Publication trends in the field of the cornea in the last 4 decades: a bibliometric study.

PURPOSE: The objective of this bibliometric study was to identify the top 100 most-cited articles on the cornea published in the English language between 1980 and 2021 using multidimensional citation analysis. METHODS: The data were obtained from the Thomson Reuters Web of Science Core Collection and the PubMed databases. The top 100 articles in terms of citation number were identified and analyzed. RESULTS: A total of 40,792 articles related to the cornea were retrieved. The 100 most-cited articles were published between 1995 and 2000. The average time since publication was 19.64 ± 5.75 years. The mean impact factor of the journals was 10.27 ± 17.14 and the Q category of most journals was Q1. Ophthalmology was the journal with the most published articles (n = 10), which represented level 3 evidence. The three most common topics among the top 100 articles were treatment modality, histopathology, and diagnostic imaging. The most frequently mentioned treatments were related to limbal stem cell failure, crosslinking, and lamellar keratoplasty. We observed a negative correlation between the average number of citations per year and the time passed since publication (r = - 0.629; p = 0.001). CONCLUSION: Our analysis of the top 100 most-cited articles on the cornea revealed scientific contributions, vital current data related to clinical implementations, and valuable insights into the current developments in ophthalmology. To our knowledge, this is the first study to evaluate the most influential papers on the cornea, and our findings highlight the research quality and latest discoveries and trends in the management cornea diseases.

Evaluation of the Optic Nerve Head Using Optical Coherence Tomography Angiography in Systemic Sclerosis Patients.

PURPOSE: To quantify microvascular vessel density in the optic disc using optical coherence tomography angiography (OCTA) in patients with systemic sclerosis (SS); to determine whether there is a difference in values between patients and controls; and to correlate the OCTA measurements with disease activity, damage risk, and drug usage. METHODS: Patients aged 20 - 76 years who were followed up after a diagnosis of SS and age- and gender-matched controls. The patients underwent RTVue-XR AngioVue OCTA imaging in this cross-sectional observational study. RESULTS: A total of 61 eyes of 61 consecutive SS patients and 60 eyes of 60 controls were investigated. There was no statistically significant difference between the patients and control groups regarding the average RNFL (retinal fiber layer) and radial peripapillary capillary (RPC) vessel density (VD) measurements (p = 0.35, p = 0.25, respectively). As the antinuclear antibody (ANA) titer increased, RNFLsuperior (p = 0.01, r = - 0.327), RPCwhole (p = 0.029, r = 0.279), RPCperipapillary (p = 0.037, r = - 0.267), RPCsuperior (p = 0.003, r = - 0.371), and RPCinferior (p = 0.02, r = 0.297) values decreased with statistical significance. The RPCinside values were lower in anti-Scl-70-positive patients compared to patients negative for anti-Scl-70 (topoisomerase I) (p = 0.021). The RNFLnasal (p = 0.03, r = - 0.278) value decreased as the years of disease increased. The RPCinside value was higher in patients using hydroxychloroquine and calcium channel blockers than those who did not use them (p = 0.021 and p = 0.027, respectively). The RPCwhole, RPCperipapillary, and RPCnasal values were higher, with statistical significance in corticosteroid users than in those patients who did not use corticosteroids (p = 0.043, 0.030, and 0.033, respectively). CONCLUSION: There was no significant difference between the patients and control groups regarding the average RPC VD measurements. However, since this is the first study to analyze optic disc vessel density in SS patients, optic nerve blood flow changes in scleroderma with OCTA could be studied.

Evaluation of the optic nerve head and macular vessel density in keratoconus patients using optical coherence tomography angiography- a cross-sectional study.

PURPOSE: Our study evaluated macular and optic disc vascular density (VD) changes in patients diagnosed with keratoconus, as compared with gender and age-matched healthy controls, in relation to the keratoconus stage. METHODS: This comparative cross-sectional study included adult patients who received a diagnosis of keratoconus at the Cornea Clinic. All scans consisted of two 4.5 mm × 4.5 mm images of the optic disc area and 6 × 6 mm images of the macular area using optical coherence tomography angiography. RESULTS: The study included 67 patients (26 women (38.8%) and 41 men (61.2%)) and 74 controls (31 women (41.9%) and 43 men (58.1%)). The mean ages of the keratoconus group and the control group were 30.0 ± 8.0 and 31.1 ± 7.5, respectively. Macular VD (whole, superficial, and deep) and peripapillary VD (whole) values were decreased statistically significant compared with the control group (p < 0.01 and p = 0.015, respectively). The keratoconus stage was negatively correlated with both the macular VD (p = 0.048, r = -0.314) and whole-peripapillary VD values (p = 0.03, r = -0.34). CONCLUSION: Keratoconus might affect the posterior and anterior segments due to similar etiologies, including diminished collagen quality. Therefore, examination of the posterior segment should be performed thoroughly in keratoconus patients.

Assessment of the retinal and choroidal microvascularization in polycystic ovary syndrome: an optical coherence tomography angiography study.

PURPOSE: To examine the retinal, peripapillary, choroidal microvascularization and the choroid thickness (CT) of the patients with polycystic ovary syndrome (PCOS) using optical coherence tomography angiography (OCT-A) and compare the results to measurements obtained from healthy controls. METHODS: In total, 47 eyes of 47 patients recently diagnosed with PCOS and 47 eyes of 47 age-matched healthy women were included in this study. An RT XR Avanti instrument with AngioVue software was used for the OCT-A imaging using 6 × 6 mm macular and 4.5 × 4.5 mm optic nerve head scans. Quantitative vessel density results of superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillaries (RPC); flow area and flow density of choriocapillaris; and foveal avascular zone (FAZ) area were analyzed. CT was evaluated by using the measurements obtained from the subfoveolar area. RESULTS: No significant differences were detected between the groups for any of vessel density results for the SCP, DCP, and RPC as well as the FAZ area. The difference in the choriocapillaris flow area and flow density between the groups was not statistically significant. The choroid was significantly thicker in women with PCOS than in the healthy group (p = 0.002). CONCLUSION: Retinal and choroidal microvascularization was comparable between the women who were evaluated early after diagnosed with PCOS and age-matched healthy controls. Choroid was found thicker in patients with PCOS than in healthy women. OCT-A, as a new and noninvasive imaging method, may help in understanding the effect of PCOS on the posterior segment of the eye.

Blood-aqueous barrier deterioration following retained metallic corneal foreign body: A laser flare photometric study.

BACKGROUND: This study aims to use laser flare photometry to evaluate flare changes in patients following corneal damage from a metallic foreign body (FB). METHODS: Foreign body injured eyes and the healthy fellow eyes of 54 consecutive patients were studied in this comparative, observational, cross-sectional study. Flare levels were analyzed according to demographics, history of previous exposures, foreign body location, and foreign body penetration into the injured cornea. RESULTS: The mean flare value was significantly higher for the eyes with corneal foreign body injury compared to the fellow-control eyes (11.35±14.17 ph/ms and 6.30±3.81 ph/ms, respectively) (p=0.014). The mean flare values were significantly lower in eyes with a history of more than one previous corneal foreign body removal flare values than in other eyes (p=0.029). CONCLUSION: Flare is increased by corneal foreign body exposure. However, eyes that experience multiple previous corneal foreign body exposures may show relatively low flare, probably due to corneal desensitization.

Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open-Angle Glaucoma.

OBJECTIVES: The goal of this study was to compare measurements of values such as the anterior chamber angle (ACA), thickness of the iris, thickness of the cornea, and the angle-opening distance (AOD) of eyes with primary open-angle glaucoma before and after undergoing phacoemulsification with intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT). METHODS: The data of 49 eyes of 39 glaucoma patients who presented at the Cataract and Refractive Surgery Unit of the Ophthalmology Clinic of , University of Health Sciences, Istanbul Traning and Research Hospital between December 2014 and May 2016 were included in the study. All of the patients were examined with AS-OCT. All of the preoperative and postoperative data were evaluated statistically using a paired t-test and the Wilcoxon test. A statistical significance level of alpha was accepted as p<0.05. RESULTS: The AS-OCT measurements of 39 patients (22 women and 17 men) with primary open-angle glaucoma were included in the study. The median age of the total population was 67±8years. No statistically significant difference was found between preoperative and postoperative measurements of the corneal thickness (p=0.480). However, there was a statistically significant difference between measurements of the ACA, AOD (500µm and 750µm), thickness of the iris curvature, anterior chamber depth, and trabecular-iris space area before and after the operation (p<0.001). Intraocular pressure (IOP) levels decreased significantly in the first and third months after surgery (p=0.019; p=0.003, respectively). CONCLUSION: This study with AS-OCT imaging has confirmed after phacoemulsification and intraocular lens implantation in patients with glaucoma, the angle of the anterior chamber grows wider. As a result, IOP decreases and becomes easier to control.

Evaluation of Anterior Segment Changes of Patients Taking Alpha1-Blockers by Ultrasound Biomicroscopy in the Drug-free Period.

OBJECTIVES: To evaluate and compare anterior segment changes in patients taking alpha-1 (α1) blockers (tamsulosin, terazosin, doxazosin, alfuzosin) for benign prostatic hypertrophy, during drug intake and drug-free period, using ultrasound biomicroscopy (UBM). MATERIALS AND METHODS: In this prospective study, UBM was done before and after pupil dilatation in 31 phakic eyes of 19 male patients taking α1-blockers. Undilated and dilated UBM was repeated before cataract extraction, after stopping the drug for 10 days. On ideal images, pupil diameter (PD), anterior chamber depth (ACD), anterior chamber angle (ACA), and angle opening distances at points 500 µm and 250 µm from the scleral spur (AOD500 and AOD250) values were noted and changes in parameters were evaluated to reveal any changes that occurred after discontinuing the drug. No patient in the study was previously or currently using any other α1-adrenergic antagonist medication. Exclusion criteria for all patients included a history of diabetes mellitus, systemic hypertension, glaucoma, pseudoexfoliation syndrome, chronic use of medicated eye drops, and previous ocular surgery. RESULTS: PD, ACD, ACA, AOD500 and AOD250 values measured before pupil dilatation in the drug-free period were not significantly different from those measured during α-blocker intake (p>0.05). In dilated eyes, the mean value of AOD500 was 0.35±0.08 mm during drug usage and 0.39±0.08 mm in the drug-free period. The mean value of AOD250 was 0.23±0.06 mm during drug usage and 0.26±0.07 mm after discontinuation. These increments were statistically significant (p<0.05, z=-3.699, z=-2.984). On the other hand, there were no significant differences in ACD, ACA, or PD values in dilated eyes after discontinuing α1-blockers (p>0.05). CONCLUSION: The interruption of taking α1-blockers in patients who have benign prostatic hypertrophy does not seem to influence anterior segment parameters generally. However, further investigation is needed.

The correlation between visual acuity outcomes and optical coherence tomography parameters following surgery for diabetic epiretinal membrane and taut posterior hyaloid.

PURPOSE: To evaluate the relationship between visual outcomes and the determinants detected by spectral domain optical coherence tomography (OCT) in eyes with epiretinal membrane (ERM) and/or taut posterior hyaloid (TPH) that underwent pars plana vitrectomy (PPV). MATERIALS AND METHODS: A total of 30 participants with diabetic ERM and TPH were included in the study. All study participants underwent PPV. Preoperative and postoperative best corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer (RNFL), macular RNFL, ganglion cell layer, inner plexiform layer, and ganglion cell complex thicknesses were measured in each participant. Linear regression analyses were performed to determine the association between the OCT parameters and the visual acuity measured at the time of the OCT measurement. RESULTS: The postoperative BCVA logarithm of the minimum angle of resolution (logMAR) values were statistically higher than the preoperative values in the ERM group and TPH group (P=0.001 and P<0.001, respectively). The postoperative BCVA logMAR value was negatively correlated with average RNFL, inferior RNFL thicknesses, and image quality (P=0.002, P=0.004, and P=0.006, respectively). The preoperative and postoperative BCVA logMAR value difference was not correlated with age and all of the OCT parameters measured (P>0.05). CONCLUSION: This study shows that achievement of better peripapillary RNFL thickness results in better visual outcome after PPV and ERM/TPH removal.

Choroidal thickness in patients with diabetic retinopathy.

PURPOSE: The aim of the study reported here was to assess choroidal thickness (CT) and central macular thickness (CMT) in patients with diabetic retinopathy. MATERIALS AND METHODS: A total of 151 eyes from 80 patients from the retina department of Istanbul Training and Research Hospital who had type 2 diabetes mellitus with diabetic retinopathy were studied retrospectively in this cross-sectional research. Patients were divided into three groups: mild-moderate nonproliferative diabetic retinopathy without macular edema (NPDR), mild-moderate nonproliferative diabetic retinopathy with macular edema (DME), and proliferative diabetic retinopathy (PDR). In addition, 40 eyes of 20 healthy individuals comprised a control group. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-µm intervals up to 1,500 µm temporal and nasal to the fovea. The CMT measurement was obtained for each eye. Serum hemoglobin A1c (HbA1c) levels were measured. RESULTS: The study included 191 eyes, comprising 151 eyes of 80 patients and 40 eyes of 20 healthy individuals. Of the 151 patient eyes, 61 had NPDR, 62 had PDR, and 28 eyes had DME. There was no statistically significant difference in age between the groups (P>0.05). In both the PDR and DME groups, the CT was statistically significantly decreased compared with the control group (P<0.001, P<0.001 for the PDR and DME groups, respectively). The mean CMT in the DME group was increased significantly compared with both the NPDR and PDR groups (P<0.001, P<0.001, respectively). In all three groups, serum HbA1c levels were found to be increased significantly compared with the control group (P=0.000). We found a statistically weak-moderate negative correlation between central macular and foveal CT (r=-289, P=0.000). There was a statistically strong correlation between CMT and HbA1c levels (r=0.577, P=0.483) and a statistically weak-moderate negative correlation between the central CT and HbA1c levels (r=-0.331, P<0.001). CONCLUSION: Diabetes changes the CT. CT was found to be significantly decreased in the DME and PDR groups.

Evaluation of choroidal thickness in cases with age -related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

To compare subfoveal choroidal thickness (SFCT) between cases with non-neovascular age-related macular degeneration ( AMD) and neovascular AMD by optical coherence tomography ( OCT ) and to evaluate the contribution of choroidal thickness (CT) measurements to the understanding of pathogenesis of neovascularization in AMD. ●METHODS: Fourty - eigth eyes of 24 patients who had neovascular AMD in one eye and non- neovascular AMD in the other eye were included in this retrospective, cross-sectional study as study group. Forty eyes of healthy,age and axial length matched individuals were selected as the control group. Eyes with drusen and/ or pigmentary changes were included in the non - neovascular AMD subgroup. Eyes with subretinal or intraretinal fluid and/orlipid exudation due to the choroidal neovascularization were included in the neovascular AMD subgroup. OCT measurements were performed with RTVue 100-2 (V 5. 1, Optovue, Fremont, CA, USA) perpendicularly from the outer part of the hyperreflective line ( retinal pigment epithelial layer) to the line corresponding to the choroido-scleral junction. Choroidal thickness was measured at 7 different points, 500μ m intervals up to 1500μ m temporal and nasal to the fovea in the study group and compared statistically between subgroups. ●RESULTS: The mean age of patients was 72. 4±8. 97 (60-82)y. The mean age of healthy individuals was 71. 2±8. 8 (58- 81) y. Mean SFCT of neovascular AMD group were significantly thicker than non- neovascular AMD group (P0. 05). ln neovascular AMD group, there was a statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness (P ●CONCLUSlON: Choroidal thickness measurements with OCT device can make a contribution to the understanding the phatophysiology of AMD and large prospective studies should be conducted to understand why SFCT was thicker in neovascular AMD.

Effects of intravitreal bevacizumab on reduced visual acuity and macular thickness secondary to branch retinal vein occlusion.

BACKGROUND: The purpose of this study was to evaluate the effects of intravitreal bevacizumab injection in the treatment of macular thickness and reduced visual acuity in patients with branch retinal vein occlusion. METHODS: In this retrospective study, we evaluated 15 eyes of 15 consecutive patients diagnosed with branch retinal vein occlusion between May 2008 and June 2011 at our institution. Detailed ophthalmologic examination, optical coherence tomography, and/or fundus fluorescein angiography was performed at diagnosis and during follow-up. A 1.25 mg intravitreal bevacizumab injection was administered to all patients on average 2.73 (1-7) times. Visual acuity and macular thickness were evaluated before and after treatment. RESULTS: Eleven patients were female (73.3%) and four were male (26.6%). The mean patient age was 62.6 years. The patients were followed for a mean of 11.4 (range 4-24) months. Mean best-corrected visual acuity was 0.92 ± 0.52 logMAR (logarithm of the minimum angle of resolution) before treatment and 0.66 ± 0.42 logMAR at the last examination. The increase in visual acuity was found to be statistically significant (P = 0.031). Mean macular thickness was 395.46 ± 106.55 µm before treatment and 302.26 ± 84.6 µm after the final treatment. The decrease in macular thickness was statistically significant (P < 0.001). CONCLUSION: Intravitreal bevacizumab injection was effective for treatment of retinal vein branch occlusion.