Evaluation of Visual Field and Balance Function Alterations in Patients Who Underwent Dermatochalasis Surgery.

PURPOSE: To compare perioperative visual field (VF), balance functions (BF), and changes in the other ocular parameters in patients undergoing upper eyelid dermatochalasis (DC) surgery. METHODS: One hundred and fifty-eight eyes of 79 patients who underwent DC surgery were included in the study. The VF, BF, intraocular pressure (IOP), pachymetry (PM), macular, and optic nerve measurements were recorded. Measurements were repeated at postoperative month 1. The preoperative and postoperative ocular measurements and the balance data were compared. RESULTS: Nineteen of 79 (24.05%) patients were male and 60 of 79 (75.95%) were female, while the mean age of the patients was 58.65 ± 7.38 years. There were statistically significant differences in terms of VF and macular thickness between the preoperative and postoperative values. The improvements in mean defect, standard loss variance, and mean sensitivity values of global VF parameters in both eyes were statistically significant after surgery. Central macular thickness, mean macular thickness, and macular volume decreased significantly in all eyes after surgery (p < 0.05). CONCLUSIONS: Although a marked improvement was observed in VF and peripheral vision after surgery, no significant change was found in BF parameters including primarily falling risk. The significant change in the macular parameters was only remarkable, and we think that the decrease was due to subtle vasospasm. There is a need for further comprehensive studies including especially patients older than 65 with a view to understanding the effect of DC surgery on BF.

Electroneuromyographic findings in pseudoexfoliation syndrome.

PURPOSE: To examine peripheral electroneuromyographic findings in patients with ocular pseudoexfoliation syndrome (PEX) and to compare them controls without PEX. METHODS: A case-control study design was used to examine 31 patients with PEX and compare the findings with those of 31 age- and sex-matched healthy controls. All patients underwent complete ophthalmologic examination that included peripheral electroneuromyography examination. Motor and sensorial nerve conduction of the median, ulnar, tibial, peroneal, and sural nerve and the sympathetic skin response were measured. RESULTS: The average sensorial nerve latency of the ulnar and sural nerve was significantly longer in the PEX group compared to the control group (p < 0.05). The average sensorial nerve conduction amplitude and the velocity of the ulnar and sural nerve were significantly lower in the PEX group (p < 0.05). DISCUSSION: Peripheral nerves, especially sensorial fibers, appear to be affected in PEX patients. These finding may indicate that PEX is a systemic disease.

Is there a correlation between the clinical findings and the radiological findings in chronic maxillary sinus atelectasis?

OBJECTIVE: Silent sinus syndrome (SSS) is a clinical syndrome that occurs as a result of chronic maxillary sinus atelectasis (CMA) and is seen with progressive enophthalmos and hypoglobus. The aim of this study was to investigate the correlation between radiological findings and clinical findings in patients with radiologically asymmetrical reduced maxillary sinus volume. MATERIAL AND METHOD: A comparison was made of patients with CMA through evaluation of paranasal sinus computed tomography, magnetic resonance imaging examination of maxillary sinus volume of the CMA side and the contralateral side, thickness of the retroantral fat tissue, infraorbital bone curve, uncinate process lateralisation measurement, middle concha diameter, and calculation of the change in location of the inferior rectus muscle. RESULTS: The study included 16 patients. Although a statistically significant difference was determined between the healthy and the pathological sides in respect to maxillary sinus volume, thickness of the retroantral fat tissue, infraorbital bone curve, uncinate process lateralisation measurement, and middle concha diameter (p = 0.00, p = 0.002, p = 0.020, p = 0.020, p = 0.007), no significant difference was determined in respect to the change in location of the inferior rectus muscle (p = 0.154). A positive correlation was determined between the increase in sulcus depth and maxillary sinus volume and inferior orbital bone curve (p < 0.05). CONCLUSION: In CMA patients suspected of having SSS, radiological maxillary sinus volume analysis, determination of retroantral fat thickness, measurement of the infraorbital bone curve, and measurement of the uncinate process lateralisation can be used as objective tests. However, it should be kept in mind that radiological findings may not always be compatible with the ophthalmological examination findings.

Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer's Type Dementia.

Aim. To asses both choroidal thickness differences among Alzheimer's type dementia (ATD) patients, mild cognitive impairment (MCI) patients, and healthy control (C) subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects) were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT) were measured at seven locations: the fovea, 500-1500-3000 µm temporal and 500-1500-3000 µm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT). Detailed neurological examination including mini mental state examination (MMSE) test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p < 0.05). The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3 ± 1.8, 24.8 ± 0.9, and 27.6 ± 1.2 in ATD, MCI, and healthy controls, respectively (p < 0.001). There were also significant correlation between MMSE score and choroidal thickness at each location (p < 0.05). Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients.

Optical coherence tomography parameters in patients with photosensitive juvenile myoclonic epilepsy.

PURPOSE: Juvenile myoclonic epilepsy (JME) is commonly associated with photoparoxysmal response (PPR) with a reported prevalence of 25-42%. In this study, we aim to explore the relationship between the PPR and Optical Coherence Tomography (OCT) parameters in order to determine whether optic nerve fiber layer or other structural differences have a pathophysiological role of photosensitivity in patients with JME. METHODS: We studied 53 consecutive patients with Juvenile myoclonic epilepsy (JME) at our outpatient department. The interictal electroencephalogram (EEG) findings for each patient were analyzed for the presence of photoparoxysmal features. The peripapillary Retina Nerve Fiber Layer (RNFL) thickness, ganglion cell thickness, macular thickness and choroid thickness levels were analyzed using OCT. RESULTS: We classified the patients into two groups as those with PPR (Group 1) and those without PPR (Group 2). There were statistically significant differences in the average RNFL thickness values of the left eye between the two groups (p<0.001). Although the RNFL thickness of the right eye was higher in Group 1, no statistically significant difference was observed between the two groups. The RFNL thickness of the superior quadrants both in the right and the left eyes was significantly higher in Group 1 patients (p<0.001). Macular thickness of the right and left eyes were significantly thinner in Group 1 patients (p<0.001). Choroid thickness of the left eye was significantly higher in Group 1 than in Group 2 patients (p<0.001). Although the choroid thickness of the right eye was higher in Group 1 patients, no statistically significant difference was observed between the two groups. CONCLUSION: This is the first study to our knowledge which has investigated the relation between the OCT parameters and photosensitivity in patients with JME. We concluded that these microstructural features may be related to photosensitivity in patients with JME.

Comparison of Measurement of Central Corneal Thickness with Spectral Domain Optical Coherence Tomography and Standard Ultrasonic Pachymeter in Premature Infants.

Purpose. To evaluate the repeatability of measurement of central corneal thickness (CCT) by spectral domain optical coherence (SD-OCT) in premature infants and compare it to CCT measurement by ultrasonic pachymetry (USP). Methods. Three CCT measurements of the left eyes of 50 premature infants were obtained by SD-OCT using the iVue system. 10 CCT measurements of each 28 left eyes of 28 infants were obtained by USP using the Pacscan 300P system. Bland-Altman plots were developed and the limit of agreement (LoA) was determined to compare the mean of the SD-OCT and USP measurements. Results. No statistically significant difference was found among the 3 CCT measurements by SD-OCT. Both USP and SD-OCT have been performed for only left eyes of 28 of the 50 babies. Those results have been compared with each other. A statistically significant difference was found between the mean CCT measurements by SD-OCT and USP (p < 0.05). The LoA between the SD-OCT and USP measurements ranged from 11.4 to -64.1. Conclusions. CCT can be measured using the iVue SD-OCT system with a high level of repeatability. Although measurement of CCT by SD-OCT and USP is highly correlated, the 2 systems cannot be used interchangeably in premature infants.

Macular findings obtained by spectral domain optical coherence tomography in retinopathy of prematurity.

Purpose. To examine the macular findings obtained with spectral domain optical coherence tomography (SD OCT) in infants with retinopathy of prematurity (ROP). Materials and Methods. The macular SD OCT images of 190 premature infants were analyzed. Data regarding central foveal thickness (CFT), cystoid macular edema (CME), and cyst grading were compared. The relationships of CFT with gestational age and birth weight were investigated. Results. The results were obtained from 358 eyes of 179 infants (81 females and 98 males) of a mean gestational age of 30.9 ± 2.7 weeks and a mean birth weight of 1609 ± 477 g. ROP was diagnosed in 126 eyes and CME in 139 eyes. A significantly greater percentage of eyes with ROP were found to have CME (54%) compared to eyes without ROP (31%; P = 0.001). The incidence of CME was 46.3% for stage 1 ROP, 57.1% for stage 2, and 87.5% for stage 3. There was a weakly inverse correlation between CFT, gestational age, and birth weight (P = 0.025, r = -0.227; P = 0.002, r = -0.182, resp., Spearman correlation test). Conclusions. High-quality SD OCT images can be obtained from premature infants using the iVue system. Severity and frequency of CME in premature infants increase as stage of ROP increases.

Tear secretion and ferning patterns among premature and full-term newborns.

In this study, we aimed to assess the quality and quantity of tears among premature and term newborns. Tear ferning and Schirmer's tests were conducted over the first 10 days of life. Correlations between tear ferning patterns, Schirmer's scores, post-conceptional age, and birth weight were evaluated. Forty-six newborns (23 preterm, 23 term) were enrolled, with a mean post-conceptional age of 36.6 weeks and a mean weight of 2598.2 g. Mean total, basal and reflex Schirmer's test results were 13.5 mm, 6.7 mm and 6.8 mm, on the right and 14.0 mm, 7.1 mm and 6.9 mm on the left eye, respectively. Median ferning score was 2 (range 1-3) bilaterally. Schirmer scores were correlated with ferning capacity and post-conceptional age. Our study shows that newborns secrete moderate quantity, good quality tears. Ferning capacity, Schirmer scores and post-conceptional age are correlated.