Diurnal variation in choroidal thickness and body temperature / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate how body temperature (BT) affects choroidal thickness (CT) according to measurements taken with enhanced depth imaging optical coherence tomography (EDI-OCT).METHODS: In this prospective study, the CT of 41 healthy patients was measured hourly from 9∶00 to 17∶00 at the fovea (SF-CT), 500 μm nasal to the fovea(N-CT), and 500 μm temporal to the fovea (T-CT) using EDI-OCT.BT was also measured hourly from 9∶00 to 17∶00 using a non-contact infrared thermometer.Possible correlations between diurnal variations of CT and BT were evaluated.RESULTS: SF-CT values significantly differed between measurements at 9∶00 and 13∶00 (P=0.021), 9∶00 and 14∶00 (P=0.012), 9∶00 and 16∶00 (P=0.048), and 9∶00 and 17∶00 (P=0.002).N-CT values also significantly differed between measurements at 9∶00 and 13∶00 (P=0.004), though T-CT did not significantly vary during the 8h period (P >0.05 for all).CONCLUSION: CT is not significantly associated with hourly changes in BT from 9∶00 to 17∶00.

Effect of Hydroxychloroquine on the Retinal Layers: A Quantitative Evaluation with Spectral-Domain Optical Coherence Tomography.

Purpose. To evaluate the effect of hydroxychloroquine on retinal pigment epithelium- (RPE-) Bruch's membrane complex, photoreceptor outer segment, and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods. In this prospective case-control study, 51 eyes of 51 hydroxychloroquine patients and 30 eyes of 30 healthy subjects were included. High-quality images were obtained using a Cirrus HD-OCT with 5-line raster mode; the photoreceptor inner segment (IS) and outer segment (OS), sum of the segments (IS + OS), and RPE-Bruch's membrane complex were analyzed. Results. The thicknesses of the IS + OS and OS layers were significantly lower in the hydroxychloroquine subjects compared to the control subjects (P < 0.05). RPE-Bruch's membrane complex thicknesses were significantly higher in the hydroxychloroquine subjects than for those of the control subjects (P < 0.05). The minimum and temporal-inferior macular GCIPL thicknesses were significantly different between the patients with hydroxychloroquine use and the control subjects (P = 0.04 and P = 0.03, resp.). Conclusions. The foveal photoreceptor OS thinning, loss of GCIPL, and RPE-Bruch's membrane thickening were detected in patients with hydroxychloroquine therapy. This quantitative approach using SD-OCT images may have important implications to use as an early indicator of retinal toxicity without any visible signs of hydroxychloroquine retinopathy.

Comparison of corneal topographic measurements and high order aberrations in keratoconus and normal eyes.

PURPOSE: The aim of this report was to compare corneal topographic measurements and anterior high order corneal aberrations in eyes with keratoconus and normal eyes by using Scheimpflug-Placido topography. METHODS: Eighty cases diagnosed with mild (group 1), moderate (group 2), and advanced (group 3) stage keratoconus (KC) according to Amsler-Krumeich Classification and 81 healthy (control group) cases were retrospectively examined. The mean keratometric measurements (as both diopters (Kavg) and mm values (mmavg)), central corneal thickness values (CCT), high order aberration (HOA), total wavefront aberration (TWA), coma, trefoil, and spherical aberration measurements were performed using Sirius topography equipment. The topographic values were compared between the groups. RESULTS: There were 25 cases in group 1 KC (15.5%), 34 cases in group 2 KC (21.1%), 21 cases in group 3 KC (13.1%), and 81 cases (50.3%) in the control group. In terms of mean age and gender distributions, there was no statistically significant difference between the groups (p>0.05). However, there was significant difference between the groups in terms of Kavg, CCT, HOA, TWA, coma, trefoil, and spherical aberration values (p<0.01). Mean HOA, TWA, coma, trefoil, and spherical aberration values were observed to increase with the severity of KC disease. CONCLUSIONS: Anterior high order corneal aberrations were significantly increased in eyes with moderate and advanced keratoconus. Anterior high order corneal aberration measurements are a useful tool to guide the physician in diagnosis and classification of keratoconus.

Retinal nerve fiber layer, ganglion cell complex, and choroidal thicknesses in migraine.

PURPOSE: To evaluate the thicknesses of the peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex (GCL), and choroid layer using spectral domain optical coherence tomography (SD-OCT) for investigating the effects of vascular changes on the eye and optic nerve in patients who have migraine with aura. METHODS: Forty-five patients who had migraine with aura (migraine group) and 45 healthy individuals (control group) were enrolled in the study. Age, gender, duration after migraine diagnosis, intraocular pressure, and axial length measurements were recorded in each case. RNFL, GCL, and choroid layer thicknesses were measured using SD-OCT in all participants. RESULTS: The mean age was 36.1 ± 6.7 (20-45) years in the migraine group and 35.7 ± 8.6 (19-45) years in the control group. There was no significant difference in the RNFL thicknesses of the temporal and nasal quadrants (p >0.05). The RNFL thicknesses of the superior and inferior quadrants were significantly lower in the migraine group compared with those in the control group (p =0.001, p <0.01, respectively). Measurements for the superior and inferior GCL were not significantly different between the groups (p >0.05). Subfoveal, temporal, and nasal choroidal thickness measurements at 500 µm, 1000 µm, and 1500 µm were significantly lower in the migraine group than in the control group (p =0.001; p <0.01, respectively). CONCLUSIONS: Compared with the controls, the RNFL and choroid layer were determined to be thinner in patients who had chronic migraine with aura.

A PILOT STUDY OF CHOROIDAL THICKNESS IN LONG-TERM SMOKERS.

PURPOSE: To compare the choroidal thicknesses in long-term smokers with those of nonsmoking healthy individuals using spectral domain optical coherence tomography. PARTICIPANTS: Forty-six individuals who had been smoking at least for 20 years, but otherwise without systemic problems, participated in this prospective pilot study. The control group comprised 42 nonsmoking individuals. METHODS: The ages, refractions, and axial length measurements of the cases were recorded. Central macular thickness and choroidal thickness at the fovea and at 500 µm intervals from the foveal center in both temporal and nasal directions were measured using spectral domain optical coherence tomography. RESULTS: Although the smoking period of the smokers was mean 32.4 ± 9 years (range: 20-60), the mean pack-years of cigarettes was 35.1 ± 23.8 (range: 10-120). No significant difference was observed regarding refraction value and axial length between smokers and nonsmokers group. In addition, no significant difference was observed for central macular thickness and choroidal thickness values at 500, 1,000, 1,500, and 2,000 µm nasal and temporal part of the fovea, between 2 groups. CONCLUSION: Macular and choroidal thicknesses in long-term smokers were observed to be similar to those of healthy individuals.

Retinal nerve fiber layer, ganglion cell complex, and choroidal thicknesses in migraine / Espessuras da camada de fibras nervosas retinianas, complexo de células ganglionares e coroide na enxaqueca

ABSTRACT Purpose: To evaluate the thicknesses of the peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex (GCL), and choroid layer using spectral domain optical coherence tomography (SD-OCT) for investigating the effects of vascular changes on the eye and optic nerve in patients who have migraine with aura. Methods: Forty-five patients who had migraine with aura (migraine group) and 45 healthy individuals (control group) were enrolled in the study. Age, gender, duration after migraine diagnosis, intraocular pressure, and axial length measurements were recorded in each case. RNFL, GCL, and choroid layer thicknesses were measured using SD-OCT in all participants. Results: The mean age was 36.1 ± 6.7 (20-45) years in the migraine group and 35.7 ± 8.6 (19-45) years in the control group. There was no significant difference in the RNFL thicknesses of the temporal and nasal quadrants (p >0.05). The RNFL thicknesses of the superior and inferior quadrants were significantly lower in the migraine group compared with those in the control group (p =0.001, p <0.01, respectively). Measurements for the superior and inferior GCL were not significantly different between the groups (p >0.05). Subfoveal, temporal, and nasal choroidal thickness measurements at 500 µm, 1000 µm, and 1500 µm were significantly lower in the migraine group than in the control group (p =0.001; p <0.01, respectively). Conclusions: Compared with the controls, the RNFL and choroid layer were determined to be thinner in patients who had chronic migraine with aura.

RESUMO Objetivo: Avaliar as espessuras de camada peripapilar de fibras nervosas retinianas (RNFL), complexo de células ganglionares (GCL) e da coroide utilizando a tomografia de coerência óptica de domínio espectral (SD-OCT), a fim de investigar os efeitos das alterações vasculares no olho e nervo óptico em pacientes que apresentam enxaqueca com aura. Métodos: Quarenta e cinco pacientes que apresentavam enxaqueca com aura (grupo enxaqueca) e 45 indivíduos saudáveis (grupo controle) foram incluídos no estudo. Idade, sexo, duração da enxaqueca, pressão intraocular e medidas de comprimento axial foram registrados em cada caso. Medidas da RNFL, GCL e espessuras da coroide foram obtidas com SD-OCT em todos os participantes. Resultados: A média da idade foi de 36,1 ± 6,7 (20-45) anos no grupo enxaqueca e 35,7 ± 8,6 (19-45) anos no grupo controle. Não houve diferença significativa em espessuras RNFL nos quadrantes temporal e nasal (p>0,05). A espessura da RNFL nos quadrantes superiores e inferiores foram significativamente menores no grupo de enxaqueca em comparação ao grupo controle (p=0,001; p<0,01). Medidas da GCL superior e inferior não mostraram diferença significativa entre os grupos (p>0,05). Espessuras subfoveais, temporais e nasais da coroide (CT) a 500 µm, 1000 µm e 1500 µm foram significativamente menores no grupo de enxaqueca em relação ao grupo controle (p=0,001; p<0,01). Conclusões: Comparados aos controles, as espessuras da RNFL e coroide foram mais finas em pacientes que apresentavam enxaqueca crônica com aura.

Choroidal and peripapillary retinal nerve fiber layer thickness in adults with anisometropic amblyopia.

PURPOSE: To evaluate choroidal thickness, macular thickness, and peripapillary retinal nerve fiber layer (RNFL) thickness in amblyopic eyes compared to fellow and normal control eyes using high-definition spectral-domain optical coherence tomography (SD-OCT). METHODS: Fifty-four without any systemic problem and ocular disease participated in this prospective study. Inclusion criteria included individuals older than 18 years with anisometropic amblyopia. Choroidal thickness, central macular thickness (CMT), and RNFL thickness were measured by using enhanced depth imaging SD-OCT. The choroidal thickness was measured at the fovea and at 500 µm intervals from the foveal center in both temporal and nasal directions. Axial length measurements of the cases were also recorded. RESULTS: Mean peripapillary RNFL thickness of the amblyopic, fellow, and control eyes was 107.5 ± 15.5 µm, 109.3 ± 12.7 µm, and 108.8 ± 8.6 µm, respectively (p = 0.343). The average CMT was 231.7 ± 14.7 µm in amblyopic eyes, 232.5 ± 15.7 µm in fellow eyes, and 230.8 ± 14.8 µm in control eyes (p = 0.599). Mean subfoveal choroidal thickness was significantly greater in the amblyopic eyes than in the fellow and control eyes (396.3 ± 104.3 µm, 361.0 ± 103.9 µm, 390.6 ± 91.7 µm). Mean axial measurement in amblyopic eyes was 22.7 ± 1.3 mm (20.5-26.1), in fellow eyes 23.1 ± 0.9 mm (20.9-25.0), and in control eyes 23.3 ± 0.9 mm. CONCLUSIONS: In adults with anisometropic amblyopia, subfoveal, temporal, and nasal choroidal thickness of amblyopic eyes are significantly thicker than in fellow eyes. However, no significant differences in peripapillary RNFL thickness or CMT were found between amblyopic and fellow or control eyes.

Relationship between pinguecula formation and exposure to tandoor ovens in a hospital-based study.

AIM: To investigate the relationship between pinguecula and the use of tandoor ovens. METHODS: A total of 539 women, ranging in age from 20 to 86y who attended an outpatient clinic were enrolled. All the patients were asked whether they used tandoor ovens. Women exposed to tandoor ovens (n=286) were accepted as participants in the study group and they were compared with participants in the control group (n=253). The age, presence of pinguecula, duration of exposure to tandoor ovens as years and occupations were recorded for all the subjects. RESULTS: Mean duration for exposure to tandoor was 20.26y (range 1-62y) in the study group. The rate of pinguecula in the study group was 82.2% (235/286), and the rate in the control group was 37.5% (95/253); this difference was statistically significant (P<0.05). Pinguecula was seen in 61.2% (330/539) of all the participants. CONCLUSION: Pinguecula is strongly associated with exposure to tandoor ovens.

Risk Factors in Post-LASIK Corneal Ectasia.

Purpose. To evaluate the risk factors for post-laser in situ keratomileusis (LASIK) ectasia. Materials and Methods. Medical records of 42 eyes of 28 (10 women, 18 men) patients who developed corneal ectasia after LASIK were retrospectively reviewed. Topographical features and surgical parameters of those patients were evaluated. Results. The mean age of patients was 34.73 ± 6.50 (23-48) years and the mean interval from LASIK to the diagnosis of post-LASIK ectasia was 36.0 ± 16.92 (12-60) months. The following factors were determined as a risk factors: deep ablation (>75 µ m) in 10 eyes, FFK (forme fruste keratoconus) in 6 eyes, steep cornea (>47 D) in 3 eyes, pellucid marginal degeneration (PMD) in 2 eyes, thin cornea (<500 µ m) in 2 eyes, thin and steep cornea in 2 eyes, thin cornea and deep ablation in 5 eyes, FFK and steep cornea in 2 eyes, and FFK, steep cornea, and deep ablation in 1 eye. However no risk factor has been determined in 9 eyes (21.4%). Conclusion. The findings of our study showed that most of the patients who developed post-LASIK ectasia have a risk factor for post-LASIK ectasia. However, the most common risk factor was deep ablation.

Combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery in cases with cataract and posterior segment diseases.

BACKGROUND: Combined cataract surgery and transconjunctival sutureless vitrectomy are a good option in patients with cataract and vitreoretinal diseases. AIM: To evaluate the effectiveness, outcomes, and complications of combined 23-gauge transconjunctival sutureless vitrectomy and cataract surgery. SETTINGS AND DESIGN: A retrospective case series was conducted at the Beyoglu Eye Education and Research Hospital. MATERIALS AND METHODS: In this study, 28 eyes of 28 patients underwent combined 23-gauge transconjunctival sutureless vitrectomy and phacoemulsification and IOL implantation for cataract and various posterior segment diseases. The outcome measures included, visual acuity, intraocular pressure changes, and anatomical success were evaluated. RESULTS: The mean follow-up was 4.8 months (range, 3-15 months). Mean overall preoperative visual acuity was 20/333, and final acuity was 20/95 (P < 0.001). Mean intraocular pressure (IOP) on the preoperative and first postoperative day was 15.6 ± 7.5 and 13.8 ± 3.3 mmHg, respectively (P > 0.05). Three eyes (10.7%) had postoperative hypotony (<6 mmHg)that all recovered spontaneously within the first postoperative week. Three eyes (10.7%) required laser treatment for iatrogenic retinal tears. Anatomical success was obtained in all cases. No serious complications such as endophthalmitis were observed during the follow-up period. CONCLUSION: Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in patients with significant lens opacities and vitreoretinal pathology. Although the anatomic and visual outcomes were satisfactory, the outcomes depended mainly on underlying vitreoretinal pathology.

Long-term follow-up of first-generation posterior chamber phakic intraocular lens.

We present a patient who received a first-generation posterior chamber phakic intraocular lens (PC pIOL) (Fyodorov IOL) to correct myopia 18 years previously. After a long lapse in the follow-up, the patient presented with a reduced endothelial cell count. Although the cataractogenic effect of first-generation PC pIOLs is well known, no sign of cataract was present. The patient was totally satisfied even after 18 years. To our knowledge, this is the first report of a long follow-up of a patient implanted with a first-generation PC pIOL.