Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis

Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique. Results. The mean age of the patients was 71.9±10.8 years. The mean percentage of ICA stenosis was 74±4.9% in Group 1 and 47.5±7.7% in Group 2. The mean SFCT was 231.9±44.6 μm in Group 1 and 216.2±46.8 μm in Group 2, which was significantly lower (P=0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r=0896, P=0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%

Evaluation of spectral domain optical coherence tomography parameters in ocular hypertension, preperimetric, and early glaucoma

Purpose: The objective of this study is to evaluate the diagnostic ability of retinal nerve fiber layer (RNFL), macular, optic nerve head (ONH) parameters in healthy subjects, ocular hypertension (OHT), preperimetric glaucoma (PPG), and early glaucoma (EG) patients, to reveal factors affecting the diagnostic ability of spectral domain-optical coherence tomography (SD-OCT) parameters and risk factors for glaucoma. Methods: Three hundred and twenty-six eyes (89 healthy, 77 OHT, 94 PPG, and 66 EG eyes) were analyzed. RNFL, macular, and ONH parameters were measured with SD-OCT. The area under the receiver operating characteristic curve (AUC) and sensitivity at 95% specificity was calculated. Logistic regression analysis was used to determine the glaucoma risk factors. Receiver operating characteristic regression analysis was used to evaluate the influence of covariates on the diagnostic ability of parameters. Results: In PPG patients, parameters that had the largest AUC value were average RNFL thickness (0.83) and rim volume (0.83). In EG patients, parameter that had the largest AUC value was average RNFL thickness (0.98). The logistic regression analysis showed average RNFL thickness was a risk factor for both PPG and EG. Diagnostic ability of average RNFL and average ganglion cell complex thickness increased as disease severity increased. Signal strength index did not affect diagnostic abilities. Diagnostic ability of average RNFL and rim area increased as disc area increased. Conclusion: When evaluating patients with glaucoma, patients at risk for glaucoma, and healthy controls RNFL parameters deserve more attention in clinical practice. Further studies are needed to fully understand the influence of covariates on the diagnostic ability of OCT parameters

Investigation of the effect of oculo-motor exercises in children with intermittent exotropia

ÖZ GİRİŞ ve AMAÇ: Çocukluk çağında sıklıkla görülen intermittan ekzotropya tedavisinde sıklıkla cerrahi dışı teknikler tercih edilmektedir. Mevcut çalışmayla okülo-motor egzersizlerin intermittan ekzotropya tedavisi ve hasta-ebeveyn memnuniyet düzeyleri ile yaşam kaliteleri üzerine etkisini değerlendirmek hedeflenmiştir. YÖNTEM ve GEREÇLER: İntermittan ekzotropya tanılı 51 hastanın demografik özellikleri, yaşları, doğum ayları, açık alanda geçirdiği süreler, sikloplejik refraksiyon ölçümleri,snellen eşeli ile elden düzeltilmiş ve düzeltilmemiş görme keskinlikleri, yakın ve uzak olmak üzere alternan prizma örtme testleri (PÖT), Titmus testleri ve konverjans ölçümleri yapıldı. Fizyoterapist tarafından 6 hafta süre ile her gün 2 seans olacak şekilde bakış stabilizasyonlu okülo-motor egzersizler hastalara ev programı olarak verildi. Egzersiz öncesi ve sonrası memnuniyet ve yaşam kalitesi testleri uygulandı. BULGULAR: Yapılan analizlerde sol göz görme keskinliği [p=0.076],sağ göz skiaskopi [p<0.001],sol göz skiaskopi [p=0.009], ve Prizma Örtme Testi uzak tahsisli ölçümleri [p=0.003], egzersiz eğitimi sonrası artış gösterirken, proksi anket [p=0.004] puanlamasında azalma izlendi. Sol göz görme keskinliği ile yaş [p<0.001], açık alan süre [p=0.024] ve egzersiz günlüğü [p=0.038] ilişkili bulunurken, Prizma Örtme Testi uzak tahsisli ile sadece yaş [p=0.039] arasında anlamlı bir ilişki bulundu. TARTIŞMA ve SONUÇ: Çalışmamızda egzersiz uygulamalarının uygulama miktarından bağımsız olarak, sol göz görme keskinliği hariç diğer ölçüm değerleri üzerine etkisinin olmadığı sonucuna ulaşılmıştır. Daha güvenilir sonuçlar için mevcut limitasyonların giderildiği geniş ölçekli ve kontrol grubu olan çalışmalara ihtiyaç olduğu düşünülmektedir.ABSTRACT INTRODUCTION: In the treatment of intermittent exotropia, which is frequently seen in childhood, non-surgical techniques are often preferred. The present study aims to evaluate the effect of oculo-motor exercises on intermittent exotropia treatment and patient-parent satisfaction levels and quality of life. METHODS: 51 patients diagnosed with intermittent exotropia were performed demographic characteristics, age, months of birth, outdoor time, cycloplegic refraction measurements, corrected and uncorrected visual acuity with snellen chart, and close and distant alternan prism covering tests (PÖT), Titmus tests and convergence measurements. Oculo-motor exercises with gaze stability as home exercise protocols were given to all participitans for two sessions per day for six weeks by the physiotherapist. Satisfaction and quality of life tests were performed before and after exercise. RESULTS: In the analysis, left eye visual acuity [p=0.076], right eye sciascopy [p<0.001], left eye sciascopy [p=0.009], and Prism Covering Test with distant measurements [p=0.003], showed increas after exercises trainning, proxy questionnaire scores [p=0.004] is decreased. While the left eye was associated with visual acuity, age [p<0.001], outdoor activities duration [p=0.024] and exercise exercise diary [p=0.038], the Prism Covering Test [p=0.039] was found to be significantly associated with age only. DISCUSSION and CONCLUSION: In our study, regardless of the application amount of exercise, it was concluded that there was no effect on other measurement values except left eye visual acuity. For more reliable results, large scale and control group studies are needed to eliminate the existing limitations

Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease

Evaluation of Pachymetric Measurements with Scheimpflug Photography-Based System and Optical Coherence Tomography Pachymetry at Different Stages of Keratoconus

The aim of this study was to compare the central and peripheral pachymetric measurements determined with Sirius system and Visante OCT and evaluate the agreement between them at different stages of keratoconus. Measurements were not significantly different in all patients and subgroups and showed high correlation for the corneal thicknesses of the entire cornea in different stages of keratoconus