Characteristics of the retina and choroid in fibromyalgia patients and their correlation with disease severity and quality of life.

BACKGROUND: To evaluate retinal and choroidal characteristics of fibromyalgia (FM) patients using spectral-domain optical coherence tomography (SD-OCT), to compare them with healthy controls, and to determine the correlation of these measurements with disease severity and quality of life. METHODS: Thirty-nine eyes of 39 patients with FM and 44 eyes of 44 age- and sex-matched healthy subjects were enrolled. The retinal nerve fiber layer (RNFL), central macular thickness (CMT), and choroidal thickness (CT) measurements of the subjects were obtained using SD-OCT (Maestro, Topcon Co. Tokyo, Japan), choroidal vascular index (CVI) was calculated by using the binarization method and the results were compared. Disease duration (DD), widespread pain index (WPI), symptom severity scale (SSS), visual analog scale (VAS), ocular pain assessment survey (OPAS), FM impact questionnaire (FIQ), European Quality of Life-5 Dimensions-3 level (EQ-5D-3 L), European Quality VAS score (EQ-VAS) and use of pregabalin were recorded. Correlations between the SD-OCT results and the FM parameters were evaluated. RESULTS: No significant difference was found in terms of age and gender (p = 0.612, p = 0.244 respectively). Patients in the FM group had significantly thinner RNFL superior quadrant and CT (p = 0,009 and p < 0.001, respectively). CVI was significantly higher in the FM group (p < 0.001). There was an inverse correlation between OPAS and CT (r = -0.379, p = 0.027) and between VAS and CVI (r = -0.398, p = 0.020). The use of pregabalin had no effect on SD-OCT (p > 0.05). CONCLUSION: Patients with FM demonstrated reduced RNFL superior quadrant and CT and increased CVI. Ocular and general body pain in FM was found to be associated with SD-OCT.

Efficacy of custom-made soft keratoconus lenses on corneal aberrations and photic phenomena in patients with keratoconus: a corneal topography imaging based study.

AIM: To evaluate the efficacy of custom-made soft keratoconus (KC) lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC. METHODS: Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone (Toris K) soft silicone hydrogel lenses. Best spectacle-corrected visual acuity (BSCVA) and contact lens-corrected visual acuity (CLCVA) were recorded. Lower- and higher-order corneal aberrations (LOAs and HOAs) were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones. Mesopic pupil diameter and subjective photic phenomena were also assessed. RESULTS: Mean CLCVA was significantly improved compared to BSCVA (P<0.0001). Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses, except for posterior corneal curvature values. In the 4.5 mm central optical zone, all wavefront aberrations decreased significantly after lens fitting (P<0.0001). In contrast, in the 7 mm (peripheral) optical zone, values for HOAs, spherical and residual aberrations, and optical path differences were increased, while LOAs, trefoil, and quadrifoil coefficients were decreased. The rate of photic phenomena was significantly higher in participants with a pupil size >6.00 mm (85.7%). CONCLUSION: Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations. This practical and nonsurgical approach appears to be an effective method for the visual management of KC.

Long-term results of micropulse laser trabeculoplasty with 577-nm yellow wavelength in patients with uncontrolled primary open-angle glaucoma and pseudoexfoliation glaucoma.

Our aim was to evaluate the long-term results of micropulse laser trabeculoplasty (MLT) with 577-nm yellow wavelength in the treatment of glaucoma. We reviewed the medical records of 51 patients (51 eyes) with uncontrolled primary open-angle glaucoma or pseudoexfoliation glaucoma who underwent 180° MLT for the first time. The success of MLT was defined as an IOP reduction of ≥ 20% and IOP < 21 mmHg after treatment. If the number of medications was increased or further laser trabeculoplasty or glaucoma surgery was required after treatment, the case was considered unsuccessful. The mean duration of patient follow-up was 18.39 ± 12.17 months (range 3-52 months). Patients included in the study used 2-4 types of antiglaucoma eye drops (mean 3.43 ± 0.7). The mean number of MLT spots was 65.54 ± 6.19, and the mean energy level was 750.98 ± 101.73 mJ. The decrease in intraocular pressure compared to baseline measurements was: 16.72 ± 11.87%, 15.07 ± 13.76%, 12.63 ± 14.29%, 16.66 ± 19.32%, and 16.75 ± 19.78% during follow-up at 3, 6, 12, 24, and 36-48 months. Successful response was achieved in 35.41%, 36.95%, 34.21%, 40%, 41.17%, and 42.85% of patients during 3, 6, 12, 18, 24, and 36-48 months of follow-ups, respectively. Of the 51 eyes studied, 12 patients (23.5%) underwent post-MLT glaucoma surgery, and 7 patients (13.7%) had cataract surgery, whose follow-up data were subsequently censored. The reduction of intraocular pressure showed a significant correlation with baseline intraocular pressure, while age and laser power showed no correlation (p > 0.05). MLT is a novel treatment option for patients with glaucoma with favorable long-term outcomes and a good safety profile.

Evaluation of peripapillary and subfoveal choroidal vascularity index in patients with multiple sclerosis.

PURPOSE: To evaluate the changes in the peripapillary choroidal vascularity index (PCVI) and subfoveal choroidal vascularity index (SFCVI) in multiple sclerosis (MS) patients and healthy subjects. METHODS: A total of 145 eyes of 73 patients were investigated in this cross-sectional study. 78 eyes of 39 MS patients (Group 1) and 67 eyes of 34 healthy subjects (Group 2) were evaluated. MS patients with a history of optic neuritis (ON) constituted Group 1a, those without a history of ON constituted Group 1b. RESULTS: The mean PCVI was significantly lower in Group 1 than Group 2 (61,39 ± 3,00% vs 64,49 ± 2,29%, respectively, p < 0.001). The mean SFCVI scores of Group 1 was significantly lower than Group 2 (64,01 ± 2,66% vs. 66,87 ± 2,14%, respectively, p < 0.001). The mean PCVI of Group 1a (59,26 ± 2,85%) was significantly lower compared to Group 1b (62,87 ± 2,08%) and Group 2 (64,49 ± 2,29%, p1 < 0.001, p2 < 0.001). The mean SFCVI of Group 1a was significantly lower than Group 2 (64.26 ± 2.75% vs. 66.87 ± 2.14%, respectively, p < 0.001). CONCLUSION: PCVI and SFCVI scores were significantly lower in MS patients compared to healthy controls. PCVI scores of MS patients who had a history of ON were significantly lower than those of patients without a previous ON attack, as were SFCVI scores. We consider that evaluation of PCVI and SFCVI might be useful for monitoring ocular involvement in patients with MS.

Evaluation of the role of spectral-domain optical coherence tomography in the early detection of macular and ganglion cell complex thickness changes in patients with rheumatologic diseases taking hydroxychloroquine.

BACKGROUND: The aim was to investigate the effects of hydroxychloroquine (HCQ) on macular and ganglion cell complex (GCC) thickness measured by spectral-domain optical coherence tomography (SD-OCT). METHODS: A total of 145 patients were included in the study. Patients who had taken HCQ for at least 6 months formed group 1 (n:81), while 34 patients with rheumatologic diseases who did not receive HCQ therapy, and 30 healthy subjects formed groups 2 and 3. The patients in group 1 were divided into two subgroups one with more than 60 months of usage (A), and the other with less than 60 months (B). All patients underwent a complete ophthalmologic examination, as well as visual field (VF) testing, and the measurement of macular and GCC thickness with SD-OCT. RESULTS: The mean duration of taking HCQ was 100.96±46.97 and 26.50±14.45 months and the total dose was 843.37±489.38 g and 208.63±135.01 g in groups 1A and 1B, respectively. Patients in group 1 had significantly worse VF scores than groups 2 and 3, but no difference was found between groups 1A and 1B. The SD-OCT macular thickness was thinner in the inner and outer nasal quadrants according to the ETDRS 9 sector chart in the patients using hydroxychloroquine, while the GCC in the group 1A patients was thinner in the superior, inferior areas and inferior inner nasal, inferior-superior outer temporal quadrants compared to the other groups (p < 0.05). CONCLUSION: Assessment of regional macular and GCC changes by SD-OCT is a valuable tool for early detection of HCQ maculopathy.

The results of Ritleng bicanalicular silicone intubation for congenital and adult partially acquired nasolacrimal duct obstruction.

OBJECTIVE: Our aim was to evaluate the long-term results of Ritleng bicanalicular silicone intubation for congenital and adult partially acquired nasolacrimal duct (NLD) obstruction. METHODS: We evaluated 28 eyes of the 26 patients treated with lacrimal intubation with the Ritleng method retrospectively. Patients were divided into two groups. Patients with congenital NLD obstruction (n: 16) constituted Group 1 and patients with adult partially acquired NLD obstruction (n: 10) constituted Group 2. The Ritleng probe was inserted from the canaliculus into the inferior meatus. Success was defined within two parameters: (1) Intubation of the silicone tube without complications and (2) recovery of the previous signs and symptoms and a normal fluorescein dye test. RESULTS: Mean of the patients' ages was 2.4±1.6 years in Group 1 and 49±15 years in Group 2. The intubation was successful in all of the patients (100%) in Group 1, meanwhile in Group 2, false passage was observed in 2 patients (20%). Silicone tube was removed through the punctum in outpatient clinic conditions between 2 weeks and 3 months (mean: 2.1 months) in Group 1 and 4-6 months (mean: 5.2 months) in Group 2. Patients in Groups 1 and 2 were followed for 26±18.6-36±25 months, respectively. Previous signs and symptoms were recovered in 75% of the patients in Group 1 and the dye tests of these patients were normal. In Group 2, only two patient's symptoms were resolved (20%). For the adult patients whose symptoms were not resolved, an external dacryocystorhinostomy operation was performed. CONCLUSION: The Ritleng lacrimal intubation system is an effective procedure for the treatment of congenital NLD obstruction for both short and long term. On the other hand, the effectiveness of the procedure is limited for the adult partially acquired NLD obstruction.

A case of Bietti crystalline dystrophy with clinical, electrophysiological, and imaging findings.

In this study, ophthalmologic examination findings, fundus fluorescein angiography, optic coherence tomography (OCT), visual field testing, electrophysiological, and systemic laboratory findings of a 43-year-old female patient who presented with blurry vision and who had retinal and corneal deposits were examined. Our patients' best-corrected visual acuity was 0.9 bilaterally. Her anterior segments and intraocular pressures were bilaterally normal. Fundus examination revealed bilateral glistening yellowish intraretinal crystalline deposits in the posterior pole and midperipheral retina. The electroretinographic examination revealed a decrease in scotopic and photopic a and b wave amplitudes. Corneal and intraretinal glistening crystalloid deposits were observed in the OCT. Our patient and her husband were relatives. Her sister's, brother's, and children's OCT also revealed bilateral corneal and intraretinal crystalloid deposits. We diagnosed this case as Bietti's crystalline dystrophy which is a rare disease with genetic inheritance that must be considered in the differential diagnosis in countries in which consanguineous marriage is often.

Evaluation of the Effect of Intravitreal Dexamethasone (Ozurdex®) Implant on Intraocular Pressure in Vitrectomized and Non-Vitrectomized Eyes with Macular Edema.

OBJECTIVES: This study aimed to retrospectively evaluate the intraocular pressure (IOP) change in vitrectomized and non-vitrectomized patients receiving 0.7 mg intravitreal dexamethasone implant to treat macular edema due to different indications. MATERIALS AND METHODS: The patients' diagnoses, IOP values before receiving the intravitreal dexamethasone implant and in follow-up examinations at 1-3 days, 1 month, 2 months, 3 months, 6 months, 9 months, and 12 months after implantation, pachymetry values, medications used, and history of vitrectomy surgery were recorded. RESULTS: A total of 134 eyes of 112 patients between 46 and 85 years of age who received intravitreal dexamethasone implants were evaluated. Seventeen eyes (12.7%) were vitrectomized and 117 (87.3%) were not vitrectomized. In non-vitrectomized eyes, the mean IOP was 14.01±2.36 mmHg before and 14.8±2.96 at 1-3 days, 16.71±3.97 at 1 month, 17.88±5.27 at 2 months, 15.54±3.35 at 3 months, 15.1±3.24 at 6 months, and 14.61±3.71 mmHg at 12 months after receiving the first dose. In this group, the increases in mean IOP at 1-3 days, 1 month, 2 months, and 3 months were significant compared to the mean IOP before the first dose (p<0.05). In vitrectomized eyes, only the increase in mean IOP at 6 months was significant compared to the mean IOP before the first dose (p<0.05). Twenty-three of the 134 eyes (17.2%) were prescribed 1-3 medications due to IOP elevation (one drug for 73.9%, two drugs for 17.4%, and three drugs for 8.7% of these eyes). CONCLUSION: The IOP increase that occurs as a side effect of intravitreal dexamethasone administration is generally mild and temporary in both vitrectomized and non-vitrectomized eyes, regardless of indication. There was no cumulative effect in patients who received two or three doses.

Clinical Performance of Samfilcon A Contact Lenses in Intensive Digital Device Users: A Multicenter, Prospective Clinical Study.

INTRODUCTION: To evaluate patient satisfaction with samfilcon A contact lenses (CLs) in intensive digital device users with myopia and to compare patient satisfaction with samfilcon A lenses to prior experience with senofilcon A or lotrafilcon B CLs. METHODS: This was a comparative, prospective, national study conducted at 14 centers in Turkey. Subjects were adults aged 18 and 45 years with myopia (range -0.25 D to -6.00 D) who spend a minimum of 3 hours viewing digital devices (e.g., computer, smartphone). A subgroup of patients were habitual lens wearers (senofilcon A or lotrafilcon B lens wear for at least 6 months prior to enrollment). The primary assessment was patient satisfaction with samfilcon A lenses (0-100 Likert scale). Secondary assessments included patient satisfaction with samfilcon A lenses compared to patients' habitual lenses, investigator satisfaction with samfilcon A lenses and investigator-evaluated slit lamp examination findings. RESULTS: Samfilcon A lenses were given high overall ratings from both patients and investigators, with a low incidence of ocular symptoms. Overall, patients were highly satisfied with samfilcon A lenses for comfort, vision and overall performance, and stated that they would consider wearing these lenses in the future. Among habitual senofilcon A or lotrafilcon B lens wearers, samfilcon A lenses were rated significantly better than the habitual lenses in regard to comfort, vision and overall performance. Investigator assessments were also highly favorable, both at initial fit and after 4 weeks of follow-up, with no significant findings noted on slit lamp examination. CONCLUSION: Samfilcon A lenses were rated highly by investigators in regard to fit, handling and slit lamp findings, and by novice and habitual lens wearers in regard to comfort, vision and overall performance. These results support the use of samfilcon A lenses among digital device users who seek day-long comfort and good visual acuity.

Update on Contact Lens Treatment of Keratoconus

Keratoconus (KC) is a progressive disease that leads to a decrease in visual acuity and quality and impairs vision-related quality of life. Contact lens (CL) application has a primary place and importance in the correction of the optic problems due to the disease. The corneal changes and increased irregular astigmatism that occur with KC progression necessitate special CL designs and fitting methods. In addition to disease stage, the patient's lens tolerance also plays a role in the application of CLs in KC patients. With recent advances in materials and design technology, the CLs used in the treatment of KC have developed considerably and there are various types available. In this review, we discuss the wide range of CLs, including rigid and soft lenses, hybrid and scleral lenses, and even custom lens designs, in light of recent scientific advances.

Neuro-Behcet's disease in a case with papilledema and intracranial hypertension as the initial presentation.

A 27-year-old female presented to the Clinic of Ophthalmology with the complaints of photophobia, headache, and diplopia. An ophthalmological examination indicated that her best-corrected visual acuity was 20/20 in both eyes with decreased contrast sensitivity. Fundoscopic examination revealed bilateral papilledema. The cerebrospinal fluid opening pressure was above normal at 38.5 cm H2O. Cranial magnetic resonance imagining venography revealed left lateral sinus thrombosis and right lateral sinus retardation of filling. Based on her history, laboratory tests, and neuro-imaging findings, she was diagnosed with vascular neuro-Behcet's disease (NBD). It is important to consider NBD in the differential diagnosis of patients with bilateral papilledema and intracranial hypertension.

Survey to Determine Perceptions and Practices in Contact Lens Use and Identify Key Features of Safe Use Education

Objectives: To identify consumers' tendencies regarding contact lens (CL) use in order to develop recommendations for messages to include in education for safe CL use and in public awareness campaigns. Materials and Methods: Subjects living in Ankara, Turkey who used eyeglasses and/or contact lenses due to refractive error were included in the study. CL users' reasons for choosing CLs for vision correction, CL-related problems they encountered, and their perceptions regarding safe CL use education and regular ophthalmologic follow-up visits were evaluated using a survey completed by 917 participants. Results: In total, 836 survey forms were included in the analysis. Most of the participants were female (59.6%), university students (91.4%), and 18-30 years old (68.9%). According to the survey results, 64.6% of eyeglass users stated that they had never tried CLs, while 17.7% reported using CLs regularly. Most of the participants (61.7%) said they visit an ophthalmologist only when they needed, while 33.1% claimed to attend regular follow-up. When all participants were considered, the level of satisfaction with glasses was 3.11 out of 5, while CL users reported satisfaction of 4.15 out of 5. Most (78.6%) of the CL users said they started using CL by their own initiative, most commonly due to a dislike of eyeglasses. The most frequent complaint from CL users was dry eye and discomfort in the evening. The most common source of CL use education was ophthalmologists (55.5% of the participants), followed by opticians (28.2%). Conclusion: Incorrect and inappropriate information on CL usage may lead to problems that can threaten eye health. The results of our study suggest that providing accurate information through concise messages in physician-supervised education and raising awareness through the media may be beneficial to public health. Therefore, we identified messages about CL usage and quality of life, safety, and the rules for proper use.

Topography and Higher Order Corneal Aberrations of the Fellow Eye in Unilateral Keratoconus.

OBJECTIVES: Comparison of topography and corneal higher order aberrations (HOA) data of fellow normal eyes of unilateral keratoconus patients with keratoconus eyes and control group. MATERIALS AND METHODS: The records of 196 patients with keratoconus were reviewed. Twenty patients were identified as unilateral keratoconus. The best corrected visual acuity (BCVA), topography and aberration data of the unilateral keratoconus patients' normal eyes were compared with their contralateral keratoconus eyes and with control group eyes. For statistical analysis, flat and steep keratometry values, average corneal power, cylindrical power, surface regularity index (SRI), surface asymmetry index (SAI), inferior-superior ratio (I-S), keratoconus prediction index, and elevation-depression power (EDP) and diameter (EDD) topography indices were selected. RESULTS: Mean age of the unilateral keratoconus patients was 26.05±4.73 years and that of the control group was 23.6±8.53 years (p>0.05). There was no statistical difference in BCVA between normal and control eyes (p=0.108), whereas BCVA values were significantly lower in eyes with keratoconus (p=0.001). Comparison of quantitative topographic indices between the groups showed that all indices except the I-S ratio were significantly higher in the normal group than in the control group (p<0.05). The most obvious differences were in the SRI, SAI, EDP, and EDD values. All topographic indices were higher in the keratoconus eyes compared to the normal fellow eyes. There was no difference between normal eyes and the control group in terms of spherical aberration, while coma, trefoil, irregular astigmatism, and total HOA values were higher in the normal eyes of unilateral keratoconus patients (p<0.05). All HOA values were higher in keratoconus eyes than in the control group. CONCLUSION: According to our study, SRI, SAI, EDP, EDD values, and HOA other than spherical aberration were higher in the clinically and topographically normal fellow eyes of unilateral keratoconus patients when compared to a control group. This finding may be due to the mild asymmetric and morphologic changes in the subclinical stage of keratoconus leading to deterioration in the indicators of corneal irregularity and elevation changes. Therefore, these eyes may be exhibiting the early form of the disease.

Dacryoadenitis and extraocular muscle inflammation associated with contact lens-related Acanthamoeba keratitis: A case report and review of the literature.

The present report discusses a new case of dacryoadenitis with extraocular muscle inflammation associated with Acanthamoeba keratitis (AK) in a contact lens wearer. A 41-year-old male, who has worn silicone hydrogel contact lenses on an extended basis for about 10 years, attended with the complaints of vision disturbance, hyperemia, and pain in his right eye. His history revealed that 1.5 month ago, he had been diagnosed with allergic conjunctivitis and had used steroid eye drops. Biomicroscopic examination revealed eyelid edema, chemosis, and ring infiltration, radial keratoneuritis and an epithelial defect in the cornea. Magnetic resonance imaging demonstrated enlarged lacrimal gland with edematous changes consistent with inflammation due to dacryoadenitis. There were also thickening and edema of the right superior oblique and lateral rectus muscle. The treatment protocol for AK was applied with no specific treatment for dacryoadenitis. After 4 months of the treatment, dacryoadenitis and keratitis regressed. Dacryoadenitis and extraocular muscle inflammation may accompany AK more frequently than expected and previously known. The evaluation of the lacrimal gland and extraocular muscles in presence of AK might be beneficial for understanding better the exact clinical picture and course of the keratitis.

Success of hydrocone (TORIS-K) soft contact lens for keratoconus and traumatic keratopathy.

OBJECTIVE: To present success of Toris-K contact lenses in keratoconus and traumatic keratopathy with irregular corneal surface. METHODS: Toris-K contact lenses were used to treat 7 eyes of 4 patients with traumatic keratopathy (Case 1) or keratoconus (Case 2, Case 3, and Case 4). All cases had a complete eye examination before the contact lens application. The case with traumatic keratopathy was a 32-year-old male who had corneal penetrating injury due to hobnail strike 23 months ago. The other 3 keratoconus cases were females at the age of 14, 16 and 22 years old. They had high myopia and irregular astigmatism due to keratoconus. All patients refused using rigid gas permeable contact lens because of intolerance. Toris-K contact lenses were fitted on all eyes. All patients were followed-up for 28 months with a complete ophthalmic examination and corneal topography every two months. RESULTS: Improvement of BCVA of the cases was remarkable. All cases were comfortable with their Toris-K contact lenses for 28 months. There was no significant distortion on the lenses during follow-up period. CONCLUSION: Toris-K lenses may be an effective alternative treatment option for the patients with keratoconus and traumatic keratopathy, especially who cannot tolerate rigid gas permeable contact lenses.

Contact Lens-Related Acanthamoeba Keratitis and Accompanying Dacryoadenitis.

OBJECTIVES: In this study, by presenting four cases, we aimed to discuss the clinical presentation, diagnosis, therapy, and methods for prevention of Acanthamoeba keratitis (AK) and to emphasize that inflammatory dacryoadenitis can be seen together with it. METHODS: This is a retrospective case series of four eyes of four wearers of hydrophilic soft contact lenses who developed AK. The diagnosis was based on clinical signs, disease course, and confocal microscopy results. In cases with dacryoadenitis, in addition to clinical findings, magnetic resonance imaging was used to establish the diagnosis. RESULTS: All of the cases were using their contact lenses without supervision of an ophthalmologist under inappropriate conditions such as swimming in a pool and during steam bath. The diagnosis was established, and the treatment was performed within the standard protocol for AK. Two of the patients had low visual acuity at the level of counting fingers with corneal scar, cataract, and glaucoma, whereas the other two healed with fewer complications and achieved better vision. Two of the 4 cases (50%) presented with dacryoadenitis accompanying the AK. Lacrimal gland swelling improved in conjunction with symptoms of keratitis without specific treatment for dacryoadenitis in these two cases. CONCLUSIONS: Despite the improvements in diagnostic tests and treatment strategies for AK, the role of prevention becomes apparent because of the bad prognosis of this serious complication; thus, contact lens wearers should be aware of the importance of using lenses under ophthalmologist's supervision. In addition, we would like to emphasize that AK may be frequently associated with lacrimal gland inflammation.

Assessment of aberrations and visual quality differences between myopic and astigmatic eyes before and after contact lens application.

OBJECTIVE: To evaluate the aberration and visual quality differences between myopic and astigmatic eyes before and after contact lens application by using corneal aberrometer and low- contrast sensitivity chart. METHODS: Eighty eyes of 40 patients were included in this study. Patients were divided into two groups as myopic (40 eyes, n=20) and astigmatic groups (40 eyes, n=20). We used aspheric Balafilcon A (Purevision and Purevision Toric Bausch&Lomb, Rochester, USA) lenses for each group. Corneal aberrations and low-contrast sensitivity values were measured and compared for each patient in both groups. RESULTS: There were no statistically significant differences between myopic and astigmatic groups when we compared low-contrast sensitivity values for both on- and off-eyes. Mean total higher-order aberration (HOA) values for off-eye, were 0.29±0.10 µm, and 0.33±0.10 µm for on-eye in the myopic group, while they were 0.42±0.14 µm in off-eye and 0.37±0.23 µm in on-eye in the astigmatic group. Off-eye mean coma, irregular astigmatism and total higher-order aberration RMS (root-mean-square) values were significantly higher in the astigmatic group compared to the myopic group (p=0.006, p=0.001, p=0.001) but mean on-eye RMS values were not. CONCLUSION: Myopic and astigmatic patients differ in terms of high-order aberrations and these differences cannot be equalized after contact lens application, but visual quality can be improved in both patients by using contact lenses.

Evaluation of the impact of persistent subepithelial corneal infiltrations on the visual performance and corneal optical quality after epidemic keratoconjunctivitis.

PURPOSE: Aim was to measure the effect of persistent subepithelial corneal infiltrates (SEIs) after epidemic keratoconjunctivitis (EKC) on visual performance and corneal optical quality. METHODS: We examined 53 patients divided into two groups. Patients with previous EKC constituted the study group (Group 1, n: 27). Healthy age matched subjects constituted the control group (Group 2, n: 26). Study group was subdivided into eyes with SEI (Group 1A, 40 eyes) and healthy fellow eyes (Group 1B, 14 eyes). Patients were submitted to a complete examination including high- and low-contrast visual acuities (HCVA, LCVA), corneal topography and aberrometry. RESULTS: The mean interval between epidemic conjunctivitis and examination was 7.25 ± 5.63 months. Mean number of corneal infiltrates was 17.30 ± 14.38. The mean HCVA and LCVA were significantly lower in the eyes with SEI than fellow eyes and control group (p = 0.001). LCVA value was also worse in the fellow eyes when compared to control (p = 0.048). Corneal topography values were significantly higher in the eyes with SEI from both fellow eyes and control group. During corneal aberrometry, the mean root mean square value of spheric aberration, irregular astigmatism and total aberration were significantly higher in SEI group when compared to fellow eyes and control group (p < 0.05). Total aberrations were higher than control subjects in the fellow eyes. Trefoil aberration was higher in SEI group only when compared to control subjects, while there was no significant difference in coma aberration values between the groups (p > 0.05). CONCLUSION: Results of this study suggested that visual performance is compromised in patients with EKC by aberrations and changes in topographic variables.

Confocal scanning laser tomography of the optic nerve head on the patients with Alzheimer's disease compared to glaucoma and control.

The purpose of this study was to evaluate optic nerve head (ONH) differences of the patients with Alzheimer's disease (AD) measured by confocal scanning laser tomography [Heidelberg Retina Tomograph (HRT) III] and compare with glaucoma and control subjects. Eighty-four patients were enrolled into the study: 44 eyes of 24 patients with mild to moderate AD (Group 1), 68 eyes of 35 patients with glaucoma (Group 2), and 49 eyes of 25 heathy volunteers as a control (Group 3). A complete ophthalmologic examination as well as a confocal scanning laser ophthalmoscopic assessment with HRT III were performed on all patients. Mean values of the ONH topographic parameters such as rim area (RA), rim volume (RV), height variation contour, linear cup/disc ratio, cup shape measure, and retinal nerve fiber layer (RNFL) were recorded. Mean values of RNFL thickness was 0.23 ± 0.07 in AD, 0.22 ± 0.09 in glaucoma and 0.24 ± 0.07 in the control group (p = 0.323). RA and RV were significantly lower, and linear C/D ratio was significantly higher in the glaucoma group when compared to AD and control (p < 0.05). There was no statistically significant difference between AD and control for the optic disc parameters tested (p > 0.05). We observed a negative correlation of the age with RNFL in all of the groups (p < 0.005). Age was the most important parameter affecting RNFL. Our results suggest that HRT does not demonstrate ONH differences between AD and control group, while it successfully differentiates glaucoma from AD and control cases of older age.