Evaluation of stereopsis in children with corrected anisometropia according to type, severity, and presence of amblyopia

Objective: This study was designed to determine the level of stereopsis in anisometropic children with and without amblyopia who used corrective glasses and to investigate the effect of the type and magnitude of anisometropia on the level of stereopsis. Materials and Methods: The medical records of 256 children with a diagnosis of non-amblyopic anisometropia or anisometropic amblyopia, and healthy controls were retrospectively reviewed for this study. Anisometropia was categorized into 3 groups: spherical equivalent-only anisometropia, astigmatic-only anisometropia, or combined anisometropia. The level of stereopsis was measured using the Titmus stereo test, compared between groups, and the correlation of the stereopsis with the magnitude of anisometropia was analyzed. Results: Patients in the non-amblyopic anisometropia group had a similar stereopsis level when compared with the control group (55.2 +/- 41.03 and 47.2 +/- 19.8 seconds of arc, respectively; p=0.223). The level of stereopsis was significantly less in the anisometropic amblyopia group (279.4 +/- 120 seconds of arc) compared with the non-amblyopic anisometropia (55.2 +/- 41.03 seconds of arc) and control groups (47.2 +/- 19.8 seconds of arc) (p=0.008, p=0.006, respectively). A greater spherical equivalent difference between the eyes resulted in poorer stereopsis in the anisometropic amblyopia group, and combined anisometropia was found to be associated with poorer stereopsis levels in the nonamblyopic anisometropia (NA) group. Conclusion: The NA patients had a similar level of stereopsis compared with controls while wearing corrective glasses. This result suggests that as long as patients have good visual acuity, stereopsis is preserved, and that refractive correction with glasses does not interfere with stereopsis in childhood anisometropia

Standardized classification of mechanical ocular injuries: Efficacy and shortfalls

Objectives: The aim of this study was to examine the efficacy and the shortfalls of the Birmingham Eye Trauma Terminology classification system for ocular trauma in predicting the visual outcome. Methods: The records of 256 eyes of 246 patients with a diagnosis of mechanical ocular trauma admitted to the Osman Gazi University Hospital ophthalmology department between 1995 and 2000 were retrospectively reviewed. The zone, type, grade, and pupil status of the injuries were determined according to the Birmingham classification system. Injuries with a good prognosis were defined as injuries that resulted in vision of equal to or better than counting fingers at 1 meter. Fischer’s exact test was used to determine the statistical significance of relationships between the final visual acuity and the initial clinical findings. Results: Open eye injuries restricted to zone I, those with no afferent pupillary defect, and those graded as 3 or better or classed as type B were significantly associated with a better visual outcome (p<0.05). Open eye injuries that extended to zone III, had an afferent pupillary defect, or were graded as 4 or worse were significantly associated with a poorer visual outcome (p<0.05). Closed eye injuries classified as type B or grade 4 were significantly associated with a poor visual outcome (p<0.05). Conclusion: The Birmingham classification system for mechanical ocular trauma offers a standardized method for both open and closed eye injuries, however, adding subclasses to type C (injuries with foreign body involvement) could enhance the classification method and help to understand the influence of foreign body properties and sizes on the outcome

Vitiligo tanısı yeni konulan hastalarda koroid melanositleri koroid kalınlıklarını etkiler mi?

Aim: Vitiligo is a chronic skin disease and considered to be an autoimmune, neural, and autocytotoxic pathophysiology in which mainly the melanocytes in the epidermis are focused and destroyed. Therefore, alterations in the choroid and retinal pigment epithelium are expected, and there are very few publications using modern technology in research of this subject. This study aimed to examine the optic disc, retinal nerve fiber layer (RNFL), and choroidal thickness in patients with vitiligo by spectral-domain optical coherence tomography (SD-OCT) as a prospective observational study. Material and Methods: This single-center prospective cross-sectional study included 40 eyes of 40 patients with vitiligo and 42 eyes of 42 healthy individuals. The RNFL thickness, choroidal thickness, and optic disc parameters (rim area, disc area, and cup volume) were compared between the two groups. Results: The study consisted of 21 female and 19 male in the vitiligo group, and 21 female and 21 male in controls; no difference was found in gender distribution between two groups (p=0.836). Vitiligo and control groups had similar optic disc parameters, and RNFL and choroidal thicknesses; so the differences in the mentioned parameters did not differ statistically (p>0.05 for all). Conclusion: Vitiligo patients’ optic disc parameters, and RNFL and choroidal thicknesses did not differ from those in healthy individuals. Based on unknown pathogenesis, the melanocytes at the choroidal region may have compensatory mechanisms in vitiligo.Amaç: Vitiligo, kronik bir deri hastalığıdır ve esas olarak epidermisteki melanositlerin hedef alındığı ve yok edildiği otoimmün, nöral ve otositotoksik bir patofizyoloji olarak kabul edilir. Bu nedenle koroidde ve retina pigment epitelinde değişiklikler beklenir ve bu konuda modern teknolojiyi kullanan çok az yayın mevcuttur Gereç ve Yöntem: Bu çalışmada vitiligolu hastalarda optik disk, retina sinir lifi tabakası (RSLT) ve koroid kalınlığının spektral alan optik koherens tomografi (SD-OKT) ile incelenmesi prospektif gözlemsel bu çalışma amaçlandı. Bu tek merkezli prospektif kesitsel çalışmaya vitiligolu 40 hastanın 40 gözü ve 42 sağlıklı bireyin 42 gözü dahil edildi. RSLT kalınlığı, koroid kalınlığı ve optik disk parametreleri (rim alanı, disk alanı ve cup hacmi) iki grup arasında karşılaştırıldı. Bulgular: Çalışmaya vitiligo grubunda 21 kadın ve 19 erkek, kontrol grubunda 21 kadın ve 21 erkek; iki grup arasında cinsiyet dağılımı açısından fark bulunmadı (p=0,836). Vitiligo ve kontrol gruplarında benzer optik disk parametreleri, RSLT ve koroid kalınlıkları; yani bahsedilen parametrelerdeki farklılıklar istatistiksel olarak farklı değildi (tümü için p>0.05). Sonuç: Vitiligo hastalarının optik disk parametreleri, RSLT ve koroid kalınlıkları sağlıklı bireylerden farklı değildi. Bilinmeyen bir patogeneze bağlı olarak, koroid bölgesindeki melanositlerin vitiligoda kendini telafi edici mekanizmaları olabilir

Açık açılı glokom tedavisinde ab interno jel implant kısa dönem sonuçlarının retrospektif incelenmesi

Aim: To evaluate the intraocular pressure (IOP) lowering and safety profiles of the Xen45 Gel Stent implantation with preoperative Mitomycin C injection during a 6 months follow-up in patients with primary open-angle glaucoma (POAG). Material and Methods: Records of fourteen eyes of 13 POAG patients who underwent surgery with XEN45 Gel Stent combined with phacoemulsification were evaluated retrospectively. IOP changes, all complications and additional procedures during follow-up period were evaluated. Primary outcome measure was IOP, and the IOP target for complete success was defined as a postoperative IOP drop of more than 20% from preoperative baseline and IOP≥6 and ≤21 at 6 months without any glaucoma medications and qualified success was defined as a postoperative IOP reduction of more than 20% and IOP≥6 and ≤21 at 6 months with or without medications. Results: Mean preoperative medicated IOP was 28.4 ± 2.7 mmHg with a mean of 2.6 ± 0.6 topical anti- glaucoma molecules. After 6 month follow-up period, mean IOP decreased to 17.8 ± 1.5 mmHg (mean IOP reduction of 37%) on 0.4 ± 1.1 antiglaucoma molecules. The complete success rate after 6 months was achieved in 42.8% and qualified success in 85.7. Totally only 2 (14.2%) patients required additional procedure (1 needling and 1 trabeculectomy). Conclusion: The study showed that the XEN45 Gel Stent implantation combined with phaco-cataract surgery is an effective surgical method in POAG in case of uncontrolled IOP with a favorable safety profile and low complication rate.Amaç: Primer açık açılı glokom (PAAG) hastalarında 6 aylık takip sırasında preoperatif Mitomycin C enjeksiyonu ile Xen45 Jel Stent implantasyonunun göz içi basıncını(GİB) düşürme ve güvenlik profillerini değerlendirmek. Gereç ve Yöntemler: Fakoemülsifikasyon ile kombine XEN45 Jel Stent ile ameliyat edilen 13 PAAG hastasının 14 gözünün kayıtları retrospektif olarak değerlendirildi. Takip süresince GİB değişiklikleri, tüm komplikasyonlar ve ek işlemler değerlendirildi. Çalışmada birincil değerlendirilen sonuç GİB idi. Tam başarı için belirlenen GİB hedefi ameliyat öncesine göre %20’nin üzerinde bir düşüş ve herhangi bir glokom ilacı olmaksızın 6. ayda GİB≥6 ve ≤21 olarak tanımlandı. Yeterli başarı ise ilaçlı veya ilaçsız olarak 6. ayda GİB’de %20’den fazla azalma ve GİB≥6 ve ≤21 olarak tanımlandı. Bulgular: Ortalama preoperatif ilaçlı GİB, ortalama 2,6 ± 0,6 topikal anti-glokom molekülü ile beraber 28,4 ± 2,7 mmHg idi. Altı aylık takip süresinden sonra ortalama GİB, 0,4 ± 1,1 anti-glokom molekülü ile beraber 17,8 ± 1,5 mmHg’ye (ortalama GİB düşüşü %37) düştü. 6 ay sonra tam başarı oranı %42,8 ve yeterli başarı oranı %85,7 olarak bulundu. Toplamda sadece 2 hastaya (%14,2) ek işlem (1 iğneleme ve 1 trabekülektomi) gerekti. Sonuç: Çalışma, fako-katarakt cerrahisi ile kombine XEN45 Jel Stent implantasyonunun, kontrolsüz GİB durumunda olumlu güvenlik profili ve düşük komplikasyon oranı ile PAAG’da etkili bir cerrahi yöntem olabileceğini göstermiştir

Üç farklı speküler mikroskopi cihazı ile ölçülen korneal endotel parametrelerinin karşılaştırılması: Karşılaştırmalı klinik çalışma

ABS TRACT Objective: The present study aimed to compare the Nidek CEM-530 (Nidek Co., Japan), Konan CellChek XL (Konan Medical, Hyogo, Japan), and Topcon SP-3000P (Topcon Corporation, Tokyo, Japan) noncontact specular microscopes (NCSM) in terms of endothelial cell density (ECD), morphological endothelial cell parameters, and central corneal thickness (CCT), in healthy subjects. Material and Methods: Right eyes of 49 patients were included in this study. ECD, CCT, average cell area, coefficient of variation, standard deviation of cell area, cell hexagonality ratio were evaluated with Nidek CEM-530, Topcon SP-3000P and The CellChek XL NCSMs. Results: The mean age was 36.2±9.6 years. The mean ECD was 2809±24.1, 2626±50.4, and 2588±32.1 in measurements with Konan CellCheck XL, Topcon SP-3000P, and Nidek CEM-530 NCSMs, respectively. The difference was statistically significant between Konan CellCheck XL with Nidek CEM-530 and Topcon SP-3000P (p<0.001 for both). The hexagonality ratio results between these 3 devices were statisti cally significant in all paired comparisons (p<0.001, for all). The mean CCT was 534.4±5.0, 553.9±5.6, 567.5±5.3 in measurements with Nidek CEM-530, Konan CellCheck XL, and Topcon SP-3000P, respectively. CCT values obtained with Topcon SP-3000P were found to be higher than with other devices (p<0.001, for both). Conclusion: Among the 3 devices, the highest ECD values were obtained with Konan CellCheck XL and the highest CCT values were obtained with Topcon SP-3000P. On account of the discrepancies in endothelial pa rameters tested in our study, we do not advise using these devices in terchangeably.Amaç: Bu çalışmada, sağlıklı kişilerde Nidek CEM-530 (Nidek Co., Japonya), Konan CellChek XL (Konan Medical, Hyogo, Japonya) ve Topcon SP-3000P (Topcon Corporation, Tokyo, Japonya) temassız speküler mikroskopların [noncontact specular microscopes (NCSM)] endotel hücre yoğunluğu (EHY), morfolojik endotel hücre parametre leri ve santral kornea kalınlığı (SKK) açısından karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya, 49 hastanın sağ gözü dâhil edildi. EHY, SKK, ortalama hücre alanı, varyasyon katsayısı, hücre alanının standart sapması, hekzagonal hücre oranı, Nidek CEM530, Topcon SP-3000P ve CellChek XL temassız speküler mikroskop cihazları incelendi. Bulgular: Ortalama yaş 36,2±9,6 yıl idi. Konan CellCheck XL, Topcon SP-3000P ve Nidek CEM-530 NCSM’lerle yapılan ölçümlerde ortalama EHY sırasıyla 2809±24,1, 2626±50,4 ve 2588±32,1 idi. Konan CellCheck XL ile Nidek CEM-530 ve Topcon SP-3000P ölçümleri arasındaki fark istatistiksel olarak anlamlıydı (her ikisi için p<0,001). Bu 3 cihaz arasındaki hekzagonal hücre oranı sonuçları, tüm ikili karşılaştırmalarda istatistiksel olarak anlamlıydı (tümü için p<0,001). Nidek CEM-530, Konan CellCheck XL ve Topcon SP-3000P ölçümlerinde ortalama SKK sırasıyla 534,4±5,0, 553,9±5,6, 567,5±5,3 idi. Topcon SP-3000P ile elde edilen SKK değerleri diğer cihazlara göre daha yüksek bulundu (her ikisi için p<0,001). Sonuç: Üç cihaz arasında en yüksek EHY değerleri Konan CellCheck XL ile, en yüksek SKK değerleri ise Topcon SP-3000P ile elde edildi. Çalışmamızda test edilen endotelyal parametrelerdeki farklılıklar nedeniyle bu cihazların birbirinin yerine kullanılmasını önermiyoruz

Intraocular pressure assessment in pediatric cases receiving long-term seasonal allergic conjunctivitis treatment

Amaç: Mevsimsel alerjik konjonktivit (MAK) tanısı ile takip ve tedavi edilen pediatrik yaş grubu hastalarda, dönemsel olarak kullanılan ilaçların uzun dönemde göz içi basıncı (GİB) üzerine olan etkisini araştırmak. Gereç ve Yöntemler: Çalışmaya 16 yaş altında, 5 yıl veya daha fazla süredir MAK tedavisi alan 230 olgu (Grup I) ve kontrol grubuna 16 yaş altında sağlıklı 255 olgu (Grup II) dahil edildi. Hastaların GİB ölçümleri non-kontakt tonometri ile yapıldı. Her iki grubun ortalama GİB değerleri istatistiksel olarak kıyaslandı. Bulgular: Çalışmaya alınan olguların yaş ortalaması grup I'de 9.3±2.0, grup II'de 9.1±2.1 bulundu. Grup I'de hastaların MAK nedeni ile tedavi aldıkları süre ortalama 5.3±0.7 yıldı. Grup I'de ortalama GİB sağ gözde 13.7±3.1 mmHg, sol gözde 13.7±2.8 mmHg bulunurken, grup II'de ortalama GİB sağ gözde 13.8±3.1 mmHg, sol gözde 13.9±3.0 mmHg olarak bulundu. İki grubun ortalama GİB değerleri arasında istatistiksel olarak anlamlı fark olmadığı görüldü (P>0.05). Grup I'de 11 hastada (% 4.8) tedavi esnasında kortikosteroid kullanımına bağlı geçici GİB yükselmesi olduğu gözlendi. Bu hastaların tümünde kortikosteroid kesildikten sonra GİB normale döndü. Sonuç: Pediatrik olgularda MAK tanısıyla dönemsel olarak verilen medikal tedavinin uzun dönemde GİB üzerine kalıcı bir etkisinin olmadığı görüldü. Bu hastalarda olası akut GİB yükselmesini fark etmek için yakın takibin önemli olduğunu düşünmekteyiz.Objective: To investigate the effect of seasonal drugs on intraocular pressure (IOP) in the long term in pediatric age group who are followed up and treated with seasonal allergic conjunctivitis (SAC) diagnosis. Materials and Methods: The study included 230 cases under the age of 16 who received SAC treatment for 5 years or more (Group I), and 255 healthy cases under the age of 16 in the control group (Group II). IOP measurements of the patients were made with non-contact tonometry. Mean IOP values of both groups were statistically compared. Results: The mean age of the patients included in the study was 9.3±2.0 in group I and 9.1±2.1 in group II. The mean duration of treatment in SAC patients was 5.3±0.7 years. In group I, the mean IOP was 13.7±3.1 mmHg in the right eye, 13.7±2.8 mmHg in the left eye, while in group II the mean IOP was 13.8±3.1 mmHg in the right eye and 13.9±3.0 mmHg in the left eye. There was no statistically significant difference between the mean IOP values of two groups (P>0.05). Temporary IOP elevation due to corticosteroid treatment was observed in 11 patients (4.8%) in group I. In all these patients, IOP lowered to normal limits after corticosteroid treatment discontinued. Conclusion: It was observed that medical treatment, which is given periodically with the diagnosis of SAC in pediatric cases, does not have a permanent effect on IOP in the long term. We think that close follow-up is important to realize possible acute IOP elevation in these patients

Comparison of the plusOptix S09 and spot vision photorefractor to cycloretinoscopy

Purpose: The purpose of this study was to compare refraction measurements for children with the PlusOptix S09 and Spot Vision with cycloplegic retinoscopy. Methods: One hundred thirty-six eyes of 68 children (26 boys and 42 girls) were evaluated prospectively. The subjects were separated into two groups. Group 1 comprised the subjects age between 5 and 9 years. Group 2 comprised the subjects age between 10 and 18 years. Photorefraction with PlusOptix S09, photorefraction with Spot Vision and cycloplegic retinoscopy were performed in each patient. Spherical equivalents, spherical power, cylindrical power and axis values were compared between three methods. Results: The mean age of the patients was 7.12 ± 1.5 years in group 1 and 12.24 ± 1.8 years in group 2. Spherical equivalent and spherical power measured with PlusOptix S09 were statistically smaller than measured with cycloplegic retinoscopy for group 1 (p = 0.001, p = 0.001) and for group 2 (p = 0.000, p = 0.000). The mean cylindrical power measured with PlusOptix S09 was not statistically different compared to cycloplegic retinoscopy for both groups (p = 0.314, p = 0.05). Spherical equivalents measured with Spot Vision were statistically smaller than measured with cycloplegic retinoscopy for both groups (p = 0.000, p = 0.012). Spherical power measured with Spot Vision was statistically smaller than measured with cycloplegic retinoscopy for group 1 (p = 0.000), but the difference was not statistically significant for group 2 (p = 0.084). The mean cylindrical power measured with Spot Vision was statistically higher than cycloplegic retinoscopy for both groups (p = 0.000, p = 0.012). Conclusions: PlusOptix S09 and Spot Vision devices give acceptable results for screening, but prescription of spectacles should not be made according to PlusOptix S09 or Spot Vision devices alone

Comparison of optical coherence tomography measurements between high hyperopic and low hyperopic children

Purpose: To identify the peripapillary retinal nerve fiber layer, total macular, ganglion celllayer, and inner plexiform layer thicknesses in children with high hyperopia using spectraldomain optical coherence tomography.Methods: Twenty-one children with high hyperopia and 20 controls were enrolled in thisstudy. Subjects with spherical equivalent +5.0D or higher were evaluated in the study groupand subject with spherical equivalent between +0.25 and +2.0 D in the control group. Theretinal nerve fiber layer thickness, macular thickness, macular ganglion cell layer and innerplexiform layer thicknesses were measured using a spectral domain optical coherencetomography, and results were compared between groups.Results: The nasal and inferior quadrant and the global retinal nerve fiber layer thicknesswere significantly thicker in the study group. The mean thickness of inferior quadrant of theinner macula was significantly thicker in the study group than those in the control group.The mean thickness of the ganglion cell layer in nasal, temporal and inferior quadrant ofouter macula was significantly thinner in the study group than the control group. The meanthickness of the inner plexiform layer in the inferior quadrant of the inner macula and nasaland inferior quadrant of the outer macula were significantly higher in study group than thosein control group.Conclusion: High hyperopic children had thicker retinal nerve fiber layer when comparedto the controls. This difference should be taken into account when evaluating children withglaucoma or other optic disc disorders

Tear osmolarity and tear film parameters in patients with ocular rosacea in response

WOS: 000387490000014We found the opportunity to read the article by Karaman Erdur et al.1 entitled “Tear Osmolarity and Tear Film Parameters in Patients With Ocular Rosacea.” They evaluated 25 eyes of 25 patients with ocular rosacea, 25 eyes of 25 patients with rosacea without ocular involvement, and 20 eyes of 20 healthy individuals using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (T-BUT), scoring of ocular surface fluorescein staining using modified Oxford scale, and tear osmolarity. They found that tear osmolarity values, OSDI, and Oxford scale scores were significantly higher and Schirmer 1 and T-BUT were lower in ocular rosacea group than the others. They concluded that further studies inspecting meibomian gland dysfunction in rosacea patients are needed

Retinal sensitivity and fixation analysis using microperimetry in children with anisometropic amblyopia

Purpose: To determine retinal sensitivity and fixation in children with anisometropic amblyopia using macular analyzer integrity assessment (MAIA) microperimetry (CenterVue).Methods: Amblyopic and non-amblyopic eyes of 39 children with the diagnosis of anisometropic amblyopia were compared using MAIA microperimetry in terms of average threshold, fixation indexes (P1 and P2), and bivariate contour ellipse area (BCEA) for 95% and 63% of points. The correlations between visual acuity and microperimetry parameters were also analyzed.Results: The mean average threshold was 26.6 +/- 5.9 dB for amblyopic eyes and 28.6 +/- 1.9 dB for fellow eyes (P = .003). The mean P1 index was 80.2% +/- 20.3% for amblyopic eyes and 87.6% +/- 8.7% for fellow eyes (P = .032). The mean P2 index was 92.5% +/- 9.6% and 943% +/- 4.8% for amblyopic eyes and fellow eyes, respectively. The mean BCEA95 value was 12.9 degrees(2) +/- 17.2 degrees(2) and 9.4 degrees(2) +/- 82 degrees(2) and the mean BCEA63 value was 4.4 degrees(2) +/- 5.6 degrees(2) and 3.1 degrees(2) +/- 2.7 degrees(2) for amblyopic eyes and fellow eyes, respectively. No statistically significant difference was found for those parameters (P > .05).Conclusions: Retinal sensitivity and P1 fixation index were significantly lower in amblyopic eyes compared to non-amblyopic eyes. Because measuring visual acuity does not represent all functions of the visual system, microperimetric evaluation may give extra information about total visual function of amblyopic eyes