Assessment of Ocular Surface in Patients With Ankylosing Spondylitis.

PURPOSE: To evaluate the clinical findings and ocular surface changes in patients with ankylosing spondylitis (AS). METHODS: This prospective study involved 45 patients with AS (group 1) and 28 healthy subjects (group 2). Patients in group 1 were in the inactive period. The study subjects underwent a complete ophthalmic examination. The right eyes of the subjects in each group were tested for the study including slit-lamp examination, Schirmer I test, tear break-up time (TBUT), conjunctival impression cytology (CIC), and ocular surface disease index (OSDI). Results between the two groups were compared. RESULTS: The mean Schirmer I test result was found as 12.2±8 mm in group 1 and 20.3±9.9 mm in group 2 (P<0.001), whereas the mean TBUT value was found as 3.8±1.9 sec in group 1 and 10.1±4.8 sec in group 2 (P<0.001). The OSDI scores were significantly higher in group 1 (36.5±19.4) than in group 2 (9.1±12.9, P<0.001). The CIC scores were significantly higher in group 1 (2.12±0.7) than in group 2 (0.57±0.6, P<0.001). Notably, none of the patients in group 1 showed grade 0 differentiation, and none of the patients in group 2 showed grade 2 or 3 differentiation. The CIC scores were significantly higher in group 1 (2.12±0.7) than in group 2 (0.57±0.6, P<0.001). CONCLUSION: Ocular surface changes, including squamous metaplasia in the bulbar conjunctiva, can be observed in patients with AS.

Subfoveal choroidal thickness change following pars plana vitrectomy with silicone oil endotamponade for rhegmatogenous retinal detachment.

PURPOSE: To report changes in subfoveal choroidal thickness (SFCT) using spectral-domain optical coherence tomography following pars plana vitrectomy (PPV) with silicone oil (SiO) endotamponade injection and subsequent removal. METHODS: In this prospective study, 24 eyes of 24 patients with macula-off rhegmatogenous retinal detachment (RD) were included. These patients underwent PPV with SiO injection removal. SFCT measurements were taken 2 weeks and 3 months after PPV and SiO injection and 1 month after SiO removal. The contralateral eyes served as controls. RESULTS: Mean SFCT values of the operated eyes were 294.1 ± 70.5 µm and 282.9 ± 80.6 µm 2 weeks and 3 months after PPV and 264.2 ± 63.3 µm 1 month after SiO removal. There was no significant change in SFCT between first and second measurements (p = 0.96). SFCT decrease was statistically significant when first and last measurements were compared (p = 0.03). SFCT percent change was correlated with duration of SiO in the eye and was not correlated with amount of endolaser photocoagulation performed during surgery. SFCT values of the fellow eyes were 317.1 ± 84.8 µm, 313.7 ± 79.8 µm and 306.1 ± 69.1 µm, at 2 weeks and 3 months after PPV and 1 month after SiO removal, respectively. There was no significant difference between the measurements of the control eyes taken at different time intervals (p = 0.430, p = 0.085, respectively). CONCLUSION: SFCT seems to decrease after the removal of the SiO which indicates that choroidal parameters should be taken into account during or after surgery for rhegmatogenous RD.

Six-month outcomes of corneal crosslinking with dextran-free isotonic riboflavin solution.

PURPOSE: To analyze the short-term clinical and topographic outcomes in patients with keratoconus after corneal collagen cross-linking treatment (CXL) with dextran-free isotonic riboflavin solution. METHODS: In this retrospective case series, 26 eyes from 26 patients with keratoconus were studied. The best corrected visual acuity (BCVA) and refractive and topographic findings were analyzed at a 6-month follow-up. RESULTS: The mean BCVA (Snellen lines) values before and 1, 3, and 6 months after CXL were 0.51 ± 0.2, 0.48 ± 0.2, 0.57 ± 0.2, and 0.64 ± 0.2, respectively, and the difference between the preoperative and 6-month values was statistically significant (p=0.006). The mean spherical equivalent refraction decreased from -5.6 ± 2.4 diopters (D) preoperatively to -5.0 ± 2.1 D, and mean simulated keratometry decreased from 48.5 ± 2.5 D to 47.8 ± 2.6 D at 6 months. (p=0.145 and p=0.001, respectively). In addition, the maximum keratometry decreased progressively and significantly from the preoperative value during follow-up (p=0.003). The central and minimal corneal thicknesses, including those of the epithelium, also decreased from 442.8 ± 25.6 µm and 430.5 ± 23.9 µm preoperatively to 420.7 ± 31.8 µm and 409.3 ± 28.7 µm at the most recent follow-up (p<0.001), respectively. No intraoperative or postoperative complications were observed. CONCLUSIONS: CXL with dextran-free isotonic riboflavin solution appears to be a safe treatment alternative for keratoconus and yields sustained short-term improvements in visual acuity, keratometric readings, and corneal thickness. However, long-term results are needed to confirm these outcomes.

Six-month outcomes of corneal crosslinking with dextran-free isotonic riboflavin solution / Resultados após seis meses de crosslinking de córnea com solução isotônica de riboflavina sem dextrano

ABSTRACT Purpose: To analyze the short-term clinical and topographic outcomes in patients with keratoconus after corneal collagen cross-linking treatment (CXL) with dextran-free isotonic riboflavin solution. Methods: In this retrospective case series, 26 eyes from 26 patients with keratoconus were studied. The best corrected visual acuity (BCVA) and refractive and topographic findings were analyzed at a 6-month follow-up. Results: The mean BCVA (Snellen lines) values before and 1, 3, and 6 months after CXL were 0.51 ± 0.2, 0.48 ± 0.2, 0.57 ± 0.2, and 0.64 ± 0.2, respectively, and the difference between the preoperative and 6-month values was statistically significant (p=0.006). The mean spherical equivalent refraction decreased from -5.6 ± 2.4 diopters (D) preoperatively to -5.0 ± 2.1 D, and mean simulated keratometry decreased from 48.5 ± 2.5 D to 47.8 ± 2.6 D at 6 months. (p=0.145 and p=0.001, respectively). In addition, the maximum keratometry decreased progressively and significantly from the preoperative value during follow-up (p=0.003). The central and minimal corneal thicknesses, including those of the epithelium, also decreased from 442.8 ± 25.6 µm and 430.5 ± 23.9 µm preoperatively to 420.7 ± 31.8 µm and 409.3 ± 28.7 µm at the most recent follow-up (p<0.001), respectively. No intraoperative or postoperative complications were observed. Conclusions: CXL with dextran-free isotonic riboflavin solution appears to be a safe treatment alternative for keratoconus and yields sustained short-term improvements in visual acuity, keratometric readings, and corneal thickness. However, long-term results are needed to confirm these outcomes.

RESUMO Objetivo: Analisar os resultados clínicos e topográficos curto prazo após crosslinking (CXL) de córnea com solução isotônica de riboflavina sem dextrano, em pacientes com ceratocone. Método: Estudamos 26 olhos de 26 pacientes com ceratocone, nesta série retrospectiva de casos. Melhor acuidade visual corrigida (BCVA), refração e achados topográficos foram analisados aos 6 meses de acompanhamento. Resultados: BCVA pré-operatória (linhas de Snellen) foi de 0,51 ± 0,2. BCVA após CXL foram de 0,48 ± 0,2, 0,57 ± 0,2 e 0,64 ± 0,2 no 1º, 3º e 6º meses, respectivamente. A diferença entre a BCVA pré-operatória e mais recente foi estatisticamente significativa (p=0,006). O equivalente esférico médio diminuiu de -5,6 ± 2,4 dioptrias (D) no pré-operatório para -5.0 ± 2.1 D e a média da ceratometria simulada diminuiu de 48,5 ± 2,5 D para 47, 8± 2,6 D aos 6 meses. (p=0,145 e p=0,001, respectivamente). A ceratometria máxima diminuiu progressivamente durante o acompanhamento com as mudanças sendo significativamente diferentes do valor pré-operatório (p=0,003). As espessuras corneanas central e mínima, diminuiram de 442,8 ± 25,6 µm e 430,5 ± 23,9 µm para 420,7 ± 31,8 µm e 409,3 ± 28,7 µm, respectivamente, na visita mais recente (p<0,001). Não foram observadas complicações intraoperatórias e pós-operatórias. Conclusões: CXL com solução de riboflavina isotônica sem dextrano parece ser uma opção segura de tratamento para o ceratocone com melhora mantida na acuidade visual, ceratometria e espessura corneana, no curto prazo. Resultados a longo prazo são necessários para confirmar estes resultados.