of both clinical and histopathologic findings. Pyoderma vegetans coexisting with GAPO syndrome has not been reported previously. Thus we wished to report it.

Incontinentia pigmenti with ocular involvement: two cases.

Incontinentia pigmenti (IP) is a rare, X-linked dominant disorder that presents at or soon after birth and presents with cutaneous signs and symptoms. Besides its typical skin signs presenting in all patients, central nervous system (CNS), ophthalmologic and dental involvement are encountered as well. In this report, we present two patients at the verrucous stage of IP and review the literature concerning the diagnosis and course of IP.

Fixed drug eruption induced by topical olopatadine ophthalmic solution.

Fixed drug eruption (FDE) usually develops after oral administration and is described as a cutaneous reaction recurring at the same location each time the drug is taken. Olopatadine is both a H1 histamine receptor antagonist and a mast cell stabilizer, indicated for the treatment of allergic conjunctivitis. Here, we report a 14-year-old male patient who developed FDE localised on the lateral side of periorbital rim bilaterally, whilst applying olopatadine 0.1% ophthalmic solution for the treatment of allergic conjunctivitis. As far as we know, FDE due to olopatadine has not been previously reported in the literature. We deem it appropriate to report this case because FDE that results from the application of topical drugs is a rare event in the literature.

Trocar-assisted sutureless intrascleral posterior chamber foldable intra-ocular lens fixation.

PURPOSE: We report a novel technique characterized by sutureless scleral fixation of three-pieces foldable intraocular lens (IOL) using 25-gauge transconjunctival sutureless vitrectomy (TSV) trocars in patients with insufficient posterior capsule support. MATERIALS AND METHODS: We performed this technique on the eight eyes of the seven patients. The scleral tunnels (STs) are prepared by insertion of the 25-gauge TSV microcannulas using the trocars, and anterior vitrectomy is performed through the clear corneal paracentesis with the aid of anterior chamber maintainer (ACM). Finally, the three-piece foldable IOL haptics are incarcerated into the prepared STs. RESULTS: The patients were followed up 5-8 months. None of the patients had complications such as postoperative endophthalmitis, glaucoma, IOL tilt or decentralization, and retinal detachment. Injection of a foldable IOL through a clear corneal small incision also contributes the less surgical-induced astigmatism. CONCLUSION: The presented novel sutureless scleral IOL fixation technique may provide minimal trauma to the surrounding tissues, good IOL stabilization decreasing the incidence of IOL tilt along with shorter operation time, and postoperative quiet eye.

Ocular pulse amplitude and retrobulbar blood flow change in dipper and non-dipper individuals.

PURPOSE: To evaluate ocular pulse amplitude (OPA), IOP values, and hemodynamic changes in the ophthalmic artery, central retinal artery, and short posterior ciliary artery in dipper and non-dipper patients. METHODS: A total of 59 right eye measurements of healthy subjects with normotensive were included to the study. Ambulatory blood pressure (BP) monitoring measurement (ABPM), Doppler imaging, and OPA measurements were performed in the same day. The patients in which systolic BP decreased during the nocturnal time by 10% of the diurnal BP or more were called dippers. A patient whose nocturnal systolic BP fell by <10% or even rose was defined as non-dipper. Color Doppler imaging was used for blood flow velocity assessment of ophthalmic, central retinal, and posterior ciliary arteries. For each artery, peak systolic and end-diastolic velocities (PSV and EDV, respectively), resistive index (RI), and pulsalite index (PI) were automatically calculated by the machine. Mean IOP and OPA values were calculated after three consecutive measurements. RESULTS: The mean OPA in non-dipper patients was significantly lower compared with that of dipper patients (P=0.011). There was no significant difference in IOP levels between groups. There was no significant difference in the PSV, EDV, RI, and PI in the ophthalmic, posterior ciliary, and central retinal arteries between the groups. CONCLUSION: Our study demonstrated that OPA level in non-dippers is lower than dippers. This may give additional information about the effect of BP changes on OPA values.

Assessment of cup-to-disc ratio with slit-lamp funduscopy, Heidelberg Retina Tomography II, and stereoscopic photos.

PURPOSE: To compare optic disc measurements achieved by slit-lamp funduscopy, Heidelberg Retina Tomography II (HRT II), and stereoscopic optic nerve photos (SONP) in glaucomatous, ocular hypertensive, and normal eyes. METHODS: A total of 176 eyes (glaucomatous [n=87], ocular hypertensive [n=40], and normal eyes [n=49]) of 90 participants were studied. Each participant underwent a full ophthalmic examination, including automated perimetry, slit-lamp funduscopy, HRT II, and SONP. To compare the three different methods being investigated, the following measurements were used: vertical cup to disc ratio (VCDR), horizontal cup to disc ratio (HCDR), and cup to disc area ratio (CDR). Slit-lamp funduscopy was evaluated only with respect to VCDR. HRT II and SONP were evaluated with all three measurements (VCDR, HCDR, and CDR). RESULTS: CDR measurements in ocular hypertensive eyes did not differ significantly according to the measurement methods used (p=0.4). CDR in the other groups of participants, as well as VCDR and HCDR, all differed significantly within each group according to the method used (p<0.05 for all). Mean VCDR measured with funduscopy was smaller than mean VCDR measured with either HRT II or SONP in the glaucoma and ocular hypertension groups (p=0.0001). However, overall, the three methods showed a strong correlation in terms of VCDR, HCDR, and CDR measurements. CONCLUSIONS: Despite the correlation among the three methods, the significant differences between their measurements of optic disc parameters may be too large for these methods to be used interchangeably in clinical situations.