Comparison of clinical outcomes between gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in advanced-stage pseudoexfoliation glaucoma.

PURPOSE: To compare clinical outcomes between gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) in patients with advanced-stage pseudoexfoliation glaucoma (PEXG). METHODS: This comparative study comprised 62 patients who underwent GATT (N = 31) or TRAB (N = 31) for advanced-stage PEXG. Primary outcome was cumulative probability of surgical success at the end of 12-month follow-up. Success was determined as intraocular pressure (IOP) reduction ≥ 30% from baseline, IOP between 6 and 18 mmHg and IOP upper limits for IOP < 15 mmHg and < 12 mmHg, separately. Secondary outcomes were IOP reduction, antiglaucoma medication (AGM) use, and complications in the study. RESULTS: Age, sex, cup/disc ratio, mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness did not significantly differ between the groups (p > 0.05 for all). The probability of cumulative surgical success at the end of 12 months was similar between the two groups for IOP < 15 mmHg and < 18 mmHg but significantly higher after TRAB (92.0%) than GATT (82.5%) for IOP < 12 mmHg (log-rank test p = 0.035). Percentage of IOP reduction from baseline was similar between the groups (53.1 ± 18.6% in GATT group and 53.0 ± 16.6% in TRAB group, p = 0.98) at the end of 12 months. No significant difference in the mean number of AGM was present at the 12-month visit (1.3 ± 1.4 in GATT and 1.1 ± 1.4 in TRAB, p = 0.65). CONCLUSION: At the end of 12 months, IOP reduction rate was similar between GATT and TRAB. Cumulative surgical success was higher after TRAB than GATT for IOP < 12 mmHg.

Evaluation of peripheral anterior synechia formation following gonioscopy-assisted transluminal trabeculotomy surgery.

PURPOSE: To quantitatively assess the development of peripheral anterior synechia (PAS) formation rate and PAS locations on gonioscopic examination following gonioscopy-assisted transluminal trabeculotomy (GATT) surgery and investigate the surgical outcomes. METHODS: A total of 35 eyes from 31 patients with open angle glaucoma who underwent GATT or combined GATT and phacoemulsification surgery were analyzed. Presence of PAS was assessed on gonioscopy in nasal, temporal, superior and inferior quadrants at months 1, 3 and 6 following surgery. Surgical outcomes were also noted. RESULTS: Frequencies of PAS formation were 38.3%, 25.3%, 17.0% and 19.1% at postoperative 1 month, 34.0%, 26.4%, 17% and 22.6% at postoperative 3 months and 32.3%, 25.8%, 16.1% and 25.8% at postoperative 6 months, in nasal, temporal, superior and inferior quadrants, respectively. The highest amount of PAS involvement was 3 clock hours in the study which was identified only in nasal and inferior quadrants. Frequency of PAS formation did not significantly differ between nasal, temporal, superior and inferior quadrants at all time points (p > 0.05). No significant differences of mean IOP levels were observed between patients who developed PAS and who did not develop PAS at postoperative 1 month (p = 0.72), 3 months (p = 0.21) and 6 months (p = 0.59). The mean IOP and mean number of antiglaucoma medications decreased from 31.5 ± 7.2 mmHg and 3.6 ± 0.6 at baseline to 13.8 ± 3.1 mmHg and 1.6 ± 1.3 at postoperative 6 months, respectively (p < 0.001, for both). Cumulative success rate (95% confidence interval) was 74.3% (69.9-78.6%) at the end of the study. Mild to moderate degrees of hyphema occurred in all cases postoperatively. CONCLUSION: Although PAS formation was observed to be relatively higher in nasal quadrant, PAS frequency was not statistically different between the angle quadrants.

An evaluation of corneal endothelial cell morphology in patients with thyroid-associated ophthalmopathy.

INTRODUCTION: To evaluate corneal endothelial cell morphology in patients with thyroid-associated ophthalmopathy (TAO). METHOD: Seventy-two eyes of 36 patients with TAO presenting to the ophthalmology department between January 2018 and January 2022 were included in the study. The findings were compared with 98 eyes of 49 healthy individuals. Mean endothelial cell density (ECD), coefficient of variation (CV), maximum cell area, minimum cell area, average cell area, and hexagonality ratio were obtained using non-contact specular microscopy. The thicknesses of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) were measured using optical coherence tomography (OCT). RESULTS: The TAO group consisted of 36 patients, 11 (30.6%) men and 25 (69.4%) women, and the control group of 49 healthy individuals, 14 (28.6%) men and 35 (71.4%). No significant differences were determined between the TAO and control groups in terms of the specular microscopy findings of mean ECD, CV, or hexagonality ratio values (p > 0,05). However, the mean Hertel values differed significantly between the two groups (p = 0.001). When the TAO group was divided into two subgroups based on patients who had previously received prednisolone therapy and those who had not, significant differences were observed in terms of mean ECD, CV, and hexagonality ratio values (p > 0.05). CONCLUSION: Comparison of patients diagnosed with active TAO and receiving prednisolone therapy and the TAO patients with inactive disease revealed lower ECD, higher CV values, and lower hexagonality ratios in the prednisolone therapy group. These findings all suggest that inflammation in patients undergoing active disease affects the corneal endothelium.

Does MARPE therapy have effects on intracranial pressure? a clinical study.

BACKGROUND: We aimed to evaluate possible intracranial pressure (ICP) changes caused by screw activations during active microimplant-assisted rapid palatal expansion (MARPE) therapy of post-pubertal individuals by measuring the optic nerve sheath diameter (ONSD) under ultrasonography (US) guidance. METHODS: This study's participants comprised 15 patients (7 males, 8 females) with posterior crossbite and a mean age of 16.7 years (14.25-20.08 years). The Maxillary Skeletal Expander (MSE) appliance was used to perform MARPE in all patients. Their vital signs (heart rate, mean arterial pressure (MAP), and peripheral oxygen saturation (SpO2)) were recorded. The ONSD was measured by US immediately before the first screw activation (T0), and the measurements were repeated 1 min (T1) and 10 min (T2) after the first activation. In the last session of active MARPE therapy, the same measurement protocol was performed as in the first activation session (T3, T4, and T5). The patients' perceptions of pain during the screw activation were also noted at T1 and T4 using a four-category verbal rating scale (VRS-4). The significant differences among different time intervals performed with the Friedman test (for all tested variables; SpO2, MAP, Heart Rate, VRS-4 and ONSD). Spearman correlation test was used for VRS-4 and ONSD comparisons. The statistical significance level was accepted as p < 0.05. RESULTS: The ONSD values ​​(T1 and T4) relatively increased within 1 min after screw activation but did not reach a statistically significant level (p > 0.05). There was also no significant difference between the initial (T0) and the final (T5) ONSD values ​​during the active MARPE therapy (p > 0.05). CONCLUSION: There is no changes or alterations in intracranial pressure in late adolescents during active MARPE therapy.

Psoriasis and uveitis.

PURPOSE: Psoriasis, which is a chronic, immune-mediated skin disease of unknown etiology, not only affects the skin, but also is linked to many systemic conditions such as arthritis, cardiovascular disease, depression, and malignancy. Although many types of eye involvement are encountered in psoriasis patients, dry eye is the first among them. Uveitis is an entity that can be associated with psoriasis and can cause severe vision loss as a result of late diagnosis, inadequate and inappropriate treatment. In this review, we aimed to shed light on the diagnosis, type, prognosis and treatment of uveitis in psoriasis patients by compiling current datas obtained from published studies and to guide the follow-up and treatment of these patients. METHODS: A systematic literature search was done on PubMed using key words including "psoriasis", "psoriatic arthritis", "uveitis", "TNF- inhibitors", "HLA B27". RESULTS: In the literature, the frequency, type and treatment of uveitis developing in the course of psoriatic arthritis are clearly defined. However, the coexistence of psoriasis and uveitis has not yet been clarified due to few numbers published studies and designs of these studies. Since we examined the existing studies, we determined that the coexistence of psoriasis and uveitis could be acute or insidious, and the probability and severity of uveitis increased as the severity of skin and joint involvement increased. In addition, we found that psoriasis-associated uveitis can be bilateral, chronic, severe progression and with a high recurrence rate. CONCLUSION: The relations between non-arthritic psoriasis and uveitis have not yet been fully elucidated. Physicians who treat these diseases must be cautious, and refer their patients who have psoriasis to an ophthalmologist for periodic examination, even if they do not have eye symptoms. On the other hand, ophthalmologists must be careful in uveitis patients in terms of skin and joint involvement, and must not overlook the underlying disease.

The evaluation of the efficacy of adalimumab in refractory non-infectious uveitis with ultra-widefield fundus fluorescein angiography.

AIM: To investigate the efficacy of adalimumab in the cases with refractory non-infectious uveitis and evaluate retinal vascular leakage changes on ultra-widefield fundus fluorescein angiography. METHODS: Twenty-three patients with refractory uveitis were included in study. RESULTS: Forty-four eyes of 23 patients with non-infectious uveitiswere evaluated. Clinically active inflammation was present in 19 eyes (43.18%), while 25 (56.8%) were inactive. The mean drug burden was a 9.91 ± 3.78 (5-21) in baseline, 7.3 ± 4.25 at third and 8.0 ± 4.71 at sixth month (p = 0.022). The mean choroidal thickness was 256.65 ± 43.63 µm in baseline, 240.49 ± 36.73 µm at third and 224.81 ± 34.91 µm at sixth month (p ≤ 0.05). In terms of leakage extend, leakage was initially present in a mean of 2.95 ± 4.55 clock hours, 2.41 ± 3.91 at third and 1.76 ± 3.44 at sixth month (p < 0.001). CONCLUSION: Adalimumab was found to be effective in establishing inflammation control by reducing drug burden, controlling retinal vascular leakage and choroidal inflammation in refractory uveitis.

The efficacy of subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy.

Central serous chorioretinopathy (CSC) is a disease characterized by a well-defined serous detachment of the neurosensory retina. Therapeutic options in chronic cases are limited, and side effects can result in a limited response. The aim of this article is to assess the efficacy of subthreshold micropulse laser therapy in patients with chronic central serous chorioretinopathy. The study included 20 eyes of 19 patients who had a history of chronic or chronic recurrent CSC and who underwent subthreshold micropulse laser therapy between January 2015 and June 2018. Twenty eyes of 19 patients with a mean age of 48.9 ± 9.40 years were included. The mean visual acuity was 0.24 ± 0.28 logMAR before laser, 0.19 ± 0.25 logMAR 3 months after laser, and 0.18 ± 0.27 logMAR after 6 months. A statistically significant difference was determined in terms of visual acuity before and after treatment (p = 0.0001). The mean central retinal thickness was 308.10 ± 95.25 µm before laser, 233.65 ± 81.17 µm 3 months after laser, and 203.88 ± 72.79 µm at 6 months. A statistically significant relationship was present between visual acuity and the duration of disease (p = 0.001), between visual acuity and the outer nuclear layer thickness (p = 0.005), and between the outer nuclear layer thickness and the duration of disease in chronic cases (p = 0.008). There was no evidence of retinal pigment epithelium or retinal damage on optical coherence tomography or fundus autofluorescence secondary to subthreshold micropulse laser therapy. Visual acuity appears to be more associated with the duration of disease and with changes in the outer nuclear layer thickness in chronic CSC. Subthreshold micropulse laser therapy seems to be effective at treating chronic CSC, while it increases success during early period of the disease before the development of permanent retinal damage.

The role of simple inflammatory blood parameters in idiopathic epiretinal membrane patients.

AIM: To evaluate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in idiopathic epiretinal membrane (IERM) patients, and their relations with visual acuity. METHOD: Fifty-seven IERM and 51 control patients were included. All patients underwent comprehensive ophthalmological examination and complete blood count tests, and NLR and PLR values were calculated. Patients with IERM were compared with the control group, and associations with visual prognosis were evaluated. These ratios' cut-off values for IERM were also calculated RESULTS: NLR values were statistically significantly higher in the IERM group than in the control group (p = 0.001). No significant difference was observed between the IERM and control groups in terms of PLR (p = 0.43). No significant correlation was determined between visual acuity and NLR or PLR (r = 0.05, p = 0.66; and r = 0.18, p = 0.16, respectively). The cut-off value for NLR was 1.91. CONCLUSION: Patients with IERM showed significantly increased NLR compared to control subjects suggesting that IERM patients may be prone to have high NLR values.

A comparison of three different tonometric methods in the measurement of intraocular pressure in the pediatric age group.

INTRODUCTION AND AIM: To compare intraocular pressure (IOP) measurements obtained with non-contact tonometry (NCT), Icare rebound tonometry (IRT) and Goldmann applanation tonometry (GAT) in pediatric cases and to examine the effect of topical anesthesia on measurements obtained using IRT. MATERIALS AND METHODS: Pediatric cases in a healthy general condition and with ophthalmic examination findings within normal limits were included in the study. IOP measurements were taken with NCT and IRT devices in all cases. Topical anesthesia was subsequently applied, and IOP measurements were then repeated using IRT and GAT tonometer devices. Differences between measurements were subjected to statistical analysis. RESULTS: One hundred ten eyes of 55 patients, 27 male, with a mean age of 11.44 ± 2.31 years (7-17) were included. Mean pre-anesthesia IOP values were 16.47 ± 2.89 mmHg with NCT and 17.49 ± 2.57 mmHg with IRT. Mean IOP values after topical anesthesia were 16.91 ± 2.17 mmHg with IRT and 15.51 ± 2.41 mmHg with GAT. IOP measurement values obtained with all three devices exhibited positive correlation with central corneal thickness values. Statistically significant correlation was present in terms of IOP measurement values between all three devices. However, IOP values obtained with the three devices exhibited statistically significant differences. The application of topical anesthesia caused a statistically significant decrease in IRT measurements; however, statistically significant this small change (0.58 mmHg) in recorded IOP would not be considered clinically significant. CONCLUSION: IOP measurements obtained with NCT, IRT and GAT devices in the pediatric age group correlate with one another, but differ from one another in a statistically significant manner. Application of topical anesthesia affects IRT measurements; however, these small changes would not be considered clinically significant.

Ultra-widefield fundus fluorescein angiography findings in patients with ankylosing spondylitis experiencing uveitis.

AIM: To evaluate ultra-widefield fundus fluorescein angiography (FFA) findings in cases of ankylosing spondylitis (AS)-associated uveitis. MATERIALS AND METHODS: Forty-five eyes of 23 AS patients followed up with a diagnosis of uveitis were included. RESULTS: Sixteen (69.6%) men and seven (30.4%) women with a mean age of 46.26 ± 10.87 years were included in the study. Retinal vascular leakage was observed in 19 (42.2%) eyes at FFA, diffuse in six (13.3%) and peripheral in 13 (28.9%) eyes. Active anterior uveitis attack was present in seven (36.8%) eyes with vascular leakage at FFA, while no active uveitis findings were present in 12 (63.15%) eyes. No statistical relation was determined between peripheral and diffuse leakage and active uveitis (p = 0.195). No significant association was also determined between both diffuse and peripheral leakage and visual acuity (p = 0.066). CONCLUSION: We observed widespread retinal vascular leakage at UWF angiography in AS patients (in eyes undergoing active uveitis attacks and inactive eyes).

A Prospective Comparison of 180 Versus 360-Degree Gonioscopy-Assisted Transluminal Trabeculotomy Outcomes in Pseudoexfoliation Glaucoma.

PRCIS: Analysis of surgical success and intraocular pressure (IOP), best-corrected visual acuity (BCVA), and antiglaucomatous medication (AGM) changes between segmental 180-degree and 360-degree gonioscopy-assisted transluminal trabeculectomy (GATT) in patients with pseudoexfoliation glaucoma (PEXG) showed no significant difference. OBJECTIVE: To compare surgical outcomes of segmental 180-degree and 360-degree GATT in patients with PEXG. MATERIALS AND METHODS: Prospective, comparative study of 65 PEXG eyes, who underwent segmental 180-degree GATT (GATT 180-degree group, 31 eyes) and 360-degree GATT (GATT 360-degree group, 34 eyes) in a tertiary academic center over a 12-month of follow-up. Primary outcome was qualified and complete surgical success rates for criterion A (IOP <18 mm Hg and >30% reduction) and criterion B (IOP <15 mm Hg and >30% reduction). Secondary outcome measures included IOP reduction, BCVA change, AGM use, and postoperative complications. RESULTS: The probabilities of qualified and complete success rates both for criteria A and B did not significantly differ between the groups ( P > 0.05). IOP and BCVA levels were similar at each time point ( P > 0.05). IOP reduction was 59.3 ± 9.5% in the GATT 180-degree group and 55.8 ± 18.1% in the GATT 360-degree group ( P = 0.33). No significant difference in the mean number of AGM was present at the 12-month visit (1.2 ± 1.1 in GATT 180-degree group vs 1.5 ± 1.2 in GATT 360-degree group, P = 0.25). Significantly higher incidences of postoperative hyphema and IOP spikes were observed in the GATT 360-degree group ( P = 0.01 and P = 0.008, respectively). CONCLUSION: Both segmental 180-degree and 360-degree GATT similarly reduced IOP and AGM with comparable surgical success rates in patients with PEXG at the end of 12 months. Postoperative hyphema and IOP spike rates were significantly higher after 360-degree GATT. Segmental 180-degree GATT may be sufficient to adequately modulate IOP with a lower incidence of postoperative complications in PEXG.

Gonioscopy-assisted transluminal trabeculotomy as a primary surgical option for glaucoma in Fuchs uveitis syndrome: A case series.

BACKGROUND: Fuchs uveitis syndrome (FUS) is a chronic intraocular inflammatory disease. It can lead to glaucoma which can be intractable to both medical and surgical treatment. In the present report, we describe our experience with GATT as a primary surgical option in the treatment of glaucoma secondary to FUS. RESULTS: Four consecutive patients with FUS-associated glaucoma underwent GATT in a single institution. Case 1 was a 28-year-old pseudophakic male with a preoperative intraocular pressure (IOP) of 43 mmHg had unsuccessful circumferential cannulation; his IOP remained high after GATT and received trabeculectomy followed by Ahmed glaucoma valve (AGV) implantation to control IOP. Although IOP was stable following AGV, he required descemet membrane endothelial keratoplasty due to persistent corneal decompansation. He had a stable IOP of 12 mmHg over 21 months. Case 2 was a 42-year-old male with preoperative IOP of 35 mmHg and posterior subcapsular cataract had 360-degree GATT combined with phacoemulsification; his IOP reduced to 14 mmHg over 18 months. Case 3 was an 52-year-old pseudophakic male with a preoperative IOP of 28 mmHg had 360-degree GATT; his IOP remained stable at 10 mmHg over 18 months. Case 4 was an 47-year-old pseudophakic female with a preoperative IOP of 39 mmHg had 360-degree GATT; her IOP remained stable at 14 mmHg over 12 months. CONCLUSION: GATT may be used as an initial approach in secondary glaucoma due to FUS. But, further evidence is still warranted to better ascertain the usefulness of GATT in this specific patient population.

Outcomes of Gonioscopy-Assisted Transluminal Trabeculotomy as a Primary Surgical Treatment for Glaucoma Secondary to Juvenile Idiopathic Arthritis-Associated Uveitis.

Gonioscopy-assisted transluminal trabeculotomy (GATT) has been used as a safe and effective procedure in the treatment of open angle glaucoma. In the present report, we demonstrated successful IOP control in two uveitic glaucoma cases secondary to juvenile idiopathic arthritis (JIA) following 360° GATT. Case 1 was a 7-year-old pseudophakic male with a preoperative IOP of 38 mmHg; his IOP stabilized at 17 mmHg with two topical antiglaucoma medications over 18 months. Case 2 was a 8-year-old aphakic male with a preoperative IOP of 42 mmHg; his IOP decreased to 12 mmHg over 15 months. We observed postoperative IOP spike in case 1 which was successfully controlled conservatively. Peripheral anterior synechia formation also occured in both cases during follow-up. One should be vigilant for possible complications after GATT in such cases. As glaucoma surgery success can have a tendency to decline with time in pediatric cases with uveitis-associated glaucoma, we believe that further evidence is still required to shed more light about the benefits of GATT technique in complex cases of pediatric secondary glaucoma subtypes like JIAU-induced glaucoma.

Effects on Intravitreal Anti-vascular Endothelial Growth Factor Injections during the COVID-19 Pandemic in the Eastern Black Sea Region of Turkey.

Objectives: To compare the number of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections performed during 2020 with that in the same period in 2019. Methods: The study investigated anti-VEGF injections performed in 2019 and 2020. Injections performed on 923 eyes of 858 patients were evaluated. The patients were treated for diabetic macular edema (DME), age-related macular degeneration (AMD), and retinal vein occlusion (RVO). Injections, new cases, and patients who either completed or did not complete three loading doses in 2019 and 2020 were first compared. The same comparisons were then performed between the pandemic period in 2020 and the same period in 2019. Results: While 2070 injections were performed on 670 eyes in 2019, 1478 injections were applied to 253 eyes in 2020 (p=0.001). The number of naive eyes was 163 in 2019 and 83 in 2020. During the pandemic period in 2020, 967 injections were performed on 181 eyes, compared with 1721 injections on 532 eyes in the same period in 2019 (p=0.001). While 86.5% of patients completed three injections in 2020, the rate was 78.9% for the same period in 2019 (p=0.025). Conclusion: The COVID-19 pandemic caused a significant decrease in the number of patients presenting to the hospital, and delays occurred in treatment protocols. However, patients admitted to the hospital during this period adapted better to the loading doses. In conclusion, the pandemic caused significant disruption to treatment, and this will inevitably result in anatomical and functional worsening in the eye.

The clinical use of ultra - Wide field imaging and intravenous fluorescein angiography in infants with retinopathy of prematurity.

PURPOSE: To investigate the potential benefits and practicality of ultra - wide field (UWF) imaging and intravenous UWF fluorescein angiography (IV UWF - FA) in infants with retinopathy of prematurity (ROP) using an Optos® California device. METHODS: This retrospective study involved 46 infants with a history of ROP who underwent UWF imaging with or without IV UWF - FA. ROP characteristics were identified using UWF color imaging. Retinal vascular findings following treatment were also assessed at IV UWF - FA analysis. All imaging sessions were performed under topical anesthesia without sedation. Main outcomes were the appearance of ROP at UWF color imaging and IV UWF-FA analysis, including status of ROP, neovascularizations, presence of plus disease, retinal vascular details, and resolution after treatment. RESULTS: Seven (three girls) of the 46 infants (22 girls) underwent IV UWF-FA. Twelve IV UWF-FA sessions were performed in total. The oldest infant during IV UWF-FA analysis was at 55 postmenstrual weeks. Clinical characteristics of disease were easily identified at UWF color imaging. IV UWF-FA images also clearly revealed non-perfused retinal areas, fluorescein leakage, macular edema, retinal vascular abnormalities, and the status of the peripheral vascular termini. Complications of IV UWF-FA occurred in one infant in the form of patchy yellow skin discoloration around the injection site which completely disappeared on the first day following the procedure. CONCLUSIONS: Providing a high resolution panoramic view of the retina in a single image capture with no need for contact with the cornea appear to represent potential advantages of UWF imaging in infants with ROP. IV UWF-FA also seems to be a safe procedure which can be performed under topical anesthesia and that shows detailed retinal vascular alterations in patients with ROP.

Long-Term Follow-Up Results of a Patient Undergoing Acute Retinal Necrosis: A Case Report and Literature Review.

PURPOSE: To describe the follow-up and treatment approach of a patient with acute retinal necrosis. Case Report. A 44-year-old male patient, who had complaints of pain in the right eye and blurred vision, was referred to our clinic. Best-corrected visual acuity (BCVA) was 0.4. There was 2+ anterior chamber reaction and diffuse smooth-rounded keratic precipitates. Fundus examination revealed optic nerve and vascular involvement. Fundus fluorescein angiography revealed extensive ischemia in the periphery. Oral antiviral therapy was preferred. In addition, systemic steroid and laser photocoagulation were applied. Nonetheless, retinal detachment developed 2 months later. Detachment, silicon removal, and cataract surgery were performed sequentially. It was observed that the patient was followed for 4.5 years and did not have contralateral eye involvement. Best-corrected visual acuity remained stable at 0.3. CONCLUSION: Early diagnosis, appropriate treatment, accurate complication management, and frequent follow-up may provide useful vision in patients with acute retinal necrosis.

Characteristics and Seasonal Variations of Rhegmatogenous Retinal Detachment in the Eastern Black Sea Region of Turkey: 8-Year Results.

Objectives: To assess seasonal variations in the incidence of rhegmatogenous retinal detachment (RRD) in the Eastern Black Sea region of Turkey. Materials and Methods: Patients presenting due to primary RRD to a university hospital operating as a reference clinic in the region between 2011 and 2018 were evaluated retrospectively. Patients' ages, sex, affected eye, and presentation times were recorded. Years were divided into months, quarters, seasons, and half-year periods, and these periods were analyzed in terms of differences in patient numbers. Results: Two hundred eighty-one eyes of 276 patients meeting the study criteria were included. The patients' mean age was 60.2 years, and the male:female ratio was 1.35:1. Right and left eye rates were similar. Detachments were most common (49.4%) in the upper temporal quadrant. Eighty-nine patients (31.6%) had undergone uncomplicated phacoemulsification surgery a mean 2.7 years previously. The mean annual case number was 35.13±5.43, and no statistically significant variation was determined in case numbers by year (p=0.558). Analysis of all years revealed a monthly mean case number of 23.42±4.4, with the highest number of cases, 29 (10.3%), being seen in September and the lowest number, 13 (4.7%), in December. No statistically significant monthly variation was determined (p=0.613). Similarly, no statistically significant variation was observed in case numbers analyzed by quarter, season, or half-year (p>0.05). Conclusion: The incidence of cases of uncomplicated RRD does not exhibit seasonal variation in our region. We also think that since 31.6% had a history of cataract surgery, patients undergoing phacoemulsification surgery, even if uncomplicated, should be periodically assessed for detachment.

Effect of Body Position on Intraocular Pressure Measured by Rebound Tonometer in Healthy Children.

Objectives: To evaluate the effect of body position on intraocular pressure (IOP) measurement in the pediatric age group. Materials and Methods: Children whose general condition was healthy and ophthalmic examination was within normal limits were included. Forty-nine eyes of 49 pediatric patients were included in the study. IOP was measured with an ICARE rebound tonometer (ICARE PRO; ICARE, Helsinki, Finland) while patients were in standing, sitting, and supine positions. Differences between the consecutive measurements were compared statistically. Results: Twenty-two of the 49 patients were female, 27 were male. The mean age was 9.61±2.66 (5-15) years. Mean IOP values in the standing, sitting, and supine positions were 18.81±2.97 (11.6-26.2) mmHg, 18.88±3.44, (12-28.2) mmHg, and 19.01±2.8 (13.5-25.9) mmHg, respectively. There were no statistically significant differences in pairwise comparisons of the measurements taken in the different positions (p=0.846, p=0.751, p=0.606). There was a statistically significant correlation between corneal thickness and intraocular pressure values in all measurements (p=0.001, r=0.516). Conclusion: IOP values measured with the ICARE rebound tonometer in healthy children are not affected by body position.