The relationship of central corneal thickness with the status of diabetic retinopathy.

BACKGROUND: To compare central corneal thickness (CCT) values measured by three different devices: slit-scanning topography (SST), ultrasonic pachymetry (UP), and optical coherence tomography (OCT) in diabetic eyes and compare the CCT values in patients with and without diabetic retinopathy. METHODS: Ninety-six patients with diabetes mellitus were included in this prospective study and divided into two groups according to the presence of diabetic retinopathy, as Group I with retinopathy and Group II without. The CCT of 96 eyes was measured by three different devices; SST (Orbscan II), UP and OCT. The results of CCT measurements with three different devices were compared. Also, the intergroup differences in CCT measurements were evaluated. RESULTS: The CCT was statistically insignificantly different between the two groups. Although the three methods of CCT measurements correlated well with each other, SST showed significantly (p < 0,0001) higher CCT results compared to both UP and OCT. CONCLUSIONS: According to our results, neither the duration of DM nor the presence of diabetic retinopathy did have a significant effect on the CCT. The CCT values obtained with three devices were all in correlation. However, the results of SST were significantly higher compared to the other two. Our findings emphasize the value anterior segment OCT in CCT measurements, since it is a non-contact method and correlate very well with UP.

Effect of diluted povidone iodine in adenoviral keratoconjunctivitis on the rate of subepithelial corneal infiltrates.

AIM: To evaluate the clinical characteristics of adenoviral keratoconjunctivitis, the management modalities, as well as the incidence of subepithelial corneal infiltrates (SEI). METHODS: Patients with characteristic clinical symptoms and signs, who presented to our clinic within the first week of symptoms and received the diagnosis of adenoviral keratoconjunctivitis between January 2013 and April 2016, were included in the study. A total of 211 patients were included in the study. Patients were evaluated for the incidence of clinical signs, late complications, management preferences, and the effect of diluted povidone-iodine (d-PVP-I) 2%. RESULTS: Patients' mean age was 33.03±14.76y. We observed an increase in the number of cases according to the years. At presentation and/or early follow-up, the clinical signs were conjunctival hyperemia (100%), conjunctival follicules (79.1%), edema of the eyelids (39.3%), chemosis (16.1%), pseudomembrane formation (16.6%), and corneal epitheliopathy (29.9%). During late follow-up 13.3% patients developed conjunctival subepithelial fibrosis, and 39.8% developed SEI. A significant decrease in the incidence of SEI development was observed in patients who used d-PVP-I 2% (P=0.032; 33.3% vs 45.9%, respectively in patients who received d-PVP-I 2% and who did not). CONCLUSION: Adenoviral keratoconjunctivitis has a tremendous effect on patient's comfort and abilities in short-term. Additionally, almost half of the patients develop visual problems related to SEI. According to our clinical experience, using d-PVP-I 2% in the first days of adenoviral keratoconjunctivitis might be helpful in reducing the risk of SEI as a complication.

Effect of Latanoprost on Choroidal Thickness.

PURPOSE: The purpose of this study was to evaluate the changes in choroidal thickness during the use of latanoprost eyedrops which shift fluid to the suprachoroidal space and change choroidal perfusion. MATERIALS AND METHODS: This prospective study included 34 eyes of 17 bilateral glaucoma or ocular hypertensive patients who had no previous hypotensive therapy. Each patient had both eyes treated with latanoprost. Each patient also underwent a complete ophthalmological examination and optical coherence tomography measurement. Choroidal thickness measurements by optical coherence tomography were carried out on the first visit before latanoprost use and at time intervals of 7 and 30 days of therapy. RESULTS: The patients' mean age was 62.3±11 years (range, 30 to 83 y). Of 17 patients, 7 were female individuals. There were no significant differences in central choroidal thicknesses at the fovea, or at each point within the horizontal nasal and temporal quadrants between visits (P<0.05 for all comparisons). CONCLUSIONS: The current study showed that choroidal thickness does not change after latanoprost therapy. However, the choroidal changes of anterior part of the eye can be effected by the latanoprost therapy. Future studies investigating the anterior part of the eye and focusing on both choroidal perfusion and choroidal thickness may give additional information concerning the mechanism of action.

Influence of glycosylated hemoglobin on the choroidal thickness.

PURPOSE: The aim of the study reported here was to assess the influence of serum HbA1c levels on foveal choroidal thickness in diabetic patients. METHODS: A total of 122 eyes from 122 patients who had type 2 DM were studied in this prospective, cross-sectional study. Patients were divided into three groups: 43 patients (43 eyes) without diabetic retinopathy (NDR), 39 patients (39 eyes) with diabetic retinopathy and no macular edema (DR/ME-), 40 patients (40 eyes) with diabetic retinopathy and macular edema (DR/ME+). Central foveal thicknesses and subfoveal choroidal thicknesses were noted. Subfoveal choroidal thickness measurement was taken perpendicularly from the outer part of the retinal pigment epithelial layer to the line corresponding to the choroidal-scleral junction. Serum glycosylated hemoglobin (HbA1c) levels were evaluated. RESULTS: No significant differences in age, gender, pseudophakia were observed between the groups. There was no significant difference in HbA1c value among the three diabetic groups. Mean foveal choroidal thickness was 270.09 ± 42.41 in NDR group, 243.18 ± 30.21 in DR/ME- group and 250.90 ± 40.06 in DR/ME+ group. Mean foveal choroidal thickness in NDR group was significantly different from DR/ME- group. There was no statistically significant difference between the other groups among foveal choroidal thicknesses. There was no correlation between HbA1c and foveal choroidal thickness. Multiple regression analyses of two diabetic retinopathy groups showed no significant correlation between foveal choroidal thickness and HbA1c and also no significant correlation between foveal choroidal thickness and duration of diabetes. CONCLUSIONS: Serum HbA1c levels were not correlated with foveal choroidal thickness. Choroidal thickness is effected by several factors as axial length, age and systemic diseases.

Measurements of Retinal Nerve Fiber Thickness and Ganglion Cell Complex in Neurofibromatosis Type 1, with and Without Optic Pathway Gliomas: A Case Series.

PURPOSE: The aim of this study was to investigate differences in retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in neurofibromatosis 1 (NF1) cases, with and without optic pathway gliomas (OPGs). MATERIALS AND METHODS: In total, 33 eyes of 33 subjects were evaluated in this prospective observational case series. Twenty-one patients with a diagnosis of NF1 were enrolled. Patients with NF1 and OPGs were included in Group 1 (n = 9), and patients with NF1 without OPGs were included in Group 2 (n = 12). The control group (Group 3) was comprised of 12 age- and sex-matched subjects with no history of ophthalmic or systemic diseases. All of the subjects underwent complete ophthalmic examinations, including best-corrected visual acuity (BCVA), slit lamp microscopy, and indirect ophthalmoscopy. Additionally, optical coherence tomography (OCT) measurements were obtained. RESULTS: There were no statistically significant between-group differences in age and sex (p = 0.227 and 0.986, respectively). The average RNFL thickness in Group 1 (NF1 patients with OPGs) was significantly lower than in Groups 2 and 3 (86.6 ± 22.5, 107.4 ± 6.65, and 108.4 ± 5.05 µm, respectively; p = 0.001). Furthermore, the average GCC thickness in Group 1 was significantly lower than in Groups 2 and 3 (78.6 ± 16.3, 94.8 ± 3.55, and 94.9 ± 3.82 µm, respectively; p < 0.001). CONCLUSIONS: Both RNFL and GCC thicknesses were significantly lower in NF1 patients with OPGs. The use of OCT to quantify damage to the visual pathway may enable earlier detection of OPGs in NF1 patients.

Intravitreal Ranibizumab Injection in Peripapillary CNVM Related to Idiopathic Intracranial Hypertension.

Peripapillary choroidal neovascular membrane (CNVM) may develop in papilledema related to idiopathic intracranial hypertension. The authors present a teenaged boy who responded well to one dose of intravitreal ranibizumab injection. [J Pediatr Ophthalmol Strabismus. 2017;54:e27-e30.].

Choroidal thickness measurements with optical coherence tomography in branch retinal vein occlusion.

AIM: To evaluate central macular thickness (CMT) and mean choroidal thickness (MCT) in eyes with branch retinal vein occlusion (BRVO), before and after ranibizumab treatment using spectral domain-optical coherence tomography (SD-OCT). METHODS: Forty-two patients with unilateral BRVO and macular edema were included in this study. There were 25 men and 17 women. Using SD-OCT, choroidal thickness was measured at 500 µm intervals up to 1500 µm temporal and nasal to the fovea. MCT was calculated based on the average of the 7 locations. All the eyes with BRVO were treated with intravitreal ranibizumab (0.5 mg/0.05 mL). Comparisons between the BRVO and fellow eyes were analyzed using Mann-Whitney U test. Pre-injection and post-injection measurements were analyzed using Wilcoxon test and repeated measure analysis. RESULTS: At baseline, there was a significant difference between the BRVO and fellow eyes in MCT [BRVO eyes 245 (165-330) µm, fellow eyes 229 (157-327) µm] and CMT [BRVO eyes 463 (266-899) µm, fellow eyes 235 (148-378) µm (P=0.041, 0.0001, respectively)]. Following treatment, CMT [295 (141-558) µm] and MCT [229 (157-329) µm] decreased significantly compared to the baseline measurements (P=0.001, 0.006, respectively). Also BCVA (logMAR) improved significantly (P=0.0001) in the BRVO eyes following treatment. After treatment CMT [BRVO eyes 295 (141-558) µm, fellow eyes 234 (157-351) µm] and MCT [BRVO eyes 229 (157-329) µm, fellow eyes 233 (162-286) µm] values did not reveal any significant difference in BRVO eyes and fellow eyes (P=0.051, 0.824, respectively). CONCLUSION: In eyes with BRVO, CMT and MCT values are greater than the fellow eyes, and decrease significantly following ranibizumab injection.

Epidermoid Cyst of Orbit in a Newborn.

A 3-day-old male newborn presented with a severe proptosis of the left eye leading to exposure keratopathy. He underwent debulking of the cyst and biopsy of the tumour and received the pathological diagnosis of epidermoid cyst of orbit. Clinicopathological features of this rare disease are discussed.

Hyperbaric oxygen therapy in combination with systemic treatment of sickle cell disease presenting as central retinal artery occlusion: a case report.

INTRODUCTION: We describe hyperbaric oxygen therapy for the treatment of central retinal artery occlusion in a young adult with sickle cell disease. CASE PRESENTATION: A 25-year-old Turkish man with a history of sickle cell disease developed sudden painless loss of vision in the left eye and was hospitalized for diagnosis and treatment. Central retinal artery occlusion was diagnosed with retinal whitening, cherry red spot, and delayed arteriovenous transit on fluorescein angiography. He underwent exchange transfusion and hyperbaric oxygen therapy. In the following three months, his visual acuity improved to 20/30. CONCLUSIONS: In this present case with sickle cell disease, the visual acuity improved with hyperbaric oxygen therapy in addition to systemic therapy. The result of our case suggests that hyperbaric oxygen therapy may be beneficial in the treatment of central retinal artery occlusion.

Retinal and choroidal thickness changes after single anti-VEGF injection in neovascular age-related macular degeneration: ranibizumab vs bevacizumab.

PURPOSE: To evaluate and compare the effects of single intravitreal injection of ranibizumab and bevacizumab on central retinal and choroidal thickness in patients with neovascular age-related macular degeneration (AMD). METHODS: Forty eyes of 40 patients with neovascular AMD that underwent intravitreal injection of vascular endothelial growth factor inhibitors (anti-VEGFs) were included. Patients were randomized into 2 groups: 20 eyes received ranibizumab and 20 eyes received bevacizumab injection. Central retinal and choroidal thicknesses of all eyes at baseline and 1 month postinjection scans were measured with Fourier-domain optical coherence tomography (OCT). Student t test and Mann-Whitney U test were used to compare the data. RESULTS: The mean central retinal thickness (CRT) showed significant decrease after single injection of ranibizumab (from 345.0 µm to 253.5 µm, p<0.01) and bevacizumab (from 329.5 µm to 251.0 µm, p<0.01) at the first month, respectively. There was no significant difference regarding the CRT change between groups (p = 0.39). The mean choroidal thickness decreased from 158.6 µm (115-317) to 155.5 µm (111-322) in the ranibizumab group and from 211.5 µm (143-284) to 201.5 µm (93-338) in bevacizumab group. The decrease was not significant between groups (p = 0.35). CONCLUSIONS: Intravitreal injection of both ranibizumab and bevacizumab provided a significant decrease in CRT; however, the agents caused no significant change in choroidal thickness. Additionally, no difference between ranibizumab versus bevacizumab was observed related to macular edema inhibition.

Interexaminer reproducibility of optical coherence tomography for measuring the tear film meniscus.

PURPOSE: New optical coherence tomography (OCT) devices with anterior segment module are able to measure the tear meniscus height (TMH) and tear meniscus area (TMA). Since the borders of the area and the height are to be marked by an examiner, the measurements are prone to be subjective. Herein, we aimed to evaluate the interexaminer reproducibility of the tear meniscus measurements with OCT. MATERIALS AND METHODS: In this prospective cross-sectional study, both eyes of 300 consecutive patients with and without dry eye were studied. Following routine ophthalmologic examination, tear-film OCT images were obtained. Two examiners, who were unaware of the other examiner's results, measured the TMH (i.e. the line connecting the intersection of the meniscus with the cornea/sclera and eyelid) and cross-sectional TMA. The reliability and correlation of the two examiners' results were assessed. RESULTS: Four right and six left eyes were excluded from the final analysis, so a total of 590 eyes were evaluated. The mean difference of the two examiners' measurements of both eyes was -0.001 ± 0.027 mm(2) in TMA, and -21.29 ± 39.95 µm in TMH. An agreement between the two examiners was found regarding TMA and TMH measurements for right and left, as well as both eyes (Cronbach's alpha > 0.900, for all). Also, the correlation between both variables was high (inter item correlation matrix > 0.840, for all). CONCLUSIONS: We showed a strong statistical agreement for both TMA and TMH measurements. According to our results, we believe that FD-OCT device is dependable in measuring the TMA and TMH values, given that its results are reproducible.

Visual outcome of intravitreal ranibizumab for exudative age-related macular degeneration: timing and prognosis.

PURPOSE: To describe 1-year clinical results of intravitreal ranibizumab treatment in patients with choroidal neovascularization secondary to exudative age-related macular degeneration (AMD) and to evaluate whether early treatment is a predictive value for prognosis of the disease. MATERIALS AND METHODS: Clinical records were retrospectively reviewed of 104 eyes that underwent intravitreal ranibizumab therapy for exudative AMD. Patients were divided into two groups according to their symptom duration: group 1, <1 month; and group 2, 1-3 months. After three monthly injections, patients were examined monthly, and subsequent injections were performed as needed. RESULTS: There were 43 female (48.9%) and 45 males (51.1%). The follow-up time was 13.7±1.9 (12-19) months. The mean logarithm of minimum angle of resolution best-corrected visual acuity (BCVA) improved significantly, from 0.45±0.639 at baseline to 0.08±0.267 at 12 months in group 1, and from 1.06±0.687 at baseline to 0.75±0.563 at 12 months in group 2. The increase in BCVA was statistically significant in group 1 (P=0.009). The mean central retinal thickness (CRT) decreased significantly, from 355.13±119.93 µm at baseline to 250.85±45.48 µm at 12 months in group 1, and from 371.88±91.047 µm at baseline to 268.61±53.51 µm at 12 months in group 2. The decrease in CRT was statistically significant in group 1 (P=0.001). CONCLUSION: Intravitreal ranibizumab therapy was effective in significantly increasing mean BVCA and reducing CRT. Shorter duration of AMD, as measured by the subjective duration of visual symptoms, is associated with better visual outcome after treatment.

Surgical results of combined pars plana vitrectomy and phacoemulsification for vitreous hemorrhage in PDR.

BACKGROUND: The purpose of this study was to evaluate the effectiveness, safety, and incidence of complications after combined clear corneal phacoemulsification with intraocular lens implantation and pars plana vitrectomy in eyes with proliferative diabetic retinopathy coexistent with significant cataract. METHODS: Eighty-five eyes of 85 patients with proliferative diabetic retinopathy underwent primary standard three-port vitrectomy with 20-gauge instruments and phacoemulsification with intraocular lens implantation for vitreous hemorrhage from 2008 to 2011. The main outcome measures were visual outcomes and surgical complications. RESULTS: Forty patients were male and 45 were female. Their age ranged from 40 to 77 years with a mean of 59.6 years. The mean follow-up was 13 months, with a range of 6-48 months. The preoperative logMAR visual acuity changed from 2.62 ± 0.6 to 0.8 ± 0.7 postoperatively. Postoperatively, visual acuity improved in 79 eyes (92.9%), and did not change in six eyes (7.1%). Intraoperative complications were transient corneal edema (five eyes) and posterior capsular rupture (one eye). Postoperative complications consisted of transient intraocular pressure elevation (25 eyes), corneal epithelial defects (six eyes), anterior chamber reaction (four eyes), hyphema (two eyes), posterior synechiae (four eyes), vitreous hemorrhage (23 eyes), retinal tears (five eyes), retinal detachment (one eye), and neovascular glaucoma (one eye). CONCLUSION: Our study suggests that the combined operation of pars plana vitrectomy, phacoemulsification, and intraocular lens implantation is safe and effective for patients with proliferative diabetic retinopathy. We believe that the visual outcome and complications depended primarily on underlying posterior segment pathology and were not related to the combined procedure technique.

Periocular Paederus dermatitis mimicking preseptal cellulitis.

OBJECTIVE: To introduce clinical and demographic characteristics of our patients with periocular Paederus dermatitis. DESIGN: Retrospective study. PARTICIPANTS: Thirteen patients diagnosed with periocular Paederus dermatitis. METHODS: We included patients who presented to our ophthalmology clinic with pain, hyperemia, and tenderness on the eyelids, and were diagnosed with Paederus dermatitis based on clinical characteristics on dermatologic and ophthalmologic evaluation. Mean age was 31.5 years, and 31% of patients were female. RESULTS: Subjective complaints included burning and epiphora in 85% and itching in 15% of the patients. Clinical findings on the eyelid skin were erythematous patches and plaques with multiple pustules (69%), erosions and bulla remnants on an erythematous base (7.7%), squamous and crusted patches and plaques (15%), and erythematous patches (7.7%). In 85% of the patients, similar lesions were detected on the other parts of the face. The treatment comprised wet dressings, weak steroid ointments for erythematous areas, and antibiotic ointments for crusted areas. Fifteen percent of the patients received methyl-prednisolone because they had significant periorbital edema. The lesions had improved in all patients at the 1-week visit after treatment. CONCLUSIONS: Paederus dermatitis should be considered in the differential diagnosis of periocular infections and preseptal cellulitis. Meticulous questioning is of utmost importance for correct diagnosis and may prevent unnecessary systemic antibiotic use.

Optical coherence tomography for measuring the tear film meniscus: correlation with schirmer test and tear-film breakup time.

PURPOSE: To compare tear meniscus height (TMH) and area (TMA) values obtained by optical coherence tomography (OCT) with the Schirmer test and tear-film break-up time (TBUT) values. MATERIALS AND METHODS: In this prospective cross-sectional study, the right eyes of 300 consecutive patients were studied. All patients underwent routine ophthalmologic examination. Schirmer and TBUT measurements were taken, and tear-film OCT images were obtained. Using OCT, the TMH (i.e. the line connecting the intersection of the meniscus with the cornea and eyelid) and cross-sectional TMA were calculated. Patients were divided into Groups 1 (Schirmer values ≤5 mm) and 2 (Schirmer values >5 mm). Data were analyzed using SPSS 13.0 software. The Mann-Whitney U-test was used for the comparison of groups. Correlations between tear parameters were analyzed. RESULTS: There were no significant differences in age, logMAR, or IOP values (p = 0.480, 0.077 and 0.146, respectively) between the two groups. Mean TBUTs were 5.1 ± 2.9 and 9.5 ± 4.2 s for Groups 1 and 2, respectively (p < 0.001). Mean TMHs were 237.9 ± 108.9 and 324.3 ± 158.9 µm for Groups 1 and 2, respectively (p < 0.001). Mean TMAs were significantly lower in Group 1 compared to Group 2 (p < 0.001; 0.027 ± 0.028 versus 0.055 ± 0.059 mm(2), respectively). Correlations between Schirmer values and TMH, and between Schirmer values and TMA, were significant (p = 0.001 and <0.001, respectively). CONCLUSIONS: OCT values were significantly lower in patients with Schirmer values of <5 mm. Tear meniscus measurements obtained by OCT are reliable for establishing a diagnosis of dry eye.

Risk factors for intraocular pressure rise following phacoemulsification.

PURPOSE: This study was designed to analyze the risk factors resulting in high intraocular pressure (IOP), which was accepted as IOP higher than 22 mmHg, following uncomplicated phacoemulsification. MATERIALS AND METHODS: The records of 812 eyes of 584 patients who underwent uncomplicated phacoemulsification were evaluated. There were 330 men and 254 women ranging between the age of 26 and 89 years (65.4 ± 9.8 years). The preoperative, postoperative first day (day 1), first week (day 7), and first month (day 30) IOP values were analyzed. Data on history of diabetes, glaucoma, pseudoexfoliation (PXF), incision site, capsular staining with trypan blue, and surgeon were recorded. A multinomial regression analysis was performed to analyse the relationship of the factors with postoperative high IOP. RESULTS: The mean IOP was 15.6 ± 4.3 mmHg preoperatively. Postoperatively that were changed to 19.7 ± 9.0 mmHg at day 1, 12.7 ± 4.5 mmHg at day 7, and 12.8 ± 3.7 mmHg at day 30. The factors such as surgeon, presence of PXF, diabetes, surgical incision site, and trypan blue were not related to the postoperative high IOP (P > 0.05, in all). The only factor that related to high IOP at all visits was glaucoma (P < 0.005). CONCLUSION: According to our results, preoperative diagnosis of glaucoma seems to be the only factor to affect the postoperative IOP higher than 22 mmHg.

The effect of smoking on choroidal thickness measured by optical coherence tomography.

BACKGROUND/AIMS: To investigate the effect of smoking on choroidal thickness using Fourier domain optical coherence tomography. METHODS: 17 otherwise healthy smokers (study group) and 17 non-smokers (control group) were enrolled. In the study group, all participants underwent optical coherence tomography scanning at baseline, and 1 and 3 h following smoking one standard cigarette. Also the participants of the control group underwent optical coherence tomography scanning in the morning which was followed by two further examinations at the first and third hours, respectively. Choroidal thickness measurements were performed. RESULTS: The mean choroidal thickness at the fovea prior to smoking was 301.1±63.1 µm, which decreased to 284.2±56.7 µm at 1 h and 270.8±80.0 µm at 3 h following smoking (p=0.001). The mean choroidal thickness was significantly decreased following smoking at all five extrafoveal points. The difference in choroidal thickness was not statistically significant at 1 and 3 h of smoking at all six points. In the control group, the mean baseline choroidal thickness at the fovea was 270.6±57.9 µm, which was 272.5±52.4 µm at 1 h and 273.8±57.4 µm at 3 h (p=0.816). CONCLUSIONS: Cigarette smoking causes a significant decrease in choroidal thickness following smoking. Fourier domain optical coherence tomography can effectively demonstrate choroidal thickness.

Late capsular block syndrome presenting with posterior capsule opacification.

PURPOSE: To assess the results of posterior neodymium:YAG (Nd:YAG) laser capsulotomy in patients with late postoperative capsular block syndrome (CBS) with decreased vision because of posterior capsule opacification (PCO). SETTING: Baskent University Hospital, Department of Ophthalmology, Ankara, Turkey. DESIGN: Case-control study. METHODS: Patients with CBS who had phacoemulsification and foldable hydrophilic or hydrophobic acrylic intraocular lens implantation with continuous curvilinear capsulorhexis were retrospectively reviewed. Transparent to slight milky fluid had collected in the capsular bag. Capsular block syndrome was undiagnosed before the PCO developed. The CBS was treated with Nd:YAG laser capsulotomy, after which the change in refraction, corrected distance visual acuity (CDVA), intraocular pressure (IOP), complications, and inflammation rate were evaluated. Follow-up examinations were at 1 day, 1 week, and 1 and 6 months. RESULTS: The mean time between cataract surgery and laser capsulotomy was 48 months ± 10.27 (SD) (range 28 to 66 months). The Nd:YAG capsulotomy was successful in all eyes. Capsulotomy did not change the refraction in 14 eyes (93.3%). One patient (6.6%) had a change of +0.75 diopter. After capsulotomy, the logMAR CDVA improved in 13 cases (mean 0.26 ± 0.18; range 0.0 to 0.7) and did not change in 2 cases. There were no complications, inflammation, or significant IOP changes. CONCLUSIONS: Neodymium:YAG laser capsulotomy in patients with PCO associated with late CBS increased visual acuity without a significant change in refraction or IOP. Capsular block syndrome may be asymptomatic and remain undiagnosed for a long time after cataract surgery before PCO develops.

Recurrent iris cyst discharge.

A 23-year-old woman with the diagnosis of anterior uveitis in the left eye was referred to our clinic. Circumferential midzonal iris epithelial cysts were observed in the right eye and corneal endothelial pigment precipitates and diffuse pigment discharge in the anterior chamber of the left eye. Topical prednisolone acetate was prescribed. After 2 days, hyperemia and pain decreased in the left eye and started in the right eye. During the following 3 months, the patient experienced 3 similar episodes, which resulted in diffuse pigment deposition in the anterior chamber angles. Intraocular pressure (IOP) elevation was observed after 1 week and 3 weeks in the left eye and right eye, respectively. Topical antiglaucomatous medication was prescribed. Nine months after the last episode, the uncorrected distance visual acuity was 20/20 and the IOP was 15 mm Hg bilaterally. The iris showed diffuse transillumination, and the pupils were unresponsive to light.

Comparison of UK and US screening criteria for detection of retinopathy of prematurity in a developing nation.

PURPOSE: To determine the incidence, risk factors, and appropriateness of differing guidelines in developed nations for screening for retinopathy of prematurity (ROP) in a single nursery in a large urban city in southern Turkey. METHODS: The records of 260 premature infants born ≤34 weeks in a single tertiary unit were retrospectively reviewed for ROP risk factors and diagnosis. Applicability of UK and US criteria were assessed by the use of receiver operating characteristic curves. RESULTS: ROP of any stage was present in 60 infants (23%); ROP requiring treatment was seen in 30 (11.5%). Univariate analysis showed a significant relationship among the following factors: gestational age, birth weight, total duration of supplemental oxygen, duration of mechanical ventilation, respiratory distress syndrome, anemia, and intraventricular hemorrhage (p < 0.0001). Multiple logistic regression analysis showed gestational age (p = 0.039), birth weight (p = 0.05), respiratory distress syndrome (p = 0.05), and anemia (p = 0.004) as independent predictors of ROP requiring treatment. Area under curve for gestational age alone for diagnosing stage 2 or greater ROP was 0.824 ± 0.03 (p = 0.0001) and for birth weight alone was 0.808 ± 0.03 (p = 0.0001). UK screening criteria detected all stage 2 and greater ROP; US screening criteria missed 2 infants with stage 2 ROP but detected all treatment-requiring disease. Adoption of these screening criteria would have reduced unnecessary examinations by either 21% (UK) or 37% (US). CONCLUSIONS: UK and US criteria improved the detection accuracy for ROP requiring treatment in Turkey and should be studied for other developing nations.