Evaluation of macular choroidal and microvascular network changes by activity scores and serum antibodies in thyroid eye patients and healthy subjects.

AIM: To investigate the choroidal thickness and the microvascular network changes around the macula in thyroid eye disease (TED) patients at different stages and the relationship of those changes with risk factors, serum antibodies and the severity of TED. METHODS: A total of 85 participants were enrolled. All participants underwent ophthalmology and endocrinology examinations. Subfoveal choroidal thickness (SFCT), superficial (s) and deep (d) foveal avascular zone (FAZ) area, mean (m) and central (c) superficial vascular density (SVD), deep vascular density (DVD) measurements of the enrolled cases were performed with Topcon swept source optical coherence tomography (OCT)/OCT angiography (OCTA) DRI OCT Triton. Multiple linear regression analysis was used to explore the associations between SFCT, FAZ area, SVD, DVD and the relevant factors of TED. RESULTS: Those with active TED patients had higher c-DVD and m-DVD levels (P<0.05), however there is no statistically significant difference in SFCT between active and stable TED patients. Among the serum antibodies, it was observed that s-FAZ and d-FAZ increased, c-SVD and m-SVD decreased in patients with high thyroid stimulating hormone-receptor autoantibodies (TRAB) level, whereas SFCT thickened in patients with high levels of both TRAB and human thyroglobulin (hTG). There was no significant difference in SFCT, FAZ, SVD and DVD measurement at gender, between hyperthyroid and euthyroid patients and among those with or without thyroid papillary carcinoma. CONCLUSION: The results show that both disease activation and serum antibodies differentially affect both superficial and deep retinal vascular density. It has also been shown that high serum antibody levels affect choroidal thickness independent of clinical activity.

Imaging of the lower punctum with anterior segment OCT in patients with dacryocystorhinostomy who underwent bicanalicular silicone tube implantation.

Spectral domain OCT imaging of the lower punctum in cases with silicone tube implantation OBJECTIVE: To record the structural changes in the lower punctum by performing spectral domain anterior segment OCT imaging of dacryocystorhinostomy cases who underwent bicanalicular silicone tube implantation. METHODS: Thirty eyes of 30 patients who underwent bicanalicular Crawford silicone tube implantation with dacryocystorhinostomy were included in the study. The mean age of the cases was 53 ± 13.96 (24-72). Of the cases, 19 were female and 11 were male, 18 of them were operated on the right eye and 12 on the left eye. The lower punctum images of the cases were recorded with spectral domain anterior segment OCT preoperatively and at the 1st day, 1st month and 6th month after explantation of the silicone tube. In the lower punctum, external punctal width(EPW) and canaliculi depth (CD) were measured. RESULTS: The mean EPW and CD measurements of the cases in the preoperative period, respectively; 544.90±144.11 µm and 451.70±197.45 µm. First day after silicone tube explantation, EPW was 818.00±186.83 µm and CD was 735.35±337.15 µm, at 1st month EPW was 665.95±142.12 µm and CD was 619.30±212.11 µm and at 6th months EPW was 530±150.29 µm and CD was 558.45±254.37 µm, respectively. Mean EPW values were found to be higher on the first day after extubation than before surgery (p = 0.001). There was no significant difference in the mean EPW values at the first and sixth months after extubation compared to pre-implantation (p>0.05). The mean CD values were higher at the 1st day, 1st month and 6th month after tube explantation than preoperative CD values, they were not statistically significant. CONCLUSIONS: According to the lower punctum OCT imaging data, silicone tube implantations applied to the canalicular system do not create a structurally significant difference in the lower punctum. The punctal opening gradually decreases after extubation. The decrease in EPW values is more pronounced than the decrease in CD values. Silicone tube implantation was more effective in maintaining canaliculi depth compared to external punctal diameter.

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.

Anterior segment optical coherence tomography findings in leukemic iris infiltration.

Iris involvement by acute lymphoblastic leukemia is a very rare primary leukemic infiltration. Blurred vision, conjunctival injection, anterior chamber reaction, pseudohypopyon, thickening of the iris stroma, change in iris shape and color are common clinical signs in leukemic iris infiltration. There is no optimal treatment. Radiotherapy, systemic chemotherapy (high-dose of methotrexate and/or high-dose cytarabine), topical and systemic corticosteroids have been reported as treatment modalities. Herein we present anterior segment optical coherence tomography findings in a 21-years-old, male, diffuse B-cell Acute Lymphoblastic Leukemia (ALL) patient who has a leukemic iris infiltration in his left eye that was successfully treated with intravitreal methotrexate.