Is Keratoconus More Than Just a Corneal Disease?

PURPOSE: The aims of this study were to compare the scleral thickness (ST), lamina cribrosa thickness (LCT), and lamina cribrosa curvature index between patients with keratoconus and healthy controls and to evaluate the relationship between these values and corneal parameters. METHODS: This cross-sectional study included 41 eyes of 41 patients with keratoconus and 30 eyes of 30 age-matched, sex-matched, and axial length-matched controls. Nasal and temporal STs were measured vertically, 4 mm posterior to the scleral spur, using anterior segment optical coherence tomography. The LCT was measured on the radial scans of the optic nerve head. The lamina cribrosa curvature index (lamina cribrosa curvature depth/curvature width × 100) was calculated to determine the degree of posterior bowing of the lamina cribrosa. RESULTS: The nasal ST and temporal ST were significantly lower in the keratoconus group than in the control group ( P = 0.016 and P = 0.023, respectively). The LCT was significantly lower in the keratoconus group compared with the control group ( P < 0.001). There was no significant difference between the groups for the lamina cribrosa curvature index ( P = 0.375). Correlation analysis revealed a significant correlation between the nasal and temporal STs and the central corneal thickness (r = 0.376, P < 0.001 and r = 0.387, P < 0.001, respectively). There was also a significant correlation between the temporal ST and the minimum corneal thickness in the keratoconus group (r = 0.332, P = 0.015). The LCT was significantly correlated with the central corneal thickness (r = 0.445, P < 0.001). CONCLUSIONS: Structural features of the cornea, sclera, and lamina cribrosa with similar collagen content may be similarly affected in patients with keratoconus. Further histologic studies are needed to confirm our results.

Agreement among Goldmann Applanation Tonometer, Easyton Transpalpebral Tonometer, Tonopen, and Icare in Patients with Keratoconus.

Objectives: The objective of the study is to evaluate the agreement between Goldmann applanation tonometer (GAT) and Easyton transpalpebral tonometer, Tonopen, and Icare in patients with Keratoconus. Methods: This cross-sectional study included 46 eyes of 26 patients with keratoconus. Intraocular pressure (IOP) is measured using easyton, icare, tonopen, and GAT. Measurements were compared and the influences of corneal topographic variables on IOP measurement were evaluated. Bland-Altman plots were used for assessing agreement between different tonometers. Results: The mean age of the participants was 24.08±6.76 (range, 18-47) years (15 males and 11 females). The highest of the mean IOP values measured with different tonometers was obtained with Easyton (12.33±1.65), followed by Tonopen (11.59±2.17), GAT (10.67±1.52), and Icare (10.04±2.33). The mean IOP value measured with Easyton was significantly higher than that measured with GAT (p<0.001). There was no significant difference between GAT and either Tonopen (p=0.154) or Icare measurements (p=0.732). There was no significant difference between Tonopen and Easyton measurements (p=0.421). Icare measurements were correlated with central corneal thickness and keratometric values. GAT measurements were correlated with only Kmax. Thirty-eight (82.6%) of the differences were within the agreement limits (assumed clinically important deviation of up to ±2 mmHg) of GAT and Tonopen, 73.9% (n=34) were within the agreement limits of GAT and Icare, and 78.3% (n=36) were within the agreement limits of GAT and Easyton. Conclusion: Compared with GAT, the gold standard method, Easyton IOP readings were higher, while both Tonopen and Icare readings were similar to GAT. All three tonometers showed acceptable agreement with the GAT, however, Tonopen showed the greatest agreement.

Simultaneous posterior eyelid ptosis repair and strabismus surgery: a single-stage approach / Cirurgia reparadora simultânea de blefaroptose posterior e de estrabismo: abordagem de estágio único

ABSTRACT Purpose: Blepharoptosis with coexisting strabismus can be observed in adults, and both these conditions affect cosmetic appearance and have psychosocial effects. Both also commonly require surgery, which is typically performed using a sequential approach. This study aimed to evaluate the efficacy of simultaneous Müller's muscle-conjunctival resection with or without tarsectomy and strabismus surgery in adult patients with ptosis and coexisting strabismus. Methods: Patients with ptosis and coexisting strabismus who underwent simultaneous Müller's muscle-conjunctival resection with or without tarsectomy and horizontal strabismus surgery were retrospectively evaluated. Analysis included measurement of the angle of deviation in prism diopters, margin reflex distance, eyelid height asymmetry, and complications following surgery. Success of Müller's muscle-conjunctival resection with or without tarsectomy was defined as a margin reflex distance of ≥3.5 and ≤5 mm with a difference between the two upper eyelids of <1 mm. Strabismus success was defined as alignment with ±10 prism diopters of orthotropia. Results: The patients comprised three women and five men with a mean age of 37.12 years (range, 22-62 years). The strabismus stage of the surgery was performed first in all patients. Upper eyelid symmetry outcomes were assessed as perfect (<0.5 mm) in four patients and good (≥0.5 mm, <1 mm) in four patients. Success of Müller's muscle-conjunctival resection with or without tarsectomy was achieved in six of eight patients (75%), and strabismus success was achieved in all patients. No revision eyelid or strabismus surgery was required following simultaneous surgery in any of the patients. Conclusion: Müller's muscle-conjunctival resection with or without tarsectomy combined with strabismus surgery may be an alternative approach for use in patients with ptosis and coexisting strabismus.

RESUMO Objetivo: Blefaroptose e estrabismo podem ser coexistentes em adultos e ambos afetam a aparência estética e o domínio psicossocial. Ambos também geralmente requerem cirurgia, realizada tradicionalmente em uma abordagem sequencial. O objetivo do presente estudo foi avaliar a eficácia da execução simultânea da ressecção musculoconjuntival de Müller, com ou sem cirurgia de tarsectomia, e da cirurgia de estrabismo em pacientes adultos com ptose e estrabismo coexistentes. Métodos: Foram retrospectivamente avaliados pacientes com ptose e estrabismo coexistentes submetidos simultaneamente à ressecção musculoconjuntival de Müller, com ou sem tarsectomia, e à cirurgia de estrabismo horizontal. A análise incluiu a mensuração do ângulo de desvio das dioptrias de prisma, a distância do reflexo à margem, a assimetria da altura palpebral e quaisquer complicações após a cirurgia. A ressecção musculoconjuntival de Müller, com ou sem sucesso na tarsectomia, foi considerada bem-sucedida com uma distância reflexo-margem medindo entre 3,5 e 5 mm, e uma diferença entre as duas pálpebras superiores menor que 1 mm. O sucesso da cirurgia de estrabismo foi definido como um alinhamento com ± 10 dioptrias prismáticas de ortotropia. Resultados: Os pacientes foram 3 mulheres e 5 homens, com média de idade de 37,12 anos (faixa de 22 a 62 anos). A parte de estrabismo da cirurgia foi realizada primeiro em todos os pacientes. Os resultados da simetria palpebral superior foram avaliados como perfeitos (<0,5 mm) em 4 pacientes, bons (≥0,5 mm, <1 mm) em 4 pacientes e regulares (≥1 mm) em nenhum. A ressecção musculoconjuntival de Müller, com ou sem sucesso na tarsectomia, teve sucesso em 6 dos 8 pacientes (75%) e a intervenção para o estrabismo foi bem-sucedida em todos os pacientes. Não foi necessária cirurgia de revisão da pálpebra ou do estrabismo após a cirurgia simultânea em nenhum paciente. Conclusão: A ressecção musculoconjuntival de Müller, com ou sem tarsectomia, pode ser combinada com a cirurgia de estrabismo em uma abordagem alternativa para pacientes com ptose e estrabismo coexistentes.

Evaluation of Pupillometric Parameters in Patients with COVID-19.

PURPOSE: To investigate the pupillary diameter and pupillary light response in patients who have recovered from the COVID-19. METHODS: Thirty two eyes of 32 patients with a history of COVID-19 in the last two months and 32 eyes of 32 age and sex-matched healthy controls were included in this prospective study. All patients had neurological symptoms. Dynamic and static pupillometry measurements were performed with the Sirius (CSO, Italy) corneal topography device. RESULTS: Patients with COVID-19 had higher mean scotopic, mesopic, and photopic pupil diameters compared to the controls (p = .01, p = .04, p = .02, respectively). In dynamic pupillometry analysis, 0th, 2th, 8th and 16th second pupil diameter measurements were higher in COVID-19 patients (p = .02, p = .04, p = .04, p = .04, respectively). There were no differences in the average speed of pupillary dilatation (p > .05). CONCLUSION: Our findings suggest that the pupillary response, an indicator of autonomic nervous system activity, may be affected in COVID-19 patients with neurological symptoms.

Simultaneous posterior eyelid ptosis repair and strabismus surgery: a single-stage approach.

PURPOSE: Blepharoptosis with coexisting strabismus can be observed in adults, and both these conditions affect cosmetic appearance and have psychosocial effects. Both also commonly require surgery, which is typically performed using a sequential approach. This study aimed to evaluate the efficacy of simultaneous Müller's muscle-conjunctival resection with or without tarsectomy and strabismus surgery in adult patients with ptosis and coexisting strabismus. METHODS: Patients with ptosis and coexisting strabismus who underwent simultaneous Müller's muscle-conjunctival resection with or without tarsectomy and horizontal strabismus surgery were retrospectively evaluated. Analysis included measurement of the angle of deviation in prism diopters, margin reflex distance, eyelid height asymmetry, and complications following surgery. Success of Müller's muscle-conjunctival resection with or without tarsectomy was defined as a margin reflex distance of ≥3.5 and ≤5 mm with a difference between the two upper eyelids of <1 mm. Strabismus success was defined as alignment with ±10 prism diopters of orthotropia. RESULTS: The patients comprised three women and five men with a mean age of 37.12 years (range, 22-62 years). The strabismus stage of the surgery was performed first in all patients. Upper eyelid symmetry outcomes were assessed as perfect (<0.5 mm) in four patients and good (≥0.5 mm, <1 mm) in four patients. Success of Müller's muscle-conjunctival resection with or without tarsectomy was achieved in six of eight patients (75%), and strabismus success was achieved in all patients. No revision eyelid or strabismus surgery was required following simultaneous surgery in any of the patients. CONCLUSION: Müller's muscle-conjunctival resection with or without tarsectomy combined with strabismus surgery may be an alternative approach for use in patients with ptosis and coexisting strabismus.

Effect of Diabetes Mellitus and Systemic Hypertension on Macular Hole Surgery.

OBJECTIVE: To evaluate the anatomical and functional results of macular hole surgery in patients with diabetes mellitus (DM) and hypertension (HT) without retinopathy. STUDY DESIGN: Descriptive comparative study. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Health Sciences University Haydarpasa Numune Training and Research Hospital, Turkey between January 2016 and December 2020. METHODOLOGY: This study included 141 eyes of 139 patients who underwent pars plana vitrectomy for macular holes. The patients were divided into two groups according to the anatomic closure after surgery. Group 1 (cases) were patients with macular hole closure, and group 2 (controls) were patients whose macular hole was not closed. The patients with and without diabetes mellitus (DM) or hypertension (HT) were compared. All patients did not have retinopathy. After surgery, the anatomical closure rate of the macular hole and the amount of increase in visual acuity were measured. Significance of the difference between the groups was evaluated using chi-square test. RESULTS: The best-corrected visual acuity (BCVA) was 1.30 logMAR before surgery and 0.7 logMAR after surgery (p<0.001). While BCVA was 1.3 logMAR before surgery in the group with DM, it was 0.7 logMAR after surgery (p<0.001). In the group with HT, BCVA was 1.3 logMAR before surgery and 0.7 logMAR after surgery (p<0.001). The anatomic success rate after surgery in patients with DM was similar to the group without DM (p=0.93). The anatomic success rate after surgery in patients with HT was similar to the group without HT (p=0.46). CONCLUSIONS: In the absence of retinopathy there is no difference between the success rates of the macular hole surgery in patients with or without DM and HT. KEY WORDS: Diabetes mellitus, Hypertension, Vitrectomy, Macular hole.

Effect of bariatric surgery on macular and peripapillary choroidal structures in young patients with morbid obesity.

OBJECTIVE: To examine the effect of bariatric surgery on the macular and peripapillary choroid in the late postoperative period in young patients with morbid obesity and compare them with a healthy control group. METHODS: This prospective controlled study included 50 eyes of 25 young patients with morbid obesity and 50 eyes of 25 age and sex-matched healthy controls. Sleeve gastrectomy was performed on all patients with obesity. Preoperative and 6-month postoperative macular and peripapillary choroidal thickness, total choroidal area (TCA), luminal area (LA), and choroidal vascularity index (CVI) were performed. Results were compared with healthy controls by using enhanced depth imaging optical coherence tomography. RESULTS: Choroidal thickness and CVI values were smaller in patients with obesity in both macular and peripapillary areas compared with the healthy control group (both p < 0.001). There was a statistically significant increase in the macular and peripapillary choroidal thickness of patients with obesity when the preoperative and the postoperative 6-month values after bariatric surgery were compared (both p < 0.001). Also, it was found that bariatric surgery increased TCA and LA values in the macular and all sectors of peripapillary areas (all p < 0.001), and CVI values in the temporal and nasal peripapillary sectors (p = 0.007, p = 0.012, respectively). CONCLUSIONS: Bariatric surgery was found to increase the macular and peripapillary choroidal thickness and the nasal and temporal peripapillary CVI values in young patients with morbid obesity in the late period. To the best of our knowledge, the current study has shown for the first time that bariatric surgery affects peripapillary choroid and CVI values.

In Vivo confocal microscopy findings after COVID-19 infection.

PURPOSE: To evaluate clinical and in vivo confocal microscopy (IVCM) findings of a patient who developed multiple unilateral subepithelial stromal opacities following conjunctivitis that developed during a COVID-19 infection. METHODS: A 22-year-old female presented to our clinic with blurred right vision. The history revealed that she had experienced a COVID-19 infection one month ago. Redness and stinging of the right eye had started at the same time and she had been prescribed topical antibiotic drops and ointments. The redness in the right eye had decreased but blurred vision had then developed. RESULTS: Slit lamp examination revealed a normal left eye. Several tiny subepithelial infiltrates without fluorescein staining of the cornea were present in the right eye. The anterior chamber, lens and fundus were bilaterally normal. IVCM revealed irregular corneal epithelial cells with bright borders in addition to scattered inflammatory cells and cell debris in the right eye. There were activated dendritic cells in the subbasal epithelial area with a significant decrease in the subbasal corneal nerve plexus. Clusters of highly reflective cells with an irregular shape were seen in the anterior corneal stroma together with foci of activated keratocytes. The corneal endothelial cell layer was normal. The left eye IVCM findings were all within normal limits. The right eye also showed decreased corneal sensitivity compared to the left. CONCLUSIONS: The possible role of corneal infiltrates as a trigger for COVID-19 could be explained with an immune-mediated mechanism. SARS-CoV-2 can result in decreased corneal sensitivity through corneal nerve involvement. The clinical results of this effect need to be evaluated in larger series.

Evaluation of serum neutrophil-to-lymphocyte ratio in corneal graft rejection after low-risk penetrating keratoplasty.

PURPOSE: To evaluate systemic inflammatory parameters in patients with corneal graft rejection after low-risk penetrating keratoplasty. METHODS: Patients undergoing penetrating keratoplasty with indications of keratoconus, pseudophakic bullous keratopathy, and Fuchs endothelial dystrophy were analyzed retrospectively. Patients who had an endothelial rejection attack within two years post-transplant were included in the rejection group (n = 20), whereas patients with at least two years of post-transplant follow-up without graft rejection or failure were included in the control group (n = 46). All patients' clinical features and preoperative laboratory parameters were obtained from hospital records. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio of the groups were calculated and compared. RESULTS: There was no difference between the two groups in terms of age, sex, indication, postmortem time and storage time of grafts, graft diameter, follow-up time, and common systemic diseases (p > 0.05). The NLR was found to be significantly lower in the rejection group when compared with the control group (2.04 ± 1.17, 2.66 ± 0.91, respectively, p = 0.023). There was no significant difference between the groups in terms of MLR and PLR (p = 0.243, p = 0.101, respectively). CONCLUSIONS: Although a high NLR value, which is an indicator of systemic inflammatory condition, is associated with many ocular diseases, NLR was found to be lower in patients with a rejection episode after transplant surgery when compared with the control group. Further studies are needed to clarify the role of these hematologic parameters in graft rejection.

Sarcoidosis Presenting with Bilateral Optic Disc Edema as the Initial Presentation.

Sarcoidosis is a chronic, progressive, granulomatous inflammatory disease of unknown etiology that affects multiple organ systems. Granulomatous anterior uveitis is the most common eye finding, and optic nerve involvement at presentation is rarely seen. Here, we report a 43-year man referred to our clinic with eye pain, decreased vision, floaters and bilateral papillitis, vitritis and cystoid macular edema. The level of serum angiotensin-converting enzyme, thoracic computed tomography and transbronchial needle aspiration biopsy of lymph nodes were confirmatory for sarcoidosis. In this case, sarcoidosis initially presented with bilateral papillitis and vitritis without granulomatous uveitis, and successful results were obtained with methylprednisolone and immunosuppressive treatment without any relapse or systemic involvement of sarcoidosis. Sarcoidosis should be considered in patients presenting with optic nerve inflammation, even when granulomatous inflammation or vasculitis are not present, which are specific for ocular sarcoidosis. Key Words: Edema, Optic disc, Papillitis, Sarcoidosis.

Evaluation of the Quality, Reliability, and Educational Content of YouTube Videos as an Information Source for Soft Contact Lenses.

OBJECTIVES: To evaluate the quality, reliability, and educational content of YouTube videos related to soft contact lenses (CL). METHODS: An online YouTube search was performed for the terms contact lens and other common CL-related terms contact lens insertion and removal, contact lens wearing, and contact lens care. The first 50 videos were evaluated for each term. Videos were evaluated using three checklists (the modified DISCERN criteria, the Journal of the American Medical Association [JAMA] criteria, and Global Quality Score [GQS]). Video popularity was also evaluated using the video power index (VPI). Videos were classified into three groups according to the source of the upload; group 1: universities/occupational organizations, group 2: medical ad/profit-oriented companies, and group 3: independent users. RESULTS: From among the 200 videos analyzed, 79 were included. The mean mDISCERN score of the videos was 2.34±1.39, the mean JAMA score was 1.20±0.99, and the mean GQS value was 3.47±1.28. There were positive correlations between the three checklists (P<0.001). Video power index was not correlated with each score. The videos in group 1 (13.9%) had the highest scores whereas videos in group 3 (41.8%) had the lowest scores. There was no significant difference between the video sources according to the VPI. CONCLUSION: Although some YouTube videos contain useful information for CL wearers, most videos have poor quality and reliability and contain insufficient information. Eye care providers should be aware of these sources and steer CL users to information sources that provide accurate and reliable information and do not contain misleading information.

Retinal and choroidal vascularity changes in healthcare professionals wearing FFP3 respirators.

PURPOSE: To evaluate short-term retinal and choroidal vascularity changes in the healthcare professionals after four hours of use filtering facepiece respirators (FFR). MATERIALS AND METHODS: This prospective study included 20 healthcare professionals. Oxygen saturation, pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), and spectral domain optical coherence tomography (OCT) imaging were evaluated at baseline and after four hours wearing of FFP3 FFRs without an exhalation valve. Superior temporal artery (STA), inferior temporal artery (ITA), superior temporal vein (STV), and inferior temporal vein (ITV) diameter were measured from OCT images. The total subfoveal choroidal area (TCA), luminal area (LA), stromal area (SA) choroidal vascularity index [(CVI), the ratio of LA to TCA] were determined after binarization of enhanced depth imaging OCT (EDI-OCT) images of the choroid. RESULTS: The mean age of the participants was 27.35 ± 2.80 years (range, 25-34). Eight of them were female and 12 were male. After wearing the FFR for four hours, a significant decrease was observed in the mean DBP (p = 0.018), MAP (p = 0.016), and MOPP (p = 0.007) when compared to base-line values. STV diameter (p = 0.019) and ITV diameter (p = 0.046) measurements were found significantly higher than baseline measurements. A significant increase in the choroidal vascularity was observed in the LA (p = 0.004) and TCA values (p = 0.043) after wearing the FFR for four hours. CONCLUSION: The current study shows that after four hours usage of FFR, in addition to systemic changes, retinal and choroidal vascularity might be affected significantly. With further studies, long-term effects and clinical significance of these short-term changes should be investigated on healthcare professionals.

Effect of migraine attack on pupil size, accommodation and ocular aberrations.

PURPOSE: To evaluate the pupil size, accommodation, and ocular higher-order aberrations (HOAs) in patients with migraine during migraine attacks and compare them with interictal period and healthy controls. METHODS: This prospective, case-control study included 48 eyes of 24 patients with migraine and 48 eyes of 24 age and sex-matched healthy controls. Measurements were performed using a Hartmann Shack aberrometer. Accommodative responses to accommodative stimulus ranging from 0 to 5 diopters (D) in increments of 0.5 D were recorded. Spherical, coma, trefoil aberration, and root mean square (RMS) of total HOAs were assessed. Patients with migraine were measured twice during the interictal phase and during migraine attack. RESULTS: The mean pupil size significantly decreased during migraine attack (5.85 ± 0.19 mm) compared with the interictal phase (6.05 ± 0.19 mm) in the patients with migraine (p = 0.012). There was a significant increase in the accommodative response to accommodative stimulus of 1.5 to 5 D during migraine attack. No significant change was observed in HOAs during migraine attack. In addition, no ictal or interictal period measurements were statistically significantly different from the controls. Comparing symptomatic and non-symptomatic sides in 17 migraine patients with unilateral headache, no significant difference was found in any of the measurements in both ictal and interictal periods. CONCLUSION: Our results suggest the presence of a subtle oculosympathetic hypofunction in patients with migraine during the ictal period compared to the interictal period. The accommodation status of the eye seems to be affected by this autonomic dysfunction.

Systemic Inflammatory Biomarkers in Patients with Fuchs' Uveitis Syndrome: Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio.

OBJECTIVE: To evaluate the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with Fuchs' uveitis syndrome (FUS). STUDY DESIGN: A case-control study. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Haydarpasa Numune Training and Research Hospital, Turkey, between July 2016 and June 2019. METHODOLOGY: Twenty-eight patients with unilateral FUS and 30 healthy subjects were enrolled in the study. The NLR and PLR were calculated from complete blood counts tests; and compared between the groups. RESULTS: There were 28 patients (14 females, 14 males; median age: 33.5 (30-47.5) in the FUS group; and 30 patients (16 females, 14 males; median age 37.5 (33-41.8) in the healthy group. The NLR (1.7 v.s 1.2, p = 0.036 was found to be significantly higher and PLR was lower (100.27 ±37.13 v.s. 141.68 ±26.50 p <0.001) in the FUS group compared with the healthy controls. The median WBC (p <0.001), neutrophil (p <0.001), lymphocytes (p <0.001), and monocyte (p=0.041) values were found significantly higher in the FUS group compared with controls. The significant correlations were not seen between the number of anterior chamber cells; which are ocular inflammatory parameter and NLRs (r = 0.312, p = 0.106) and PLRs (r = 0.148, p = 0.453). CONCLUSION: The current study suggests that a slowly progressive immune-mediated process can affect peripheral blood inflammatory biomarkers and there is evidence of benign subclinical systemic inflammation in patients with FUS. Key Words: Fuchs uveitis syndrome, Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio.

Optic Nerve Head Changes in Patients with Optic Neuritis Secondary to Multiple Sclerosis: A Comparison of the Affected and Fellow Healthy Eyes.

OBJECTIVE: To evaluate the thickness of lamina cribrosa (LC) in patients with multiple sclerosis (MS) using optical coherence tomography (OCT) and the effect of optic neuritis (ON) attack on these measurements during the remission period. METHODS: The study included 20 cases diagnosed with relapsing-remitting MS with a history of ON attacks affecting one eye and in remission of MS and ON attacks for at least three months, and 28 randomly selected eyes of age- and sex-matched healthy controls. In the MS group, the eyes affected by ON attack were assigned as Group 1 (MS+ON), their fellow unaffected eyes as Group 2 (MS-ON), and healthy control eyes as Group 3. The LC, peripapillary retinal nerve fiber layer (ppRNFL), and subfoveal choroidal thickness measurements were made by using OCT in all cases, and results were compared between the groups. RESULTS: The mean LC thickness in MS+ON and MS-ON groups was significantly lower than the control group (p<0.001). There was no significant difference between MS+ON and MS-ON groups in terms of mean LC thickness (p=0.073). The mean ppRNFL in the MS+ON and MS-ON groups was statistically significantly lower than the control group (p=0.003, p=0.035, respectively). CONCLUSIONS: It is noteworthy that LC is significantly affected in eyes with MS who have not had a history of ON attack. Evaluation of the LC measurements can be important for early detection of optic nerve damage in patients with MS.