Retinal findings in hyperviscosity syndromes

Kanı oluşturan bileşenlerde bir anormallik varsa, bu anormallik tüm vücudu etkiler, göz ve özellikle retina etkilenir. Görme azalması şikayeti olabilir veya bazen hiçbir belirti olmayabilir. Hastalar hastalığın erken evresinde veya ilerleyen evrelerinde göz hastalıkları polikliniğine başvurabilirler. Bu hiperviskozite sendromları arasında orak hücreli anemi, polisitemi, lösemiler, disproteinemiler ve kanama-pıhtılaşma bozuklukları yer almaktadır.If there is an abnormality in the components that constitute the blood, this abnormality will affect all body, and the eye and especially the retina will be affected. There may be a complaint of decreased vision, or sometimes there may be no symptoms. Patients can refer to the ophthalmology clinic in the early stage or in the later stage of the disease. These hyperviscosity syndromes include sickle cell anemia, polycythemia, leukemias, dysproteinemias, and bleeding-coagulation disorders

İris renk spektrumuna göre ön ve arka segment parametrelerinin karşılaştırılması

Comparison of eye anterior and posterior segment parameters according to iris color Methods: 150 eyes of 150 patients who applied to Aksaray Training and Research Hospital between 2019-2020 were included in the study. 28 blue, 30 green, 29 light brown (light pigmentation), 31 medium brown (medium pigmentation) and 30 dark brown (heavy pigmentation)eyes, 5 groups of patients were included in the study. Biomicroscopy and fundus examination were performed on the patients. After measuring the refraction of the patients, corneal topography and optical biometry, Intraocular Pressure (IOP), Central Corneal Thickness (CCT), Anterior Chamber Depth (ACD), Anterior Chamber Angle (ACA), Lens Thickness (LK), Axial Length (AU) Retinal nerve fiber thickness (RSLK), central retinal thickness (CRC) and subfoveal choroidal thickness (SFKK) measurements were made with OCT. Results: The mean age of the patients was 33.4 ±5.5, 35.7±4.7, and 32.9 ±6.7 in patients with blue, green and brown eyes, respectively. There were 15 women and 13 men in the blueeyed group, 16 women and 14 men in the green-eyed group, and 47 men and 43 women in the brown-eyed group. In terms of anterior and posterior segment parameters, a difference was found between blue eyes and brown eyes in terms of CCT, ACD and LK (p=0.035, 0.004 and 0.012). A difference was found between blue eyes and green eyes in terms of ACD and LK (p=0.006 and 0.041). There was no significant difference between the anterior and posterior segment parameters of the green-eyed and brown-eyed patients. In addition, there was no difference between the groups in terms of other factors (p>0.05). As a result of the correlation analysis performed in terms of parameters according to iris pigmentation level, no positive or negative correlation was found with any parameter (p>0.05). Conclusions:When evaluating patients, it should be kept in mind that the normal values of some eye parameters may vary according to the differences in iris color.İris rengine göre göz anterior ve posterior segment parametrelerinin karşılaştırılması Yöntem: Aksaray Eğitim ve Araştırma Hastanesine 2019-2020 yılları arasında başvuran 150 hastasının 150 gözü çalışmaya dahil edildi.28 mavi, 30 yeşil, 29 hafif kahverengi(hafif pigmentasyon), 31 orta kahverengi(orta pigmentasyon) ve 30 koyu kahverengi(ağır pigmentasyon) göz olmak üzere 5 grup hasta çalışmaya alındı. Hastalara biyomikroskobik ve fundus muayenesi yapıldı. Hastaların refraksiyonları ölçüldükten sonra, korneal topografi ve optik biyometri ile Göz İçi Basıncı (GİB), Santral Korneal Kalınlık(SKK), Ön Kamara Derinliği(ÖKD), Ön Kamara açısı(ÖKA), Lens Kalınlığı(LK), Aksiyel Uzunluk(AU) ölçümleri ve OCT ile de retinal sinir lifi kalınlığı(RSLK), santral retinal kalınlık(SRK) ve subfoveal koroid kalınlık(SFKK) ölçümleri yapıldı. Bulgular: Hastaların yaş ortalamaları mavi, yeşil ve kahverengi gözlü hastalarda sırası ile 33.4 ±5.5, 35.7±4,7 ve 32,9 ± 6,7 idi. Mavi gözlü grupta 15 kadın 13 erkek, yeşil gözlü grupta 16 kadın 14 erkek ve kahverengi gözlü grupta 47 erkek 43 bayan yer aldı. Ön ve arka segment parametreleri açısından mavi göz ile kahverengi göz arasında SKK, ÖKD ve LK açısından fark saptandı (p=0.035, 0.004 ve 0.012). Mavi göz ile yeşil göz arasında ÖKD ve LK açısından fark saptandı (p=0.006 ve 0.041). Yeşil göz ve kahverengi gözlü hastaların ön ve arka segment parametreleri arasında da anlamlı bir farklılık saptanmadı. Ayrıca diğer faktörler açısından da gruplar arasında fark saptanmadı (p>0.05). İris pigmentasyon düzeyine göre parametreler açısından yapılan korelasyon analizi sonucu hiç bir parametre ile pozitif yada negatif korelasyon saptanmadı (p>0.05). Tartışma: Hastalar değerlendirilirken bazı göz parametrelerinin normal değerlerinin iris rengindeki farklılıklara göre değişiklik gösterebileceği akılda bulundurulmaldır

Evaluation of the relationship between rosacea cutaneous subtype and meibography findings

Acne rosacea (AR) is a chronic inflammatory skin disease that can cause serious ocular complications. This study was designed to evaluate dry eye disease (DED) and meibomian gland dysfunction (MGD) in AR patients and to investigate the relationship between the cutaneous subtype of AR and ocular involvement. Materials and Methods: This study included 67 participants with AR and 50 healthy individuals. Patients diagnosed with 3 cutaneous subtypes were examined: erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), and phymatous rosacea (PR). An ophthalmatological examination was performed that included an evaluation of lid margin alterations due to meibomian gland (MG) obstruction, Ocular Surface Disease Index assessment, tear film break-up time testing, Schirmer testing, and a corneal conjunctival fluorescein staining assessment. Meibography was used to evaluate the upper and lower lids for MG loss. Results: Findings in the AR group revealed MGD in 45.5% and DED in 28.1%. The meibomian gland loss rate (MGLR) was 38.7±16.9% and the meibomian gland loss grade (MGLG) was 1.57±0.82%. The rate of MGLR and MGLG was significantly greater in the AR group than in the control group (p<0.001). PPR was seen in 59.7% of the 67 patients, ETR in 29.9%, and PR in 13.4%. A comparison of the MGD, MGLR, MGLG, and presence of DED in the 3 cutaneous subtype groups yielded statistically insignificant results. Conclusion: AR can affect MG morphology, which may result in MGD or DED. Though we did not find a significant difference in the ocular findings by subgroup, ocular involvement is a recognized risk in AR. Ophthalmologists and dermatologists should cooperate in the evaluation of AR patients. Additional studies to further examine the effects in subtype groups are recommended

An uncommon diagnosis in spontaneous hyphema: ankylosing spondylitis secondary anterior uveitis

56 yaşında erkek hasta kliniğimize sol gözünde 3 gün önce başlayan görme azalması ve gözde kızarıklık, ağrı şikayeti ile başvurdu. Sol görmesi 5 metreden parmak sayma düzeyinde idi. Ön segment muayenesinde sol gözde 3/10 hifema mevcuttu ve pupil alanında membran mevcuttu. Hastadan ayrıntılı kan testlerinin yanısıra romatoloji ve hematoloji konsültasyonları istendi. Hastaya fundus floresein anjiyografisi ve oküler ultrasonografi tetkikleri yapıldı patoloji saptanmadı. Tetkiklerinde HLA B27 pozitif olarak geldi. Hastada topikalsteroid ile baskılanan ön üveit mevcuttu. Spontan hifema ile başvuran hastalarda nadirde olsa üveit akılda bulundurulması gereken bir oküler hastalıktır.A 56-year-old male patient was admitted to our clinic three days ago complaining of vision loss and eye pain in the left eye. His left vision was counting fingers from 5 meters. Anterior segment examination revealed 3/10 hyphema in the left eye and a membrane in the pupillary area. In addition to detailed blood tests, rheumatology and hematology consultations were requested. Fundus fluorescein angiography and ocular ultrasonography were performed and no pathology was detected. HLA B27 showed positive results. The patient had anterior uveitis suppressed with topical steroids. Uveitis is an ocular disease that should be kept in mind in patients presenting with spontaneous hyphema

The importance of refractive status and axial length in patients with subconjunctival hemorrhage

Subconjunctival hemorrhage(SCH) is a painless disease that occurs as a result of the localized extravasation of blood to subconjunctival tissue and episcleral space by suddenly rupturing conjunctival vessels. Our aim is evaluate the refractive status, axial length and anterior segment parameters in patients with subconjunctival hemorrhage in this study. A fifty-one eye of 51 patients with subconjunctival hemorrhage and 40 eyes of 40 healthy individuals were enrolled in this prospective study. In detail, systemic diseases, used drugs, and other risk factors were questioned. After demographic questioning, a detailed biomicroscopy eye examination was performed for risk factors. Then refractive error, intraocular pressure, axial length, lens thickness, central corneal thickness, and anterior chamber depth were measurements performed. The mean age of patients with SCH was 49.4±6.8 (28-59) and the mean age of the control group was 50.4±6.8 (32-57). In terms of risk factors of SCH, the patients were divided into 3 groups that had sufficient statistical analysis (HT, use of anticoagulants and history of Valsalva). According to results, a significant difference was found between patients with HT and control groups in terms of spherical refraction (hyperopia) (p0.05). If the hyperopia, short axial length, and narrow anterior camera are detected in the examination of patients with SCH, the patients should be investigated in detail in terms of HT. In addition, eye related parameters were found to be important in SCH etiology.Subkonjonktival kanama (SKH), konjonktival damarların aniden yırtılması ile kanın subkonjonktival dokuya ve episkleral boşluğa lokalize sızması sonucu ortaya çıkan ağrısız bir hastalıktır. Bu çalışmada amacımız subkonjonktival kanamalı hastalarda refraktif durum, aksiyel uzunluk ve ön segment parametrelerini değerlendirmektir. Bu prospektif çalışmaya subkonjonktival kanaması olan 51 hastanın 51 gözü ve 40 sağlıklı bireyin 40 gözü dahil edildi. Ayrıntılı olarak sistemik hastalıklar, kullanılan ilaçlar ve diğer risk faktörleri sorgulandı. Demografik sorgulamadan sonra risk faktörleri için ayrıntılı biyomikroskopi göz muayenesi yapıldı. Daha sonra kırma kusuru, göz içi basıncı, eksenel uzunluk, lens kalınlığı, santral kornea kalınlığı ve ön kamara derinliği ölçümleri yapılarak sonuçlar kaydedildi. SKH'li hastaların yaş ortalaması 49.4±6.8 (28-59) ve kontrol grubunun yaş ortalaması 50.4±6.8 (32-57) idi. SKH risk faktörleri açısından hastalar yeterli istatistiksel analize sahip 3 gruba ayrıldı (HT, antikoagülan kullanımı ve Valsalva öyküsü). Sonuçlara göre, HT'li hastalar ile kontrol grupları arasında hipermetrop (p 0.05). SKH'li hastaların muayenesinde hipermetrop, kısa aksiyel uzunluk ve dar ön kamera tespit edilirse, hastalar HT açısından ayrıntılı olarak araştırılmalıdır. Ek olarak SKH etiyolojisinde gözle ilgili parametrelerin de önemli olduğu bulunmuştur

Dijital çağın yeni salgın hastalığı bilgisayarlar gözümüze düşman mı

Aim: Many people work, especially due to the recent covid 19 pandemic lockdown, at home. These people are progressively increasingly exposed to digital screen use. This situation may express an explanation for the get a bigger ratio of myopia. Methods: In this prospective study, we evaluated the eye measurements of medical secretaries who use computers for 8 hours a day. Volunteers were followed before/after the work shift. (8am and 4pm) Refraction, intraocular pressure, axial length and lens thickness measurement, measurement of anterior segment parameters (central corneal thickness, horizontal visible iris diameter, corneal volume, anterior chamber depth, anterior chamber volume, anterior chamber angle, pupil diameter) mean were recorded. Result: 110 eyes of 110 volunteers were included in the study. The mean age of the volunteers was between 25 and 47 and the mean was 35.8 ± 5.8. There were 95 (86%) female and 15 (14%), male volunteers, by gender. Comparing before and after the work shift spherical refraction ( pre-shift -0,29±1,46 / post-shfit -0,54±1,57 )(p 0.05) Conclusıon: Considering the one day period, there are some changes in corneal biomechanics in long-term computer users and this situation may explain the development of myopia.Amaç: Pek çok insan, özellikle de son zamanlarda ortaya çıkan covid 19 salgını nedeniyle evde çalışıyor. Bu insanlar giderek artan bir şekilde dijital ekran kullanımına maruz kalıyor. Bu durum, toplumda miyopi oranının artmasını açıklayabilir. Materyal ve Metot: Bu ileriye dönük çalışmada, günde 8 saat bilgisayar kullanan tıbbisekreterlerin göz ölçümlerini değerlendirdik. Gönüllüler mesaiden önce / sonra takip edildi. (08:00 ve 16.00) Refraksiyon değeri, göz içi basıncı, aksiyel uzunluk ve lens kalınlığı ölçümü, ön segment parametrelerinin ölçümü (merkezi kornea kalınlığı, yatay görünür iris çapı, kornea hacmi, ön kamara derinliği, ön kamara hacmi, ön kamara açısı, pupil çapı) kaydedildi. Bulgular: 110 gönüllünün 110 gözü çalışmaya dahil edildi. Gönüllülerin ortalama yaşı 25 ile 47 arasında ve ortalama 35.8 ± 5.8 idi. Cinsiyete göre 95 (% 86) kadın ve 15 (% 14) erkek gönüllü vardı. Mesai öncesi ve sonrası sferik kırılma (mesai öncesi -0,29 ± 1,46 / mesai sonrası -0,54 ± 1,57) (p <0,001), lens kalınlığı (mesai öncesi 3,71 ± 0,35 / mesai sonrası 3.74 ± 0,30) (p = 0,006) ve pupil çapı (mesai öncesi 3,43 ± 0,41 / mesai sonrası 3,23 ± 0,54) (p <0,001 ) olarak tespit edildi. Diğer parametrelerde önemli bir değişiklik bulunamadı. (p> 0.05) Sonuç: Bir günlük süre düşünüldüğünde, uzun süreli bilgisayar kullanıcılarında kornea biyomekaniğinde bazı değişiklikler olabilir ve bu durum miyopi gelişimini açıklayabilir

Vitrectomy in Congenital Vitreous pathologies

Konjenital vitreus hastalıkları, vitreusun embriyolojik gelişim kusurlarının sonucu oluşmakta ve bu hastalıklar, bozulmuş vitreus yapısını içeren geniş bir yelpazeye sahiptir. Aynı zamanda bu hastalıklar, çocukluk dönemi görülen vitreus ve retinal patolojilerde ilk akla gelen hastalıklardır. Birçoğunda pars plana vitrektominin, tedavide önemli bir rolü vardır. Hastalık patofizyolojisi ve hastaların yaşı nedeniyle, rutin uygulanan pars plana vitrektomide yöntemlerinde farklılıklar mevcuttur. Bu derlemede konjenital vitreus patolojileri ve bu patolojilerin tedavisinde uygulanan vitrektomi yöntemi tartışılacaktır.Congenital vitreous diseases are the result of embryological development defects of the vitreous. These diseases have a wide spectrum including congenital vitreous disorders and genetically impaired vitreous structure. Also, these diseases are the first diseases that should come to mind in vitreous and retinal pathologies seen in the early childhood. In many of them, pars plana vitrectomy has an important role in the treatment. Due to the disease pathophysiology and age of the patients, they differ from the standard pars plana vitrectomy. In this review, congenital vitreous pathologies and vitrectomy method applied in the treatment of these pathologies will be discussed

The effects of nasal septum deviation on eye posterior segment finding

Aim: Deviation of the nasal septum, which can cause upper respiratory tract obstruction and systemic hypoxia, may also affect the eye. The aim of this study was to detect changes in posterior segment parameters of the eye in patients with nasal septal deviation. Material and Methods: The study included 50 patients with nasal septal deviation, and a control group of 30 healthy subjects with no nasal septal deviation. Choroidal thickness, central macular thickness and retinal nerve fiber layer thickness were measured with Optical Coherence Tomography. Results: Choroidal thickness was significantly lower in patients with severe nasal septal deviation compared to the control group. (p=0.001) There is no statistically significant change in other measurements. Conclusion: The study results suggest that marked nasal septal deviation may lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening

Does Sjogren's syndrome affect only the lacrimal gland in the eye? Time to replace the missing stones

Purpose: This study aimed to reveal the cause of meibomian gland disease and meibomian gland loss in patients with Sjogren's syndrome (SS) as the leading factor for dry eyes. Methods: The study included a total of 30 patients with SS and dry eye symptoms and a control group of 50 age- and gender-matched healthy subjects. The dryness parameters of all the participants were evaluated. At first, meibography was performed to measure meibomian gland loss using noninvasive methods. Later, meibomian gland expression and secretion quality were evaluated using silt-lamp biomicroscopy. Correlations between the measurements were analyzed statistically. Results: In patients with SS, MG loss was significantly greater than in the control group (19.7 +/- 71%, 12.7 +/- 9.6%, P < 0.001). All dry eye parameters (tear film breakup time, Schirmer's test score, OSDI, stain score, dry eye disease) were statistically significant in the SS group. There was an extremely negative correlation between upper MB loss and BUT (P = 0.08, r: -0.781). There was an extremely positive correlation between upper MB loss and staining (P = 0.015, r: 0.739). An extremely negative correlation was determined between sub-MB loss and BUT (P = 0.18, r:-0.781), and a moderately positive significant correlation was found between sub-MB loss and staining (P = 0.031, r: 0.659). Conclusion: The results of this study demonstrated that patients with SS were at a higher risk of being exposed to meibomian gland loss, which directly leads to the severe dry eye symptoms associated with SS

Is pseudomyopia associated with anxiety and related disorders

Objective: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders. Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined. Results: The average age of patients in the study was 15,4 +/- 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D +/- 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D +/- 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D +/- 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount. Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase