Can hypothyroidism cause acute central serous chorioretinopathy

To evaluate selected systemic findings, especially thyroid functions, in acute central serous chorioretinopathy (CSC) patients. Materials and Methods: In all, 71 consecutive acute CSC patients who fulfilled the inclusion criteria and 70 age-matched healthy control subjects were included in the study. Systemic findings, including serum levels of thyroid hormones, thyroid stimulating hormone (TSH), mean arterial pressure (MAP), pulse rate, serum lipid levels and optical coherence tomography findings, were compared between the groups. Independent samples t-test was used for statistical analysis. Results: The mean ages of the CSC and control groups were 41.06 ± 6.49 and 40.06 ± 7.08 years old, respectively. Retinal thickness, choroidal thickness, TSH levels, pulse rate and MAP were significantly different between CSC patients and healthy control subjects (range of p values: <0.001–0.042). In the logistic regression analysis, MAP, serum triglyceride concentration and central choroidal thickness were positively associated with CSC (range of p values: <0.001–0.035). Conclusion: Acute CSC patients had significantly higher pulse rates and MAP and significantly thicker choroidal thickness than were found in healthy subjects

Major factors affecting intraocular pressure spike after intravitreal ranibizumab injection: Vitreous reflux and its amount

The aim of this study was to assess the effect of vitreous reflux and its amount on short-term intraocular pressure after intravitreal injection of ranibizumab. Methods: The study included 316 eyes of 276 patients. Intraocular pressures were measured before intravitreal injection (preIOP), immediately after intravitreal injection (postIOP0), and 30 min after intravitreal injection (postIOP30). The amount of vitreous reflux was evaluated by measuring conjunctival bleb diameter, and patients were grouped as; group 1: no vitreous reflux, group 2: less vitreous reflux, and group 3: more vitreous reflux. The data were analyzed using variance analysis, chi-square test, and regression analysis. Results: PostIOP0 values were highest in group 1, followed by group 2 and group 3 (all p values < 0.001). PostIOP30 values were similar in group 1 and group 2 (p = 0.261), but were lower in group 3 than other two groups (p < 0.001, p = 0.001, respectively). Vitreous reflux was identified as the only factor affecting postinjection intraocular pressure changes (p < 0.001), and a negative correlation was found between the total number of intravitreal injection and vitreous reflux (p = 0.032). Conclusion: The major factor affecting short-term postinjection intraocular pressure elevation was vitreous reflux, and intraocular pressure levels increased as the amount of vitreous reflux decreased. Vitreous reflux and its amount decreased as the total number of intravitreal injection increased

Effect of fasting on choroidal thickness and Its diurnal variation

The aim of this study was to assess the effect of Ramadan fasting on choroidal thickness (CT) and its associated diurnal variations using spectral domain optic coherence tomography. Materials and Methods: Ocular measurements were performed on a single eye of 87 healthy individuals. Eyes were evaluated twice a day around 8.00 a.m. and 4.00 p.m. during Ramadan. Evaluations were repeated at the same time of the day, 1 month following Ramadan on the same subjects. Measurements of choroidal and retinal thickness were performed at central, temporal and nasal segments. Results: The comparison of measurements revealed that temporal CT at 8.00 a.m. and foveal, temporal and nasal CTs at 4.00 p.m. were significantly reduced during fasting (p values were 0.005, <0.001, 0.001 and 0.046, respectively). Mean changes of CTs during fasting were 14.76 ± 16.01, 9.90 ± 19.57 and 8.10 ± 16.81 µm at the fovea, temporal and nasal segments, respectively. However, CTs at non-fasting conditions were measured as 6.13 ± 12.93, 3.78 ± 15.23 and 5.05 ± 13.60 µm, respectively. In comparison, diurnal variations of foveal and temporal CTs during fasting were significantly higher than the controls (p values were <0.001 and 0.004, respectively). Additionally, retinal thicknesses during fasting were significantly reduced compared to the controls in all segments measured at 4.00 p.m. (p for all values <0.05) Conclusions: The results of the present study revealed that fasting and dehydration caused a reduction of the choroidal and retinal thicknesses. Likewise, they are also responsible for the increased diurnal variation of CTs. Therefore, early hours of the day may be preferred to evaluate retinal and choroidal thicknesses during Ramadan to avoid the effects of dehydration on the measurement results

Effect of quadrant switch on intraocular pressure change in intravitreal aflibercept or ranibizumab injection applications

To evaluate the effect of injection quadrant switch on the intraocular pressure (IOP) change in intravitreal aflibercept or ranibizumab applications. Methods: 123 eyes of 123 patients who received intravitreal injection (IVE) into the superotemporal quadrant at least 10 times for age-related macular degeneration or diabetic macular edema have been recruited. The demographic data, lens status, IOP values (preoperative, postoperative 0th min, and postoperative 30th min), and amount of vitreous reflux (VR) following IVE have been recorded. Next IVE application was performed into the inferotemporal quadrant of the patient, which had never been injected before. Results: The mean IOP value at postoperative 0th min was 50.24 ± 7.66 mmHg after injections into the superotemporal quadrant and was 34.85 ± 4.96 mmHg after injections into the inferotemporal quadrant. No significant difference was observed between the preoperative and postoperative 30th min-IOP values (p > 0.05), while a significant difference was found between the postoperative 0th min-IOP values among quadrants (p < 0.001). VR was significantly higher in applications into the inferotemporal quadrant than those into the superotemporal quadrant (p < 0.001). Conclusion: One of the most principal factors affecting the postoperative short-term IOP increase is the amount of VR, and this amount decreases the IOP following an IVE

Investigation of the choroidal thickness in patients with hypothyroidism

Purpose: The effect of hypothyroidism on the choroidal thickness (CT) was investigated in patients with subclinical hypothyroidism and overt hypothyroidism, and biochemically and clinically euthyroid patients receiving levothyroxine treatment. The patients were compared with healthy subjects. Materials and Methods: One eye of 71 hypothyroid and 22 healthy subjects between 20 and 40 years of age were included in this study. CT measurements were taken at the fovea and at 2 points that were 1500 μm nasal and temporal to the fovea using spectral-domain optical coherence tomography. Independent sample t-test′s and was used for statistical analysis of the data. Results: The CT was significantly thicker in hypothyroid patients compared to healthy subjects (P values were 0.013 for subfoveal, 0.015 for temporal and 0.020 for nasal segments). The intraocular pressure (IOP) and body mass index (BMI) were also significantly higher in hypothyroid patients (P values were 0.021 and 0.003, respectively). There was not a statistically significant difference in the BMI and IOP measurements between healthy subjects and euthyroid patients (P > 0.05). However, there was a statistically significant difference in the subfoveal, temporal and nasal CT measurements between healthy subjects and euthyroid patients (P values were 0.006, 0.031 and 0.013, respectively). Conclusions: All subgroups of hypothyroid patients had thicker CT compared to healthy subjects. Euthyroid patients receiving levothyroxine treatment had lower IOP, BMI levels, and serum lipid levels than patients with subclinical hypothyroidism and overt hypothyroidism

Evaluation of the acute effects of cigarette smoking on the eye of non-Smoking healthy young male subjects by optical coherence tomography angiography

Investigation of the acute effects of cigarette smoking on the eye using optical coherence tomography angiography (OCTA) on young healthy non-smoking male subjects. Materials and methods: The right eye of 25 healthy non-smoking male subjects were included in this study. Selected parameters of the macular and circumpapillary vasculature were measured, including macular flow indices, foveal avascular zone, vessel densities of macula and optic disc using OCTA. The measurements of the subjects were performed on the first day without smoking at 0 min, 5 min, 30 min and 60 min. Measurements were repeated at the same regime on the second day after smoking. Paired samples t-test and repeated measures one-way analysis of variance test was used for the statistical analysis. Results: The repeated measures analysis of variance test using the Bonferroni adjustment demonstrated a significant change for superficial and deep foveal vessel density, flow area of choriocapillaris, and circumpapillary capillary density following smoking (range of p value was <0.001–0.004). Intraocular pressure, foveal avascular zone area, flow area of outer retina and foveal non-flow area of superficial layer measurements did not have any significant changes following smoking (range of p value was 0.192–0.812). Conclusion: In non-smoking cases, even smoking only one cigarette significantly decreased the vessel density parameters at the acute period. Even though there was an increase in measured parameters shortly after smoking, it had lessened when compared to non-smokers, even one hour following smoking