Comparison of postoperative morphological changes and retinal displacement in diabetic and idiopathic epiretinal membranes.

PURPOSE: To compare the postoperative retinal displacement by optical coherence tomography (OCT) in idiopathic epiretinal membranes (iERM) and diabetic epiretinal membranes (dERM). METHODS: This retrospective study included 36 iERM and 22 dERM cases. In cross-sectional OCT images (B-scan) the presence of foveal pit, subfoveal fluid, cotton ball sign (CBS), intraretinal cystic changes (ICC), disorganization of retinal inner layers (DRILs) and ectopic inner foveal layer (EIFL) were recorded. Central macular thickness (CMT) and EIFL thicknesses were calculated. Retinal displacement was quantified using infrared image of OCT approach consisting of the fovea to disc margin, interarcade distance and perimacular distances. RESULTS: The presence of subfoveal fluid (p = 0.014) and DRIL (p = 0.02) was significantly higher in the dERM group. CMT decreased significantly in both groups (p˂0.001). The EIFL was significantly thicker in the iERM group compared to the dERM group (p = 0.049), and it decreased significantly in the iERM group postoperatively. In the iERM group, while the fovea-disc margin distance decreased, the interarcade and perimacular distance increased significantly (p˂0.001). In the dERM group, the disc-fovea distance change was not significant (p = 0.082). Significant visual improvement was achieved with vitrectomy in both groups (p˂0.001). In the dERM group, the presence of DRIL was associated with lower pre and post-op visual acuity (VA) (r = 0.596 and p = 0.004 for pre-operative and r = 0.567 and p = 0.007 for post-operative). CONCLUSION: Significant retinal displacement occurs after vitrectomy in both iERM and dERM. The low VA in the dERM group may be related to the presence of DRILs.

Association of triglyceride­glucose index in branch retinal vein occlusion.

BACKGROUND: To investigate the association between the triglyceride-glucose (TyG) index and newly diagnosed branch retinal vein occlusion (BRVO) in patients. METHODS: The study included 57 individuals with BRVO and a control group comprising 50 healthy volunteers matched for age and gender. Detailed eye examinations were conducted, and various blood biochemistry and hematological parameters were recorded. The TyG index was calculated using fasting plasma glucose and triglyceride values. RESULTS: The mean age was 61.4 ± 9.6 years for the BRVO group and 60.6 ± 10.3 years for the control group. The TyG values were significantly higher in the BRVO group when compared to the control group (8.84 ± 0.41 vs. 8.52 ± 0.29, p < 0.001). Multivariate analysis revealed that the TyG index independently predicted BRVO (odds ratio = 2.58, 95% confidence interval = 1.69-3.93; p < 0.001). In receiver operating characteristics analysis, the TyG index had an area under the curve of 0.749, and a TyG index higher than 8.52 predicted BRVO with 83% sensitivity and 70% specificity. CONCLUSIONS: This study establishes a significant association between an elevated TyG index and BRVO. Consequently, the TyG index could serve as a valuable predictive tool for identifying individuals at risk for BRVO.

Evaluation of the lamina cribrosa in different stages of diabetic retinopathy.

PURPOSE: To evaluate the relationship of the peripapillary retina nerve fiber layer (RNFL) and lamina cribrosa (LC) with diabetic retinopathy (DR) in type 2 diabetes mellitus (DM) cases. STUDY DESIGN: Prospective comparative study. METHODS: This study included 50 non-DR (Group 1), 55 non-proliferative diabetic retinopathy (NPDR) (Group 2), 28 DM cases with proliferative diabetic retinopathy (PDR) (Group 3) and 45 healthy volunteers (Group 4). All participants were evaluated with visual acuity, intraocular pressure (IOP) with Goldman applanation tonometry, anterior segment biomicroscopy, 24 - 2 visual field testing, and dilated fundus examination. Retinal nerve fiber layer (RNFL) thickness, lamina cribrosa thickness (LCT) and anterior lamina cribrosa depth (ALCD) were examined by spectral-domain optical coherence tomography (OCT). RESULTS: There was no difference between the groups in terms of age and gender. Visual acuity (p < 0.001) was significantly different between the groups, while IOP (p = 0.068) was similar. Mean (p = 0.010), superior-temporal (p = 0.024), and superior-nasal (p = 0.011) RNFL thickness decreased significantly in correlation with the stage of DR. LCT decreased significantly as the stage of DR progressed in both vertical and horizontal radial OCT scans (p < 0.001). ALCD was not different between groups (p = 0.954 for horizontal scan, p = 0.867 for vertical scan). CONCLUSION: Peripapillary RNFL and LCT significantly decreases as the DR stage progresses. The biomechanical effects of the LC may also be responsible for diabetes-induced neurodegeneration.

Comparison of intravitreal ranibizumab, aflibercept and bevacizumab therapies in diabetic macular edema with serous retinal detachment.

PURPOSE: To compare the effects of ranibizumab, aflibercept and bevacizumab treatments in treatment-naive diabetic macular edema(DME) patients with serous retinal detachment(SRD). MATERIAL AND METHODS: This is a retrospective, comparative study. In a sample of 86 eyes of 86 untreated DME patients with accompanying SRD, 23 patients were treated with ranibizumab (IVR), 28 patients with aflibercept (IVA), and 35 patients with bevacizumab (IVB). All were injected intravitreally once a month for a 3-month loading dose. Subsequently, all participants were evaluated every months and if neccessary they received additional intravitreal treatments.Mean changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), and SRD height over the 6-months study period were compared. RESULTS: At baseline, the groups did not differ in mean BCVA,CRT and SRD height. During the first 3 months, in IVA group the mean decrease in CRT and SRD height were significantly more than in the other two groups (p < 0.05 for all). However, these differences disappeared at 6 months.The number of injections was similar between the groups during the study period. CONCLUSION: In patients with DME accompanied by SRD, IVA is a more advantageous option in terms of reduction in CRT and SRD height from baseline to 3 months. In the 6-month period of treatment, IVR, IVA and IVB therapies areanatomically and functionally similar and significant effective modalities.

Systemic oxidative stress biomarkers in patients with vitreomacular traction syndrome.

PURPOSE: To evaluate whether the systemic oxidative stress biomarkers increased in patients with vitreomacular traction syndrome (VMT). METHODS: This study compared 25 patients diagnosed with VMT with 20 healthy controls. As a biomarker of systemic oxidative stress, malondialdehyde (MDA) was measured. Total oxidant status (TOS) and total antioxidant status (TAS) were measured to evaluate the systemic oxidant status. RESULTS: Serum MDA values were significantly higher among the patients (p < 0.001). The ideal cut-off value for MDA was determined to be 22.1 µmol/L, with 80% sensitivity and 75% specificity. The between-group differences were not statistically significant for TOS or TAS (p = 0.326 and p = 0.698, respectively). CONCLUSION: Increased MDA levels suggest that systemic oxidative stress may play a role in VMT.

Evaluation of YouTube videos as sources of information about multifocal intraocular lens.

PURPOSE: This study investigated the quality of YouTube videos addressing multifocal intraocular lens (IOL) as educational resources. MATERIALS AND METHODS: An online search of YouTube was performed for the terms "multifocal lens implants" and "multifocal iol". A total of 339 videos were recorded. After these videos were investigated, the final remaining 140 videos were enrolled in the study. All videos were evaluated in terms of their DISCERN, Journal of the American Medical Association (JAMA), and Global Quality (GQ) scores by two independent experienced ophthalmologists. RESULTS: The median DISCERN score was 33 (poor quality), JAMA score was 1.25 (lowest quality), and GQ score was 2 (poor quality). Of the 140 videos, 80 videos (57.1%) were uploaded by physicians and another 60 videos (42.9%) were uploaded by non-physicians. There was no statistically significant difference in general characteristics of the videos between the physicians and non-physicians groups. Also, their mean DISCERN, JAMA and GQ scores were similar between the groups (p = .101, p = .441 and p = .209, respectively). CONCLUSION: Our findings suggest that the content of YouTube videos regarding multifocal IOLs is of generally poor quality and is not adequately educational for patients. Nevertheless, to ensure patients' access to accurate medical information, we believe that the content and reliability of medical information obtained from online videos should be examined by healthcare specialists from the viewpoint of patients.

Elevated Monocyte-to-High-Density Lipoprotein Ratio as an Indicator of Systemic Inflammation in Patients with Branch Retinal Vein Occlusion.

OBJECTIVES: This study was designed to assess the monocyte-to-high-density lipoprotein (HDL) ratio (MHR) as a possible marker of systemic inflammation in patients with branch retinal vein occlusion (BRVO). METHODS: A study group of 62 patients with BRVO and a control group of 60 age-matched, healthy individuals were enrolled in the study. The blood lipid profile, hematology profile, and C-reactive protein (CRP) level were measured. The MHR was calculated as the ratio of the monocyte count to the HDL level, and the neutrophil-to-lymphocyte ratio (NLR) was calculated as the ratio of the neutrophil count to the lymphocyte count. RESULTS: In patients with BRVO versus controls, the mean MHR was 14.1±5.1 vs 12.2±4.3 (p=.032), the mean NLR was 1.99±0.69 vs 2.01±0.86 (p=.889), and the mean CRP level was 3.44±2.53 mg/L vs 2.81±1.57 mg/L (p=.102). The area under the receiver operating characteristic curve for the MHR and the NLR was 0.621 and 0.519, respectively. The sensitivity and specificity of the MHR and the NLR to predict BRVO was 51% and 73% vs 79% and 35%, respectively. CONCLUSION: The MHR values were higher in patients with BRVO compared with those of the control group. BRVO seems to be associated with systemic inflammation.

A Patient With Bilateral Conjunctivitis Positive for SARS-CoV-2 RNA in a Conjunctival Sample.

PURPOSE: To present a patient with bilateral conjunctivitis, testing positive for viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in both nasopharyngeal and conjunctival samples. METHODS: A 40-year-old man with bilateral acute conjunctivitis and suspicious signs of coronavirus disease 2019 (COVID-19) presented to the hospital. A detailed ophthalmic examination was performed. Samples obtained from conjunctival and nasopharyngeal swabs were tested by reverse transcription PCR (RT-PCR) for the detection of SARS-CoV-2 virus. Ocular findings and duration of the presence of viral RNA in the conjunctival specimens were evaluated at follow-up visits. RESULTS: Slit-lamp biomicroscopy revealed bilateral acute follicular conjunctivitis. The RT-PCR assay demonstrated the presence of viral RNA in the nasopharyngeal and conjunctival specimens at the initial visit and at the 4-day follow-up. Conjunctivitis findings were decreased after 4 days and recovered completely without any sequelae within10 days. The PCR results of both nasopharyngeal and conjunctiva specimens were negative for the viral RNA at 10 days. CONCLUSIONS: Bilateral conjunctivitis is rare in patients infected with COVID-19. Although it is difficult to detect viral RNA from conjunctival swabs, conjunctival secretions may be a source of contamination, and protective measures must be taken.

Comparison of Ranibizumab versus Aflibercept in Treating Macular Edema among Patients with Serous Retinal Detachment Secondary to Branch Retinal Vein Occlusion.

Purpose: To compare the effectiveness of ranibizumab and aflibercept in macular edema (ME) with serous retinal detachment (SRD) following branch retinal vein occlusion (BRVO).Methods: Once every month for 3 months, 33 patients were treated with ranibizumab (Group 1), whereas 30 others were treated with aflibercept (Group 2). In 9 months after that, patients were evaluated every 4 weeks and received additional injections if they met prespecified criteria for retreatment. Corrected visual acuity (BCVA), central foveal thickness (CFT), and height of SRD was measured.Results: During the first 3 months, the improvement of CFT, BCVA, and height of SRD were greater in Group 2 than Group 1. Those differences disappeared in the subsequent 9 months, and changes in CFT, BCVA, and height of SRD were similar between groups at all other visits.Conclusion: Aflibercept was more effective than ranibizumab from baseline to Month 3 in ME with SRD following BRVO.

Apelin-13: A Promising Biomarker for Age-Related Macular Degeneration?

PURPOSE: To investigate the value of serum apelin-13 levels in patients with age-related macular degeneration (AMD). METHODS: Patients with dry-type AMD, patients with treatment-naïve neovascular-type AMD, and healthy controls were included in this study. Diagnoses were confirmed on detailed fundus examination, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA). Central foveal thickness and subfoveal choroidal thickness were evaluated. Both serum apelin-13 and vascular endothelial growth factor (VEGF) levels were measured by a competitive enzyme-linked immunosorbent assay (ELISA) principle. RESULTS: A total of 84 subjects, i.e., 24 in the dry-type AMD group (group 1), 27 in the neovascular-type AMD group (group 2), and 33 in the control group (group 3) were included in the study. Mean best-corrected visual acuity (BCVA) was 76 ± 4.5, 48.4 ± 16.3, and 83.4 ± 3.09 ETDRS letters in group 1, 2, and 3, respectively. The level of serum VEGF was 44.11 ± 26.14, 56.53 ± 53.77, and 61.47 ± 41.62 pg/mL in groups 1, 2, and 3, respectively (p = 0.553, p = 0.286, and p = 0.896, respectively). The level of serum apelin-13 was 586.47 ± 167.56, 622.18 ± 324.52, and 379.31 ± 171.96 pg/mL in groups 1, 2, and 3, respectively (p = 0.847, p = 0.04, and p ≤ 0.001, respectively). There was a negative correlation between the level of serum apelin and visual acuity (VA) and choroidal thickness. CONCLUSION: Serum apelin-13 levels were higher in both dry-type and neovascular-type AMD patients than in controls. Further studies demonstrating the relationship of the level of serum apelin-13 and AMD are needed.

Determination of Neurodegeneration in Polycystic Ovary Syndrome with Retinal Segmentation Analysis.

Purpose: To compare the thickness of each retinal layer in patients with polycystic ovary syndrome (PCOS) versus healthy, age-matched controls by using retinal segmentation analysis.Methods: In our cross-sectional study, 37 patients with PCOS (i.e., patient group) and 35 healthy individuals (i.e., control group) underwent spectral-domain optical coherence tomography imaging. Using built-in automatic retinal segmentation software to analyze the images collected, we compared the thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, photoreceptor layer (PRL), retinal pigment epithelium (RPE), inner retinal layers, and outer retinal layers between the groups. To analyze the measurements, we used a traditional Early Treatment Diabetic Retinopathy Study (ETDRS) grid.Results: In ETDRS subfields, 6-mm nasal RNFL thickness; 3- and 6-mm nasal GCL thickness; 3-mm superior and 6-mm nasal IPL thickness; 1-mm central, 3-mm nasal, superior, and inferior, and 6-mm nasal and inferior PRL thickness; and 6-mm inferior RPE thickness were significantly thinner in patients with PCOS than that of healthy controls.Conclusion: The results of our retinal segmentation analysis indicate that patients with PCOS tend to have thinner GCL, IPL, and PRL than healthy, age-matched controls due to neurodegeneration likely caused by insulin resistance, or subclinical retinal inflammation.

Monocyte to high-density lipoprotein and neutrophil-to-lymphocyte ratios in patients with acute central serous chorioretinopathy.

Purpose: To investigate monocyte to high-density lipoprotein (HDL) ratio (MHR) and neutrophil-to-lymphocyte ratio (NLR) as indicators of systemic inflammation in acute central serous chorioretinopathy (CSC). Methods: The HDL levels, hematological profiles, erythrocyte sedimentation rates (ESR), and C-reactive protein (CRP) levels of 38 patients with acute CSC (Group I) and 38 controls without CSC (Group II) were measured. Results: MHRs were significantly higher in Group I (13.30 ± 2.95) than in Group II (11.52 ± 2.42, P = 0.005), whereas NLRs, CRP values, and ESR values did not significantly differ between the groups (P = 0.726, P = 0.219, and P = 0.441, respectively). Multivariate analysis revealed that the MHR was an independent predictor of acute CSC (OR = 1.266, 95% CI = 1.054-1.521, P = 0.012). Conclusion: Indicating an association between increased MHRs and acute CSC, the MHR might represent simple, inexpensive, reliable biomarkers of inflammation in acute CSC.

Comparison of the balafilcon A and samfilcon A lenses on postoperative pain control and epithelial healing time after photorefractive keratectomy: a contralateral eye study.

To compare the effects of balafilcon A and samfilcon A silicone hydrogel bandage contact lenses on postoperative pain control and epithelial healing time after photorefractive keratectomy (PRK). Seventy-four eyes of 37 patients who underwent bilateral PRK were included in this randomized clinical trial study. In the end of the surgery, a balafilcon A lens was used in one eye and a samfilcon A lens was used in the fellow eye randomly. Pain, blurred vision, epiphora, photophobia, and foreign body sensation were assessed on the first and third postoperative day using a visual analogue scale (0 = no ocular pain or discomfort, 10 = highest level of ocular pain and discomfort). For balafilcon A and samfilcon A lenses, mean scores for pain were 6.22 ± 2.81 and 3.11 ± 2.90 on first postoperative day (p < 0.001) and 1.57 ± 1.65 and 0.68 ± 0.85 on third postoperative day (p = 0.001), respectively; mean scores for foreign body sensation were 6.11 ± 2.53 and 3.19 ± 2.72 on first postoperative day (p < 0.001) and 3.16 ± 1.92 and 1.35 ± 1.43 on third postoperative day (p < 0.001), also respectively; and mean scores for epiphora were 6.46 ± 2.64 and 5.46 ± 3.40 on first postoperative day (p = 0.007) and 1.68 ± 1.60 and 1.32 ± 1.31 on third postoperative day (p = 0.065), again respectively. No significant difference in blurred vision or photophobia emerged between the lenses on first and third postoperative day after PRK. On the third postoperative day, reepithelialization was complete in 83.7% of eyes with the balafilcon A lens and 89.1% of eyes fitted with the samfilcon A lens. Wearing samfilcon A lenses after photorefractive keratectomy can significantly manage pain, decrease foreign body sensation on first and third postoperative day, and reduce epiphora on first postoperative day.

The Influence of Type 1 Diabetes Mellitus on Amplitude of Accommodation.

PURPOSE: The aim of the study was to assess the amplitude of accommodation (AA) in patients with type 1 diabetes mellitus (DM) and without diabetic retinopathy. MATERIALS AND METHODS: In two age- and sex-matched groups - one with twenty-nine eyes of 29 patients with type 1 DM, the other with twenty-nine eyes of 29 healthy individuals - retinal nerve fibre layer thickness and macular volume were determined by using optic coherence tomography in all quadrants, whereas AA was measured with the minus lens technique. The mean values of all three measurements were compared between the groups, and the effect of age, disease duration, (HbA1c and fasting blood glucose on AA were analysed using multiple regression analysis. RESULTS: On average, participants were 25.0 ± 3.3 years old (range 19-30) in both groups (P = 1.000), and patients had type 1 DM for an average of 13.0 ± 3.3 years. Mean AA in the right eye was 7.3 ± 1.1 D among patients and 8.1 ± 1.1 D among controls (P = .005), as well as significantly negatively correlated with age in both groups (r = -0.735, P <.001 and r = -0.819, P < .001, respectively) and disease duration among patients (r = -0.434, P = .019). In multivariable regression, age and disease duration significantly affected AA in patients, with an R2 value of 0.623 (P < .001 and P = .025, respectively). Average RNFL thickness was significantly different between the groups (P = .014). Mean macular volumes for areas 1, 3 or 5 mm in diameter were similar between the groups. CONCLUSIONS: AA was significantly lower among patients with type 1 DM than among healthy individuals, which suggests that the former might experience presbyopia earlier in life than the general population.

Evaluation of the lamina cribrosa thickness and depth in patients with migraine.

PURPOSE: The aim of the study was to evaluate the lamina cribrosa (LC) thickness, LC depth, and retinal nerve fiber layer (RNFL) thickness, in migraine patients with and without aura, by using optical coherence tomography (OCT). METHODS: This single-center, case-control study included 27 migraine with aura (Group I), 35 migraine patients without aura (Group II), and 35 healthy controls (Group III). In only the right eyes of participants, RNFL thickness in all quadrants was analyzed via OCT, whereas LC thickness and depth were measured by enhanced depth imaging OCT. RESULTS: The mean age and sex distributions did not differ significantly across the groups (p = 0.460 and p = 0.941). The RNFL thickness was significantly lower in Group I (average and superotemporal, superonasal, and inferotemporal quadrants) and Group II (average and superotemporal and superonasal quadrants) when compared with Group III. Disease duration was significantly correlated with RNFL thickness on average and in all quadrants except in the superonasal quadrant in Groups I and II. Patients in Groups I and II had significantly thinner LC thicknesses and deeper LC depth than healthy participants in Group III. CONCLUSIONS: The LC and RNFL thicknesses were thinner and the LC depth was deeper in migraine patients with or without aura than in healthy individuals, and disease duration correlated significantly with RNFL thickness. Both results suggest that migraine patients are at risk of developing glaucoma.

Aflibercept Treatment for Macular Edema following Branch Retinal Vein Occlusion: Age-Based Responses.

PURPOSE: The aim of this study was to compare responses to aflibercept treatment in age-based groups of patients with macular edema following branch retinal vein occlusion (BRVO). METHODS: Eighty-five patients with macular edema following BRVO were divided into 4 groups according to their age: Group I (i.e., 45- to 54-year-olds), Group II (i.e., 55- to 64-year-olds), Group III (i.e., 65- to 74-year-olds), and Group IV (i.e., 75- to 84-year-olds). Each patient received a loading dose of 3 monthly intravitreal aflibercept injections. The treatment response was evaluated with visual acuity (VA) and optical coherence tomography measurements of the central foveal thickness (CFT), outer nuclear layer thickness (ONLT), and photoreceptor layer thickness (PRLT) before treatment and 1 month after the first and third injections. RESULTS: In Group I (n = 19), Group II (n = 25), Group III (n = 23), and Group IV (n = 18), the mean values of VA, CFT, ONLT, and PRLT improved significantly 3 months after treatment. Whereas VA improved the most in Group I, its improvement significantly decreased in each progressively older age group, as did the reduction of the CFT, ONLT, and PRLT values, all of which were greater in groups I and II. Furthermore, age significantly correlated with changes in VA, CFT, ONLT, and PRLT across all groups. CONCLUSION: The efficacy and effectiveness of aflibercept treatment decrease in patients with macular edema following BRVO as they age, most likely due to age-related changes in posterior ocular structures.

Thickness of the Lamina Cribrosa, Retinal-Nerve Fiber Layer, and Peripapillary Choroid in Patients with Branch Retinal Vein Occlusion.

PURPOSE: To compare the thickness of the lamina cribrosa (LC), retinal-nerve fiber layer (RNFL), and peripapillary choroid (PC) in patients with unilateral branch retinal-vein occlusion (BRVO) and healthy individuals. METHODS: The 70 eyes of 35 patients with unilateral BRVO, grouped as either affected or unaffected, and 38 right eyes of 38 healthy individuals were examined for LC, RNFL, PC thickness, and LC depth with spectral-domain optical coherence tomography. RESULTS: The unaffected eyes of patients with BRVO had a significantly thinner RNFL on average and in the inferior quadrant than the eyes of healthy controls. Mean LC thickness in BRVO-affected and BRVO-unaffected eyes was significantly thinner than in controls, and mean LC depth was significantly deeper as well. The average, superior, and inferior PC thickness in both BRVO-affected and BRVO-unaffected eyes and nasal PC thickness in the BRVO-affected eyes were significantly thinner than in the eyes of controls. CONCLUSION: Thinner LCs and PCs in both eyes of patients with unilateral BRVO and thinner RNFLs in BRVO-unaffected eyes than in the eyes of healthy controls suggest that BRVO and glaucoma have underlying pathological mechanisms and risk factors in common that lead to their development.

An Analysis of YouTube Videos as Educational Resources for Patients About Refractive Surgery.

PURPOSE: The aim of the study was to assess the quality of videos on YouTube as educational resources about refractive surgery. METHODS: This is a retrospective, cross-sectional, register-based study. A search of YouTube was performed for the term "refractive surgery" without any changes to the Web site's standard search preferences. The first 160 videos were recorded. Additional videos from the search engine were also searched for the other common terms "LASIK," "PRK," and "laser eye surgery." The first 50 videos for each additional term were evaluated. A total of 310 videos were evaluated regarding DISCERN score (min-max: 16-75), Journal of the American Medical Association score (min-max: 0-4), and Global Quality score (min-max: 0-5). RESULTS: Once 135 videos that did not meet the inclusion criteria were excluded from the sample, the remaining 175 videos were analyzed. The mean DISCERN, Journal of the American Medical Association, and Global Quality scores were 33.25 ± 15.34 (poor quality), 0.74 ± 0.82 (lowest quality), and 1.74 ± 0.81 (poor quality), respectively. Of the 175 videos, 77 (42%) had been uploaded by physicians, 67 (38.2%) by health channels, 16 (9.1%) by patients, and another 15 (8.5%) by medical organizations. CONCLUSIONS: Although some of the analyzed online videos contain beneficial information, YouTube videos do not generally seem to be useful as educational resources for patients about refractive surgery. Nevertheless, health care professionals should continue to assess the reliability and usefulness of medical information provided by online resources from the viewpoint of patients.

Relationship between erythrocyte sedimentation rate and choroidal and retinal thickness in Behçet's disease.

PURPOSE: To compare retinal and choroidal thickness in patients with Behçet's disease with and without ocular involvement as well as to evaluate the correlation between erythrocyte sedimentation rate and choroidal thickness among patients with Behçet's disease. METHODS: This was a prospective interventional study investigating erythrocyte sedimentation as well as choroidal and retinal thickness among patients with Behçet's disease. Patients who were diagnosed based on The International Criteria for Behçet's Disease with (Group A) or without (Group B) ocular involvement and a matched control group (Group C) participated in the study. Optical coherence tomography measurements and blood tests were performed on the same day. Retinal and choroidal thickness were measured using spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany), and central macular thickness, central subfoveal choroidal thickness, and retinal nerve fiber layer thickness were measured using optical coherence tomography. RESULTS: Average erythrocyte sedimenta-tion values were 9.89 mm/h in Group A, 16.21 mm/h in Group B, and 3.89 mm/h in Group C; average central subfoveal choroidal thickness values were 350.66, 331.74, and 325.95 mm, respectively. Average central macular thickness and retinal nerve fiber layer thickness values of patients in Groups A, B and C were 226.39 and 225.97mm; 234.11 and 92.00 mm; and 97.58 and 99.84 mm, respectively. No significant difference was seen between Group A and B patients in central subfoveal choroidal thickness, central macular thickness, or retinal nerve fiber layer thickness values. Central macular thickness was statistically significantly thinner in Groups A and B than in Group C (p=0.016). Group A had thinning in the nasal quadrant of the retinal and general retinal nerve fiber layers when compared with those in Group C (p=0.010 and 0.041, respectively). A connection could not be established between the erythrocyte sedimentation, central subfoveal cho-roidal thickness, central macular thickness, and retinal nerve fiber layer thickness in the patients with Behçet's disease. CONCLUSION: The erythrocyte sedimentation rate is typically used to test for activation of Behçet's disease and assess treatment response. In our study, we could not establish a connection between the erythrocyte sedimentation rate and central subfoveal choroidal thickness, central macular thickness, and retinal nerve fiber layer thickness in patients with systematically active Behçet's disease without ocular involvement.