Peripapillary and macular vascular densities in healthy, ocular hypertensive, and different stages of glaucomatous eyes

AIM: To investigate vascular changes in different stages of glaucoma and to evaluate the role of optical coherence tomography angiography (OCTA) in the early diagnosis of glaucoma. METHODS: Glaucoma patients and healthy controls (n=29 eyes) were investigated in this cross-sectional comparative study. Glaucoma patients were grouped as ocular hypertension (n=44 eyes), preperimetric glaucoma (PPG; n=32 eyes), early glaucoma (EG; n=35 eyes), moderate stage glaucoma (MG; n=36 eyes), and advanced glaucoma (AG; n=35 eyes). Peripapillary and macular vascular densities (VDs) of all participants were compared and correlations of VDs and retinal nerve fiber layer thickness (RNFLT), ganglion cell analysis (GCA), and visual field (VF) tests were evaluated. Area under the receiver operation characteristic curves (AUC) of the peripapillary and macular VD parameters were obtained. RESULTS: VD values ??decreased with the progression of glaucoma. Most peripapillary and macular VD parameters of PPG and EG groups were lower than healthy controls (P<0.001). There was no significant difference in RNFLT between the PPG and EG groups, but most peripapillary and macular VDs were found to be lower in EG group than in PPG group (P<0.05). In most disease group, VDs were significantly correlated with OCT parameters (P<0.001) and VF index (P<0.05). There were no significant correlations between VF and RNFLT indices in the AG group, but significant correlations were found between VF and VD values (P<0.05). AUC for discriminating between healthy and glaucomatous eyes were highest in whole image peripapillary VD (AUC: 0.865, 0.929, and 0.986, respectively in EG, MG, and AG groups). CONCLUSION: OCTA can be used in the early diagnosis of glaucoma and can be useful in follow-up of the advanced disease. In cases where limitations or suspicions in structural and functional tests are present, OCTA can be used as a supportive diagnostic test, both in EG and AG

Macular and Peripapillary Vascular Densities in Non-Glaucomatous Eyes of Patients with Unilateral Glaucoma

Objectives:Our purpose was to investigate vascular alterations in the non-glaucomatous eyes of patients with unilateral primary open angle glaucoma using optical coherence tomography angiography and to evaluate the role of vascular damage in glaucoma pathogenesis.Materials and Methods:This cross-sectional study included 60 eyes of 30 patients with unilateral glaucoma (63.4±8.8 years) and 30 eyes of 30 healthy subjects (65.6±9.1 years). Three groups were formed: group A, affected eyes of unilateral glaucoma patients; Group B, non-glaucomatous eyes of unilateral glaucoma patients; and group C, healthy controls.Results:When group A was compared with groups B and C, significant differences were detected in rim area, cup volume, mean cup/disc ratio, and retinal nerve fiber layer thickness parameters (p0.05 for all). In peripapillary and macular vessel density (VD) comparisons, all parameters except intradisc VD were found to be lower in group A (p0.05 for all).Conclusion:The VD values in eyes with glaucoma were found to be lower than in the other two groups. However, no difference was observed between the non-glaucomatous eyes of glaucoma patients and those of healthy individuals. Thus, the results did not support our hypothesis that VD alterations would be observed in the fellow eyes of patients with unilateral glaucoma if the vascular pathway were responsible in the pathogenesis of glaucoma

Clinical Evaluation of Ocular Trauma

Ocular trauma is a condition that may lead to loss of vision, subsequently of the eye, and to economic losses. Ocular trauma is a preventable, worldwide public health problem, especially affecting children and working–age adults. Ocular trauma is an important part of the ophthalmic pathology and involves 10-15% all of ophthalmologic disease. Rapid assessment and examination following trauma to the eye is crucial. A thorough knowledge of potential injuries is imperative to ensure rapid diagnosis, to prevent further damage to the eye, and to preserve visual capacity. (Turk J Ophthalmol 2012; 42: Supplement 16-22

Treatment and clinical results in cases with postoperative endophthalmitis

AMAÇ: Postoperatif endoftalmi göz cerrahisinde en çok korkulan komplikasyonların başında gelmektedir. Bu çalışmada postoperatif endoftalmi görülme sıklığı, klinik özellikler, risk faktörleri, tedavi yaklaşımları ve prognoz araştırılmıştır. GEREÇ VE YÖNTEM: Çalışmaya Ankara Eğitim ve Araştırma Hastanesi Göz Kliniği'nde postoperatif endoftalmi tanısı alan olgular dahil edildi. Postoperatif endoftalmi görülme sıklığı, hastaların oküler ve sistemik hastalıkları, başvuru semptomları, göz muayene bulguları, bakteriyel kültür sonuçları, uygulanan medikal ve cerrahi tedaviler ve prognoz incelendi. BULGULAR: Çalışmaya postoperatif endoftalmi tanısı alan 41 olgu dahil edildi. Olguların yaş ortalaması 62.8 ± 22.4 yıl idi. Endoftalmi 38 gözde (%92.8) katarakt cerrahisi ve/veya göz içi mercek implantasyonu sonrasında, 1 gözde (%2.4) trabekülektomi, 1 gözde (%2.4) penetran keratoplasti ve 1 gözde (%2.4) pars plana vitrektomi sonrası gelişmişti. Olgularda ameliyat sonrasında hastaneye başvuru süresi ortalama 15.7 ± 17.5 (2-60) gündü. Vitreus / hümör aköz kültürü olguların %46.3’ünde pozitifti. Tüm olgulara en az bir kez intravitreal antibiyotik enjeksiyonu ve 15 (%36.6) olguya pars plana vitrektomi yapıldı. Işık hissini kaybeden 7 olgudan 3’üne evisserasyon uygulandı. Olgular ortalama 11.1 ± 4.9 (6-25) ay takip edildi. Takip sonucunda 7 (%17.1) olguda ışık hissi kaybı görülürken, 12 (%29.3) olgu ışık hissi-el hareketi, 11 (%26.8) olgu 1 metreden parmak sayma - <0.1 arasında, 10 (%24.4) olgu 0.1 ve üzerinde görme keskinliği ile sonuçlandı. Bir (%2.4) olguda yaşından ötürü görme keskinliği ölçülemedi. Çalışmamızda PPV'nin sonuç görme keskinliği üzerine etkisi saptanmadı (T test, p = 0.560). SONUÇ: Postoperatif endoftalmili olgularda acilen intravitreal antibiyotik yapılması, gerektiğinde tekrarlanması ve gereken olgularda doğru zamanda uygun cerrahi tedavi ile kabul edilebilir görsel ve anatomik sonuç elde etmek mümkündür.INTRODUCTION: Postoperative endophthalmitis is one of the most frustrating complications of ophthalmic surgery. In this study we aimed to evaluate the postoperative endophthamitis incidence, clinical features, risk factors, treatment strategies and prognosis in patients with postoperative endophthalmitis. MATERIAL AND METHOD: We evaluated postoperative endophthalmitis cases in Ankara Training and Research Hospital, Department of Ophthalmology. Postoperative endophthamitis incidence, ocular and systemic illness, initial symptoms, eye examination findings, bacteriologic culture results, medical and surgical treatments and prognosis were investigated. RESULTS: Forty-one patients with postoperative endophthalmitis were included in the study. The mean age was 62.8 ± 22.4 years (range 2 months - 90 years). Endophthalmitis developed in 38 eyes (92.8%) after cataract surgery and/or intraocular lens implantation, in 1 eye (2.4%) after glaucoma surgery, in 1 eye (2.4%) after penetrating keratoplasty and in 1 eye (2.4%) after pars plana vitrectomy. The mean duration of admission to the hospital postoperatively was 15.7 ± 17.5 (2-60) days. Cultures from vitreous / aqueous humor specimens were positive in %46.3 of the patients. All the cases had at least one intravitreal antibiotic injection. Pars plana vitrectomy was performed in 15 cases (36.6%). Evisceration was performed to 3 of 7 patients who lost their sense of light. The mean follow-up was 11.1 ± 4.9 (6-25) months. Light perception was lost in 7 cases (17.1%). Visual acuity was between light perception-hand motion in 12 cases (29.3%), counting finger from a meter – <0.1 in 11 cases (26.8%), 0.1 and above in 10 cases (%24.4). We couldn’t measure visual acuity in one (2.4%) preverbal patient. Pars plana vitrectomy didn’t change functional outcome in our series (T test, p = 0.560). CONCLUSION: It is possible to obtain acceptable visual and anatomical results in postoperative endophthalmitis by performing intravitreal antibiotics immediately, repetition if necessary, and performing surgical treatment when necessar

The Profile and Management of Glaucoma in Adult Aphakic Patients Following Complicated Cataract Surgery

Objectives: To determine the profile and clinical course of glaucoma in adult aphakic patients following complicated cataract surgery. Materials and Methods: Retrospective chart review of 22 adult aphakic patients (29 eyes) with glaucoma. Results: Mean age was 57.69±14.18 years when aphakia occurred. Mean age at time of presentation to our glaucoma clinic was 62.57±12.47 years. Mean follow-up time was 42.83±57.04 months. Changes between the first and last follow-up visits were as follows: mean intraocular pressure decreased from 26.21±13.86 mmHg to 18.14±9.63 mmHg (p=0.003); mean number of glaucoma medications used increased from 1.41±1.27 to 2.07±1.04 (p=0.005); and mean vertical cup/disc ratio increased from 0.69±0.25 to 0.78±0.24 (p=0.024). Glaucoma was managed using medications in 26 eyes (89.7%), whereas 3 eyes underwent surgical treatment. However, surgery alone was not sufficient to control intraocular pressure and additional glaucoma medications were needed. Conclusion: Prevention of glaucomatous optic neuropathy in aphakic patients is challenging both medically and surgically. Although a significant decrease in intraocular pressure can be achieved with glaucoma medications, glaucomatous disc changes may progress