Increased Subfoveal Choroidal Thickness and Retinal Structure Changes on Optical Coherence Tomography in Pediatric Alport Syndrome Patients

Objective. To evaluate optical coherence tomography (OCT) findings of pediatric Alport syndrome (AS) patients with no retinal pathology on fundus examination. Materials and Methods. Twenty-one patients being followed up with the diagnosis of AS (Group 1) and 24 age- and sex-matched healthy volunteers (Group 2) were prospectively evaluated. All participants underwent standard ophthalmologic examination, retinal nerve fibre layer (RNFL) analysis, and horizontal and vertical scan macula enhanced depth imaging OCT (EDI-OCT). Statistical analysis of the data obtained in this study was performed with SPSS 15.0. Results. Macula thickness was significantly decreased in the temporal quadrant in Group 1 compared to those of the control group (p=0.013). RNFL measurements revealed statistically significant thinning in the temporal, superior, inferotemporal, and inferonasal quadrants and in average thicknesses in cases with AS compared to the controls (p<0.001, p<0.001, p=0.022, p=0.016, p<0.001, respectively). The mean subfoveal coronial thickness (SCT) was 362.2 ± 77.8 μm in Group 1 and 256,18 ± 71.7 μm in Group 2. There was a statistically significant difference between the two groups in terms of mean CT (p<0.001). Conclusion. OCT provides valuable information in identifying the structural changes and evaluation of ocular findings in patients with AS. Even if no pathological retinal findings were found in the clinical examination, structural changes in the OCT examination begin in early period of AS

Optic nerve and dura mater involvement as the first sign of multiple myeloma

WOS: 000352200400015PubMed ID: 24832040Purpose: To report a case of optic nerve and dura mater involvement as the first sign of multiple myeloma. Methods: Case report. Results: A 43-year-old woman presented with a headache and decreased vision in both eyes. Ophthalmic examination revealed anterior uveitis and subretinal mass around the optic nerves with accompanying disc edema bilaterally. Magnetic resonance imaging showed dural and optic nerve infiltration with tram-track enhancement in the optic nerve sheath. The diagnosis of multiple myeloma was made as a result of systemic investigations. The patient underwent systemic chemotherapy and cranial radiotherapy. After treatment, the patient's headache disappeared, the papilledema regressed, and the ocular findings improved but complete recovery could not be achieved because of fibrous subretinal tissue and degenerative changes of the optic nerve. Conclusions: Neurologic and ophthalmic involvement in multiple myeloma may appear as the first manifestation of disease. The correct diagnosis is important because it can be life-saving

Hyphema as a Complication of Blunt Ocular Trauma and Additional Ocular Findings

Objectives: To investigate the frequency of angle recession, commotio retinae, and other ocular findings in patients with hyphema due to blunt ocular trauma. Materials and Methods: The medical records of 66 patients hospitalized between July 2010 and May 2012 with a diagnosis of traumatic hyphema were retrospectively reviewed. The age, gender, period between injury and the first examination, visual acuity at presentation, intraocular pressure (IOP), time of disappearance of hyphema, cause of blunt injury, additional ocular findings, medical and/or surgical treatment, follow-up time, and visual outcome were noted. Results: The mean age of the patients was 23.8±19.2 years. Males constituted the 83.3% of the whole group. Game-related injury (43.9%) and work-related injury (22.7%) were the most common causes of blunt trauma. The bead gun was the most common tool involved in injury. Angle recession was detected in 36 patients (54.5%). Development of secondary glaucoma was higher in the patients with angle recession (chi-square test, p<0.05). Commotio retinae was observed in 47% of patients. The mean visual acuity at presentation was 0.4±0.3, while at the last visit, it was 0.8±0.3. There was a statistically significant difference between baseline and final visual acuity (paired-samples t-test, p<0.001). Conclusion: Hyphema due to blunt ocular trauma is observed mostly in young men and children. The most common blunt ocular injuries are game-and work-related. Angle recession and commotio retinae are the main complications of blunt ocular trauma causing hyphema. In cases with blunt ocular trauma, the presence of hyphema makes it difficult to examine the anterior chamber angle and the fundus. It is important to perform these investigations at the earliest stage to manage the complications since commotio retinae and angle recession accompany many cases with hyphema. (Turk J Ophthalmol 2014; 44: 19-22

Retinopathy of Prematurity in Very Low Birth Weight Infants: Effects of Serum Vitamin A and Clinical Parameters

Pur po se: Retinopathy of prematurity (ROP) is a proliferative vascular disease which affects premature newborns and occurs during vessel development. The pathogenesis of ROP is complex and includes oxidative damage to the developing retina. The aim of this study was to evaluate the relationship of ROP with serum vitamin A levels and clinical parameters in infants with a gestational age of ≤32 weeks and birth weight of ≤1500 grams. Ma te ri al and Met hod: Newborns admitted to Newborn Intensive Care Unit within the first 24 hours of life, with gestational age ≤ 32 weeks, birth weight ≤1500 grams, without any major congenital anomalies, inborn error of metabolism or prior history of blood/blood products transfusion were included in the study. The patients were divided into two groups, ROP (+) and ROP (-), according to the presence of ROP at any stage. Serum vitamin A levels and gender, type of delivery, birth weight, gestational age, duration of hospitalization and oxygen supply, multiple gestation, preeclampsia, PDA, sepsis and intraventricular hemorrhage of the groups were compared with Mann-Whitney U and chi-square tests. Re sults: The mean gestational age of these infants was 29.2±2.0 weeks and the mean birth weight was 1287±197 grams. ROP was diagnosed in 48% of infants and the mean serum vitamin A level was 0.56±0.45 μmol/L. In 44 cases (84%), vitamin A level was determined low (<0.7 μmol/L) and was extremely low (<0.35 μmol/L) in 17 cases (32.7%). There was no significant difference between the ROP (+) and ROP (-) groups in terms of vitamin A levels. There was a statistically significant difference between the groups in terms of birth weight, gestational age, multiple gestation, duration of hospitalization and oxygen supply. Dis cus si on: Our results suggest that low birth weight, small gestational age, duration of hospitalization, oxygen exposure time and multiple gestation may increase the risk of ROP, while serum vitamin A level was not found to be associated with ROP in the present study. (Turk J Ophthalmol 2011; 41: 309-1