Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers.

PURPOSE: The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. METHODS: The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. RESULTS: The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). CONCLUSION: Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci-garette smoking.

Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers / Avaliação da superfície ocular e das alterações morfológicas nas glândulas meibomianas através de meibografia sem contato em usuários de cigarros eletrônicos

ABSTRACT Purpose: The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. Methods: The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. Results: The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). Conclusion: Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci­garette smoking.

RESUMO Objetivo: Avaliar a superfície ocular e a morfologia da glândula meibomiana em usuários de cigarros eletrônicos. Métodos: Foram avaliadas através de meibografia Sirius as pálpebras superiores e inferiores de 25 usuários de cigarros eletrônicos do sexo masculino e 25 pacientes não usuários saudáveis, também do sexo masculino. A perda nas glândulas meibomianas foi calculada automaticamente com o módulo de software de imagem de meibografia Phoenix. O resultado foi obtido como perda percentual. O questionário Ocular Surface Disease Index (OSDI), o teste do tempo de ruptura lacrimal e o teste de Schirmer II foram administrados em todos os casos. Resultados: A duração média do uso de cigarros eletrônicos foi de 4,9 ± 0,9 anos (intervalo de 3,4-7 anos). O valor médio do teste de Schirmer II foi de 9,16 ± 2,09 mm no grupo de usuários de cigarros eletrônicos e de 11,20 ± 2,14 mm no grupo controle (p=0,003). O valor médio do teste do tempo de ruptura lacrimal foi de 6,96 ± 2,31 segundos no grupo de usuários de cigarros eletrônicos e 9,84 ± 2,13 segundos no grupo controle (p=0,002). O valor médio do Ocular Surface Disease Index foi de 28,60 ± 6,54 e 15,16 ± 7,23 para os grupos de usuários de cigarros eletrônicos e controle, respectivamente (p<0,001). Na meibografia de Sirius, a perda média para a pálpebra superior foi de 23,08 ± 6,55% para o grupo de usuários de cigarros eletrônicos e 17,60 ± 4,94% para o grupo controle (p=0,002), e a perda média para a pálpebra inferior foi de 27,84 ± 5,98% e 18,44 ± 5,91%, respectivamente (p<0,001). Além disso, foi observada uma correlação positiva significativa entre a taxa de perda na meibografia palpebral superior e inferior com a duração do tabagismo eletrônico, respectivamente de (r=0,348, p<0,013) e (r=0,550, p<0,001). Conclusão: O uso prolongado de cigarros eletrônicos causa danos às glândulas meibomianas. Portanto, esses danos devem ser considerados em distúrbios da superfície ocular devidos ao uso desses dispositivos.

Changes in retinal vessel and retinal layer thickness after cross-linking in keratoconus via swept-source OCT angiography.

PURPOSE: To analyze the postoperative foveal avascular zone (FAZ) area, superficial capillary plexus (SCP), deep capillary plexus (DCP) vascular densities (VD), and retinal layers after cross-linking (CXL) for keratoconus treatment. METHODS: Twenty-seven eyes with cross-linking treatment for keratoconus were included in the study. Foveal avascular zone (FAZ) area, SCP VD, DCP VD, and retinal layers were evaluated by using optical coherence tomography angiography (OCTA). OCTA measurements were made at preoperative, first week, and first and sixth months after the surgery. In addition, corneal topography measurements were also made. RESULTS: Although there was a decrease in corneal thickness in the follow-up of the patients, there was no significant difference in axial length and anterior chamber depth. There was no significant difference in full retinal thickness in the foveal and parafoveal areas. While there was a significant increase in retinal nerve fiber layer (RNFL) thickness in the foveal area (p = 0.032, p = 0.015, p = 0.017; preoperative values compared to first week, first month, and sixth month respectively), there was a decrease in ganglion cell layer (GCL) thickness in the parafoveal area in the postoperative sixth month (p = 0.028). There was no difference in FAZ measurements. In the parafoveal area, a decrease was observed in SCP VD in the sixth-month control (p = 0.019). There was a significant increase in DCP VD in the foveal area (p = 0.008, p = 0.043, p = 0.040). The preoperative mean CDVA (corrected distance visual acuity) was 0.37 ± 0.16 logMAR and postoperative sixth month mean CDVA was 0.39 ± 0.15. There was no significant difference in visual acuity (p = 0.71). CONCLUSION: Keratoconus patients successfully treated with CXL had significant changes in retinal layers and vessel density in the superficial and deep retinal plexus.

Analysis of optical coherence tomography angiographic findings of prematurely born children and its relationship with macular edema of prematurity.

PURPOSE: To compare foveal avascular zone (FAZ) area, foveal vascular density (VD), and foveal thickness in pre- and full-term children and to evaluate their relationship with cystoid macular edema (CME) in the prematurity period using spectral domain optical coherence tomography angiography (SD-OCTA). METHODS: OCTA imaging was performed at 4-6 years of age in 90 eyes of 45 prematurely born children and 50 eyes of 25 term children. Subjects were divided into three groups: prematurely born with CME (group 1); prematurely born without CME (group 2); healthy, term children (group 3). Imaging results in the three groups were compared. RESULTS: FAZ area was significantly larger in group 3 than in groups 1 and 2 (P < 0.001 [ANOVA]). FAZ area was found to be correlated with birth weight (r = 0.511; P < 0.001) and gestational age (r = 0.532; P < 0.001). No significant relationship was found between history of CME and FAZ area. CONCLUSIONS: In our study cohort, FAZ area was smaller in prematurely born children and was correlated with older gestational age and higher birth weight. CME in the neonatal period did not seem to affect retinal microvascular development in premature infants.

Comparison of bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity treatment.

PURPOSE: To compare the efficacy and refractive outcomes of intravitreal bevacizumab, ranibizumab and aflibercept in retinopathy of prematurity (ROP) treatment. METHODS: We analyzed the files of patients treated with intravitreal bevacizumab, ranibizumab and aflibercept for ROP, retrospectively. A total of 187 eyes of 111 patients were included. Recurrence time after initial treatment, recurrence rate, age and rate of additional treatment, refractive outcomes in age 1, 2 and 3 were evaluated and compared between the groups. RESULTS: Fifty-four eyes of 30 patients formed bevacizumab group (Group-1), 77 eyes of 47 patients formed ranibizumab group (Group-2) and 56 eyes of 34 patients formed aflibercept group (Group-3). No significant difference was found in gender, gestational age, birth weight and risk factors between the groups (p>0.05). Success rate was higher in group 3, but the difference was not significant (p = 0.174) (74.1% in group-1, 62.4% in group-2 and 76.8% in group-3). Recurrence rate was higher in group 2, but the difference was not significant (p = 0.158) (25.9% in group-1, 37.6% in group-2 and 23.2% in group-3). Recurrence time after initial treatment was significantly shorter in group 2 (p < 0.01). Additional treatment rate was also higher, and the age of additional treatment was lower in group-2 (p < 0.05 and p < 0.01, respectively). We found refractive values more myopic in ages of 1, 2 and 3 in group 1. CONCLUSIONS: Bevacizumab, ranibizumab and aflibercept are effective treatment alternatives for ROP. We observed more frequent and much earlier recurrence in eyes treated with ranibizumab. A myopic shift was found in bevacizumab group. We also emphasize the necessity of longer follow-ups for infants treated with anti-VEGF drugs.

Evaluation of the Findings of Patients Who Underwent Sutureless Flanged Transconjunctival Intrascleral Intraocular Lens Implantation with or without Pars Plana Vitrectomy.

PURPOSE: To compare the visual outcomes and complications of patients who underwent flanged transconjunctival sutureless intrascleral intraocular lens (SIS IOL) implantation after anterior and pars plana vitrectomy. METHODS: All patients who underwent flanged transconjunctival SIS IOL fixation using a 27-gauge needle between September 2017 and November 2019 and were followed up for at least six months were evaluated. The cases in which anterior vitrectomy was performed were classified as Group 1, and those that underwent pars plana vitrectomy were classified as Group 2. The best-corrected visual acuity (BCVA), spherical equivalent values, corneal endothelial cell density, and intraocular pressures were compared between the two groups before and after the operation. Intraoperative and postoperative complications were assessed. RESULTS: The study included 108 eyes of 108 patients who were included in the study. Group 1 consisted of 48 patients and Group 2 comprised of 60 patients. When the findings between Groups 1 and 2 were compared in the postoperative period, there was no statistically significant difference in terms of the mean intraocular pressure increase, endothelial cell density, BCVA, and spherical equivalent value (P=0.818, 0.601, 0.368, and 0.675, respectively). When all the patients were considered as a single group, the mean spherical value at the sixth postoperative month was 0.3 ± 2.2 D (min-max, (-5.5)-(+6)), the mean cylindrical value was -1.7 ± 2.4 D (min-max, (-9.25)-(+4)), and the mean spherical equivalent value was -0.5 ± 2.3 D (min-max, (-6.5)-(+6)). CONCLUSION: The flanged transconjunctival SIS IOL fixation technique performed using a 27-gauge needle is safe and effective in the patient group with aphakia and lens/IOL dislocation or subluxation. However, in patients planned to undergo flanged transconjunctival SIS IOL implantation, pars plana vitrectomy seems to be a more suitable option than anterior vitrectomy to reduce complications.

Are YouTube Videos Useful in Informing Patients about Keratoplasty?

Purpose: The objective of this study was to analyze the quality of videos on YouTube as educational resources about keratoplasty surgery.Methods: The first 100 videos found after the keyword "keratoplasty for patients" was used in the YouTube search engine were included in the study. General video assessment included duration, views, likes, dislikes, and comments. The quality and accuracy of the information were evaluated by 2 independent ophthalmologists using DISCERN score, Journal of the American Medical Association (JAMA) score, global quality score and usefulness scoring system. Interobserver agreement and individual correlations of the data of each video were statistically analyzed.Results: Eighty-four of the first 100 videos met the inclusion criteria. The mean DISCERN score was 42.11, the mean JAMA score was 1.82, the mean global quality score was 2.35, and the mean usefulness score was 2.01. Twenty-eight (33.3%) of the surgical procedures described in the videos were penetrating keratoplasty, 18 (21.4%) were DMEK, 13 (15.5%) were DALK, four (4.8%) were DSAEK, and one (1.2%) was keratoprosthesis, while the remaining 20 (23.8%) videos did not mention any surgical procedure. Of the 84 videos, 26 (31%) had been uploaded by physicians, 46 (54.8%) by university/private health institutions, 11 (13.1%) by health channels, and one (1.2%) by a patient.Conclusion: YouTube is an important platform that can be used by patients to acquire information about keratoplasty. Increasing the number of uploads of informative keratoplasty videos by healthcare professionals will provide higher quality, more reliable, and more instructive content in this area.

Long-term full-field and multifocal electroretinographic changes after treatment with ranibizumab in patients with diabetic macular edema.

PURPOSE: To investigate changes in macular and panretinal neuroretinal functions by electroretinographic examinations in eyes with diabetic macular edema (DME) treated with intravitreal ranibizumab. MATERIAL AND METHODS: Sixty-four patients with DME were included in this prospective study. Patients were treated with ranibizumab injection according to the PRN regimen for over 12 months. Before treatment, all patients underwent fundus fluorescein angiography, optical coherence tomography (OCT), best-corrected visual acuity (BCVA) assessment, full-field (ff-ERG), and multifocal electroretinography (mf-ERG). In monthly visits, BCVA and OCT were performed. Besides, mf-ERG recordings were obtained at months 3, 6, 9, and 12, and ff-ERG was performed at month 12. RESULTS: Fifty-eight patients completed the study. The mean age was 61.1 ± 8.5 (39-80) years. The mean number of injections was 6.19 ± 1.9. The decimal BCVA improved from 0.30 to 0.45 during the 12-month follow-up (p < 0.05). Macular thickness decreased from 413.5 µm to 329.5 µm (p < 0.05). The mf-ERG recordings in the central macular region showed improvements N1 and P1 amplitudes at months 9 and 12. There was a positive correlation between the baseline central (p < 001; r: - 0.378 and p < 0.05; r:-0.335, respectively), the second ring (p < 0.05; r: - 0.260 and p < 0.05; r: - 0.270, respectively) P1- and N1-wave amplitudes, and the BCVA at month 12. Full-field ERG recordings showed that peripheral neuroretinal responses were maintained or improved at month 12. Statistically significant improvements in BCVA and macular thickness were observed at all follow-up visits. CONCLUSION: Multifocal electroretinographic recording started to improve 6 months after the beginning of intravitreal ranibizumab treatment in eyes with DME. This improvement was significant at months 9 and 12. A significant improvement in ff-ERG was observed at month 12.

Prevalence of primary open-angle glaucoma in a Somalia population.

PURPOSE: To determine the prevalence of primary open-angle glaucoma (POAG) in patients over 40 years that presented to our tertiary hospital in Somalia Mogadishu. METHODS: This prospective cross-sectional study included 1550 patients older than 40 years that presented to the ophthalmology clinic of Somalia Mogadishu - Turkey Training and Research Hospital. The patients were evaluated in terms of age, gender, intraocular pressure, and optical cup/disk (C/D) ratio, and central corneal thickness measurements were taken. RESULTS: The prevalence of glaucoma in the study population over the age of 40 years was 7%. The prevalence of glaucoma was 40% in the 40-50-year group, 6.8% in the 50-60-year group, 7% in the 60-70-year group, 9.9% in the 70-80-year group, and 12.3% in the 80-90-year group. The prevalence of glaucoma statistically significantly increased with advancing age (p < 0.001). The mean intraocular pressure was measured as 16.7 ± 3.3 mmHg for the overall patient population, 16.3 ± 2.9 mmHg for the female patients, and 17.1 ± 3.1 mmHg for the male patients. The mean intraocular pressure of the patients diagnosed with POAG was 27.3 ± 4.2 mmHg, and their mean corneal thickness was 507.9 µm, which was significantly lower than the value of the patients without POAG (545.8) (p < 0.001). The mean C/D ratio was calculated as 0.56 ± 0.21 for the patients with POAG and general 0.24 ± 0.16 for the overall patient population, indicating a statistically significant difference (p < 0.001). CONCLUSIONS: A high rate of POAG is seen in patients over 40 years of age in Somalia. The mechanism underlying POAG needs to be investigated in this population.

Ischemia-Modified Albumin Levels and Thiol-Disulphide Homeostasis in Diabetic Macular Edema in Patients with Diabetes Mellitus Type 2.

PURPOSE: It was aimed to assess the role of thiol-disulphide homeostasis and ischemia-modified albumin (IMA) level in the development of diabetic macular edema (DME) in patients with diabetes mellitus type 2 (T2DM). MATERIALS AND METHODS: Sixty-six study patients were divided into two groups. Group I included 43 patients with T2DM and DME, and Group 2 included 23 patients with T2DM without eye involvement. A novel colorimetric method was used to assess thiol-disulphide homeostasis. Between the two groups IMA, total anti-oxidant, and total oxidant levels were measured and compared. RESULTS: In Group 1, total and native thiol levels and disulphide levels were lower compared to Group 2 (p = .025, p < .001 and p = .013, respectively). Disulphide/native thiol, disulphide/total thiol ratios and native thiol/total thiol were similar between the groups. Total anti-oxidant level (TAL) reduced whereas total oxidant level (TOL) increased in Group 1 compared to Group 2 (p = .001, p = .002, respectively). Albumin level decreased, whereas IMA level increased in Group 1 compared to Group 2 (p < .001 for both). CONCLUSIONS: The disruption in thiol/disulphide homeostasis, increased IMA and oxidative stress have an impact on the development of diabetic macular edema.

Effect of macular edema in the premature period on refraction in infants screened and treated for retinopathy of prematurity.

BACKGROUND: To determine the effect of macular edema on refraction in infants with retinopathy of prematurity (ROP) at the ages of one, two and three years using Optical Coherence Tomography (OCT). METHODS: Optical coherence tomography (OCT) was performed to detect and categorize edema in 280 eyes of 280 premature infants. The cross-sectional spectral domain OCT imaging of the macular region was performed between weeks 36 and 42 to assess macular development. Refraction measurement was performed during follow-up at the ages of one, two and three years. Macular thickness, choroidal thickness, macular edema severity, and the spherical, cylindrical and spherical equivalent (SE) values were measured. RESULTS: A positive correlation was found between macular thickness in the premature period and the SE value at age one and a negative correlation at age three. No correlation was found between gestational age and the SE value, but there was a positive correlation between birth weight and the SE value at ages one and two. Although no correlation was determined between edema and gestational age or between edema and birth weight, the prevalence of macular edema in infants with ROP was significantly higher than that of infants without this disease. CONCLUSIONS: Macular edema during the premature period can have an impact on refraction at the ages one, two and three years by effecting the emmetropization process.

The effect of electronic cigarette smoking on retinal microcirculation: Enlargement of the foveal avascular zone.

BACKGROUND: To evaluate retinal microcirculation in electronic cigarette (e-cigarette) smokers using optical coherence tomography angiography (OCTA). METHODS: OCTA measurements were performed on the left eyes of 21 e-cigarette smokers and 21 healthy controls. Superficial and deep foveal, perifoveal and parafoveal vessel densities, outer retina and choriocapillaris flow area, foveal avascular zone (FAZ), and central macular thickness were evaluated in both groups. RESULTS: The FAZ area was larger in e-cigarette smokers than the control group, and the difference was statistically significant (p = 0.003). The superficial foveal, superficial total, deep foveal and deep total vascular densities were significantly lower in the e-cigarette group compared to the control group (p = 0.011, p = 0.012, p = 0.022, and p = 0.041, respectively). Central macular thickness was lower in the e-cigarette smokers but the difference was not statistically significant (p = 0.678). CONCLUSIONS: E-cigarette smoking causes enlargement of the FAZ area and decreases vascular densities.

The Effect of Hemodialysis on Axial Length, Ocular Surface, and Intraocular Pressure in Patients with End-Stage Renal Failure.

PURPOSE: To evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), axial length, and ocular surface in patients with end-stage renal failure after single-session hemodialysis treatment and to examine the correlation of these findings with systemic hemodynamic parameters. PATIENTS AND METHODS: A total of 112 eyes of 112 patients enrolled in a hemodialysis treatment program for three times a week (approximately four hours per session) for at least three months in our hospital between December 2019 and March 2020 were included in the study. Approximately 30 minutes before and after hemodialysis, the best-corrected visual acuity measurement, slit-lamp examination, IOP measurement, and dilated fundus examination with the Goldmann applanation tonometer were performed in all patients. The axial length measurement was undertaken by ultrasonic biometry, and the CCT measurement by ultrasonic pachymetry. The ocular surface evaluation was performed based on the tear breakup time (BUT), basal secretion time (BST) and keratoepitheliopathy score. Blood pressure, serum osmolarity, and body weight were measured before and after hemodialysis. RESULTS: The mean IOP decreased from 12.2 ± 3.5 to 10.8 ± 2.2 mmHg, and the mean decrease was 1.4 ± 2 mmHg, indicating statistical significance (p<0.001). The mean CCT dropped from 502 ± 41.2 to 494.1 ± 35.4 µm, and the mean decrease was 8.1 ± 7.7 µm, which also indicated a statistically significant change (p<0.001). The mean axial length was reduced from 23.1 ± 0.8 to 22.9 ± 0.8 mm. The reduction in the axial length was significant with an average value of 0.26 ± 0.15 mm (p<0.001). When the ocular surface changes were examined, BUT decreased from 7.4 ± 3.1 to 6.3 ± 2.5 s, BST from 8.6 ± 1.7 to 6.6 ± 1.3 mm, and the keratoepitheliopathy score increased from 0.36 ± 0.61 to 1.59 ± 0.93, and all these changes were statistically significant (p<0.001). There was a significant correlation between the axial length change and the IOP change (r=0.202, p=0.03). A significant correlation was also observed between BST and plasma colloid osmotic pressure (r=-0.268, p=0.004). In addition, there was a strong correlation between serum osmolarity and the keratoepitheliopathy score (r=-0.437, p<0.001). CONCLUSION: Hemodialysis causes significant changes in IOP, CCT, axial length, and ocular surface. These changes should be considered in the ophthalmological examination of patients after the hemodialysis session.

Endophthalmitis in Retinopathy of Prematurity after Intravitreal Aflibercept Injection.

We report the case of a male infant who had an intravitreal anti-VEGF (aflibercept) injection for the treatment of retinopathy of prematurity at 35-week postmenstrual age. Four days following the injection, retinal imaging demonstrated a yellowish gray blurred mass that extended into the vitreous in the right eye, and the vitreous body was blurred. After two days, despite starting endophthalmitis treatment, there was still no improvement in the retinal lesion. Due to the worsening of the clinical signs, we decided to perform 25-gauge lens-sparing pars plana vitrectomy.

Inner Retinal Layer Disease: Multiple Sclerosis.

OBJECTIVES: This study was an analysis of the retinal layer thickness in multiple sclerosis (MS) patients using spectral-domain optical coherence tomography (SD-OCT). METHODS: A total of 42 patients diagnosed in the neurology clinic with MS according to the McDonald Criteria and 21 healthy individuals were included in the study and 4 groups were created. The first group comprised 21 eyes of 21 MS patients without eye involvement, the second group was made up of 21 eyes of 21 MS patients with a history of optic neuritis, the third group included the other eye of patients in the second group without a history of optic neuritis, and the fourth group was a control group of 21 eyes of 21 healthy individuals. SD-OCT was used to visualize and measure the retinal layers and the thickness was analyzed using the device software. RESULTS: The mean age of the patient groups was 35.39±7.52 years, while it was 32.86±2.60 years in the control group. The mean duration of the disease was 9.81±6.65 years with a mean of 4.84±2.38 attacks. The ganglion cell layer (GCL) and the inner plexiform layer (IPL) of all of the patients were thinner compared with the control group in the parafoveal and perifoveal areas. All regions of the retinal nerve fiber layer (RNFL) of patients in the second group were thinner than those of the control group. The RNFL, GCL, and IPL in the central, parafoveal and perifoveal macular rings in group 3 were thinner than the group 1 measurements; however, this difference was not statistically significant. Although the RNFL, GCL, and IPL layer thicknesses were lower in group 2 than group 3, only the difference in the parafoveal GCL thickness was statistically significant. CONCLUSION: This study demonstrated that MS affects retinal layer thickness, and particularly the inner retinal layers.

Is age-related macular degeneration a local manifestation of systemic disorder? Changes in nailfold capillaries at age-related macular degeneration.

AIMS: Determining whether nailfold capillary involvement is present in patients with Age-related macular degeneration (AMD) and whether there are different nailfold capillaroscopy findings between wet and dry types. METHODS: From January 2016 to December 2017, with an initial diagnosis of AMD, 53 consecutive adult patients (AMD group) and 91 age- and sex-matched healthy individuals were studied prospectively. There was no history of any other ocular disease and other disease affecting nailfold capillaries. All subjects underwent a complete ophthalmic examination. The classified and advanced stages of wet and dry types were not included. All nailfold capillaroscopy examinations were performed by the same rheumatologist. RESULTS: It was found that the frequency of major capillaroscopic findings such as capillary ectasia, micro-hemorrhage, tortuosity, neo-formation, bizarre capillary, and bushy capillaries increased in the AMD group according to the normal group, but no significant relationship was found for capillary aneurysm. In dry or wet type of AMD in terms of ectasia, micro-hemorrhage, tortuosity, neo-formation, bizarre structure, bushy structure, or aneurism of nailfold capillaries, no significant correlation was found. CONCLUSIONS: Nailfold capillaroscopy can detect microvascular changes in the nailfold capillary, in early and late stages of AMD. There were morphological changes in the nailfold capillaries of AMD patients, suggesting that there are systemic superficial microvascular changes that may be due to the systemic nature of the disease.

Anticataractogenic effect of betaine in chick embryo hydrocortisone-induced cataract model.

Background & objectives: Cataract is one of the leading causes of blindness in the world. The aim of the present study was to investigate anticataractogenic effect of betaine in chick embryo hydrocortisone (HC)-induced cataract model. Methods: The study included 60 fertilized eggs divided into six groups each having 10 eggs: one group treated with only HC (HC group); three treated with both HC and different doses of betaine (HC/B 1.00, HC/B 0.50 and HC/B 0.25 groups) and two non-HC groups treated with only phosphate-buffered saline (PBS group) or betaine (B group). After the injections, lenses of the embryos were removed and classified into five stages according to the lens opacification. The amounts of reduced glutathione (GSH) in the removed lenses were measured. Results: All the lenses in non-HC-treated groups were clear, whereas in the HC-treated group, 90 per cent of the lenses had cataract (stages 4 and 5). The mean score of lens opacity was significantly lower in all HC/B groups compared to HC group (2.4-3.5 vs. 4.4, P<0.05). Among HC/B groups, the HC/B 0.25 group had significantly lower mean score of lens opacity compared to remaining HC/B groups treated with higher doses of betaine. In addition, the mean reduced GSH level was significantly higher in HC/B 0.25 group compared to HC, HC/B 1.00 and HC/B 0.50 groups (P<0.001). Interpretation & conclusions: The present results show beneficial anti-cataract and anti-oxidant effects of 0.25 µmol/egg betaine on HC-induced cataract in the chick embryo.

Bilateral serous retinal detachment accompanied by a rare intraretinal fluid configuration in preeclampsia and PRES Syndrome.

Purpose: To present the association between posterior reversible encephalopathy (PRES) syndrome due to preeclampsia and bilateral serous retinal detachment (SRD) accompanied by intraretinal fluid configuration. Methods: A 24-year-old woman, at 28 weeks of gestation presented with blurred vision bilaterally related to bilateral SRD involving the center of the macula accompanied by intraretinal fluid. The patient was diagnosed as pre-eclampsia accompanied by PRES syndrome. The patient approved and underwent delivery the same day. On day 9, ophthalmologic examination revealed complete resolution of SRD and normal visual acuity bilaterally and cranial MRI showed complete resolution of the vasogenic edema with medical treatment. Conclusion: SRD and accompanying retinal edema must be considered among etiological factors leading to sudden vision loss in patients with preeclampsia and PRES syndrome. Abbreviations: PRES = Posterior reversible encephalopathy, SRD = Serous retinal detachment, SD-OCT = Spectral-domain optical coherence tomography, RPE = Retinal pigment epithelium, CSC = Central serous chorioretinopathy, ONL = Outer nuclear layer, INL = Inner nuclear layer, IPL = Inner plexiform layer, RNFL = retinal nerve fiber layer.

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study.

BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study

ABSTRACT BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.