Chiari I malformation presenting with ganglion cell complex thinning on routine examination

Chiari I malformation (CMI) is a rare congenital disorder characterized by the caudal displacement of cerebellar tonsils through the foramen magnum into the cervical canal(1). Ophthalmological signs include retro-orbital pain, diplopia, photophobia, impaired visual acuity, nystagmus, strabismus, and papilledema(2-4). The diagnosis is mostly based on magnetic resonance imaging (MRI) findings © This content is licensed under a Creative Commons Attributions 4.0 International License

Selenoprotein P levels in patients with diabetes mellitus with complications

Aims: Increasing evidence has shown that selenoprotein P levels are elevated in type 2 diabetes mellitus and are associated with insulin resistance and release. This study aimed to determine if there was a connection between selenoprotein P levels and metabolic parameters in patients with diabetes with microvascular complications. Methods: Serum selenoprotein P concentrations were measured by ELISA in 44 patients with diabetes with complications and 36 patients with diabetes without complications. Results: There was no statistically significant difference in selenoprotein P levels between the groups [1.9 (0.9–2.6) and 1.9 (0.8–2.4) ng/mL, respectively, p = 0.565]. Selenoprotein P, glucose, glycosylated hemoglobin, C-reactive protein, triglycerides, total cholesterol, and low-density lipoprotein cholesterol levels were not statistically significantly correlated in patients with complications. However, there was a significant correlation with high-density lipoprotein cholesterol (r = − 0.401, p = 0.042). Conclusions: We did not find high selenoprotein P levels in patients with complications, but its inverse association with high-density lipoprotein cholesterol indicates that it may play a role in developing cardiovascular disease in this community of patients. © 2021, The Author(s), under exclusive licence to Research Society for Study of Diabetes in India

Choroidal vascularity index after a single dose of intravitreal dexamethasone implant in patients with refractory diabetic macular oedema

Purpose: To evaluate choroidal vascularity index (CVI) after a single dose of intravitreal dexamethasone implant in refractory diabetic macular oedema (DME). Methods: Total choroidal area, luminal area, and CVI were measured at baseline, 1st month, and at 3rd month after dexamethasone implant using binarization of enhanced depth imaging optical coherence tomography (EDI-OCT) images. Results: A total of 25 eyes of 25 patients (mean age: 61.4 ± 8.3 years; 12 males, 13 females), were enroled in the study. All eyes had been previously treated with intravitreal aflibercept injections (mean number of injections 4.6 ± 2.5). Mean CVI was 70.3 ± 8.1 prior to intravitreal dexamethasone treatment. It was decreased to 66.1 ± 9.3 at 1 month and 63.5 ± 10.1 at 3 months after treatment. The mean CVI was significantly decreased at 3 months compared with pre-treatment measures (p = 0.033). Conclusion: CVI was found to be decreased in patients who responded to intravitreal dexamethasone implant. © 2022 Elsevier B.V

Structural alterations of the choroid evaluated using enhanced depth imaging optical coherence tomography in patients with coronavirus disease

Purpose: To assess choroidal changes using enhanced depth imaging optical coherence tomography in coronavirus disease (COVID-19). Methods: Thirty-two patients with moderate COVID-19 and 34 healthy subjects were included in the study. Choroidal thickness was measured at 3 points as follows: at the subfovea, 1500 mm nasal to the fovea, and 1500 mm temporal to the fovea. The total choroidal area, luminal area, stromal area, and choroidal vascular index were measured with Image-J. All the measurements were performed during the disease and at 4 months after remission. Results: In the patient group, the subfoveal, nasal, and temporal choroidal thicknesses were decreased as compared with those in the controls, but without statistically significant differences (p=0.534, p=0.437, and p=0.077, respectively). The mean total choroidal, stromal, and luminal areas and choroidal vascular index were statistically significantly decreased in the patient group (p<0.001, p=0.001, p=0.001, and p=0.003; respectively). At 4 months after remission, the choroidal structural parameters and choroidal vascular index revealed statistically significant increases as compared with the baseline measurements in the patients with COVID-19 (all p<0.001 and p=0.047, respectively). Conclusion: The choroidal vascular and stromal parameters showed significant transient decreases during the disease course of COVID-19. © This content is licensed under a Creative Commons Attributions 4.0 International License

Choroidal vascularity index and retinal nerve fiber layer reflectivity in newly diagnosed migraine patients

Purpose: To evaluate the choroidal structural parameters, peripapillary retinal nerve fiber layer (RNFL) thickness, and optic density index (ODI) and their correlations in patients with migraine. Methods: Twenty-eight newly diagnosed migraine patients and 28 age-matched healthy controls were included in this prospective cross-sectional study. The enhanced depth-optical coherence tomography images were evaluated. The choroidal area (CA) was binarized to the luminal area (LA) and stromal area (SA) using Image J. The choroidal vascularity index (CVI), the mean peripapillary RNFL thickness, superior-inferior-nasal-temporal quadrant RNFL thicknesses, and the ODI were compared statistically. Results: The difference in the mean CVI between the patient group and controls reached a statistical significance (p=0.035). The mean RNFL thickness was significantly decreased in patients with migraine compared with the controls (p=0.040). The mean RNFL thickness in the superior, temporal, and inferior quadrants was significantly decreased in the patient group in comparison to the control subjects (p=0.030, p=0.001, and p=0.022, respectively). There were no significant differences between the migraine group and the controls for the mean ODI of RNFL (p=0.399). Conclusion: The CVI and the RNFL thickness except for the nasal quadrant were significantly decreased in newly diagnosed migraine patients. © 2021 Elsevier B.V

Choroid and Retinal Nerve Fiber Layer Thickness in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

Purpose. We aimed at measuring the choroid and retinal nerve fiber layer thickness with optic coherence tomography (OCT) in patients diagnosed with chronic obstructive pulmonary disease (COPD). Methods. A total of 60 patients with COPD and 23 healthy controls were evaluated in the scope of this prospective, observational study. COPD patients were divided into two groups as those that were stable and those with an exacerbation based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. Subfoveal choroid thickness (SFCT) of the patients and the control group was compared by measuring the choroid thickness at points 1000 µm nasal and temporal to the fovea and the mean retinal nerve fiber layer (RNFL) thickness. Results. The subfoveal choroid thickness of the COPD patients in both the exacerbation and stable groups was found to be statistically significantly thinner than the control group (p=0.047 and p=0.046, resp.). No statistically significant difference was found between the subfoveal choroid thickness of the patients that were stable and those that had an exacerbation (p=0.813). No statistically significant difference was found between the mean RNFL, 1000 µm nasal, or 1000 µm temporal choroid thicknesses of the COPD patients and the control group (p=0.263, p=0.455, and p=0.611, resp.). Conclusion. Decreased subfoveal choroid thickness was found in the COPD patients both during an exacerbation and in the stable period, when compared to the control group. The mean RNFL thickness was similar in the exacerbation and stable period of the stable COPD patients when compared to the control group. This suggests that ocular findings might be important in terms of COPD morbidity. This trial is registered with www.chictr.org.cn/enIndex.aspx

Problems Due to Reuse of Single-Use Lens Cartridges in Cataract Surgery

Fakoemülsifikasyon (FE) yöntemi ile yapılan katarakt cerrahisinde tek kullanımlık malzemelerin kullanımı giderek artmaktadır. Tek kullanımlık malzemelerin sterilize edilerek tekrar kullanılması, görme kaybına kadar gidebilen birçok probleme yol açabilmektedir. Ülkemizde Sağlık Bakanlığı tarafından tek kullanımlık malzemelerin yeniden sterilizasyonu yasaklanmış olup bu konuda çeşitli yazılar sağlık hizmet sunucularına gönderilmiştir. Bu bildiride sunulan iki olguda tek kullanımlık göz içi lens (GİL) kartuşunun etilen oksit ile sterilize edilip tekrar kullanılmasına bağlı GİL arkasında görme problemlerine yol açan salyangoz izi şeklinde birikintiler izlendi. Denatüre viskoelastik kalıntısı olabileceğini düşündüğümüz bu birikintiler ameliyat sonrasında her iki olguda flu görme ve kamaşma şikayetlerine yol açtı. Bu tür problemlerin yaşanmaması için tek kullanımlık malzemeler sadece bir kez kullanılmalıdırThe use of single-use material for cataract surgery with the phacoemulsification (PE) method is constantly increasing. The reuse of single-use material following sterilization can cause many problems, including loss of vision. The sterilization of single-use material has been forbidden by the Ministry of Health in our country and relevant notifications have been sent to healthcare providers. We report snail-track deposits at the back surface of the intraocular lens (IOL) that caused visual problems following the sterilization by ethylene oxide and reuse of an IOL cartridge in two cases. We postulate the deposits that caused symptoms of postoperative blurred vision and glare in both cases were residue of the viscoelastic substance that had undergone denaturation. Single-use material should only be used once to avoid such problem

Intraocular Pressure after Intravitreal Injection of Anti-Vascular Endothelial Growth Factors

Amaç: Anti-vasküler endotelyal büyüme faktörlerinin göz içi basıncı üzerine etkisini araştırmaktır.Gereç ve Yöntem: Çalışmaya intravitreal aflibersept enjeksiyonu yapılan 25 yaşa bağlı maküla dejenerasyonu hastası ile intravitreal ranibizumab enjeksiyonu yapılan 24 diyabetik maküla ödemi hastası olmak üzere toplam 49 hasta dahil edildi. Hastaların enjeksiyon öncesi veenjeksiyon sonrası 1. saat, 1. gün ve 1. ay göz içi basınçları ölçülüp, sonuçlar eşleştirilmiş t testi ile değerlendirildi.Bulgular: Hem ranibizumab grubunda hem de aflibersept grubunda enjeksiyon sonrası 1. saat göz içi basıncı ölçüm değerleri enjeksiyonöncesine göre istatistiksel olarak anlamlı daha yüksek bulundu (p<0,05). Tüm olgular birlikte değerlendirildiğinde yine 1. saat göz içi basıncıölçüm değerleri anlamlı olarak daha yüksek bulundu. Ancak hem ranibizumab ve aflibersept ilaç gruplarına göre hem de tüm olgular birliktedeğerlendirildiğinde 1. gün ve 1. ay göz içi basıncı ölçüm değerleri ile enjeksiyon öncesi değerler arasında anlamlı farklılık tespit edilmedi.Sonuç: İntravitreal anti-vasküler endotelyal büyüme faktörlerin enjeksiyon sonrası volüm artışına bağlı olarak enjeksiyon sonrası 1. saatte göz içi basıncı istatistiksel olarak anlamlı yüksek bulundu.Objective: To evaluate the effect of anti-vascular endothelial growth factors on intraocular pressure. Material and Method: 25 patients with age related macula degeneration who underwent intravitreal aflibercept injection and 24 patients with diabetic macular edema who underwent intravitreal ranibuzumab injection, totally 49 patients were included in the study. Intraocular pressures of all patients were measured before the injection and 1 hour, 1 day and 1 month after the injection and results were evaluated with paired t-test. Results: In both ranibizumab and aflibercept groups, intraocular pressure measurements 1 hour after the injection were found to be statistically significantly higher than the measurements before the injection (p<0.05). When all the cases taken into account 1st hour intraocular measurements were also found significantly higher. However for both ranibizumab and aflibercept groups seperatly and when all the cases taken into account, there was not any significant difference between 1st day and 1st month intraocular measurements and measurements before the injection. Conclusion: Intraocular pressures 1 hour after the intravitreal anti-VEGF injection were found to be significantly higher according to increased volume

Anterior segment parameters in patients with coronavirus disease

Since first identified in December 2019 at Wuhan, China, the coronavirus disease (COVID-19) has become a major public health challenge wordlwide(1). As of September 4, 2020, more than 26 million COVID-19 cases, including 869,600 deaths, were reported in 216 countries(2). The ophthalmological alterations caused by COVID-19 are mainly limited to external ocular diseases such as conjunctivitis(3,4). Therefore, in patients with the infection, we measured anterior segment (AS) parameters, which may show subtle changes in the acute phase of the infection and serve as a tool for monitoring the long-term changes after recovery from COVID-19