Objective evaluation of changes in lens clarity after repeated injections of ranibizumab in patients with neovascular age-related macular degeneration.

PURPOSE: To objectively evaluate changes in lens densitometry in eyes with neovascular age-related macular degeneration (n-AMD) treated with repeated intravitreal ranibizumab injections during a 12-month period and to compare the results with those in untreated healthy fellow eyes and healthy control eyes. METHODS: In this prospective study, the 36 treated eyes and the 37 untreated fellow eyes of 38 patients with n-AMD and the 32 control eyes of 32 healthy individuals were analyzed. Lens densitometry was evaluated using the Scheimpflug imaging. All data in both groups regarding lens densitometry were recorded at baseline and 12 months. RESULTS: The mean densitometry of zone 1 in the treated eyes of patients had increased significantly at 12 months compared with the baseline (baseline: 9.3 ± 1.5, 12 months: 11.9 ± 1.7, p = .004) and was significantly greater than those measurements in the fellow eyes (9.8 ± 1.6 p = .02) and control eyes (9.6 ± 1.9, p = .01) at 12 months as well. There were no significant differences in terms of densitometry values between the fellow and control eyes at baseline and 12 months (for all, p > .05). CONCLUSIONS: Our results objectively demonstrate early nuclear lens density changes using with Scheimpflug images in eyes with n-AMD that were treated with repeated ranibizumab injections for 12 months.

Assessment of choriocapillaris/Sattler and Haller layer changes after intravitreal injection in eyes with neovascular age-related macular degeneration: aflibercept vs ranibizumab.

PURPOSE: To evaluate the changes in choriocapillaris (CC)/Sattler and Haller layer thicknesses in eyes with neovascular age-related macular degeneration (nAMD) after aflibercept or ranibizumab injections. STUDY DESIGN: Retrospective. METHODS: A total of 70 eyes of 70 patients with treatment-naïve exudative nAMD were treated with 3 consecutive injections of aflibercept (IVA) or ranibizumab (IVR). CC/Sattler and Haller layer thicknesses were measured at the nasal and temporal regions 1000 µm from the center of the fovea by enhanced-depth imaging optical coherence tomography at baseline and after the 3 monthly intravitreal injections. In addition, the hyperfluorescence region (HF) was measured as the largest horizontal diameter of the hyperfluorescence area on the early-middle phase fluorescein angiographic images at baseline and after the 3 loading doses. RESULTS: After the 3 consecutive injections, the mean reductions in the nasal/temporal CC/Sattler layer thicknesses in the IVR and IVA groups were - 10.1 ± 2.3/ - 8.5 ± 1.8 and - 25.2 ± 15.2/ - 19.4 ± 12.8 µm, respectively. Also, the mean reductions in the nasal/temporal Haller layer thicknesses in the IVR and IVA groups were - 6.5 ± 3.6/ - 7.2 ± 7.9 and - 9.5 ± 8.0/ - 7.0 ± 6.2 µm, respectively. The changes in the CC/Sattler layer thicknesses of the IVA group were greater than those of the IVR group (P < .001); however, the changes in the Haller layer thickness were similar between the groups (P > .05). The mean decrease in the HF size of the IVA group was greater than that of the IVR group (P < .001). CONCLUSIONS: Aflibercept treatment has a more pronounced effect on the CC/Sattler layer. Such results may indicate that aflibercept treatment influences choroidal neovascularization, possibly by reducing the capillary permeability associated with active neovascularization in the CC layer.

Change in retinal vessel diameter and choroidal thickness in patients with severe COVID-19: Change In Retinal Parameters In Patients With Severe COVID-19.

PURPOSE: To compare the differences in retinal vascular structure and choroidal thickness between the active disease and post-recovery periods in COVID-19 patients and healthy controls. MATERIAL AND METHODS: This prospective, cross-sectional study included 30 eyes from 30 patients with severe COVID-19 and 30 eyes of 30 sex-matched healthy controls. Central macular thickness (CMT), subfoveal choroidal thickness (CT) and retinal vascular changes of patients were measured after positive polymerase chain reaction (PCR) (where the patient had COVID-19-related symptoms) and then three months after two negative PCRs. Laboratory parameters, including C-reactive protein and d-dimer levels, were also recorded. RESULTS: The mean age of the patients was 47.90 ± 9.06 years in patients group, 49.07 ± 8.41 years in control goups (p = 0.467). In terms of choroidal thicknesses subfoveal, nasal and temporal region were significantly higher in the active disease period than control group (p = 0.019, p = 0.036, p = 0.003, respectively). When the after recovery period was compared with the control group in terms of choroidal thickness, although the choroidal thickness was higher in all regions, this difference was not found statistically significant. There was no statistically significant difference in CMT between groups (p = 0.506).The mean venous and arterial wall thicknesses were significantly higher in the active period than after recovery (p = 0.023, p = 0.013, respectively) but there were no differences between after recovery and control groups in the pairwise comparison (p = 0.851, p = 0.715, respectively). CONCLUSION: In patients with severe COVID-19, there are changes in thickness of the choroid and retinal vessel walls. While vascular wall thickness increases due to inflammation, the absence of lumen changes may be associated with hemodynamic variables.

Evaluation of the change in retinal thickness after femtosecond laser-assisted laser in situ keratomileusis and photorefractive keratectomy.

PURPOSE OF THE STUDY: To investigate the change in individual retinal layer thickness by spectral-domain optical coherence tomography (SD-OCT) in eyes underwent femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and photorefractive keratectomy (PRK). METHODS: In patients who underwent PRK and FS-LASIK, changes in the thickness of all retinal layers in the foveal, parafoveal, and perifoveal regions were evaluated by SD-OCT automated segmentation analysis at pre-operatively and different time points post-operatively. RESULTS: Seventy-one eyes of 71 patients (38 patients in PRK, 33 patients in LASIK) were included. In the pre-operative period, mean spherical equivalent (SE), mean keratometry, axial length, and segmentation values of the retinal layers were similar (P> .05). In the PRK group, the pre-operative measurements of individual retinal layers did not show a statistically significant difference compared to the post-operative measurements on the 1st day, 1st week, and 1st month. In the FS-LASIK group, the mean inner nuclear layer (INL) thickness one day after the surgery was significantly higher than that before surgery in the foveal (21.22 ± 4.66 µm vs 19.03 ± 4.50 µm, P= .013) and parafoveal regions (41.98 ± 3.70 µm vs 40.56 ± 3.49 µm, P= .044). CONCLUSIONS: The findings of our study suggest that the increase of INL thickness may be due to temporary structural and circulatory changes of the retina that may occur in the suction phase in the FS-LASIK procedure.

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.

EVALUATION OF RETINAL VESSEL DIAMETERS IN EYES WITH ACTIVE CENTRAL SEROUS CHORIORETINOPATHY.

PURPOSE: To compare the retinal vessel diameters of healthy eyes and active central serous chorioretinopathy (CSC) eyes, and to evaluate possible effect of retinal vessel diameter alterations on the pathogenesis of CSC. METHODS: This retrospective study included 39 patients with CSC and 34 healthy individuals. Spectralis optical coherence tomography + HRA with an infrared reflectance image were used to evaluate structure of retinal vessels in the circular region around the optic disc. For each eye, vertical inner and outer diameters of the four major arteries and veins were measured using infrared reflectance images, and vessel wall thicknesses were also calculated based on inner and outer diameters. RESULTS: The 304 vessels of the 39 active CSC eyes and 266 vessels of the 34 healthy eyes were used in the analyses. The mean venous wall thickness in active CSC eyes was significantly thicker than that in healthy eyes (40.0 ± 4.9 vs. 33.5 ± 4.1 µm, P = 0.001), whereas the mean venous inner diameter in active CSC eyes was significantly narrower (52.5 ± 9.7 vs. 61.3 ± 8.1 µm, P = 0.001). Also, the mean venous outer diameter was wider in CSC eyes, albeit not significantly (131.1 ± 7.0 vs. 128.5 ± 8.4 µm, P = 0.074). CONCLUSION: Our results suggest that the alterations of retinal venous diameters may play a potential role in the pathogenesis of CSC in addition to alterations in choroidal thickness.

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.

Using Anterior Segment Optical Coherence Tomography to Assess Angle Anatomy in Patients with Neurofibromatosis Type 1.

SIGNIFICANCE: Lisch nodules have been identified in more than 90% of patients 16 years or older with neurofibromatosis type 1 (NF1). According to our hypothesis, the presence of Lisch nodules in patients with NF1 might affect the anterior chamber angle (ACA) parameters. PURPOSE: The aim of this study was to evaluate the anterior segment angle parameters using anterior segment optical coherence tomography in patients with NF1. METHODS: A total of 42 eyes from 21 patients with NF1 (study group) and 42 eyes from 21 age- and sex-matched healthy individuals (control group) were included in this study. Angle opening distance at 500 (AOD500) and 750 µm (AOD750) anterior to the scleral spur, ACA, and iris thickness (IT) values were measured in the temporal (T) and nasal (N) quadrants using anterior segment optical coherence tomography. RESULTS: The mean AOD500 and AOD750 values in both quadrants were significantly lower in the study group compared with the control group (T-AOD500: 548 ± 151 vs. 761 ± 288 [P < .001], T-AOD750: 705 ± 175 vs. 921 ± 334 [P < .001], N-AOD500: 599 ± 223 vs. 777 ± 292 [P = .002], and N-AOD750: 756 ± 268 vs. 948 ± 303 [P = .003], respectively). The mean ACA values in both quadrants were significantly narrower in the study group compared with the control group (T-ACA: 29.52 ± 6.36 vs. 40.83 ± 8.90 [P < .001] and N-ACA: 30.05 ± 7.11 vs. 41.29 ± 8.68 [P < .001], respectively). The IT values in both quadrants were significantly thicker compared with the control group (T-IT500: 406 ± 78 vs. 355 ± 59 [P = .001], T-IT750: 453 ± 103 vs. 362 ± 100 [P < .001], N-IT500: 416 ± 93 vs. 353 ± 54 [P < .001], and N-IT750: 437 ± 91 vs. 370 ± 95 [P = .002], respectively). CONCLUSIONS: We have revealed lower angle opening distance values in individuals with NF1 than in the healthy ones, as well as significantly narrower ACA values and significantly thicker IT values.

Evaluation of lamina cribrosa thickness in patients diagnosed with central retinal vein occlusion.

PURPOSE: To evaluate the thickness of lamina cribrosa (LC) in both eyes of patients with unilateral central retinal vein occlusion (CRVO) and to compare with eyes of age-matched healthy control subjects. METHODS: This prospective case-control study included a total of 38 patients with unilateral CRVO and 42 healthy control subjects. The LC thickness was measured at the center of the optic disc using an enhanced depth imaging with the spectral domain optical coherence tomography in both eyes of patients with unilateral CRVO and eyes of healthy control subjects. The LC thickness of CRVO patients was evaluated one month after dexamethasone intravitreal implant (Ozurdex) injection. RESULTS: The mean LC thickness in affected eyes of patients with CRVO was significantly thinner than that of the healthy eyes (204.4 ± 8.8 and 228.0 ± 7.1 µm, p < 0.001, respectively). Also, the unaffected fellow eyes had significantly thinner LC compared with eyes of healthy subjects (205.3 ± 9.3 and 228.0 ± 7.1 µm, p < 0.001, respectively). There was no statistically significant difference in the thickness of LC between the affected and unaffected fellow eyes (p = 0.669). CONCLUSIONS: The LC thickness in both eyes of CRVO patients was thinner than that of the healthy eyes. This finding suggests that thin LC may contribute to the development of CRVO as an ocular risk factor in addition to systemic factors.

Relationship between erythrocyte sedimentation rate and choroidal and retinal thickness in Behçet's disease / A relação entre a taxa de sedimentação eritrocitária, espessuras de coroide e retina na doença de Behçet

ABSTRACT 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 sedimenta­tion 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 cho­roidal 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.

RESUMO Objetivos: Comparar a espessura da retina e da coroide em pacientes com doença de Behçet, com e sem acometimento ocular e avaliar a correlação entre a taxa de sedimentação de eritrócitos e a espessura da coroide em pacientes com doença de Behçet. Métodos: Estudo prospectivo intervencional que investigou a sedimentação de eritrócitos, espessura de coroide e da retina em pacientes com doença de Behçet. Os pacientes que foram diagnosticados com base nos Critérios Internacionais para a Doença de Behçet com (Grupo A) ou sem (Grupo B) envolvimento ocular e um grupo controle correspondente (Grupo C) participaram do estudo. Medidas de tomografia de coerência óptica e exames de sangue foram realizados no mesmo dia. As espessuras da retina e da coroide foram medidas utilizando tomografia de coerência óptica de domínio espectral (Spectralis, Heidelberg Engineering, Hidelberg, Germany) e a espessura macular central, a espessura coroidal subfoveal central e a espessura da camada de fibra nervosa da retina foram medidas usando tomografia de coerência óptica. Resultados: Os valores médios de sedimentação de eritrócitos foram de 9,89 mm/h no Grupo A, 16,21 mm/h no Grupo B e 3,89 mm/h no Grupo C; os valores médios da espessura da coroide subfoveal central foram 350,66, 331,74 e 325,95 mm respectivamente. Os valores médios da espessura macular central e da espessura da camada de fibra nervosa da retina dos pacientes nos grupos A, B e C foram de 226,39, 225,97, 234,11 mm e 92,00, 97,58, 99,84 mm respectivamente. Não houve diferença significativa entre pacientes do Grupo A e B na espessura da coroide subfoveal central, espessura macular central ou valores da espessura da camada de fibra nervosa da retina. A espessura macular central foi estatisticamente significativamente mais fina nos Grupos A e B do que no Grupo C (p=0,016). O Grupo A apresentou afinamento na porção nasal das camadas retiniana e geral da fibra nervosa da retina quando comparado com o Grupo C (p=0,010, p=0,041, respectivamente). Não foi possível estabelecer uma conexão entre a sedimentação dos eritrócitos, a espessura subfoveal central da coroide, a espessura macular central e espessura da camada de fibras nervosas da retina nos pacientes com doença de Behçet. Conclusão: A taxa de sedimentação de eritrócitos é comumente utilizada para testar a ativação da doença de Behçet e avaliar a resposta ao tratamento. Em nosso estudo, não foi possível estabelecer uma conexão entre a taxa de sedimentação de eritrócitos e a espessura da coroide subfoveal central, espessura macular central e espessura da camada de fibras nervosas da retina em pacientes com doença de Behçet sistematicamente ativa sem envolvimento ocular.

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.

The Effect of Age on Dexamethasone Intravitreal Implant (Ozurdex®) Response in Macular Edema Secondary to Branch Retinal Vein Occlusion.

PURPOSE: To investigate the effect of age on dexamethasone intravitreal implant (Ozurdex®) response in macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: Seventy-three eyes of 73 patients with macular edema secondary to BRVO were recruited in the study. The patients in the study were divided into the following four groups according to their ages: group 1 (<60 years), group 2 (60-69 years), group 3 (70-79 years), and group 4 (≥80 years). Single-dose Ozurdex injection was applied to all patients. The effectiveness of Ozurdex treatment on macular edema is evaluated via optical coherence tomography (OCT) according to the age groups. RESULTS: Two months after Ozurdex injection, mean reduction of central retinal thickness in groups 1, 2, 3, and 4 were -466.4 ± 149.6, -379.7 ± 238.7, -280.1 ± 233.0, and -180.5 ± 81.4 µm, respectively. This reduction of central retinal thickness decreased with aging (p = 0.001). Also, ages of patients were negatively correlated with the mean reduction of central retinal thickness for the whole study group (r = -0.439, p < 0.001). CONCLUSION: Our study revealed that the effectiveness of Ozurdex treatment decreases with aging.

Assessing posterior ocular structures in ß-thalassemia minor.

PURPOSE: The aim of this study was to investigate the effect of ß-thalassemia minor on choroidal, macular, and peripapillary retinal nerve fiber layer thickness. METHODS: To form the sample, we recruited 40 patients with ß-thalassemia minor and 44 healthy participants. We used spectral-domain optical coherence tomography to take all measurements of ocular thickness, as well as measured intraocular pressure, axial length, and central corneal thickness. We later analyzed correlations of hemoglobin levels with ocular parameters. RESULTS: A statistically significant difference emerged between patients with ß-thalassemia minor and the healthy controls in terms of mean values of subfoveal, nasal, and temporal choroidal thickness (p = 0.001, p = 0.016, and p = 0.010, respectively). Except for central macular thickness, differences in paracentral macular thicknesses between the groups were also significant (superior: p < 0.001, inferior: p = 0.007, temporal: p = 0.001, and nasal: p = 0.005). Also, no statistically significant differences were noted for retinal nerve fiber layer thickness between two groups. CONCLUSION: Mean values of subfoveal, nasal, temporal choroidal, and macular thickness for the four quadrants were significantly lower in patients with ß-thalassemia minor than in healthy controls.

The eyes of children with celiac disease.

PURPOSE: To determine possible eye involvement in pediatric patients with celiac disease. METHODS: Children (aged 5-18 years) with classic celiac disease and sex- and age-matched controls were included. In addition to a complete ophthalmologic examination, all patients were scanned by a Scheimpflug camera and spectral domain optical coherence tomography, and Schirmer and break-up time (BUT) tests were performed. Data were evaluated by paired t test, with a P value of <0.05 considered statistically significant. RESULTS: A total of 31 celiac patients (19 females [61%]) and 34 controls (20 females [59%]) were included. Mean age of the celiac patients was 11.0 ± 4.4 years (range, 4-18 years); of the controls, 10.4 ± 2.6 years (range, 5-15 years; P = 0.473). Mean follow-up of patients was 5.4 ± 1.7 years (range, 3-7.2 years). The eyes of children with celiac disease, compared to controls, did show decreased anterior chamber depth (3.5 ± 0.2 vs 3.7 ± 0.2, resp.; P < 0.001), decreased anterior chamber volume (170.8 ± 25.5 vs 190.7 ± 27.4; P < 0.001), lower Schirmer (17.9 ± 9.1 vs 21.6 ± 4.1; P = 0.038), and lower BUT (10.8 ± 3.8 vs 12.1 ± 1.7; P = 0.046), as well as lower retinal nerve fiber layer (general 102.8 ± 8.2 vs 108.9 ± 10.1; P < 0.001). CONCLUSIONS: Decreases in retinal nerve fiber, anterior chamber shallowing, and qualitative and quantitative reduction in tears can occur in celiac patients, even if routine ocular examination reveals no abnormality.

The assessment of choroidal thickness with spectral-domain optical coherence tomography during Valsalva maneuver.

PURPOSE: The purpose of the study was to evaluate the effect of Valsalva maneuver (VM) on choroidal thickness. METHODS: All the volunteers underwent a detailed opthalmic examination. Third-generation Spectralis OCT device (software version 5.6.3.0; Spectralis OCT, Heidelberg Engineering, Dossenheim, Germany) was used for assessment. Subfoveal and perifoveal CT of all volunteers were measured by using EDI-OCT technology. Perifoveal CT was measured 1500 µm nasally and 1500 µm temporally apart from the foveal center. The measurements were repeated while volunteers were performing VM. RESULTS: Sixty-four eyes of 32 healthy volunteers were assessed. The volunteers were aged 29-50. The mean age was 32.8 ± 6.6 years. Choroidal thickness measurements differed with statistical significance between resting position and VMin all regions (p < 0.001). While mean subfoveal CT was 350.64 ± 87.73 µm during resting position, it was 369.95 ± 90.12 µm during VM (p < 0.001). While mean nasal CT was 292.14 ± 81.67 µm during resting position, it was 305.46 ± 85.80 µm during VM (p < 0.001). While mean temporal CT was 325.93 ± 80.91 µm during resting position, it was 343.21 ± 81.53 µm during VM (p < 0.001). CONCLUSIONS: We found statistically significant increase in choroidal thickness during the VM in healthy volunteers. This result might be important for future studies researching autoregulation of choroidal and retinal blood flow in physiologic and pathologic conditions. Also, our study is noteworthy to stand out the errors in EDI-OCT measurements caused by unintentional breath holding of patients.

Evaluation of foveal photoreceptor layer in eyes with macular edema associated with branch retinal vein occlusion after ozurdex treatment.

The aim of this study was to evaluate the central retinal thickness (CRT), outer nuclear layer thickness (ONLT), photoreceptor layer thickness (PLT), photoreceptor layer integrity, and the correlation between visual acuity and PLT in eyes with branch retinal vein occlusion (BRVO) 2 months after treatment with intravitreal dexamethasone implant (Ozurdex; Allergan, Inc, Irvine, CA). In this prospective study, 32 eyes of 32 patients were enrolled. A single injection of Ozurdex was administered to all the patients. CRT, ONLT, and PLT were measured using spectral-domain optical coherence tomography before and 2 months after the injection. Best-corrected visual acuity (BCVA [logMAR]) and photoreceptor cell integrity were also evaluated. The average CRT, ONLT, PLT, and BCVA values for the sample group before the treatment were as follows: 707 ± 261, 608 ± 288, 70 ± 25, and 0.96 ± 0.22 µm, respectively. The average CRT, ONLT, PLT, and BCVA values for the sample group 2 months after the Ozurdex injection were as follows: 299 ± 149, 211 ± 138, 77 ± 20, and 0.63 ± 0.30 µm, respectively (p < 0.05). Two months after the Ozurdex injection, BCVA correlated with ONLT and PLT (r = 0.365, p = 0.048 and r = -0.488, p = 0.021, respectively), whereas BCVA was not correlated with CRT (r = 0.239, p = 0.189). Photoreceptor layer is associated with the visual function of eyes with macular edema secondary to BRVO. Also, ONLT seems to be more closely related to visual acuity improvement than CRT decrement.

Short-term effects of intravitreal dexamethasone implant (OZURDEX®) on choroidal thickness in patients with naive branch retinal vein occlusion.

PURPOSE: The objective of this study was to evaluate subfoveal choroidal thickness (SFCT) using enhanced depth imaging optical coherence tomography (EDI-OCT) in patients with naïve branch retinal vein occlusion (BRVO) before and after intravitreal dexamethasone implant (Ozurdex®) injection. METHODS: Thirty-nine patients with unilateral BRVO and 35 healthy subjects were included in this prospective study. Choroidal thickness was evaluated by EDI-OCT at baseline and 1 month after dexamethasone implant. RESULTS: The mean SFCT measured in 39 patients with BRVO was 299.41 ± 55.86 µm, significantly greater than that in contralateral eyes (283.76 ± 57.44 µm; p=0.009) and control eyes (276.14 ± 39.06 µm; p=0.044). The mean SFCT after the treatment was 279.64 ± 50.96 µm, significantly thinner than that before intravitreal dexamethasone therapy (p=0.004). CONCLUSIONS: SFCT in treatment-naive BRVO eyes was significantly greater than that in contralateral eyes and healthy eyes and decreased significantly after intravitreal dexamethasone implantation.

Short-term effects of intravitreal dexamethasone implant (OZURDEX®) on choroidal thickness in patients with naive branch retinal vein occlusion / Os efeitos a curto prazo do implante de dexametasona intravítrea (OZURDEX®) na espessura da coroide em pacientes com oclusão primária de ramo da veia central da retina

ABSTRACT Purpose: The objective of this study was to evaluate subfoveal choroidal thickness (SFCT) using enhanced depth imaging optical coherence tomography (EDI-OCT) in patients with naïve branch retinal vein occlusion (BRVO) before and after intravitreal dexamethasone implant (Ozurdex®) injection. Methods: Thirty-nine patients with unilateral BRVO and 35 healthy subjects were included in this prospective study. Choroidal thickness was evaluated by EDI-OCT at baseline and 1 month after dexamethasone implant. Results: The mean SFCT measured in 39 patients with BRVO was 299.41 ± 55.86 µm, significantly greater than that in contralateral eyes (283.76 ± 57.44 µm; p=0.009) and control eyes (276.14 ± 39.06 µm; p=0.044). The mean SFCT after the treatment was 279.64 ± 50.96 µm, significantly thinner than that before intravitreal dexamethasone therapy (p=0.004). Conclusions: SFCT in treatment-naive BRVO eyes was significantly greater than that in contralateral eyes and healthy eyes and decreased significantly after intravitreal dexamethasone implantation.

RESUMO Objetivo: O objetivo deste estudo foi avaliar a espessura da coróide (SFCT) usando imagens de tomografia de coerência óptica com profundidade aprimorada (EDI-OCT) no tratamento de pacientes com oclusão primária de ramo da veia central da retina (BRVO) antes e após o implante de dexametasona intravítrea (Ozurdex®). Métodos: Trinta e nove pacientes com BRVO unilateral e 35 indivíduos saudáveis foram incluídos neste estudo prospectivo. Espessura da coróide foi avaliada por EDI-OCT na antes e um mês após o tratamento. Resultados: A média da SFCT medida em 39 pacientes com BRVO foi 299,41 ± 55,86 µm, o que foi significativamente maior do que a dos olhos contralaterias (283,76 ± 57,44 µm) e dos olhos controle (276,14 ± 39,06 µm) (p=0,009 e p=0,044, respectivamente). A média da SFCT após o tratamento foi 279,64 ± 50,96 µm, o que foi significativamente menor do que antes do mesmo (p=0,004). Conclusões: A SFCT do tratamento de olhos com BRVO primária foi significativamente maior do que a dos olhos contralaterais e dos olhos saudáveis, e diminuiu significativamente após o implante intravítreo de dexametasona.

Evaluation of anterior segment parameters in patients with neurofibromatosis type 1.

PURPOSE: To evaluate anterior segment parameters in patients with neurofibromatosis type 1 (NF1) in comparison to healthy individuals. METHODS: A total of 34 eyes from 17 patients with NF1 and 34 eyes from 17 age- and sex-matched healthy individuals were included in this study. Each participant underwent a comprehensive ophthalmic assessment including best-corrected visual acuity, slit-lamp biomicroscopy, stereoscopic fundus examination, and intraocular pressure. Central corneal thickness, corneal volume, corneal curvatures (K1 and K2), anterior chamber depth, anterior chamber volume, iridocorneal angle, and pupil size values were measured by Pentacam Scheimpflug camera. RESULTS: The mean anterior chamber depth, iridocorneal angle, and anterior chamber volume measurements revealed significantly lower values when compared with the control group (p<0.001, p<0.001, and p = 0.041, respectively). However, the mean pupil size was significantly larger when compared with the control group (p = 0.008). Central corneal thickness, corneal volume, K1, and K2 values were similar between the study and control groups (p = 0.875, p = 0.549, p = 0.066, and p = 0.166, respectively). CONCLUSIONS: Our results reveal that NF1 is associated with statistically significant alterations in anterior chamber depth, iridocorneal angle, anterior chamber volume, and pupil size in patients with NF1 when compared with healthy controls.