Comparison of the Effects of Phacoemulsification and Dexamethasone Implantation in the Same Session with Other Phakic Conditions.

Objectives: The objective of the study is to evaluate anatomical and functional results such as best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) in patients who received intravitreal dexamethasone (DEX) implant for diabetic macular edema (DME), and to compare the efficacy according to patients' lens status and concurrent phacoemulsification surgery. Methods: A total of 70 eyes of 55 patients with DME who received intravitreal DEX implantation were included in this retrospective study. Patients who received intravitreal DEX implantation were divided into three groups phaco-DEX (group 1), pseudophakic (group 2), and phakic (group 3). The BCVA, CMT, and IOP changes were compared between the three groups. Results: One month after the intravitreal DEX implant, BCVA improved in all three groups. (p=0.001, p=0.01, and p=0.009, respectively). There was a decrease in CMT at the end of 1st and 4th months in all three groups compared to the preoperative measurements (p=0.005, p<0.001, p<0.001 respectively). While IOP was increased in group 2 and group 3, no IOP increase was observed in group 1. (p=0.41, p=0.01, and p=0.01, respectively). Conclusion: Combining intravitreal DEX implantation with phacoemulsification surgery seems to be an effective and reliable method in patients with DME accompanied by cataract. The IOP elevation in follow-up visits of phakic and pseudophakic patients after intravitreal DEX implantation was not observed in the Phaco-DEX group.

Evaluation of Sudden Visual Loss and Central 10-Degree Visual Field Change Following Glaucoma Surgery in Severe and End-Stage Eyes.

Objectives: The purpose of the study was to evaluate the sudden visual loss and central 10-degree visual field (VF) change following glaucoma surgery in eyes with severe and end-stage glaucoma. Methods: This was a single-center retrospective study. The charts of patients with severe and end-stage glaucoma who had undergone trabeculectomy and Ahmed glaucoma valve (AGV) implantation surgery were reviewed. Patients who had 10-2 Humphrey VF automated (HVFA) at follow-up were included and classified into two following groups: With split fixation on 10-2 HVFA before surgery split fixation group (SFG) and those without split fixation (WSFG). Results: The data of 37 patients in SFG and 28 patients in WSFG were reviewed. The mean follow-up duration was 2.06±0.24 years in SFG and 2±0.3 years in WSFG. 10-2 HVFA revealed that SFG had a mean MD -25.8±5.2 dB preoperatively and -25.2±1.1 dB (p=0.18) at last visit, WSFG had a mean MD -9.8±4.8 dB preoperatively and -10.8±1.5 dB at last visit (p=0.10). In SFG, the mean intraocular pressure (IOP) decreased from 30.1±9.5 mmHg to 12.3±0.62 mmHg (p<0.001), and in WSFG, the mean IOP decreased from 30±6.9 mmHg to 12.3±0.90 mmHg at last visit (p<0.001). There was no statistical difference for visual acuity of both the groups at the follow-up (p=0.30 and p=0.70). In SFG, one patient had wipe-out phenomenon who had undergone AGV surgery. Conclusion: Although wipe-out phenomenon was a rare complication, it can develop not only after trabeculectomy but also after AGV surgery, and patients with split fixation and severe and end-stage glaucoma were at risk for this phenomenon regardless of the type of surgery. Both trabeculectomy and AGV surgery appear to provide stability of the central 10° VF.

Neurobrucellosis Manifesting as an Altitudinal Visual Field Defect.

Brucellosis is a zoonotic disease with a wide range of ophthalmic manifestations, including optic neuritis. It is most commonly caused by the consumption of raw or unpasteurised dairy products. We report a case of a 43-year male patient with an altitudinal visual field defect and unilateral optic neuritis caused by Brucella. While his visual acuity improved within 6 months of receiving anti-Brucella therapy and corticosteroid therapy, the altitudinal visual field defect persisted. Brucellosis can affect the central nervous system and eyes, in addition to having systemic manifestations. The ocular involvement of Brucella remains poorly understood. Early diagnosis and appropriate treatment can prevent serious complications in endemic areas. Key Words: Optic neuritis, Neurobrucellosis, Ocular brucellosis.

Screening for retinopathy of prematurity in a tertiary ophthalmology department in Turkey: incidence, outcomes, and risk factors.

BACKGROUND AND OBJECTIVE: The aim of this study is to determine the incidence of retinopathy of prematurity (ROP), the number of preterm infants requiring treatment for ROP, and the factors influencing the development of ROP requiring treatment in a Turkish population. PATIENTS AND METHODS: Data on 1,252 infants who were screened for ROP in an ophthalmology department were retrospectively reviewed. Infants with a gestational age (GA) of no more than 28 weeks (n = 157) were designated group 1, those between 29 and 32 weeks (n = 572) were assigned to group 2, and those between 33 and 37 weeks (n = 523) were assigned to group 3. RESULTS: In group 1, ROP was detected in 70.0% of infants, 17.8% of whom required therapy. In group 2, ROP was detected in 41.4%, and 4.0% of those required therapy. In group 3, 18.1% were diagnosed with ROP, with 0.8% requiring treatment. CONCLUSION: Retinopathy of prematurity occurs, even among more mature infants, at a frequency that merits astute screening within parameters that reflect socioeconomic differences that appear to have an effect on the incidence.