Determination of normative data of retinal nerve fiber layer thickness and optic nerve head features with optical coherence tomography in a sample of Turkish population

Amaç: Türk toplumunun bir kesitinde optik koherans tomografi ile retina sinir lifi tabakası ve optik sinir başı özelliklerinde normatif verilerin tesbiti. Gereç ve Yöntem: Polikliniğe rutin muayene amacı ile başvuran ve daha önce glokom tanısı almamış ve çukurluk/disk oranı ≤ 6/10 olan 240 olgunun 480 gözü çalışma kapsamına alındı. Tüm olgulara tam oftalmik muayene, gün içi göz içi basınç takibi, gonyoskopi, santral kornea kalınlığı ve görme alanı testleri yapıldı. Herhangi bir patoloji saptanmayan hastalara optik koherans tomografi ile optik sinir başı ve retina sinir lifi tabakası analizleri yapıldı. Bulgular: Sağ göz saat- 4 dilimi ve sol göz saat- 8 dilimi ortalaması ile optik koherans tomografi cihazının normatif ortalaması arasında anlamlı bir fark saptanmadı (p=0,505). Sağ ve sol göz saat- 6 dilimi ortalaması ile optik koherans tomografi cihazının normatif ortalaması arasında anlamlı bir fark tespit edilmedi (p=0,022). Belirtilen bu saat dilimleri dışındaki diğer dilimlerin retina sinir lifi tabakası kalınlık ortalamaları ile optik koherans tomografi cihazının normatif ortalamaları arasında istatistiksel olarak anlamlı bir fark olduğu görüldü (p<0,001). Çalışmamızda bulunan ortalama retina sinir lifi tabakası kalınlığı 99,05±9,29 µm iken optik koherans tomografi cihazının ortalama retina sinir lifi tabakası kalınlığı 104,80±10,70 µm’dur ve bu iki ortalama değer arasında istatistiksel olarak anlamlı bir fark olduğu izlendi (p<0,001). Aynı zamanda, ortalama retina sinir lifi tabakası kalınlığı ile yaş arasında ters yönlü anlamlı bir korelasyon tespit edildi. Sonuç: Bu çalışmada Türk toplumunun bir kesitinin ortalama retina sinir lifi tabakası kalınlığının optik koherans tomografi cihazının ortalama retina sinir lifi tabakası kalınlığından anlamlı olarak farklı olduğu gözlediğimiz için toplumumuza ait daha geniş serilerden normatif veri oluşturulması gerektiği sonucuna vardık.Objetive: Determination of normative data of retinal nerve fiber layer thickness and optic nerve head features with optical coherence tomography in a sample of Turkish population. Material and Method: Four hundred and eighty (480) eyes of two hundred and forty (240) patients who applied to the polyclinic for routine examination and had no previous glaucoma diagnosis and had a cup/disc ratio of ≤ 6/10 were included in the study. In all cases, complete ophthalmic examination, intraocular pressure followed by day, gonioscopy, central corneal thickness, visual field tests were performed. In cases without any pathology analyses of optic nerve head and retinal nerve fiber layer with optical coherence tomography were performed. Results: There was no significant difference between right eye hour- 4 slices and left eye hour- 8 slice averages and normative averages of optical coherence tomography (p=0.505). There was no significant difference between right and left eye hour-6 slice averages and normative averages of optical coherence tomography (p=0.022). Statistically significant differences were found between the retinal nerve fiber layerthickness averages and the normative averages of the optical coherence tomography device in the other slices except for the mentioned time zones (p<0.001). The average retinal nerve fiber layer thickness in our study was 99.05±9.29 μm, while the average retinal nerve fiber layer thickness of the optical coherence tomography was 104.80±10.70 μm and a statistically significant difference was observed between these two mean values (p<0.001). At the same time, there was a significant negative correlation between mean retinal nerve fiber layer thickness and age. Conclusion: In this study, we observed that the mean retinal nerve fiber layer thickness of the sample Turkish population was significantly different from the mean retinal nerve fiber layer thickness of the optical coherence tomography device. For this reason, we have to conclude that normative data should be generated from the wider series of our society

Eye Involvement in Möbius Syndrome and its Treatment

Möbius syndrome is a congenital disease which is characterized by horizontal ophthalmoplegia and facial paralysis. Four patients who were referred to our clinic and were diagnosed as Möbius syndrome were included in the study. Of these, two cases were followed up on a regular basis. In one of these two cases, bilateral medial rectus recession and inferior oblique tenotomy were performed. The other case underwent strabismus surgery followed by amniotic membrane transplantation. In this patient, lateral rectus muscle was determined as hypoplastic during the surgery and medial rectus muscle resection was performed. It was observed that satisfactory refractive and surgical outcomes could be achieved in patients with esotropia. It should be considered that structural muscle anomalies and/or horizontal gaze palsy may accompany this condition, therefore, cranial and orbital magnetic resonance imaging can be helpful in determining these anomalies before the surgery. (Turk J Oph thal mol 2011; 41: 417-22