Aflibercept Treatment for Macular Edema following Branch Retinal Vein Occlusion: Age-Based Responses.

PURPOSE: The aim of this study was to compare responses to aflibercept treatment in age-based groups of patients with macular edema following branch retinal vein occlusion (BRVO). METHODS: Eighty-five patients with macular edema following BRVO were divided into 4 groups according to their age: Group I (i.e., 45- to 54-year-olds), Group II (i.e., 55- to 64-year-olds), Group III (i.e., 65- to 74-year-olds), and Group IV (i.e., 75- to 84-year-olds). Each patient received a loading dose of 3 monthly intravitreal aflibercept injections. The treatment response was evaluated with visual acuity (VA) and optical coherence tomography measurements of the central foveal thickness (CFT), outer nuclear layer thickness (ONLT), and photoreceptor layer thickness (PRLT) before treatment and 1 month after the first and third injections. RESULTS: In Group I (n = 19), Group II (n = 25), Group III (n = 23), and Group IV (n = 18), the mean values of VA, CFT, ONLT, and PRLT improved significantly 3 months after treatment. Whereas VA improved the most in Group I, its improvement significantly decreased in each progressively older age group, as did the reduction of the CFT, ONLT, and PRLT values, all of which were greater in groups I and II. Furthermore, age significantly correlated with changes in VA, CFT, ONLT, and PRLT across all groups. CONCLUSION: The efficacy and effectiveness of aflibercept treatment decrease in patients with macular edema following BRVO as they age, most likely due to age-related changes in posterior ocular structures.

Evaluation of the lamina cribrosa thickness and depth in patients with migraine.

PURPOSE: The aim of the study was to evaluate the lamina cribrosa (LC) thickness, LC depth, and retinal nerve fiber layer (RNFL) thickness, in migraine patients with and without aura, by using optical coherence tomography (OCT). METHODS: This single-center, case-control study included 27 migraine with aura (Group I), 35 migraine patients without aura (Group II), and 35 healthy controls (Group III). In only the right eyes of participants, RNFL thickness in all quadrants was analyzed via OCT, whereas LC thickness and depth were measured by enhanced depth imaging OCT. RESULTS: The mean age and sex distributions did not differ significantly across the groups (p = 0.460 and p = 0.941). The RNFL thickness was significantly lower in Group I (average and superotemporal, superonasal, and inferotemporal quadrants) and Group II (average and superotemporal and superonasal quadrants) when compared with Group III. Disease duration was significantly correlated with RNFL thickness on average and in all quadrants except in the superonasal quadrant in Groups I and II. Patients in Groups I and II had significantly thinner LC thicknesses and deeper LC depth than healthy participants in Group III. CONCLUSIONS: The LC and RNFL thicknesses were thinner and the LC depth was deeper in migraine patients with or without aura than in healthy individuals, and disease duration correlated significantly with RNFL thickness. Both results suggest that migraine patients are at risk of developing glaucoma.

Frequent Mutation in the FTL Gene Causing Hyperferritinemia Cataract Syndrome in Turkish Population Is c.-160A>G

Objective: Hyperferritinemia cataract syndrome (HFCS) is an autosomal dominantly inherited disease characterized by increased serum ferritin levels and bilateral cataract formation in the early period of life. Heterozygote mutations in the 5' untranslated region of the L-ferritin gene (FTL) have been reported to cause this disease. In this study, our purpose was to research the FTL gene mutations that cause HFCS in Central Anatolia and the clinical effects of these mutations. Materials and Methods: Seventeen patients from 6 families with high ferritin levels in performed serum measurements, those who were found to have cataracts in eye examinations, and families with vertical inheritance, since the disease is autosomal dominant, were included in the study. Exons, exon-intron boundaries, and 5' and 3' untranslated regions of FTL (NM_000146) were sequenced using the Sanger sequencing method. Results: The female/male ratio of the patients was 7/10. All of the patients were found to have c.-160A>G heterozygous mutation in the FTL gene. Conclusion: In the Turkish population, the prevalence of HFCS is about 1/100,000 and the commonly observed mutation is c.-160A>G mutation.

Evaluation of posterior ocular changes using enhanced depth imaging-optical coherence tomography in patients with obstructive sleep apnea syndrome.

PURPOSE: Evaluation of the nerve fiber thicknesses of the macula, choroid, and retina using the apnea-hypopnea index in individuals with obstructive sleep apnea syndrome (OSAS) without systemic components. METHODS: Prospective, controlled study. The central macular, choroidal, and retinal nerve fiber layer (RNFL) thicknesses were evaluated using enhanced depth imaging-spectral domain optical coherence tomography in individuals with OSAS. In people with severe OSAS who had received treatment, posterior ocular structures were examined over 3 months (4th and 12th weeks), and changes were evaluated. Only the right eyes of the participants were evaluated in the study. RESULTS: A total of 72 people were involved in the study, with 18 in the control group and 19 with mild, 16 with moderate, and 19 with severe OSAS. No significant difference was found among the groups in terms of demographic measures. No significant differences were found among the groups in terms of the measures of central macular, central subfoveal choroidal (CSCT), temporal choroidal, nasal choroidal, and RNFL thicknesses. In severe OSAS cases in which treatment was administered, although subjective clinical recovery was observed, statistically significant thinning was detected during the 3-month follow-up period in the CSCT, general RNFL, as well as in the inferior and superior nasal quadrants, and temporal superior quadrant (p=0.005, p=0.009, p=0.039, p=0.003, and p=0.02, respectively). CONCLUSION: In the group with severe OSAS, thinning in some posterior ocular tissues was observed. Although patients with severe OSAS may experience clinical recovery, we recommend that they would be followed up in terms of ocular ischemic injury.