Thickness of anterior sclera and corneal layers in systemic sclerosis.

PURPOSE: To evaluate the thickness of anterior sclera and corneal layers in patients with systemic sclerosis. METHODS: The present cross-sectional study included 41 patients with systemic sclerosis and 41 age- and gender-matched healthy controls. The study and control groups were compared in terms of the thickness of anterior sclera, corneal epithelium, Bowman's layer, corneal stroma, and Descemet's membrane-endothelium complex. The thickness measurements were obtained using the anterior segment module of spectral-domain optical coherence tomography. RESULTS: The thickness of anterior sclera, corneal epithelium, Bowman's layer, and Descemet's membrane-endothelium complex were similar in the patients with systemic sclerosis and healthy controls (P > 0.05). Total corneal thickness at the apex was 511.1 ± 33.5 µm in the systemic sclerosis group and 528.4 ± 29.5 µm in the control group (P = 0.015). The corneal stroma was thinner in the systemic sclerosis patients compared to the healthy controls (P = 0.02). CONCLUSIONS: The corneal stroma was thinner in the patients with systemic sclerosis compared to that of healthy controls, while the thickness of the anterior sclera was similar in both groups.

Iris thickness measurements in patients with diabetic retinopathy.

PURPOSE: The aim of the study was to investigate iris alterations in diabetic retinopathy (DR). METHODS: Sixty-nine eyes of 69 patients were recruited and three groups of patients were examined: proliferative DR (n = 25), non-proliferative DR (n = 21) and healthy controls (n = 23). Macular optical coherence tomography (OCT), anterior segment iris OCT, and slit lamp digital camera photographs were taken. The thicknesses of the iris at a distance of 1 mm, 2 mm, and 3 mm from pupil margin were measured via iris OCT. Iris crypt count, furrow extent, color tone and collarette/diameter ratio were measured by means of anterior segment photography. Visual acuity, refractive error, intraocular pressure, and numbers of intravitreal injections were also recorded. RESULTS: The iris thickness measurements at 1 mm from pupil margin were significantly correlated with the macular thickness measurements (r = 0.32, p = 0.016). In the proliferative DR group, total number of injections were significantly correlated with the iris thickness measurements at 1 mm (r = 0.25, p = 0.04). The iris thickness measurements at distances 1 mm, 2 mm, and 3 mm from the pupil margin were similar in all of the groups (p > 0.05). Iris thickness did not correlate with age, intra-ocular pressure and collarette iris ratio in all the participants (p > 0.05). CONCLUSION: Iris thickness is similar in diabetic patients and healthy controls. Meanwhile, iris thickness near the pupillary margin is positively correlated with macular thickness.

Alterations in retinal and choroidal thickness following nonarteritic anterior ischemic optic neuropathy.

PURPOSE: To show alterations of retinal arteriolar caliber (RAC), retinal venular caliber (RVC), retinal nerve fiber layer thickness (RNFLT), peripapillary choroidal thickness (ppCT), and central macular thickness (CMT) in acute and chronic phases of nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: Forty-one eyes of 41 patients with NAION were included in this retrospective study. RAC, RVC, RNFLT, ppCT, and CMT measurements were performed via spectral-domain optical coherence tomography in the acute and chronic phases of NAION. RESULTS: RVC, RNFLT, ppCT, and CMT were significantly thinner in the chronic phase compared to the acute phase (p < 0.001), whereas RAC remained similar throughout the visits (p = 0.26). The visual acuity difference between the acute and chronic phases was not correlated with the changes of RAC, RVC, RNFLT, ppCT, or CMT. CONCLUSIONS: RVC, RNFLT, ppCT, and CMT decreases in the chronic phase when compared to the acute phase of NAION, whereas RAC does not change significantly.

Relationship of Sighting Ocular Dominance with Macular Photostress Test Time and Thickness of the Middle Macular Layers.

SIGNIFICANCE: The mechanisms of sighting ocular dominance, which is particularly important in monovision therapies and sports vision, are not fully understood yet. Whether the macula affects ocular dominance or ocular dominance affects the macula is also a subject of interest. PURPOSE: The aim of this study was to investigate the relationship of sighting ocular dominance with macular photostress test time and middle macular layer thickness. METHODS: One-hundred eyes of 50 healthy adult volunteers were included in this cross-sectional study. Sighting eye dominance was decided by a hole-in-the-card test. The macular photostress test was performed by exposing the eye to the ophthalmoscope light for 10 seconds and measuring the time taken to return to visual acuity within one row of pre-light exposure acuity. The spectral-domain optical coherence tomography examinations were performed to measure thickness of middle macular layers (i.e., outer nuclear, outer plexiform, inner nuclear, and inner plexiform). Refractive error and intraocular pressure (IOP) measurements were also recorded. RESULTS: The comparison of dominant and nondominant eyes in the aspect of refractive error, IOP, and macular photostress test time did not show statistically significant differences (P > .05). The thicknesses of macular outer nuclear, outer plexiform, inner nuclear, and inner plexiform layers were similar in the dominant and nondominant eyes (P > .05). In addition, macular photostress time was not statistically significantly correlated with the thickness of middle macular layers (P > .05). CONCLUSIONS: The thickness of middle macular layers and macular photostress recovery time are similar in dominant and nondominant eyes.

Inner retinal thickness and optic disc measurements in obese children and adolescents.

PURPOSE: This study aimed to evaluate optic nerve head parameters and inner retinal layer thicknesses in obese children and adolescents. METHODS: Forty-one eyes of 41 pediatric obese participants and 41 eyes of 41 age- and sex-matched healthy controls were included in this study. Body mass index was calculated, based on sex and age, using body weight and height measurements. Blood lipid values (i.e., cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride) were measured in obese participants. Optical coherence tomography was used to examine optic nerve head parameters, including rim area, disc area, cup-to-disc ratio, and cup volume, as well as the thicknesses of retinal nerve fiber layers and macular ganglion cell-inner plexiform layers. RESULTS: Optic disc parameters were similar in obese and healthy children (p>0.05). The percentage of binocular retinal nerve fiber layer thickness symmetry was significantly different between obese and control groups (p=0.003). Compared to the control group, participants in the obese group exhibited thinner retinal nerve fiber layers in the superior quadrants (p=0.04) and thinner ganglion cell-inner plexiform layers in the superior-temporal sectors (p=0.04). There were no statistically significant correlations between the ocular parameters and lipid blood test values assessed in this study (p>0.05). Body mass index was significantly negatively correlated with the mean retinal nerve fiber layer thickness (r=-0.33, p=0.03) in the obese group. There was no significant correlation between intraocular pressure and body mass index (r=0.05, p=0.74). CONCLUSION: Compared to healthy children, obese children had greater binocular retinal nerve fiber layer thickness asymmetry and thinner retinal nerve fiber and ganglion cell-inner plexiform layers in several sectors. Blood lipid levels were not associated with retinal thickness or optic disc parameters in obese children.

Inner retinal thickness and optic disc measurements in obese children and adolescents / Espessura retiniana interna e medidas do disco óptico na obesidade pediátrica

ABSTRACT Purpose: This study aimed to evaluate optic nerve head parameters and inner retinal layer thicknesses in obese children and adolescents. Methods: Forty-one eyes of 41 pediatric obese participants and 41 eyes of 41 age- and sex-matched healthy controls were included in this study. Body mass index was calculated, based on sex and age, using body weight and height measurements. Blood lipid values (i.e., cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride) were measured in obese participants. Optical coherence tomography was used to examine optic nerve head parameters, including rim area, disc area, cup-to-disc ratio, and cup volume, as well as the thicknesses of retinal nerve fiber layers and macular ganglion cell-inner plexiform layers. Results: Optic disc parameters were similar in obese and healthy children (p>0.05). The percentage of binocular retinal nerve fiber layer thickness symmetry was significantly different between obese and control groups (p=0.003). Compared to the control group, participants in the obese group exhibited thinner retinal nerve fiber layers in the superior quadrants (p=0.04) and thinner ganglion cell-inner plexiform layers in the superior-temporal sectors (p=0.04). There were no statistically significant correlations between the ocular parameters and lipid blood test values assessed in this study (p>0.05). Body mass index was significantly negatively correlated with the mean retinal nerve fiber layer thickness (r=-0.33, p=0.03) in the obese group. There was no significant correlation between intraocular pressure and body mass index (r=0.05, p=0.74). Conclusion: Compared to healthy children, obese children had greater binocular retinal nerve fiber layer thickness asymmetry and thinner retinal nerve fiber and ganglion cell-inner plexiform layers in several sectors. Blood lipid levels were not associated with retinal thickness or optic disc parameters in obese children.

RESUMO Objetivo: O objetivo deste estudo foi avaliar os parâmetros da cabeça do nervo óptico e a espessura da camada interna da retina em crianças e adolescentes obesos. Métodos: Quarenta e um olhos de 41 participantes pediátricos obesos e 41 olhos de 41 controles saudáveis pareados por idade e sexo foram incluídos neste estudo. O índice de massa corporal foi calculado com base no sexo e na idade, utilizando medidas de peso e estatura corporal. Os valores de lipídios no sangue (colesterol, lipoproteína de baixa e alta densidade e triglicérides) foram medidos nos participantes obesos. A tomografia de coerência óptica foi usada para examinar os parâmetros da cabeça do nervo óptico, incluindo a área da borda, área do disco, razão escavação/disco, volume da escavação, espessura s camadas de fibra nervosa da retina e as camadas plexiformes internas das células ganglionares da mácula. Resultados: Os parâmetros do disco óptico foram semelhantes em crianças obesas e saudáveis (p>0,05). A porcentagem da simetria da espessura da camada de fibras nervosas da retina binocular foi significativamente diferente entre os grupos obesos e controle (p=0,003). Comparados ao grupo controle, os participantes do grupo obeso exibiram camadas mais finas de fibras nervosas da retina nos quadrantes superiores (p=0,04) e camadas plexiformes mais finas da célula ganglionar interna nos setores temporal superior (p=0,04). Não houve correlação significante entre os parâmetros oculares e os valores dos exames de sangue lipídico avaliados neste estudo (p>0,05). O índice de massa corporal foi significativamente correlacionado negativamente com a espessura média da camada de fibras nervosas da retina (r=-0,33, p=0,03) no grupo obeso. Não houve correlação significativa entre a pressão intraocular e o índice de massa corporal (r=0,05, p=0,74). Conclusão: Comparadas às crianças saudáveis, as crianças obe sas apresentaram maior assimetria binocular na espessura da ca mada de fibras nervosas da retina e fibras nervosas da retina mais finas e camadas plexiformes internas das células ganglionares em vários setores. Os níveis de lipídios no sangue não foram associados à espessura da retina ou aos parâmetros do disco óptico em crianças obesas.

Evaluation of corneal layers and anterior sclera in patients with primary Sjögren's syndrome / Avaliação das camadas da córnea e da esclera anterior na síndrome de Sjögren primária

ABSTRACT Purpose: We aimed to compare the thickness of anterior sclera, corneal layers, and pre-ocular tear film between patients with primary Sjögren's syndrome and healthy individuals. Methods: Fifty-one patients with primary Sjögren's syndrome and 41 healthy control participants were recruited in this cross-sectional and comparative study. The thickness of the pre-ocular tear film, corneal epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium were measured on the corneal apex. Anterior scleral thickness was measured at distances of 1 mm and 3 mm from the limbus. The anterior segment module of spectral-domain optical coherence tomography was used to measure thicknesses of pre-ocular tear film, corneal layers, and anterior sclera. Results: Tear film thickness, Schirmer's test, and tear break up time values were significantly lower in the Sjögren's disease group than in the healthy controls (p<0.05). The thickness measurements of corneal layers and sclera were similar between the groups. Tear film thickness was moderately correlated with the Schirmer's test results (r=0.34, p=0.001), but there was no correlation between the Schirmer's test results and tear break up time (r=0.18, p=0.09). Conclusions: Pre-ocular tear film, as measured by anterior segment optical coherence tomography, was thinner in patients with primary Sjögren's syndrome than in the healthy controls. The thicknesses of corneal layers and anterior sclera were similar between the groups.

RESUMO Propósito: Nosso objetivo foi comparar a espessura da esclera anterior, camadas da córnea e do filme lacrimal pré-ocular entre pacientes com síndrome de Sjögren primária e indivíduos saudáveis. Métodos: Cinquenta e um pacientes com síndrome de Sjögren primária e 41 controles saudáveis foram recrutados neste estudo comparativo e transversal. A espessura do filme lacrimal pré-ocular, epitélio corneal, camada de Bowman, estroma, membrana de Descemet e endotélio foram medidos no ápice corneal. A espessura da esclera anterior foi medida às distâncias de 1 mm e 3 mm do limbo. O módulo do segmento anterior da tomografia de coerência óptica de domínio espectral foi utilizado para mensurar as espessuras do filme lacrimal pré-ocular, camadas da córnea e esclera anterior. Resultados: A espessura do filme lacrimal, o teste de Schirmer e os valores do tempo de ruptura do filme lacrimal foram significativamente menores no grupo com síndrome de Sjögren do que nos controles saudáveis (p<0,05). As medidas de espessura das camadas corneais e da esclera foram similares entre os grupos. A espessura do filme lacrimal foi moderadamente correlacionada com os resultados do teste de Schirmer (r=0,34, p=0,001), mas não houve correlação entre os resultados do teste de Schirmer e tempo de ruptura (r=0,18, p=0,09). Conclusões: O filme lacrimal pré-ocular, medido pela tomografia de coerência óptica de segmento anterior, foi mais fino em pacientes com síndrome de Sjögren primária do que nos controles saudáveis. As espessuras das camadas da córnea e da esclera anterior foram semelhantes entre os grupos.

Evaluation of corneal layers and anterior sclera in patients with primary Sjögren's syndrome.

PURPOSE: We aimed to compare the thickness of anterior sclera, corneal layers, and pre-ocular tear film between patients with primary Sjögren's syndrome and healthy individuals. METHODS: Fifty-one patients with primary Sjögren's syndrome and 41 healthy control participants were recruited in this cross-sectional and comparative study. The thickness of the pre-ocular tear film, corneal epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium were measured on the corneal apex. Anterior scleral thickness was measured at distances of 1 mm and 3 mm from the limbus. The anterior segment module of spectral-domain optical coherence tomography was used to measure thicknesses of pre-ocular tear film, corneal layers, and anterior sclera. RESULTS: Tear film thickness, Schirmer's test, and tear break up time values were significantly lower in the Sjögren's disease group than in the healthy controls (p<0.05). The thickness measurements of corneal layers and sclera were similar between the groups. Tear film thickness was moderately correlated with the Schirmer's test results (r=0.34, p=0.001), but there was no correlation between the Schirmer's test results and tear break up time (r=0.18, p=0.09). CONCLUSIONS: Pre-ocular tear film, as measured by anterior segment optical coherence tomography, was thinner in patients with primary Sjögren's syndrome than in the healthy controls. The thicknesses of corneal layers and anterior sclera were similar between the groups.

Evaluation of optic disc, retinal nerve fiber and macular ganglion cell layers in pediatric diabetes.

PURPOSE: Our aim was to compare optic disc parameters, retinal nerve fiber (RNFL) and macular ganglion cell layers between children and adolescents with diabetes mellitus (type 1) and healthy controls. METHODS: Sixty-three eyes of 63 pediatric diabetic patients without diabetic retinopathy and 44 eyes of 44 healthy controls were included in this cross-sectional and comparative study. Diabetic and control groups were similar in the aspect of age, gender and refractive error. Measurements of optic disc parameters (i.e., rim area, disc area, cup-to-disc ratio, cup volume), thickness of RNFL and macular ganglion cell-inner plexiform layers (GCL + IPL) were taken with the spectral domain optical coherence tomography. RESULTS: There were not statistically significant differences between the diabetic patients and healthy controls in terms of intraocular pressure (p = 0.14), retinal nerve fiber layer thickness (p = 0.61), rim area (p = 0.92), disc area (p = 0.10), vertical cup-to-disc ratio (p = 0.16), cup volume (p = 0.13), and average macular GCL + IPL thickness (p = 0.43). On the other hand, binocular RNFL thickness symmetry percentage was statistically significantly different in the diabetic and control groups (p = 0.01). CONCLUSION: Diabetic children and adolescents without diabetic retinopathy have more binocular RNFL thickness asymmetry compared to healthy controls.

Correlations of Corneal Optical Densitometry, Endothelial Hexagonality Percentage, and Epithelium Thickness.

PURPOSE: Our aim was to examine the associations between the cornea morphological parameters, endothelial cell density, and anterior chamber measurements. METHODS: This observational study included 50 eyes of 50 healthy volunteers. The thicknesses of corneal epithelium, Bowman's layer, stroma, Descemet's membrane-endothelium complex, and pre-ocular tear film were measured by means of anterior segment optical coherence tomography. The keratometry (K), corneal volume (CV), corneal optical densitometry (COD), iridocorneal angle (ICA), anterior chamber depth (ACD), and anterior chamber volume (ACV) measurements were taken by the Scheimpflug anterior segment imaging. The corneal endothelial cell density and percentage of hexagonality were measured by specular microscopy. RESULTS: The COD was only correlated with the thickness of Bowman's layer (r = -0.30, p = 0.035). The hexagonal endothelial cell percentage was correlated with the thickness of the pre-ocular tear film (r = -0.50, p < 0.001), ACD (r = 0.40, p = 0.004), and ACV (r = 0.34, p = 0.015). The corneal epithelium thickness was associated with the ACD (r = 0.30, p = 0.034), ACV (r = 0.34, p = 0.018), K-flat (r = -0.35, p = 0.013), and K-steep (r = -0.29, p = 0.038) readings. CONCLUSIONS: The anterior chamber morphological parameters (i.e., ACV, ACD) were significantly positively correlated with the hexagonal endothelial cell percentage and corneal epithelium thickness in healthy adults.

Assessment of optic disc and ganglion cell layer in diabetes mellitus type 2.

The purpose of this study was to compare the optic disc parameters, retinal nerve fiber (RNFL), and macular ganglion cell layers between patients with diabetes mellitus (DM) type 2 and healthy controls.In this cross-sectional study, 69 eyes of 69 diabetic patients without diabetic retinopathy and 47 eyes of 47 healthy controls were included. Optic disc parameters (i.e., rim area, disc area, cup to disc ratio, cup volume), RNFL, and macular ganglion cell-inner plexiform layers (GCL + IPL) thickness were measured by means of spectral domain optical coherence tomography.There were not statistically significant differences between the diabetic patients and healthy controls in terms of RNFL thickness (P = .32), rim area (P = .20), disc area (P = .16), cup volume (P = .12), and average macular GCL + IPL thickness (P = .11). Nevertheless, binocular RNFL thickness symmetry percentage (P =.03), average cup to disc ratio (P = .02), and superior-nasal macular GCL + IPL thickness (P = .04) were statistically significantly different in the diabetic and control groups.Diabetic patients without retinopathy have more binocular RNFL thickness asymmetry, higher cup to disc ratio, and thinner sectoral macular GCL + IPL when compared to healthy controls. Our results may support the statement that DM causes inner retinal neurodegenerative changes.

Publication trends in corneal transplantation: a bibliometric analysis.

BACKGROUND: Our aim was to demonstrate the publication trends of corneal transplantation in the last decade. METHODS: All of the keratoplasty research articles, letters, case reports, reviews and meeting abstracts published between January 2006 and December 2015 indexed on the Thomson Reuters Web of Knowledge were evaluated. A bibliometric filter was used to capture keratoplasty related publications by using the key words 'keratoplasty', 'corneal transplantation' or 'keratoprosthesis' in the 'title' selection mode. RESULTS: A total of 2726 publications were evaluated in the present study. Documents related to penetrating keratoplasty only have been decreased, whereas the documents related to endothelial keratoplasty were increased in the last decade. The total keratoplasty publication counts had been increased from the year 2006 to 2015. The average citation count per keratoplasty documents was 9.34. CONCLUSIONS: There is a growing interest to the lamellar keratoplasty techniques especially the endothelial keratoplasty in the last decade.

Effects of ocular dominance on contrast sensitivity in middle-aged people.

Purpose. Our aim was to compare contrast sensitivity values of the dominant and nondominant eyes of healthy middle-aged subjects. Material and Methods. Ninety eyes of 45 healthy middle-aged subjects (30 males and 15 females) were included in this study. Patients were aged between 40 and 60 years, having uncorrected visual acuity (UCVA) of 20/25 or better (Snellen chart). Ocular dominance was determined by hole-in-the-card test. Functional acuity contrast testing (F.A.C.T.) was measured using the Optec 6500 vision testing system (Stereo Optical Co. Inc., Chicago, IL, USA) under both photopic and mesopic conditions. Results. At all spatial frequencies (1.5, 3, 6, 12, and 18 cpd), under mesopic conditions, the contrast sensitivity values of the dominant eyes were slightly greater than those of the nondominant eyes; but only 18 cpd spatial frequency measurements' difference was statistically significant (P = 0.035). Under photopic conditions, the contrast sensitivity values of the dominant eyes and non-dominant eyes were similar at all spatial frequencies (P > 0.05). Conclusions. The photopic and mesopic contrast sensitivity values of dominant and nondominant eyes of healthy middle-aged people were similar at all spatial frequencies, except at mesopic 18 cpd spatial frequency.

Impact of Valsalva maneuver on corneal morphology and anterior chamber parameters.

PURPOSE: Our aim was to examine the influence of the Valsalva maneuver (VM) on corneal morphology and anterior chamber parameters. METHODS: This prospective observational study included 35 eyes of 35 healthy volunteers. One of the eyes of each subject was selected randomly. The keratometry (K), pachymetry, corneal volume, iridocorneal angle, anterior chamber depth, anterior chamber volume, and corneal wave front measurements (high-order aberration, low-order aberration, total root mean square) were performed with the Pentacam HR (Oculus, Wetzlar, Germany). RESULTS: The subjects were aged between 22 and 41 years. There were 24 men (69%) and 11 women (31%). The VM did not have any significant influence on K-flat and K-average values (P > 0.05), but it decreased K-steep values significantly (P = 0.006). The VM did not have any significant impact on low-order aberrations and total root mean square parameters (P > 0.05), but it increased high-order aberrations significantly (P = 0.008). The central corneal thickness and corneal volume decreased significantly during the VM (P < 0.05). The iridocorneal angle, anterior chamber depth, and anterior chamber volume decreased markedly during the VM (P < 0.001). CONCLUSIONS: The VM has some influence on corneal morphology and anterior chamber parameters, so that it should be considered during anterior segment examinations and operations.