Ganglion cell complex thickness in nonexudative age-related macular degeneration

Purpose To evaluate ganglion cell complex(GCC) thickness with spectral domain opticalcoherence tomography (SD-OCT) in eyes withnonexudative age-related maculardegeneration (NEAMD).Methods Forty-seven eyes of 28 patientswith nonexudative age-related maculardegeneration (NEAMD) and 54 eyes of 28age-matched healthy subjects were enrolled.Each subject underwent a completeophthalmic examination before SD-OCT wereobtained. Macular scans were taken withsoftware version 6.0 of the ganglion cellanalysis (GCA) algorithm. GCC thickness wasevaluated automatically as the average,minimum, temporal superior, superior, nasalsuperior, nasal inferior, inferior, andtemporal-inferior segments by SD-OCT andparameters were compared between groups.Results The mean age was 68.7±8.73 yearsin patient group, and 61.51±5.66 years incontrol group. There were no significantdifferences in mean age, gender distribution,intraocular pressure, and sferic equivalent atimaging between the groups (P40.05). Themean (±SD) GCC thicknesses were asfollows; average 71.53±16.53 µm, minumum62.36±21.51 µm, temporal superior72.23±14.60 µm, superior 72.76±20.40 µm,nasal superior 72.31±20.13 µm, nasal inferior69.74±20.51 µm, inferior 69.38±19.03 µm, andtemporal-inferior 73.12±15.44 µm in patientgroup. Corresponding values in control groupwere 81.46±4.90 µm, 78.66±6.00 µm,81.51±4.66 µm, 82.94±5.14 µm,81.79±5.86 µm, 80.94±6.18 µm,80.14±6.30 µm, and 81.75±5.26 µm,respectively. There were significantdifferences between two groups in eachsegments (Mann–Whitney U-test, Po0.05).Conclusion The average GCC thicknessvalues (in all segments) of NEAMD patients were lower than control group. NEAMD,which is considered as a disease of outerlayers of retina, may be accompanied witha decrease of ganglion cell thickness, so innerlayers of retina may be affected

A tipi kişilik yapısına sahip bireylerde koroid ve ganglion hücre kompleks kalınlıkları: Optik koherens tomografi çalışması

Aim: To evaluate choroidal thickness (CT) and ganglion cell complex (GCC) thickness with spectral domain optical coherence tomography (SD-OCT) in subjects with type A behavior pattern (TABP). Material and Method: Thirtyeight eyes of 38 healthy controls and 38 eyes of 38 patients with TABP were enrolled. Each subject underwent a complete ophthalmic examination before SD-OCT images were obtained. Choroidal thicknesses were measured manually at the central of fovea (subfoveal) and 500 µm intervals up to 1500 µm temporal (T1, T2, T3) and nasal (N1, N2, N3) to the fovea with Enhanced Depth Imaging (EDI ) mode. GCC thickness was evaluated automatically as the minimum and the average thicknesses. Parameters were compared between the groups. Results: The mean ages were 38.7±13.8 years in TABP group, and 40.3±11.5 years in control group. There were no significant differences in mean age, gender distribution, intraocular pressure and spherical equivalent between the groups (p>0.05). The mean (±SD) CT for each of the 7 points (subfoveal, N1, N2, N3, T1, T2, T3) in TABP group were 325.4±45.1, 301.3±39.4, 284.6±35.2, 269.5±41.9, 293.2±40.7, 274.5±43.8, 260.5±44.3 µm, respectively. CT values in control group were 322.9±27.9, 301.8±33.2, 288.5±35.0, 278.1±33.4, 297.2±31.5, 285.1±33.0, 271.4±39.5 µm, respectively. There was no significant differences in CT for all 7 points between the groups (p>0,05). The mean and minimum GCC thicknesses in TABP group were 82.2±5.3 µm and 79.0±6.4 µm, respectively. Corresponding values in control group were 86.3±7.2 µm and 83.5±6.0 µm, respectively. There were significant differences in mean and minimum GCC thicknesses between the groups (p>0,05). Discussion: Although no detectable difference between the groups in terms of CT, the mean and minimum GCC thickness values of TABP patients were statistically lower than control group. TABP may be accompanied with a decrease of ganglion cell thickness

Clinical outcomes and optical performance of four differentmultifocal intraocular lenses

Background/aim: The purpose of the present study was to evaluate clinical outcomes and optical performance of 4 different multifocal intraocular lenses (IOLs). Materials and methods: Ninety eyes of 51 patients who received Reviol MFM 611, Reviol MFM 625, Acri.LISA, and ReSTOR SN6AD3 multifocal IOLs after cataract surgery were retrospectively evaluated. The patients were similar in terms of age, sex, cataract hardness and axial length. The mean outcome measures were uncorrected and corrected distance visual acuity (UDVA, CDVA), distance-corrected intermediate and near visual acuity (DCIVA, DCNVA), intra or postoperative complications, and contrast sensitivity (CS) results under mesopic conditions. The mean follow up period was 10.5 months (range: 6 12 months). Results: All cases were within ± 0.75 D of emmetropia. Postoperative increase in UDVA and DCNVA was statistically significant in all groups. The Acri.LISA group showed slightly lower DCIVA compared with the other IOLs. CS was clinically similar between the groups. None of the patients developed any early or late postoperative complication or neuroadaptation problem, which necessitated explantation of the lens. Conclusion: All four multifocal lens designs provided satisfactory visual functions and CS results in patients who fulfilled the criteria for multifocal lens implantation

The correlation of choroidal thickness and ocular pulse amplitude in non-exudatıve age-related macular degeneration

Introduction: The choroid is involved in the pathogenesis of various retinal diseases, including age-related macular degeneration (AMD). The ocular pulse amplitude (OPA) gives useful information about intraocular blood flow and is an indirect indicator of choroidal perfusion. In this study, we aimed to assess the correlation between the OPA and choroidal thickness (CT) in the eyes of healthy individuals and of individuals with non-exudative early stage AMD. Materials and Method: Fourty-four eyes of 44 non-exudative AMD patients and 41 age-matched eyes of 41 healthy individuals were included in the study. All eyes underwent a detailed ophthalmic evaluation, including axial length (AL) and ocular pulse amplitude (OPA) measurements. The CT was measured using optical coherence tomography. Parameters were compared between the two groups and correlation between OPA and CT was assessed. Results: The mean subfoveal, foveal, and parafoveal CT were 245.82 +/- 24.29 mu m, 230.66 +/- 23.44 mu m, 219.55 +/- 25.39 mu m in AMD group, respectively. The corresponding values were 278.44 +/- 34.18 mu m, 263.76 +/- 32.45 mu m, and 253.79 +/- 34.81 mu m in control group, respectively. The mean ages of groups were 69.6 +/- 8.97 years, and 65.0 +/- 5.89 years, respectively. The mean OPA was 3.43 +/- 1.14mmHg and 3.49 +/- 1.12mmHg, respectively. The average CT in AMD patients were significantly lower than the control group in all three regions (subfoveal- foveal- parafoveal) (all p<0,001). In controls, there was a moderate positive correlation between the OPA and CT in the three segments (p=0.002, 0.009, and 0.003; respectively). However only the foveal CT showed significant positive correlation with the OPA in AMD group (p=0.047). Conclusion: Our results showed a considerable correlation between ocular pulse amplitude and choroidal thickness in healthy subject. In non-exudative AMD group, there was a weak correlation between them. It can be hypothesized that; in patients with AMD, degeneration and/or thinning of choroidal pattern is a reason for this result

Neuroimaging in atypical normal tension glaucoma: debating routine implementation in the absence of classic neurological findings

AIM: To assess the necessity of neuroimaging in patients with neurological or atypical findings of normal tension glaucoma (NTG) who do not exhibit typical glaucoma manifestations. METHODS: A retrospective analysis was conducted on 90 atypical NTG patients who underwent cranial magnetic resonance imaging (MRI) due to atypical symptoms. The demographic characteristics, clinical parameters, and radiological findings were recorded. RESULTS: Among the patients, 66.7% had abnormal radiology results, with the most common findings being gliosis (34.4%), sequelae of cerebrovascular events and vascular malformations (14.4%), and benign intracranial mass lesions (11%). Non-glaucomatous visual field defects were more frequently observed in patients with abnormal neuroimaging results. However, there were no significant differences in intraocular pressure, optic disc parameters, retinal nerve fiber layer thickness, and visual field indices between patients with normal and abnormal radiological results. The mean age of the patients was 58.74y. Interestingly, there was a significant age difference, with the abnormal radiology group having a higher median age (P=0.021). CONCLUSION: The study highlights the importance of cranial imaging in older NTG patients to detect underlying pathologies and prevent misdiagnosis. It suggests that neuroimaging may be warranted in NTG patients with atypical visual field defects incompatible with glaucoma. However, routine neuroimaging in all NTG patients without classic neurological signs may not be necessary

Multiple evanescent white dot syndrome presenting that as central serous chorioretinopathy

A 28-year-old man presented to the clinic with metamorphopsia, central scotoma, and visual loss in his right eye. After detailed ophthalmicexamination, fundoscopy showed localized elevation of the macula,and optical coherence tomography also showed subretinal serofi brinousaccumulation temporal to the fovea. He was evaluated as idiopathic central serous chorioretinopathy (CSCR). At the fi fth day of presentationhe was seen by the retinal consultant with fl uorescein angiography (FA) and indocyanine green angiography (ICGA) which were characteristicof multiple evanescent white dot syndrome (MEWDS) in the right eye. The diagnosis was changed as MEWDS presenting that as CSCR, andit was seen that the serofi brinous elevation began to decline after the fi rst week of presentation. Symptoms and visual disturbance recoveredwithout any further treatment at sixth month in this case

Santral Seröz Koryoretinopati Şeklinde Prezente Olan Multipl Geçici Beyaz Nokta Sendromu

A 28-year-old man presented to the clinic with metamorphopsia, central scotoma, and visual loss in his right eye. After detailed ophthalmicexamination, fundoscopy showed localized elevation of the macula,and optical coherence tomography also showed subretinal serofi brinousaccumulation temporal to the fovea. He was evaluated as idiopathic central serous chorioretinopathy (CSCR). At the fi fth day of presentationhe was seen by the retinal consultant with fl uorescein angiography (FA) and indocyanine green angiography (ICGA) which were characteristicof multiple evanescent white dot syndrome (MEWDS) in the right eye. The diagnosis was changed as MEWDS presenting that as CSCR, andit was seen that the serofi brinous elevation began to decline after the fi rst week of presentation. Symptoms and visual disturbance recoveredwithout any further treatment at sixth month in this case.Yirmisekiz yaşında erkek hasta metamorfopsi, santral skotom ve görme kaybı ile kliniğimize başvurdu. Detaylı oftalmolojik muayenede fundusta makulada lokalize seröz dekolman, optik koherens tomografi ile de foveanın temporalinde subretinal seröfi brinöz birikim tespit edildi ve hastamız idiopatik santral seröz koryoretinopati (SSKR) tanısı ile retina bölümüne yönlendirildi. Beşinci günde tekrar görülen hastanın fundus fl öresein ve indosiyanin yeşili anjiografi sinde multipl geçici beyaz nokta sendromuna (MGBNS) karakteristik bulgular saptandı. Hastanın tanısı SSKR şeklinde prezente olan MGBNS olarak değiştirildi. Birinci haftadan sonra seröfi brinöz elevasyon azalmaya başladı. Semptomlar ve görme bozukluğu 6. ayın sonunda hiçbir tedavi gerektirmeden tamamiyle düzeldi

Unilateral sequential papillophlebitis and central retinal artery occlusion in a young healthy patient

A 23-year-old girl presented to the clinic with metamorphopsia and photopsia in her left eye. After detailed ophthalmic examination, central retinal vein occlusion with optic disc edema was detected in that eye. Three days after diagnosis, the patient returned to our clinic with visual acuity decrease. Central retinal artery occlusion sparing cilioretinal artery was detected. All the laboratory tests were normal except for heterozygous methylenetetrahydrofolate reductase mutation (A1298C genotypes) and an indefinite Lyme disease seropositivity. Symptoms and visual disturbance recovered without any further treatment other than acetylsalicylic acid for prophylaxis

Evaluating of Tear Meniscus Parameters with Optical Coherent Tomography in Dry-Eye Patients

Purpose: To evaluate the changes in meniscus parameters with optical coherence tomography (OCT) after treatment and consider the correlation between the OCT parameters and dry-eye tests. Material and Method: Thirty-two dry-eye patients and 30 healthy individuals were included. Visual acuities, biomicroscopic evaluation, Schirmer-I test, tear-break-up time (T-BUT), and lower-tear meniscus parameters measured with OCT were evaluated. Ocular surface disease index (OSDI) was performed. The measurements were repeated on the 10th day and 1st month of the treatment. Lower tear meniscus height (LTMH), depth (LTMD), area (LTMA) and α-angle were measured. The tear meniscus parameters of the dry-eye group were compared with the control group before treatment, and the correlation between the dry-eye tests and OCT measurements were evaluated. The change in the results of the dry-eye tests and OCT measurements with treatment were assessed. Results: There was statistically no significant difference between the age and gender of the patients in groups. Before treatment the mean Schirmer-I test, TBUT and OSDI scores were different. The LTMH and LTMA were higher in the control group. In the dry-eye group before treatment, there was a negative correlation between the OSDI score and OCT parameters, however, no meaningful correlation was observed between any other test and OCT parameters. Although there were no change in LTMD and α-angle with treatment, the 1st month values of LTMH and LTMA were significantly higher from the pre-treatment and 10th day values. Discussion: When diagnosing dry-eye, TBUT and OSDI scores were found to be more effective compared to Schirmer-I test for the diagnosis of dry eye. Although not adequate by itself, tear meniscus parameters measured with OCT, LTMH and LTMA, may be helpful for evaluating the efficacy of treatment, and the correlation of these two parameters with the OSDI score may increase the objectivity while questioning the symptoms. (Turk J Ophthalmol 2013; 43: 258-62