Compare of optic coherence tomography parameters in recreational synthetic tetrahydrocannabinol use and healthy control.

PURPOSE: To evaluate retinal thickness (RT), retinal nerve fiber layer thickness (RNFLT), and choroidal thickness (CT) changes in synthetic cannabinoid (SC) users. METHODS: This prospective study evaluated the RT, RNFLT, and CT values of 56 SC users and 58 healthy controls. The individuals using SCs were referred to us by our hospital's forensic medicine department. Retinal and choroidal images were obtained using spectral-domain optical coherence tomography (OCT). Measurements (one subfoveal, three temporals, three nasal) were taken at 500 µm intervals up to 1500 µm using the caliper system. Only the right eye was used for subsequent analysis. RESULTS: Mean ages were 27.7 ± 5.7 years in the SC-user group and 25.4 ± 6.7 in the control group. Subfoveal Global RNFLT was in the SCs group 102.3 ± 10.5 µm and 105.6 ± 20.2 µm in the control group (p = 0.271). Subfoveal CT was in the SC group mean of 316.1 ± 100.2 µm and in the control group mean 346.4 ± 81.8 µm (p = 0.065). RT, T500 (283.3 ± 36.7 µm, 296.6 ± 20.5 µm, p = 0.011) and N1500 (355.1 ± 14.3 µm, 349.3 ± 18.1 µm, p = 0.049) were significantly higher in the SC group than in the control group, respectively. CONCLUSION: Analysis of OCT findings of individuals who had been using SC for more than one year revealed no statistically significant difference between RNFLT and CT, although N1500 was significantly higher in RT. Further studies in the field of OCT are important to explore the pathology of SC.

The Effects of Long-term Growth Hormone Treatment on Ocular Findings.

PURPOSE: This study aimed to examine the long-term changes in anterior chamber depth (ACD), central corneal thickness (CCT), axial length (AxL), peripapillary retinal nerve fibre layer thickness (RNFLT), peripapillary ganglion cell layer - inner plexiform layer (GCL-IPL) thickness, and peripapillary choroidal thickness (ChT) after rhGH replacement treatment in paediatric patients with IGHD, compared to healthy controls. METHODS: Twenty-two children with IGHD including 12 girls and 10 boys were enrolled in the study group, and 30 (16 girls, 14 boys) healthy children composed the control group. A detailed ophthalmological examination was performed for each participant. ACD, CCT, AxL, peripapillary RNFLT, GCL-IPL thickness and ChT measurements were performed before the rhGH replacement treatment and in the 12th month of the post-treatment period, as well as the corresponding visits in the control group. AxL ultrasound pachymetry (CCT), peripapillary RNFL thickness, peripapillary RNFLT, GCL-IPL thickness, and peripapillary ChT parameters were measured by spectral-domain optical coherence tomography. RESULTS: The mean age of the groups were similar (p = 0.143). 12-month CCT, ACD, and AxL measurements of the study group showed significantly higher results than the pre-treatment measurements (p = 0.005, p = 0.024, and p = 0.002, respectively). Similarly, the mean RNFLT and ChT measurements of the study group obtained from all sectors were significantly higher in the 12th-month visit (p < 0.001 for both) other than the RNFLT, and GCL-IPL thickness measurements (p > 0.05 for all). However, all these parameters were similar at pre- and post-treatment visits in the control group (p > 0.05 for all). The mean pre-treatment values of all these parameters were significantly lower in the study group compared to the control group (p < 0.05 for all), other than the RNFLT, GCL-IPL thickness measurements (p > 0.05 for all), while the mean post-treatment values of all these parameters in both groups were similar at month 12 (p > 0.05 for all). CONCLUSION: GH replacement treatment in childhood may play an important role in the development of the neural retina and can be effective on the anterior segment, RNFLT and ChT measurements.

Visual evoked potential changes following Botox administration in patients with blepharospasm.

PURPOSE: To examine visual evoked potential (VEP) changes following botulinum toxin type A (BTA) administration in patients with blepharospasm. METHODS: Patients diagnosed with blepharospasm receiving BTA administration were included in the study. Three groups, a control group and two study groups (patients examined 14 days after BTA administration-Study Group 1, and patients examined 28 days after BTA administration-Study Group 2) were evaluated. Dilated fundus examinations were performed following detailed ophthalmological examinations and VEP tests. Keypoint (Dantec, Denmark) and ISCEV criteria were adopted for pattern VEP (PVEP) recording. BTA was applied in the form of local injections at a total 15-30 units, at 2.5-5 units per injection. RESULTS: A mean 19.4 ± 3.2 units of BTA was used for each eye. N70 (ms), P100 (ms), and P100 (uV) values were statistically significantly lower in both study groups following drug administrations compared to the control group (p < 0.001 for all). Significant positive correlation was observed between increased P100 amplitudes and age in the control group (p = 0.008, r = 0.200). Significant negative correlation was observed between the BTA units used and decreased P100 amplitudes in both study groups 1 and 2 following drug administrations (p = 0.017, r = - 0.180 and p = 0.043, r = - 0.153, respectively). CONCLUSION: VEP may be an important method in the diagnosis and follow-up of blepharospasm and in determining the success of drug administration and additional therapeutic requirements.

The effects of subconjunctival bevacizumab, ranibizumab, and aflibercept on corneal neovascularization.

PURPOSE: To investigate the effects of subconjunctival bevacizumab, ranibizumab, and aflibercept in an experimental corneal neovascularization model. MATERIALS AND METHODS: The eyes of 24 rats were chemically cauterized and randomly divided into four groups: bevacizumab group (0.05 mL/1.25 mg bevacizumab), ranibizumab group (0.05 mL/0.5 mg ranibizumab), aflibercept group (0.05 mL/1.25 mg aflibercept), and control group (0.05 mL saline solution). Plasma vascular endothelial growth factor (VEGF) levels were among the major measurement outcomes to assess corneal neovascularization. The collected plasmas were analyzed using the SIGMA RAB0511 Rat VEGF Elisa kit. The PCR technique and VEGF amplification procedures were used for molecular analysis. Each cornea was removed and histologically examined on day 21. Corneal images were evaluated by image analyzer software. RESULTS: In the post-injection period, the number of major corneal arteries decreased significantly in the injection groups when compared to the control group (p = 0.037), but no statistically significant differences were noted among the injection groups (p > 0.05). The aflibercept group had the lowest area of neovascularization. Immunohistochemical staining revealed substantially lower VEGF percentages in neovascularized arteries of the injection groups than the control group (p = 0.015). In TUNEL staining, the mean TUNEL value (number/1hpf) was substantially greater in the control group than in the injection groups, but the mean TUNEL values were similar between the injection groups (p = 0.019, p > 0.05, respectively). No statistically significant differences were observed between the groups in terms of corneal surface area with increased cellularity, edema, and inflammation (p = 0.263). The mean plasma VEGF concentration in the control group was statistically greater than those in the injection groups (p = 0.001). CONCLUSION: Subconjunctival bevacizumab, ranibizumab, and aflibercept crossed the blood and seemed to be effective in inhibiting corneal neovascularization without causing epitheliopathy in an experimental rat model compared to the controls. However, no significant results were noted between these three anti-VEGF molecules.

Comparison of central corneal thickness and intraocular pressure measured with two different tono/pachymeter devices in non-glaucomatouse children.

PURPOSE: The goal of this research is to compare the intraocular pressure (IOP) and the mean central corneal thickness (CCT) values obtained from the measurements with Nidek NT-530P and Canon TX-20P devices with the values obtained by ultrasound pachymetry (UP) and Goldmann applanation tonometry (GAT) in children. METHODS: This prospective study was conducted with 119 healthy children. The measurements were repeated three times for each eye. The intraclass correlation coefficient (ICC) was used to assess the correlation between the measurements obtained from different devices. The Bland-Altman plot was used to analyze the agreement between two different devices graphically. The measurements were taken in the same order in all subjects: TX-20P, NT-530P, UP, and GAT. RESULTS: The mean age of the children was 10.1 ± 3.2 (6-17) years. The mean CCT values for the eyes were 568.90 and 569.68 (TX-20P), 571.44 and 566.37 (NT-530P), 564.77 and 564.67 µm UP, (right and left, respectively). The highest correspondence observed for CCT was between UP and NT-530P devices (ICC, 0.982, the left eye). The mean IOP measurements for Canon TX-20P, NT-530P, and GAT were 16.5 ± 3.2, 16.3 ± 3.2, and 16.8 ± 3.6 mmHg for the right eyes, respectively, while those for the left eyes were 16.6 ± 3.1, 16.2 ± 3.3, and 16.8 ± 3.7 mmHg. The highest correspondence was noted between measurements obtained using GAT and Nidek NT-530P devices (ICC, 0.945, in the left eye). CONCLUSION: Tono/pachymetry devices in the healthy children are provides significant agreements with the gold standard methods for IOP and CCT measurements.Clinical Trial Registration number: 2016-94.

The effects of non-invasive mechanic ventilator modes on intraocular pressure in COPD patients with hypercapnic respiratory failure.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is not fully reversible disease that is characterized by progressive restricting airflow. Non-invasive mechanical ventilation (NIMV) treatment can be used in COPD patients who had type 2 respiratory failure. This study aimed to determine the effect of BPAP S/T and AVAPS modes on intraocular pressure (IOP), central corneal thickness (CCT) in 40 type 2 respiratory failure patients with COPD. METHODS: Forty patients with type 2 respiratory failure who were hospitalized between June and December 2018 with the diagnosis of COPD exacerbations were included to the study. Patients followed up without NIMV for 12 hours after the end of exacerbations treatments end. After IOP, visual acuity and CCT were measured in all patients at the same time (11.00 am), same NIMV treatment was applied to the patients for 4 hours (AVAPS-BPAP S/T). Then the measurements were repeated. The effects of these NIMV modes on IOP were evaluated. RESULTS: After NIMV treatment, it was observed that the mean IOP increased statistically significantly (13.3 vs 12.3 mm Hg; P = 0.001). After treatment with NIMV, there was a decrease for CCT close to statistical significance (P = 0.057) CONCLUSION: As a result; increased IOP and thinning of CCT after NIMV treatment has been shown. The type of NIMV and the level of inspiratory pressure needed in hypercapnic respiratory failure seem to affect IOP and it should be cautiously used to increase IOP.

Evaluation of ocular findings in patients with lichen planus.

INTRODUCTION: Lichen planus (LP) is a chronic, inflammatory disease of unknown etiology. AIM: To evaluate the tear functions and the retinal and choroidal thickness (CT) in patients with LP. MATERIAL AND METHODS: In total, 33 patients and 30 healthy controls were enrolled. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer 1 test (with anesthesia), tear break-up time (TBUT) test, intraocular pressure (IOP), axial length (AL), and central corneal thickness (CCT). The measurements of retinal thickness (RT) and CT were obtained by spectral domain optical coherence tomography. RESULTS: No significant difference was observed between the groups in IOP, AL, CCT, or RT (p > 0.05 in each group). There was a significant difference in the Schirmer 1 test, TBUT, and OSDI questionnaire (p < 0.05 in each group). Choroidal thickness in LP patients was thinner than that in the controls (p = 0.001 in each location). There was a moderate negative correlation between the disease duration and Schirmer 1 test, TBUT, and subfoveal CT (r = -0.426, r = -0.555, r = -0.637; p = 0.001, p = 0.001, p = 0.001, respectively). There was a moderate negative correlation between the oral mucosal involvement and Schirmer 1 test, TBUT, and subfoveal CT (r = -0.345, r = -0.392, r = -0.467; p = 0.006, p = 0.001, p = 0.001, respectively). There was a positive correlation between disease duration, oral mucosal involvement and OSDI score (r = 0.717, r = 0.345; p = 0.001, p = 0.006, respectively). CONCLUSIONS: Lichen planus may influence tear function tests and may cause dry eye. Patients with LP had lower CT values than healthy controls. Further studies are needed to clarify the effect of LP on the eyes.

The Effect of Smoking on Macular, Choroidal, and Retina Nerve Fiber Layer Thickness

Objectives: This study aimed to compare the thickness of the macula, choroid, and peripapillary retina nerve fiber layer (RNFL) in smokers with those of healthy, nonsmoking individuals using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: Sixty-eight healthy smokers with an average of 19.75 pack-years and 71 nonsmoker subjects (control group) were included in the study. Macular thickness, RNFL thickness, and choroidal thickness (CT) were measured by SD-OCT. Results: The mean age of the smokers was 42.76±6.97 years and that of the control group was 41.15±11.61 years (p=0.32). Inferonasal and temporal RNFL thicknesses were 121.60±27.40 µm and 69.75±9.82 µm in the smokers group and 109.05±21.71 µm and 75.95±15.01 µm in the nonsmoker group, respectively. The differences were statistically significant (p=0.003, p=0.005, respectively). Central macular thickness (CMT) was 222.97±18.95 µm and subfoveal CT was 369.52±105.36 µm in the smoker group, while these values were 222.98±17.72 µm and 347.42±104.63 µm in the nonsmoker group, respectively. There were no significant differences in these comparisons (p=0.99, p=0.49, respectively). A significant negative correlation was found between smoking exposure and nasal and temporal CT. Conclusion: The results of our study revealed that RNFL thickness was decreased but CMT and CT were not affected in healthy chronic smokers.

Ocular abnormalities in morbid obesity / Anormalidades oculares na obesidade mórbida

ABSTRACT Purpose: Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. Methods: Morbidly obese volunteers (n=101, body mass index [BMI] ³40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. Results: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 mm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-mm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 mm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 mm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 mm, and nasal 500, 1000, and 1500 mm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). Conclusion: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.

RESUMO Objetivo: A obesidade está associada a doenças oulares, mas as mudanças estruturais subjacentes e os mecanismos patogênicos não foram examinados detalhadamente. Aqui avaliamos os efeitos da obesidade mórbida nos índices morfométricos da doença ocular. Métodos: Voluntários obesos mórbidos (n=101, índice de massa corporal ³40) e indivíduos saudáveis (n=95, índice de massa corporal 18,50 a 24,99) foram examinados por tonometria de aplanação de Goldman, paquimetria e tomografia de coerência óptica de domício espectral. A pressão intraocular, profundidade da câmara anterior, comprimento axial, espessura central da córnea, espessura da camada de fibras nervosas da retina, espessura foveal central e espessura da coroide foram comparadas entre os grupos. Resultados: A pressão intraocular não corrigida foi significativamente maior no grupo com obesidade mórbida do que no grupo controle saudável (15,5 ± 2,5 vs. 14,5 ± 2,6 mmHg, p=0,009), enquanto que o comprimento axial, profundidade da câmara anterior e espessura central da córnea não diferiram entre os grupos. A espessura média da camada de fibras nervosas da retina no quadrante temporal foi reduzida no grupo com obesidade mórbida (72,7 ± 13,6 vs. 85,05 ± 52,6 mm, p=0,024). Da mesma forma, a média das espesuras da retinianas nas localizações nasal e temporal de 1500 m foi menor no grupo com obesidade mórbida (346,6 ± 18,2 mm vs. 353,7 ± 18,8 mm, p=0,008; 323,1 ± 20,3 mm vs. 330,0 ± 18,9 mm, p=0,001). A espessura média da coroide também foi reduzida em quase todos os locais de mensuração (fóvea, temporal 500 e 1000 mm, nasal 500, 1000 e 1500 mm) do grupo obeso (p<0,05). Peso e índice de massa corporal foram negativamente correlacionados com a espessura da coroide subfoveal (r=-0,186, p=0,009; r=-0,173, p=0,015). Conclusão: A obesidade mórbida está associada à elevada pressão intraocular não corrigida e a sinais de neuropatia e retinopatia. A obesidade pode, assim, aumentar os riscos de glaucoma e neuropatia óptica glaucomatosa.

Effects of topical azithromycin, moxifloxacin, and povidone iodine on conjunctival bacterial flora in patients undergoing intravitreal injection / Os efeitos da azitromicina tópica, moxifloxacina e iodopovidona na flora bacteriana conjuntival em injeções intravítreas

ABSTRACT Purpose: To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection. Methods: A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation. Results: The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217). Conclusion: Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.

RESUMO Objetivo: Comparar os efeitos de iodopovidona tópico a 5% com azitromicina e moxifloxacina profiláticas sobre a flora bacteriana em pacientes submetidos à injeção intravítrea. Métodos: Um total de 132 pacientes foram aleatoriamente designados para receber tratamento com azitromicina ou moxifloxacina ou nenhum tratamento (grupo controle). No total, 528 amostras foram obtidas no momento na admissão, 4 dias antes da injeção intravítrea, 4 dias após a injeção intravítrea e 8 dias após a injeção intravítrea. As amostras foram imediatamente enviadas para o laboratório de microbiologia para incubação. Resultados: O microorganismo mais frequentemente observado foi o Staphylococcus coagulase-negativo (23,8%). Quando os resultados das amostras obtidas no dia 4 antes da injeção foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi significativamente menor no grupo mo xifloxacina, em comparação com os controles (p=0,049). Acinetobacter baumannii continuou a crescer após a administração de azitromicina (p=0,033). Quando os resultados de 4 dias após a injeção intravítrea foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi maior no controle, em comparação com pacientes que receberam azitromicina ou moxifloxacina (p=0,004). A taxa de erradicação também foi significativamente maior no grupo moxifloxacina do que no grupo controle (p=0,001). As amostras obtidas no dia 8 após injeção intravítrea mostraram níveis semelhantes de crescimento bacteriano em todos os grupos (p=0,217). Conclusão: A moxifloxacina foi mais eficaz do que 5% de iodopovidona no controle do crescimento da flora bacteriana conjuntival. O uso de moxifloxacina em combinação com 5% de iodopovidona resultou em um efeito sinérgico.

Ocular abnormalities in morbid obesity.

PURPOSE: Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. METHODS: Morbidly obese volunteers (n=101, body mass index [BMI] ³40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. RESULTS: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 mm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-mm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 mm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 mm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 mm, and nasal 500, 1000, and 1500 mm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). CONCLUSION: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.

Effects of topical azithromycin, moxifloxacin, and povidone iodine on conjunctival bacterial flora in patients undergoing intravitreal injection.

PURPOSE: To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection. METHODS: A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation. RESULTS: The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217). CONCLUSION: Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.

Association of ABO blood groups and Rh factor with retinal and choroidal thickness.

PURPOSE:: To evaluate if ABO blood group and Rh factor have an effect on retinal and choroidal thickness. METHODS:: This study was designed prospectively. Retinal nerve fiber layer, retinal, and choroidal thicknesses were measured with spectral-domain optical coherence tomography. Retinal and choroidal thickness measurements (one subfoveal, three temporal, and three nasal) were obtained at 500-µm intervals up to 1500 µm with the caliper system. RESULTS:: In this study, 109 male and 151 female, 260 individuals in total were included. There were 125 subjects in group A, 29 in group B, 34 in group AB, and 72 in group O. Rh factor was positive in 194 subjects and negative in 66. There was no significant difference between the groups regarding age (p = 0.667). The groups did not show any statistical difference in retinal nerve fiber layer thickness. There was significant difference found for mean retinal thickness at temporal 1000 µm when four groups were compared (p = 0.037). No statistically significant difference was detected for the remaining retinal and choroidal sectoral regions. The groups did not statistically significantly differ concerning Rh factor (p > 0.05). CONCLUSION:: Although we found a significant difference in retinal thickness in the temporal retina between group B with group A and group O, we suggest that both blood group and Rh factor have no effect on retinal and choroidal thickness.

Evaluation of Intraocular pressure, Corneal thickness, and Retinal nerve fiber layer thickness in patients with Obstructive Sleep Apnea Syndrome.

OBJECTIVE: To evaluate the intraocular pressure (IOP), central corneal thickness (CCT), and peripapillary retinal nerve fiber layer (RNFL) thickness in Patients with Obstructive Sleep Apnea Syndrome. METHODS: In this prospective study, 103 patients with OSAS (study group) and 37 healthy subjects were enrolled. All participants underwent comprehensive ophthalmic examinations. Mean outcome measures were intraocular pressure by Goldmann applanation tonometry, CCT measurement using ultrasound pachymeter and peripapillary RNFL thickness measured by spectral-domain optical coherence tomography. RESULTS: The differences between the mean values of RNFL thickness in all quadrants were similar in both groups and were not statistically significant (p=0.274). The IOP and CCT measurement averages of all patients with OSAS were lower than the control group. However, this difference was not statistically significant. There was no correlation between the apnea-hypopnea index, lowest oxygen saturation (LAST) or Body Mass Index (BMI) and the peripapillary RNFL thickness, IOP or CCT when OSAS group was divided by severity. CONCLUSIONS: The study results suggest that peripapillary RNFL thickness, IOP or CCT did not differ significantly between OSAS and control groups. We also found no correlation between apnea severity (AHI), lowest oxygen saturation (LAST) and BMI and RNFL, CCT and IOP.

A Comparison of Three Different Photoscreeners in Children.

PURPOSE: To compare the results obtained from three non-cycloplegic handheld photorefractometers with cycloplegic autorefractometry (Topcon KR-8100; Topcon Corporation, Tokyo, Japan) measurement in children. METHODS: The refractive status of 238 eyes in 119 healthy children was assessed. The values acquired using photorefraction with the non-cycloplegic PlusoptiX A12 (Plusoptix GmbH, Nuremberg, Germany), Retinomax K-plus 3 (Righton, Tokyo, Japan), and Spot Vision Screener (Welch Allyn, Skaneateles Falls, NY) devices were compared with those obtained from the cycloplegic Topcon KR-8100. The agreement between the measurements was assessed using the intraclass correlation coefficient. RESULTS: The mean age was 10.1 ± 3.2 years (range: 6 to 17 years). The mean spherical value for the right eyes was 0.38 diopters (D) (range: -4.50 to 6.25 D) for the Plusoptix A12; 0.45 D (range: -4.50 to 6.25 D) for the Spot Vision Screener; -1.15 D (range: -8.75 to 6.50 D) for the Retinomax K-plus 3; and 0.62 (range: -4.50 to 6.00) for the Topcon KR-8100. The mean spherical equivalent value for the right eyes was 0.41 D (range: -4.50 to 7.90 D) for the Plusoptix A12; 0.18 D (range: -4.75 to 6.13 D) for the Spot Vision Screener; -1.30 D (range: -10.50 to 6.38 D) for the Retinomax K-plus 3; and 0.67 D (range: -4.00 to 6.00 D) for the Topcon KR-8100 (for the right eyes). CONCLUSIONS: The photorefractometer method was beneficial in the measurement of refractive errors of school-aged children. The PlusoptiX A12 photorefractometer method may eliminate the need for cycloplegia in the detection of refractive errors in children. [J Pediatr Ophthalmol Strabismus. 2018;55(5):306-311.].

Comparison of central corneal thickness with four different optical devices.

BACKGROUND: To compare the consistency between the average scores of the contact central corneal thickness measurements from ultrasound pachymetry devices still gold standard, such as iPac® and Echoscan US-500, and noncontact measurements via Pentacam HR and Sirius topography. METHODS: This prospective study, subsequently admitted to the ophthalmology department, 76 healthy individuals were performed. The measurements were repeated three times for each eye, and average scores were statistically analyzed on the same day and almost at the same time. While measuring the eyes, Pentacam HR, Sirius topography, iPac®, and Echoscan US-500 were used, respectively. The inter-rater agreement of measurements from the devices was assessed with intraclass correlation coefficient, and 95% Confidence Interval and p values demonstrating statistically significance were also presented. In the graphical assessment of the agreement, the Bland-Altman graph was used. RESULTS: Among 76 study participants, 43 (56.6%) were composed of women, and age level was 38.6 ± 12.5 years, ranging between 18 and 69. It was observed that the highest agreement was between the measurements obtained from Echoscan US-500 and iPac® devices, but the agreement between the measurements of different devices was higher than 0.90. Bland-Altman graphics were also investigated; the results of four different devices were seen to be consistent with one another. CONCLUSIONS: Therefore, the devices we compared in the study can be used as alternatives to one another due to the higher consistency between CCT measurements provided with through UP devices of Echoscan US-500 and iPac®, and Pentacam HR and Sirius topography devices. CLINICAL TRIAL REGISTRATION NUMBER: 2016/112.

Retinal and Choroidal Thickness in Patients with High Myopia without Maculopathy.

OBJECTIVE: To evaluate macular choroidal thickness (CT) and retinal thickness in Turkish patients with high myopia without maculopathy and in normal subjects and to examine the association with age, axial length (AL), best corrected visual acuity (BCVA), cycloplegic refraction, and spherical equivalent (SE). METHODS: This prospective study was performed between January 2015 and June 2016 in the Department of Ophthalmology, Duzce University Medical Faculty. It had 65 individuals (30 patients with high myopia, 35 healthy subjects). Retinal and choroidal images were obtained using spectral-domain optical coherence tomography (OCT). Measurements (one subfoveal, three temporal, three nasal) were taken at 500 µm intervals up to 1,500 µm using the caliper system. Only the right eye was used for subsequent analysis. RESULTS: The mean age was 29.5 ± 14.5 years and 25.6 ± 7.0 in the high myopia and control groups, respectively. The subfoveal CT was significantly lower in the high myopia group (mean, 218.3 ± 102.25 mm) than the control group (mean, 331.83 ± 99.06 mm; p < 0.001). In both groups, the choroid was thinnest at the nasal 1,500 µm location, being 158.40 ± 90.8 µm and 301 ± 103.59 µm, respectively. Retinal thickness in both groups was thickest at the nasal 1,500 µm location and thinnest in the subfoveal region. In patients with high myopia, CT was negatively correlated with AL (r=-0.490, p=0.006) and age (r=-0.455, p=0.012). CONCLUSIONS: Highly myopic eyes have a thinner choroid, which may be secondary to longer AL but is not an independent factor. Further studies in the field of OCT are important to exploring the pathology of high myopia.

Frog saliva-induced toxic keratopathy: a case report.

Corneal toxicity due to exposure to many chemicals and medications have been described in the literature. We present a case of toxic keratopathy by corneal exposure to salivary secretion of a frog. A 40-year-old male patient reported a sudden splash of frog saliva in his right eye while he was examining it at a close distance. Corneal punctate epitheliopathy and stromal oedema and Descemet folds were the initial clinical findings, which completely recovered on the 2nd control day of topical dexamethasone and ofloxacin treatment. We aimed to show the toxic effects of animal-derived secretions on the cornea as a rare cause of toxic keratopathy.

Unilateral exudative retinal detachment as the sole presentation of relapsing acute lymphoblastic leukemia.

Ocular findings are rarely the initial symptom of leukemia, although up to 90% of all leukemia patients have fundus changes during the course of the disease. Herein we report a relapsing acute lymphoblastic leukemia patient with thesole presentation of sudden visual loss and exudative retinal detachment. An 8-year-old boy with acute lymphoblasticleukemia developed sudden visual loss during his first remission period. Bullous retinal detachment with total afferentpupillary defect was observed. Orbital magnetic resonance imaging revealed an intraocular mass lesion; simultaneouslyobtained bone marrow and cerebrospinal fluid samples showed no evidence of leukemic cells. Following local irradiation,and systemic and intrathecal chemotherapy the mass disappeared. Local irradiation, and systemic and intrathecalchemotherapy effectively controlled the isolated ocular relapse of acute lymphoblastic leukemia and eliminated the needfor enucleation.

The use of the QuantiFERON-tuberculosis gold test in the diagnosis of ocular tuberculosis.

Ocular tuberculosis without systemic manifestations may rarely occur. The diagnosis of ocular tuberculosis is important because it has a wide spectrum of presentations and requires a multidisciplinary approach. The QuantiFERON-tuberculosis gold test is a new diagnostic test that may be useful in making a suitable diagnosis.