Comparison of the retinal and choroidal structures in 3 refractive groups

Objectives: This study investigated the retinal layer thickness, choroidal thickness (CT), and retinal nerve fiber layer (RNFL) parameters in 3 refractive groups. Methods: A total of 201 eyes of 201 subjects were enrolled in this prospective and comparative study. The patients were divided into 3 groups according to refractive status: Group 1 consisted of 60 eyes of myopic subjects, Group 2 comprised 72 eyes of emmetropic subjects, and 69 eyes of hyperopic subjects were categorized as Group 3. The retinal layer thickness, CT, and RNFL parameters were measured using optical coherence tomography and compared between groups. Results: The mean age of the patients was 22.33±10.11 years in Group 1, 21.55±8.3 years in Group 2, and 23.73±11.08 years in Group 3 (p=0.741). Group 1 consisted of 34 women and 26 men, Group 2 contained 44 women and 28 men, and Group 3 was made up of 45 women and 24 men (p=0.124). The mean spherical equivalent value was −6.16±2.01 D in Group 1, 0.13±0.5 D in Group 2, and 5.48±1.32 D in Group 3 (p<0.001). The RNFL and macular thickness values were lower in the myopic patients compared with those of the other groups (p<0.05). The CT measurement was lower in the myopic patients and higher in the hyperopic patients compared with the emmetropic patients (p<0.05). Conclusion: The myopic patients had a lower CT and RNFL thickness measurement than the emmetropic and hyperopic patients, whereas the hyperopic patients had a higher CT than the other patient types

Keratokonus Hastalarında 2 Farklı Hızlandırılmış Korneal Çapraz Bağlama Yönteminin Karşılaştırılması: 9mW/cm2- 18 mW/cm2

GİRİŞ VE AMAÇ:İki farklı protokolde uygulanan hızlandırılmış kornea çapraz bağlama (KÇB) tedavisinden sonra yüksek sıralı aberasyonlar ve en iyi düzeltilmiş görme keskinliğindeki (EDGK) değişiklikleri belirlemek ve karşılaştırmak. YÖNTEM:Progresif keratokonus sebebiyle hızlandırılmış KÇB tedavisi uygulanmış olan (10 dk,9Mw/cm2 ve 5dk,18mW/cm2) 43 hastanın (30 erkek, 13 kadın) 65 gözü retrospektif olarak incelendi. Hastalar hızlandırılmış KÇB tedavi protokolüne göre grup 1 (10 dk,9mW/cm2, 21 hastanın 32 gözü) ve grup 2 (5dk,18mW/cm2,22 hastanın 33 gözü) olarak ikiye ayrıldı. Topografik bulgular (santral kornea kalınlığı, düz ve dik K değerleri) ve düzeltilmemiş görme keskinliği ve EDGK değerleri (logMAR) preoperatif ve postoperatif 6. ay değerleri kaydedildi. Yüksek sıralı aberasyonların preoperatif ve postoperatif 6. ay değerleri Pentacam yardımıyla elde edildi. BULGULAR:Her 2 grupta da düzeltilmemiş görme keskinliği ve EDGK düzeylerinde preoperatif ve postoperatif 6. ay arasında anlamlı düzelme saptandı (sırasıyla Grup 1; p:0.000001, p:0.000001 ve Grup 2; p:0.000001, p: 0.000008). Grup 1’de horizontal ve vertikal trefoil değerlerinde preoperatif ve postoperatif 6.ay sonuçları karşılaştırıldığında anlamlı fark saptanmadı (sırasıyla p: 0.16, p:0.62). Horizontal koma önemli ölçüde azalmış olmasına rağmen (p:0.00054) vertikal komada anlamlı fark saptanmadı (p:0.34). Grup 2’de horizontal ve vertikal trefoil değerlerinde preoperatif ve postoperatif 6.ay sonuçları karşılaştırıldığında anlamlı fark saptanmadı (sırasıyla p: 0.85, p:0.14). Horizontal komada anlamlı farklılık saptanmamasına rağmen (p:0.96) vertikal komada anlamlı fark saptandı (p:0.02). TARTIŞMA VE SONUÇ:Her iki hızlandırılmış KÇB protokolü keratokonusun ilerlemesini engellemekle birlikte görme keskinliği ve topografi bulgularında önemli iyileşme sağladı. Bununla birlikte horizontal komadaki iyileşme grup 1’de (9Mw/cm2) grup 2’den (18mW/cm2) daha iyiydi

Assessment of tear film anomalies in childhood obesity

Purpose To determine if childhood obesity has an effect on the ocular surface and tear film of children who are afflicted. Methods Patients who had childhood obesity, 85 eyes, and patients who were healthy, 75 eyes, were enrolled in this prospective and comparative study. The tear film breakup time (TF-BUT), tear meniscus area and height (TMA and TMH) values, Schirmer test scores, and ocular surface disease index (OSDI) scores were obtained for all participants. Results The TMH, TMA, TF-BUT, and Schirmer test results were statistically significantly lower in the obesity group (p < 0.001 for all). The children with obesity and insulin resistance had lower TMH, TMA, TF-BUT, and Schirmer test results when compared to the children without insulin resistance (p < 0.05 for all). The body mass index was found to be correlated with the TMH, TMA, TF-BUT, and Schirmer test results (p < 0.001 for all). Conclusion Children with obesity had lower TMA, TMH, TF-BUT, and Schirmer test results than healthy subjects. When insulin resistance was added to obesity, these values were even lower

Comparison of two different accelerated corneal cross-linking procedure outcomes in patients with keratoconus

Background: Corneal cross-linking treatment is the unique treatment method that can cease the progression of keratoconus disease. Because of the long duration of conventional treatment, accelerated cross-linking treatment methods are being developed. Aims: To compare two different accelerated corneal cross-linking protocols in terms of postoperative visual acuity and topographic findings (higher-order aberrations and keratometry values). Study Design: Retrospective comparative study. Methods: Sixty-five eyes of 43 patients (30 men and 13 women) who underwent two different accelerated corneal cross-linking protocols (10 min, 9 mW/cm2 and 5 min, 18 mW/cm2) for progressive keratoconus were retrospectively analyzed. Patients were divided into two groups according to the accelerated corneal cross-linking treatment protocol: group 1 (10 min, 9 mW/cm2, 32 eyes of 21 patients) and group 2 (5 min, 18 mW/cm2, 33 eyes of 22 patients). Uncorrected visual acuity and best-corrected visual acuity values and topographic findings (central corneal thickness and flat and steep keratometry values) were recorded preoperatively and 6 months after corneal cross-linking treatment. High-order aberration values measured with Pentacam preoperatively and 6 months after corneal cross-linking were also recorded. Results: In both groups, a significant improvement was detected in the uncorrected visual acuity and best-corrected visual acuity levels preoperatively and 6 months postoperatively (group 1: p=0.001, p=0.001 and group 2: p=0.001, p=0.001, respectively). In addition, central corneal thickness values decreased significantly in both groups (p=0.006 and 0.001). Trefoil values showed no significant difference preoperatively and 6 months postoperatively in group 1 (p=0.160 and 0.620, respectively). In groups 1 and 2, coma values were found to decrease significantly in the 6th postoperative month compared with preoperative values (p=0.001 and 0.020, respectively). There was no significant difference between preoperative and 6th month postoperative horizontal and vertical trefoil values in both groups (p=0.850 and 0.140, respectively). There was no significant difference between the two groups in terms of preoperative and 6th month postoperative higher-order aberrations, refractive errors, keratometry values, and uncorrected visual acuity and best-corrected visual acuity levels. Conclusion: Both accelerated corneal cross-linking procedures provide similar improvement in topographic findings, coma values and visual acuity

Correlation of Non-invasive Tear Break-Up Time with Tear Osmolarity and Other Invasive Tear Function Tests

Aim: To compare the outcomes of non-invasive break-up time (NI-BUT) test and the other conventional dry eye tests. Methods: The right eyes of 170 subjects were included in the study. In order to evaluate the tear quality of the patients, NI-BUT levels were measured by the Scheimplug-Placido disk system (Sirius topography). Tear osmolarity test was performed with TearLab Osmolarity System. Topical anesthesia-assisted type I Schirmer test and topical anesthesia-assisted BUT were lastly applied to all patients in order not to affect other measurements. Results: The mean NI-BUT value was 9.59 ± 4.37 sec, tear osmolarity was 292.93 ± 9.30 mOsm/L, Schirmer test was 15.32 ± 6.05 mm/5 min, and biomicroscopic BUT value was 8.98 ± 3.79 sec. The Schirmer test results were statistically significantly correlated with biomicroscopic BUT and NI-BUT values (p = .019, r = 0.180 and p = .030, r = 0.166; respectively). It was also found that tear osmolarity was strongly and inversely correlated with biomicroscopic BUT and topographic NI-BUT values (p < .001, r = ?0.554 and p < .001, r = ?0.528; respectively). There was no significant correlation between Schirmer test and tear osmolarity. Conclusion: It is important to use a sensitive, reproducible and non-invasive method in the evaluation of tear functions. We think that the objective and noninvasive topographic NI-BUT measurements and the minimally invasive osmolarity measurements should be used more frequently in practice because they are correlated with the measurements obtained by invasive methods and should be widespread in clinics

Evaluation of retinal structure in pediatric subjects with vitamin D deficiency

Purpose: To quantitatively evaluate the retinal structural parameters of pediatric patients who were determined to be deficient in vitamin D. Design: Prospective, cross-sectional study. Methods: Retinal structural parameters, including the peripapillary retinal nerve fiber layer (RNFL), central macula, retinal layer, and choroidal thicknesses, central retinal artery equivalent (CRAE), and central retinal vein equivalent (CRVE), in pediatric subjects with vitamin D deficiency (group 1) and those without (group 2) were compared. Results: Group 1 comprised 70 individuals, while group 2 comprised 80 individuals. The mean peripapillary RNFL (except for the nasal superior sector [P = .037]), central macula, and retinal layer thicknesses were also determined to be similar in both groups (P > .05 for both groups). The mean choroidal thickness was lower in the subfoveal (P = .006) and nasal 3000-µm–diameter areas (P = .004) in group 1. The mean CRAE was determined to be lower (P = .031) and the CRVE was higher in group 1 (P = .005); it was determined that there was a significant correlation between the vitamin D level and both the CRAE (r = 0.447, P < .001) and CRVE (r = −0.320, P = .013). Conclusion: Choroidal thinning, a decrease in the CRAE, and increase in the CRVE were structural changes that occurred in the pediatric subjects who had vitamin D deficiency. The alterations in these parameters became more prominent in pediatric subjects who were determined to have lower vitamin D levels