Gonioscopy-assisted transluminal trabeculotomy as a primary surgical option for glaucoma in Fuchs uveitis syndrome: A case series.

BACKGROUND: Fuchs uveitis syndrome (FUS) is a chronic intraocular inflammatory disease. It can lead to glaucoma which can be intractable to both medical and surgical treatment. In the present report, we describe our experience with GATT as a primary surgical option in the treatment of glaucoma secondary to FUS. RESULTS: Four consecutive patients with FUS-associated glaucoma underwent GATT in a single institution. Case 1 was a 28-year-old pseudophakic male with a preoperative intraocular pressure (IOP) of 43 mmHg had unsuccessful circumferential cannulation; his IOP remained high after GATT and received trabeculectomy followed by Ahmed glaucoma valve (AGV) implantation to control IOP. Although IOP was stable following AGV, he required descemet membrane endothelial keratoplasty due to persistent corneal decompansation. He had a stable IOP of 12 mmHg over 21 months. Case 2 was a 42-year-old male with preoperative IOP of 35 mmHg and posterior subcapsular cataract had 360-degree GATT combined with phacoemulsification; his IOP reduced to 14 mmHg over 18 months. Case 3 was an 52-year-old pseudophakic male with a preoperative IOP of 28 mmHg had 360-degree GATT; his IOP remained stable at 10 mmHg over 18 months. Case 4 was an 47-year-old pseudophakic female with a preoperative IOP of 39 mmHg had 360-degree GATT; her IOP remained stable at 14 mmHg over 12 months. CONCLUSION: GATT may be used as an initial approach in secondary glaucoma due to FUS. But, further evidence is still warranted to better ascertain the usefulness of GATT in this specific patient population.

A Prospective Comparison of 180 versus 360-Degree Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes in Pseudoexfoliation Glaucoma.

PRECIS: Analysis of surgical success and intraocular pressure (IOP), best-corrected visual acuity (BCVA) and antiglaucomatous medication (AGM) changes between segmental 180-degree and 360-degree gonioscopy-assisted transluminal trabeculectomy (GATT) in patients with pseudoexfoliation glaucoma (PEXG) showed no significant difference. PURPOSE: To compare surgical outcomes of segmental 180-degree and 360-degree GATT in PEXG patients. MATERIALS AND METHODS: Prospective, comparative study of 65 PEXG eyes, who underwent segmental 180-degree GATT (GATT 180° group, 31 eyes) and 360-degree GATT (GATT 360° group, 34 eyes) in a tertiary academic center over a 12-month of follow-up. Primary outcome was qualified and complete surgical success rates for Criterion A (IOP <18 mmHg and >30% reduction) and Criterion B (IOP <15 mmHg and >30% reduction). Secondary outcome measures included IOP reduction, BCVA change, AGM use and postoperative complications. RESULTS: The probabilites of qualified and complete success rates both for Criteria A and B did not significantly differ between the groups (P>0.05). IOP and BCVA levels were similar at each time point (P>0.05). IOP reduction was 59.3±9.5% in GATT 180° group and 55.8±18.1% in GATT 360° group (P=0.33). No significant difference in the mean number of AGM was present at the 12-month visit (1.2±1.1 in GATT 180° group vs 1.5±1.2 in GATT 360° group, P=0.25). Significantly higher incidences of postoperative hyphema and IOP spike were observed in GATT 360° group (P=0.01 and P=0.008, respectively). CONCLUSION: Both segmental 180-degree and 360-degree GATT similarly reduced IOP and AGM with comparable surgical success rates in PEXG patients at the end of 12-months. Postoperative hyphema and IOP spike rate were siginificantly higher after 360-degree GATT. Segmental 180-degree GATT may be sufficient to adequately modulate IOP with lower incidence of postoperative complications in PEXG.

Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma.

PURPOSE: To compare clinical outcomes between gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) in patients with advanced-stage pseudoexfoliation glaucoma (PEXG). METHODS: This comparative study comprised 62 patients who underwent GATT (N = 31) or TRAB (N = 31) for advanced-stage PEXG. Primary outcome was cumulative probability of surgical success at the end of 12-month follow-up. Success was determined as intraocular pressure (IOP) reduction ≥ 30% from baseline, IOP between 6 and 18 mmHg and IOP upper limits for IOP < 15 mmHg and < 12 mmHg, separately. Secondary outcomes were IOP reduction, antiglaucoma medication (AGM) use, and complications in the study. RESULTS: Age, sex, cup/disc ratio, mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness did not significantly differ between the groups (p > 0.05 for all). The probability of cumulative surgical success at the end of 12 months was similar between the two groups for IOP < 15 mmHg and < 18 mmHg but significantly higher after TRAB (92.0%) than GATT (82.5%) for IOP < 12 mmHg (log-rank test p = 0.035). Percentage of IOP reduction from baseline was similar between the groups (53.1 ± 18.6% in GATT group and 53.0 ± 16.6% in TRAB group, p = 0.98) at the end of 12 months. No significant difference in the mean number of AGM was present at the 12-month visit (1.3 ± 1.4 in GATT and 1.1 ± 1.4 in TRAB, p = 0.65). CONCLUSION: At the end of 12 months, IOP reduction rate was similar between GATT and TRAB. Cumulative surgical success was higher after TRAB than GATT for IOP < 12 mmHg.

Evaluation of peripheral anterior synechia formation following gonioscopy-assisted transluminal trabeculotomy surgery.

PURPOSE: To quantitatively assess the development of peripheral anterior synechia (PAS) formation rate and PAS locations on gonioscopic examination following gonioscopy-assisted transluminal trabeculotomy (GATT) surgery and investigate the surgical outcomes. METHODS: A total of 35 eyes from 31 patients with open angle glaucoma who underwent GATT or combined GATT and phacoemulsification surgery were analyzed. Presence of PAS was assessed on gonioscopy in nasal, temporal, superior and inferior quadrants at months 1, 3 and 6 following surgery. Surgical outcomes were also noted. RESULTS: Frequencies of PAS formation were 38.3%, 25.3%, 17.0% and 19.1% at postoperative 1 month, 34.0%, 26.4%, 17% and 22.6% at postoperative 3 months and 32.3%, 25.8%, 16.1% and 25.8% at postoperative 6 months, in nasal, temporal, superior and inferior quadrants, respectively. The highest amount of PAS involvement was 3 clock hours in the study which was identified only in nasal and inferior quadrants. Frequency of PAS formation did not significantly differ between nasal, temporal, superior and inferior quadrants at all time points (p > 0.05). No significant differences of mean IOP levels were observed between patients who developed PAS and who did not develop PAS at postoperative 1 month (p = 0.72), 3 months (p = 0.21) and 6 months (p = 0.59). The mean IOP and mean number of antiglaucoma medications decreased from 31.5 ± 7.2 mmHg and 3.6 ± 0.6 at baseline to 13.8 ± 3.1 mmHg and 1.6 ± 1.3 at postoperative 6 months, respectively (p < 0.001, for both). Cumulative success rate (95% confidence interval) was 74.3% (69.9-78.6%) at the end of the study. Mild to moderate degrees of hyphema occurred in all cases postoperatively. CONCLUSION: Although PAS formation was observed to be relatively higher in nasal quadrant, PAS frequency was not statistically different between the angle quadrants.

The clinical use of ultra - Wide field imaging and intravenous fluorescein angiography in infants with retinopathy of prematurity.

PURPOSE: To investigate the potential benefits and practicality of ultra - wide field (UWF) imaging and intravenous UWF fluorescein angiography (IV UWF - FA) in infants with retinopathy of prematurity (ROP) using an Optos® California device. METHODS: This retrospective study involved 46 infants with a history of ROP who underwent UWF imaging with or without IV UWF - FA. ROP characteristics were identified using UWF color imaging. Retinal vascular findings following treatment were also assessed at IV UWF - FA analysis. All imaging sessions were performed under topical anesthesia without sedation. Main outcomes were the appearance of ROP at UWF color imaging and IV UWF-FA analysis, including status of ROP, neovascularizations, presence of plus disease, retinal vascular details, and resolution after treatment. RESULTS: Seven (three girls) of the 46 infants (22 girls) underwent IV UWF-FA. Twelve IV UWF-FA sessions were performed in total. The oldest infant during IV UWF-FA analysis was at 55 postmenstrual weeks. Clinical characteristics of disease were easily identified at UWF color imaging. IV UWF-FA images also clearly revealed non-perfused retinal areas, fluorescein leakage, macular edema, retinal vascular abnormalities, and the status of the peripheral vascular termini. Complications of IV UWF-FA occurred in one infant in the form of patchy yellow skin discoloration around the injection site which completely disappeared on the first day following the procedure. CONCLUSIONS: Providing a high resolution panoramic view of the retina in a single image capture with no need for contact with the cornea appear to represent potential advantages of UWF imaging in infants with ROP. IV UWF-FA also seems to be a safe procedure which can be performed under topical anesthesia and that shows detailed retinal vascular alterations in patients with ROP.

Infliximab therapy provides beneficial effects for choroidal thickness increase in patients with active ankylosing spondylitis: A possible mechanism mediating the suppressing of uveitis attacks.

OBJECTIVES: This study aims to quantitatively assess the profile of the choroidal thickness (ChT) in patients with ankylosing spondylitis (AS) using optical coherence tomography (OCT), and to examine whether the posterior eye segment abnormalities in active AS patients are reversible by infliximab therapy. PATIENTS AND METHODS: October 2014 and March 2016 Thirty-one patients with AS (22 males, 9 females; mean age 39.6±12.3 years; range, 22 to 68 years) and 24 healthy controls (16 males, 8 females; mean age 40.8±8.9 years; range, 35 to 61 years) were enrolled. Patients' clinical and demographic characteristics were recorded. Using OCT, we performed retinal nerve fiber layer (RNFL) thickness, ganglion cell complex, and ChT measurements in AS patients before and six months after the initiation of infliximab therapy, and in healthy controls. RESULTS: At baseline, patients with AS had higher ChT (mean±standard deviation: 347.5±114.4 µm) compared to healthy controls (322.1±62.8 µm), although this did not reach statistical significance level (p=0.283). At six months after the first measurement, the mean ChT was significantly decreased (under infliximab therapy: 326.5±99.7 µm vs. before: 347.5±114.4 µm, p=0.018) in AS group, while no significant change was observed in the control group (p=0.102). RNFL thickness in the AS group was significantly decreased after six months of treatment with infliximab (p=0.008). CONCLUSION: By evaluating the posterior eye segment of patients with AS using OCT, this study has demonstrated that active AS patients had higher ChT. The significant reduction in this ChT after infliximab therapy may be mediating the established effective suppressing action of infliximab on uveitis attacks.

Effect of Body Position on Intraocular Pressure Measured by Rebound Tonometer in Healthy Children.

Objectives: To evaluate the effect of body position on intraocular pressure (IOP) measurement in the pediatric age group. Materials and Methods: Children whose general condition was healthy and ophthalmic examination was within normal limits were included. Forty-nine eyes of 49 pediatric patients were included in the study. IOP was measured with an ICARE rebound tonometer (ICARE PRO; ICARE, Helsinki, Finland) while patients were in standing, sitting, and supine positions. Differences between the consecutive measurements were compared statistically. Results: Twenty-two of the 49 patients were female, 27 were male. The mean age was 9.61±2.66 (5-15) years. Mean IOP values in the standing, sitting, and supine positions were 18.81±2.97 (11.6-26.2) mmHg, 18.88±3.44, (12-28.2) mmHg, and 19.01±2.8 (13.5-25.9) mmHg, respectively. There were no statistically significant differences in pairwise comparisons of the measurements taken in the different positions (p=0.846, p=0.751, p=0.606). There was a statistically significant correlation between corneal thickness and intraocular pressure values in all measurements (p=0.001, r=0.516). Conclusion: IOP values measured with the ICARE rebound tonometer in healthy children are not affected by body position.

A comparison of three different tonometric methods in the measurement of intraocular pressure in the pediatric age group.

INTRODUCTION AND AIM: To compare intraocular pressure (IOP) measurements obtained with non-contact tonometry (NCT), Icare rebound tonometry (IRT) and Goldmann applanation tonometry (GAT) in pediatric cases and to examine the effect of topical anesthesia on measurements obtained using IRT. MATERIALS AND METHODS: Pediatric cases in a healthy general condition and with ophthalmic examination findings within normal limits were included in the study. IOP measurements were taken with NCT and IRT devices in all cases. Topical anesthesia was subsequently applied, and IOP measurements were then repeated using IRT and GAT tonometer devices. Differences between measurements were subjected to statistical analysis. RESULTS: One hundred ten eyes of 55 patients, 27 male, with a mean age of 11.44 ± 2.31 years (7-17) were included. Mean pre-anesthesia IOP values were 16.47 ± 2.89 mmHg with NCT and 17.49 ± 2.57 mmHg with IRT. Mean IOP values after topical anesthesia were 16.91 ± 2.17 mmHg with IRT and 15.51 ± 2.41 mmHg with GAT. IOP measurement values obtained with all three devices exhibited positive correlation with central corneal thickness values. Statistically significant correlation was present in terms of IOP measurement values between all three devices. However, IOP values obtained with the three devices exhibited statistically significant differences. The application of topical anesthesia caused a statistically significant decrease in IRT measurements; however, statistically significant this small change (0.58 mmHg) in recorded IOP would not be considered clinically significant. CONCLUSION: IOP measurements obtained with NCT, IRT and GAT devices in the pediatric age group correlate with one another, but differ from one another in a statistically significant manner. Application of topical anesthesia affects IRT measurements; however, these small changes would not be considered clinically significant.

The Relation of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio with High Axial Myopia.

Purpose: To investigate the relation between high axial myopia and neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values.Methods: Seventy-nine cases were enrolled, 50 myopic and 29 emmetropic. All participants were assigned into three groups: Group I (high myopia with no retinal involvement), Group II (high myopia with retinal involvement) and Group III (control). NLR and PLR values calculated from blood tests were compared among the groups.Results: Mean NLR levels were 2.23 ± 0.78 in Group I, 2.36 ± 1.06 in Group II, and 1.57 ± 0.33 in Group III. Mean PLR levels were 114.62 ± 23.21 in Group I, 145.16 ± 52.36 in Group II, and 91.42 ± 18.73 in Group III. NLR and PLR values in the high myopia groups were significantly higher than in the control group.Conclusion: NLR and PLR values in cases with high axial myopia were higher than in the emmetropic group. Higher inflammation in the degenerative myopic group in particular may be related to pathological chorioretinal changes.

Repeatability and Agreement of Macular Thickness Measurements Obtained with Two Different Scan Modes of the Optovue RTVue Optical Coherence Tomography Device

Objectives: To evaluate the repeatability and agreement of macular thickness measurements obtained with E-MM5 and MM6, two different scan modes, on the Optovue RTVue optic coherence tomography (OCT) device. Materials and Methods: Three consecutive macular thickness measurements in 30 healthy volunteers were taken using the OCT device E-MM5 and MM6 scan modes. The repeatability and agreement of these measurements obtained from the two scan modes and divided into nine anatomical regions based on early treatment diabetic retinopathy study were subjected to statistical analysis. Results: The mean age of the participants was 29.7±6.39 years. Intraclass correlation (all ICC values ≥0.86) and coefficient of variation (all coefficient of variation values ≤2%) analyses of consecutive OCT measurements in the nine regions of the macula obtained in both E-MM5 and MM6 scan modes gave high repeatability rates. Mean macular thickness values in the foveal region were 243.76±21.79 µm in E-MM5 mode and 247.04±19.83 µm in MM6 mode (p=0.543). Values for measurements obtained in E-MM5 and MM6 scan modes in parafoveal macular regions were also statistically similar (p>0.05 for all). However, a statistically significant difference was observed between the two modes in perifoveal macular measurements, except in the superior region. Conclusion: The Optovue RTVue OCT device gives highly repeatable measurement results for macular thicknesses in both E-MM5 and MM6 scan modes. However, it should be considered that measurements performed in E-MM5 and MM6 modes give different results in perifoveal regions.

An investigation of the ocular toxic effects of levetiracetam therapy in children with epilepsy.

OBJECTIVE: To investigate the potential toxic effects of levetiracetam monotherapy on ocular tissues in cases of pediatric epilepsy using optical coherence tomography (OCT). METHODS: Thirty epileptic children (group 1) receiving levetiracetam monotherapy at a dosage of 20-40 mg/kg/day for at least 1 year with a first diagnosis of epilepsy and 30 age- and gender-matched healthy children (group 2) were included in the study. In addition to a detailed eye examination, peripapillary retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, foveal thickness (FT), and central corneal thickness (CCT) were measured in all children by means of spectral domain OCT. The data obtained from the two groups were then subjected to statistical analysis. RESULTS: The mean age of both groups was 12 ± 3.64 years [1-12]. The mean duration of levetiracetam in group 1 was 24.07 ± 12.82 months. Mean RNFL values in groups 1 and 2 were 106.1 ± 10.42 and 104.98 ± 10.04 µm, mean GCC values were 94.72 ± 6.26 and 94.4 ± 6 µm, mean FT values were 240.73 ± 17.94 and 240.77 ± 15.97 µm, and mean CCT values were 555.1 ± 44.88 and 540.97 ± 32.65 µm, respectively. No significant difference was determined between the two groups in terms of any parameter. Best corrected visual acuity values of the subjects in both groups were 10/10, and no color vision or visual field deficit was determined. CONCLUSION: Levetiracetam monotherapy causes no significant function or morphological change in ocular tissues in pediatric epilepsies.

A comparison of the effects of perindopril arginine and amlodipine on choroidal thickness in patients with primary hypertension

Background/aim: This study aimed to investigate the effects of two different medical treatment options on choroidal thickness (CT) in patients with primary hypertension. Materials and methods: Forty newly diagnosed primary hypertension patients and 21 healthy volunteers were included. The patients were randomly divided into two subgroups. Group I started on perindopril arginine and Group II started on amlodipine. Submacular CT using optical coherence tomography (OCT) was measured before treatment and at the third and sixth months after treatment. Results: Initial mean arterial pressure (MAP) values in Groups I and II and the control group were 113.4, 109.8, and 89.4 mmHg, respectively, and mean CT values were 257.9, 286.5, and 300.9 µm. Mean MAP values in Groups I and II and the control group at the sixth month after treatment were 99.7, 99.6, and 90.2 mmHg, respectively, and mean CT values were 293.1, 286, and 297.4 µm. Analysis of the changes occurring during the study revealed significant variation in MAP in Groups I and II, and in CT in Group I only. Conclusion: A gradual increase in CT developed with perindopril arginine therapy in patients with primary hypertension, while no significant change occurred in CT in the amlodipine group.

Bilateral acute angle closure developing due to use of ipratropium bromide and salbutamol.

Acute angle closure can be seen as a side effect of some medications that can be used systemically. In this article, clinical characteristics of 54-year-old female patient who applied to our clinic with bilateral acute angle closure and has been received nebulized form of salbutamol and ipratropium bromide due to asthma for 4 days was evaluated. Right and left eye IOP were measured as 50 and 48 mmHg. IOP was reduced with anti-glaucomatous treatment. and peripheral iridectomy was done, and then the patient was discharged. It is necessary to be careful to prevent contact with the eye of nebulized form of these drugs which may result in angle closure glaucoma when used systemically.

ACCIDENTAL DUPLICATION: Investigation of the effect of hemoglobin F and A levels on development of retinopathy of prematurity.

The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jaapos.2017.03.006. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Evaluation of the effects on choroidal thickness of bimatoprost 0.03% versus a brinzolamide 1.0%/timolol maleate 0.5% fixed combination.

OBJECTIVE: To investigate the effects of two different medical treatment options on choroidal thickness (CT) in cases of open-angle glaucoma (OAG). METHODS: Sixty-seven eyes newly diagnosed with OAG and 52 healthy eyes constituting the control group were included in the study. Glaucomatous eyes were randomly divided into two subgroups; Group I was started on bimatoprost 0.03% and Group II on a brinzolamide 1.0%/timolol maleate 0.5% fixed combination (BTFC). Intraocular pressure (IOP), ocular pulse amplitude (OPA) and subfoveal CT measurements were performed in all eyes in the study before treatment and on weeks 2, 4 and 8 after treatment. RESULTS: Mean initial IOP values in groups I and II and the control group were 25.5 ± 4.7, 25.1 ± 5.2 and 16.1 ± 2.9 mmHg, mean OPA values were 3.7 ± 1, 3.6 ± 1.4 and 2.4 ± 0.6 mmHg and mean CT values were 269.4 ± 83, 264.5 ± 84.4 and 320.1 ± 56.6 µm, respectively. Eight weeks after treatment, mean IOP values in Groups I and II and the control group were 18.3 ± 2.6, 18.1 ± 3.4 and 15.7 ± 2.9 mmHg, mean OPA values were 2.9 ± 1.2, 2.8 ± 1.5 and 2.3 ± 0.8 mmHg and mean CT values were 290.2 ± 87.3, 271.8 ± 82.5 and 319.3 ± 56.8 µm, respectively. No significant difference was determined in terms of the decrease in IOP and OPA obtained after treatment in Group I and Group II. However, a significant difference was observed between the two groups in terms of choroidal thickening after treatment. CONCLUSION: The use of topical ocular hypotensive medication in eyes with OAG results in an increase in CT. This increase is relatively greater with bimatoprost 0.03% therapy compared to BTFC.

The Relationship between Serum Carbonic Anhydrase I-II Autoantibody Levels and Diabetic Retinopathy in Type 1 Diabetes Patients.

OBJECTIVES: To investigate the relationship between serum carbonic anhydrase I-II (CA-I and II) autoantibody levels and diabetic retinopathy (DRP) in cases with type 1 diabetes. MATERIALS AND METHODS: A total of 37 type-1 diabetic patients, 17 with DRP (group 1) and 20 without (group 2), and 38 healthy control subjects (group 3) were included. CA-I and CA-II autoantibody levels were measured in serum samples obtained from each of the three groups and compared statistically. Additionally, the correlation between CA-I and CA-II autoantibody levels and the presence of diabetic macular edema was examined. RESULTS: Mean measured CA-I autoantibody levels were 0.145±0.072, 0.117±0.047, and 0.138±0.061 ABSU in group 1, group 2, and group 3, respectively (p=0.327). The average CA-II autoantibody levels achieved in the same groups were 0.253±0.174, 0.155±0.137, and 0.131±0.085 ABSU, respectively (p=0.005). No significant difference was obtained between the subgroups of group 1, with macular edema (n=8) and without (n=9), in terms of both CA-I and CA-II autoantibody levels (p=0.501, p=0.178, respectively). CONCLUSION: A significant correlation was observed between the development of DRP and serum CA-II autoantibody levels in type 1 diabetic cases. However, there was no correlation between the autoantibody levels and the presence of diabetic macular edema in cases with DRP.

Investigation of the effect of hemoglobin F and A levels on development of retinopathy of prematurity.

PURPOSE: To investigate the effect of hemoglobin F (HbF) and hemoglobin A (HbA) levels on development of retinopathy of prematurity (ROP) in premature infants. METHODS: In this prospective study, blood samples were collected from the side of the heel of 49 premature infants at postnatal months 0, 1, 2, and 3. HbF and HbA levels were measured in all samples and analyzed statistically. Furthermore, correlation analysis was performed regarding development of ROP, blood transfusion, and HbF and HbA levels. RESULTS: A total of 49 infants were included. The mean gestational age of the premature infants was 30.9 ± 2.7 weeks (range, 25-35 weeks); mean birth weight, 1542 ± 582 g (range, 520-3240 g). Of the 49 premature infants, stage 1 ROP or above developed in 26 (53%). Mean HbF levels were lower at postnatal months 1 and 2 in premature infants with ROP compared to those without ROP (P = 0.013 and 0.02, respectively); however, mean HbA levels were higher in the infants with ROP than the others (P = 0.034 and 0.029, respectively). Analysis of covariance that ignored transfusion revealed no difference between the means of Hb variants in the infants with and without ROP (P = 0.572 and 0.486). CONCLUSIONS: Blood transfusion significantly altered the levels of HbF and HbA in premature infants, and Hb variants have no direct effect on development of ROP.

Evaluation of Retinal Changes Using Optical Coherence Tomography in a Pediatric Case of Susac Syndrome.

Susac syndrome is a rare occlusive vasculopathy affecting the retina, inner ear and brain. The cause is unknown, although it generally affects young women. This syndrome can be difficult to diagnose because its signs can only be revealed by detailed examination. These signs are not always concomitant, but may appear at different times. This report describes a pediatric case who was diagnosed with Susac syndrome when retinal lesions were identified in the inactive period with the help of optical coherence tomography (OCT). The purpose of this case report is to emphasize the importance of OCT in clarifying undefined retinal changes in Susac syndrome.

Determination of regional screening criteria for retinopathy ofprematurity in the Eastern Black Sea region of Turkey.

BACKGROUND/AIM: To establish a regional screening protocol for retinopathy of prematurity (ROP). MATERIALS AND METHODS: Data were analyzed from the hospital records of 1241 infants with gestational age (GA) at birth ≤36 weeks and birth weight (BW) of ≤3600 g. RESULTS: The mean GA of the infants was 32.05 ± 2.7 weeks and the mean BW was 1780.5 ± 576 g. ROP at any stage was detected in 703 of the 1241 infants (555 female). Eleven infants with type 1 ROP were treated with 810 nm diode laser photocoagulation. No treatment was needed in infants born after 33 weeks of gestation and weighing over 1760 g. Logistic regression analysis showed a significant relationship between the development of ROP and GA, BW, number of deliveries, respiratory distress syndrome, and treatment with oxygen or mechanical ventilation. Receiver operating characteristic curve analysis showed that a GA of 33 weeks or a BW of 1770 g appears to be an appropriate criterion for identifying infants who may require ROP treatment. CONCLUSION: GA ≤ 33 weeks and BW ≤ 1770 g can be used as screening criteria in terms of ROP in infants for the Eastern Black Sea region.

The effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide injection in branch retinal vein occlusion-related macular edema.

OBJECTIVE: To investigate the effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide (PSTA) application in branch retinal vein occlusion (BRVO)-related macular edema. METHODS: Patients with confirmed BRVO-related macular edema were enrolled in the study. Patients were injected with a single, therapeutic dose of 40 mg PSTA. Detailed ophthalmic examination was performed at baseline and at 1, 3 and 6 months after the treatment. Best corrected visual acuity (BCVA), intraocular pressure (IOP), cataractogenic change (CC) and macular optical coherence tomography (OCT) analysis results were evaluated. The results were compared statistically. RESULTS: Forty-one eyes of 41 patients with a mean age of 63.49 ± 10.99 (55-86) years, 15 (36.6%) females, were included in the study. BCVA in LogMAR values at 1 and 3 months were significantly better than at baseline, while no significant difference from baseline was observed in sixth month values (p < 0.001, p < 0.001 and p = 0.846, respectively). Central macular thickness values obtained using OCT were significantly lower at the first, third and sixth months compared to baseline (p < 0.001 for all). IOP elevation was determined in only two eyes (4.8%) at the end of the study period, and no CC was detected in any case. CONCLUSION: PSTA application is an effective and safe option in BRVO-related macular edema.