Long-term follow-up of choroidal changes following COVID-19 infection: analysis of choroidal thickness and choroidal vascularity index.

OBJECTIVE: To investigate subclinical choroidal involvement in patients with systemic coronavirus disease 2019 (COVID-19) infection and evaluate its long-term course. MATERIALS AND METHODS: This prospective, longitudinal study included 32 eyes of 16 COVID-19 patients and 34 eyes of 17 age-matched healthy control subjects. All the participants had a detailed ophthalmologic assessment, including visual acuity assessment, slit-lamp examination, and indirect ophthalmoscopy. Enhanced depth optical coherence tomography imaging of the posterior pole and peripapillary region was performed in the early (days 15-40) and late (ninth month) postinfectious periods. Choroidal vascularity index (CVI) was calculated using ImageJ software (National Institutes of Health, Bethesda, Md.). RESULTS: None of the patients had any examination finding associated with the ocular involvement of COVID-19. Subfoveal choroidal thickness (SFCT) decreased significantly in the early postinfectious period compared with the healthy control individuals (p = 0.045). SFCT increased significantly in the late postinfectious period compared with the early period (p = 0.002), and the difference between patients and control individuals became statistically insignificant (p = 0.362). There was a similar trend for the peripapillary choroidal thickness measurements. CVI remained unchanged (p = 0.721) despite the significant decrease in SFCT and total choroidal area (p = 0.042), indicating that this decrease occurred both in choroidal stroma and in blood vessels. CVI remained unchanged in the late postinfectious period (p = 0.575) compared with the early period, indicating that recovery occurred in the entire choroidal tissue. CONCLUSION: This study demonstrates that choroidal thickness was reduced in all measured areas and that this decrease affected all choroidal layers. This choroidopathy was reversible and recovered in the ninth postinfectious month.

The effect of different types of convergent strabismus on horizontal eye movements.

PURPOSE: To investigate the effect of different types of convergent strabismus on horizontal eye movements and compare data with healthy control subjects. MATERIALS AND METHODS: This prospective, cross-sectional study included 38 patients with convergent strabismus (16 fully accommodative, 13 partially accommodative and 9 non-accommodative esotropia) and 19 age-matched control subjects. All of the participants had a detailed ophthalmological examination including visual acuity assessment, cover-uncover prism test, slit lamp, and indirect ophthalmoscopy examination. Videonystagmography (VNG) was used for the evaluation of horizontal eye movements such as saccadic accuracy, velocity, latency, and smooth pursuit velocity gain. RESULTS: The saccadic accuracy in the rightward direction was lower in the fully accommodative esotropia group compared to the partially accommodative esotropia group in the right eye (p = 0.002). The saccadic latency in the rightward direction was longer in the fully accommodative esotropia group compared to the control group (p = 0.008) and smooth pursuit velocity gain in the leftward direction was lower in the partially and non-accommodative esotropia group compared to the control group in binocular recording (p = 0.004, p = 0.001, respectively). There was no difference in the saccadic velocity among the study groups (p > 0.05). Finally, asymmetry of saccadic velocity and latency was observed between right- and leftward directions in the partially accommodative esotropia group in the right eye (p = 0.003, p = 0.008, respectively). CONCLUSION: This study demonstrated that horizontal eye movements may vary in different types of convergent strabismus. VNG may be an auxiliary tool to the clinical examination in differentiating fully or non-accommodative esotropia.

Vestibulo-ocular reflex evaluation of the children with acquired esotropia.

OBJECTIVES: This study aims to evaluate the effects of acquired esotropia on vestibulo-ocular reflex (VOR) gain in children using video (vHIT) and functional head impulse (fHIT) tests. METHODS: A total of 62 children aged 6-18 years, with acquired esotropia and normal vision, were evaluated in the study. The patients were divided into two sub-groups: accommodative and non-accommodative. VOR gains were analyzed by performing lateral canal vHIT and fHIT with monocular and binocular recordings by a single examiner. RESULTS: Seventeen (10 male, 7 female) children with accommodative esotropia, 24 (14 male, 10 female) children with non-accommodative esotropia, and 21 (8 male and 12 female) healthy controls were included in this study. The vHIT findings did not differ between the groups (p˃.05). In the non-accommodative esotropia group, the location of the camera in both binocular and monocular vHIT recordings made a significant difference in the left VOR gain (p = .025, z = -2.243, p = .032, and z = -2.143, respectively), but no difference was observed in the right VOR gain. In the accommodative esotropia group, while the camera was on the left there was a significant difference in the right VOR gain between binocular and monocular recordings (p = .016, z = -2.413) but no difference was observed in the left VOR gain. No overt or covert saccade was detected in any group. CONCLUSIONS: The statistical differences found in vHIT and fHIT in acquired esotropia patients are thought to be sporadic and based on the results of this study no correction or change in recording technique is required for vHIT or fHIT in children with acquired esotropia.

Low levels of soluble low-density lipoprotein receptor-related protein 1 in patients with type 2 diabetes mellitus and diabetic retinopathy.

Low-density lipoprotein receptor-related protein-1 (LRP-1) is a large transmembrane receptor. LRP-1 plays a role in diverse cellular processes, including lipid metabolism, cell growth, migration, and regeneration. Soluble form of LRP-1 (sLRP-1) can be detected in serum. sLRP-1 can serve as a biomarker of atherosclerosis and cardiometabolic diseases. This study investigated the concentrations of the circulating serum sLRP-1 in patients with retinopathy and type 2 diabetes mellitus. Fifty-two patients with diabetic retinopathy and 71 controls were enrolled based on well-defined eligibility criteria. Venous blood samples were collected after 12 h of fasting. sLRP-1 concentrations were measured using the commercially available ELISA in an accredited laboratory. The mean age of patients and control groups were 63.6 and 48.5 years, respectively. The median disease duration was 8.1 years. The median serum sLRP-1 levels were lower in patients with diabetic retinopathy compared to the controls (2.11 µg/mL versus 2.44 µg/mL, p = 0.034). No significant correlation was observed between the sLRP-1 and serum lipid levels. The sLRP-1 levels are low in patients with diabetic retinopathy compared to healthy controls, and future studies are needed to assess sLRP-1 as a potential biomarker in diabetic retinopathy.

A comprehensive enhanced depth imaging spectral-domain optical coherence tomography analysis of pseudoexfoliation spectrum from non-glaucomatous to advanced stage glaucoma in the aspect of Bruch's membrane opening-minimum rim width.

PURPOSE: To compare the correlations between lamina cribrosa (LC) and related structures with Bruch's membrane opening-minimum rim width (BMO-MRW) and retinal nerve fiber layer (RNFL) thickness in pseudoexfoliation syndrome (PXS) and different stages of pseudoexfoliation glaucoma (PXG). METHODS: This prospective cross-sectional study included 32 PXS eyes of 24 patients and 94 PXG eyes (early-stage (n: 55) and advanced-stage glaucoma (n: 39) of 78 patients. Global and six sectors of RNFL thicknesses and BMO-MRW parameters were measured with enhanced depth imaging (EDI) mode of SD-OCT. Structural parameters; lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD), prelaminar tissue thickness (PLTT), four quadrants of peripapillary choroidal thicknesses (PPCT), and subfoveal choroidal thickness (SFCT) were measured and statistical relationships between the structural parameters have been laid out. We apply the generalized estimating equations method to take into account dependency of right and left eyes. RESULTS: From PXS to mild and advanced PXG groups LCT and PLTT decrease from 147.29 ± 33.10, 145.62 ± 30.64, 126.30 ± 29.14 and 260.93 ± 185.07, 247.27 ± 142.58, 159.89 ± 86.84, respectively, and LCD varies as 159.89 ± 86.84, 420.88 ± 117.80, and 505.64 ± 183.25. The correlations between LCD, LCT, and PLTT and the stage of the disease are significant. BMO-MRW shows slightly stronger correlations than the RNFL with LC related parameters. SFCT does not exhibit any significant relationship with the stage of the disease. However, PPCT in only the interior quadrant does. The significant correlations between LCD and all quadrants of PPCT is the sign of important anatomic relationship. CONCLUSION: These findings show that the BMO-MRW parameter may be more sensitive than RNFL and can safely be used in the diagnosis and follow-up in PXS and PXG, but this result should be supported with longer and larger series.