Tekrarlayan pterjiyumlu olgularda konjonktival otogreft transplantasyonu ile kombine amniyotik membran transplantasyonu cerrahisi sonuçları

Aim: To evaluate the results of conjunctival autograft transplantation (CAT) combined with amniotic membrane transplantation (AMT) surgery in recurrent pterygium cases.Methods: This is a retrospective interventional case series involving patients admitted to our clinic with recurrent pterygium. Patients' examination and postoperative findings were taken through standard slit-lamp examinations. Fourteen eyes of 14 patients were included in the study. All cases were treated with excision, followed by CAT combined with AMT. Corneal recurrence was evaluated as the main result. Fibrovascular proliferation greater than 1 mm on the cornea was accepted as recurrence after surgery.Results: The mean age of patients was 56.4 ± 7.5 (range: 40 – 65) years. During the mean follow-up period of 24.9 ± 10.7 (range: 12 – 50) months, pterygium and symblepharon recurred in only one eye (7.1%) after 4 months.Conclusion: In this study, it was seen that acceptable results were obtain and low recurrence rates could be achieved with the combination of CAT and AMT for the treatment of recurrent pterygium.Amaç: Tekrarlayan pterjiumlu olguların tedavisinde konjonktival otogreft transplantasyonu (KOT) ile kombine amniyotik membran transplantasyonu (AMT) sonuçlarını değerlendirmekMetot: Bu çalışma kliniğimize tekrarlayan pterjiyum ile başvuran hastaları içeren retrospektif girişimsel bir vaka serisidir. Hastaların muayeneleri ve postoperatif bulgular standart yarık lamba biomikroskopi ile yapıldı. Çalışmaya 14 hastanın 14 gözü alındı. Tüm olgularda pterjium eksizyonunu takiben KOT ile kombine AMT yapıldı. Ana sonuç olarak korneal nüks değerlendirildi. Kornea üzerinde 1 mm'den fazla fibrovasküler proliferasyon ameliyat sonrası rekürrens olarak kabul edildi.Bulgular: Hastaların ortalama yaşı 56.4 ± 7.5 (aralık: 40- 65) yıldı. Ortalama 24.9 ± 10.7 (aralık: 12- 50) aylık takip süresi sonunda sadece bir gözde (% 7.1) 4 ay sonra pterjium ve symblepharon tekrarladı.Sonuç: Bu çalışmada, tekrarlayan pterjium tedavisi için KOT ve AMT kombinasyonu ile kabul edilebilir sonuçlar alındığı ve düşük nüks oranları sağlanabileceği görüldü

Evaluation of tear film layer and meibomian gland morphology in glaucoma patients

Purpose: This study aims to investigate the changes in meibomian gland (MG) morphology and tear film layer in glaucoma patients. Materials and Methods: The study included 88 eyes of 44 glaucoma patients and 166 eyes of 83 healthy subjects. Noncontact meibography and noninvasive tear break-up time (TBUT) tests were performed with the Sirius Scheimpflug camera. Results: The total meiboscore, first and mean noninvasive TBUT, invasive TBUT, and OSDI scores were 3.57 ± 1.57, 9.24 ± 5.86, 10.76 ± 4.81, 7.62 ± 3.04, and 14.11 ± 10.48, respectively, for the glaucoma group and 2.43 ± 1.42, 11.17 ± 5.72, 12.30 ± 4.65, 9.56 ± 3.39, and 8.17 ± 7.17, respectively, for the control group. Conclusion: Morphological changes in the MG, decreases in TBUT tests and increases in OSDI scores were observed in glaucoma patients. The changes in the MG occurring in glaucoma patients may be associated with long-term use of topical antiglaucoma medication

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

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

Kronik blefaritli geriatrik hastalarda meibomian bez morfolojisi ve göz yaşı film tabakasının değerlendirilmesi

Introduction: To investigate the changes in meibomian gland morphology and their effects on tear parameters in geriatric patients with chronic blepharitis. Materials and Method: The study included 70 eyes of 35 healthy subjects in the control group and 60 eyes of 30 patients with chronic blepharitis. The patients were requested to complete a symptom questionnaire [Ocular surface disease index] before clinical examination. Non-contact meibography and non-invasive tear break-up time tests were performed with the Sirius Scheimpflug camera. Meibography scoring (Meiboscore) of the upper and lower lids was performed in all patients. Invasive tear break up time was performed 1 min after putting a single drop of fluorescein in all patients. Results: The mean age of the patients was 74.6±7.1 and 73.9±6.3 years in the blepharitis and control groups, respectively (p = 0.669). The total meiboscore, non-invasive first and mean tear break up time, invasive tear break up time, and ocular surface disease index score were 3.6±1.7, 8.0±4.8, 9.7±4.0, 7.1±3.0, and 27.4±11.7, respectively, for the blepharitis group and 3.0±1.4, 10.4±5.7, 11.4±5.0, 8.6±3.1, and 18.0±6.4, respectively for the control group (respectively p = 0.03, 0.01, 0.03, 0.00, 0.00). Conclusion: Chronic blepharitis in patients aged ≥65 years was associated with morphological changes in meibomian gland, decreased tear break up time, and increased ocular surface disease index scores. In these patients, meibomian gland atrophy score is considered as a valuable method consistent with clinical findings.Giriş: Bu çalışmada kronik blefariti olan geriatrik hastalarda meibomian bez morfolojisini ve bunun gözyaşı parametrelerine olan etkisini değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Bu çalışmaya 30 kronik blefaritli hastanın 60 gözü ve kontrol grubuna 35 sağlıklı bireyin 70 gözü dahil edildi. Klinik muayene öncesinde tüm hastalardan semptom anketini tamamlaması istendi [Oküler yüzey hastalık indeksi]. Non-kontakt meibografi ve noninvaziv göz yaşı kırılma zamanı ölçümleri Sirius Scheimpflug Camera ile yapıldı. Tüm olgularda her iki gözde alt ve üst kapaklarda meibografi skorlaması (Meiboskor) yapıldı. Tüm olgularda invaziv gözyaşı kırılma zamanı bir damla floresein damlatıldıktan 1 dakika sonra ölçüldü. Bulgular: Çalışmaya alınan olgularda yaş ortalaması blefarit grubunda 74.6±7.1, kontrol grubunda 73.9±6.3 yıldı (p = 0.669). Sırasıyla toplam meiboskor, non-invaziv ilk ve ortalama gözyaşı kırıma zamanı, invaziv gözyaşı kırılma zamanı, oküler yüzey hastalık indeksi skoru blefarit grubunda 3.6±1.7, 8.0±4.8, 9.7±4.0, 7.1±3.0, 27.4±11.7 iken kontrol grubunda 3.0±1.4, 10.4±5.7, 11.4±5.0, 8.6±3.1, 18.0±6.4 bulundu (sırasıyla p = 0.03, 0.01, 0.03, 0.00, 0.00). Sonuç: Altmışbeş yaş ve üzerindeki kronik blefaritli hastalarda meibomian bezlerde morfolojik değişiklikler, azalmış gözyaşı kırılma zamanı ve artmış oküler yüzey hastalık indeksi skorları olduğu görülmektedir. Bu hastalarda, meibomian bez atrofi skorunun klinik bulgularla uyumlu değerli bir yöntem olduğu düşünüldü

Relation between visual acuity, macular retinal thickness, visual field and multifocal electroretinography in patients with retinitis pigmentosa

Purpose: To investigate the correlation between corrected visual acuity (CVA), macular retinal thickness, visual fi eld and multifocal electroretinography (mfERG) responses in patients with retinitis pigmentosa (RP). Materials and Methods: The study included RP patients who were admitted to our clinic between January 2014 and December 2018 and had CVA at least ≥0.05. All patients underwent thorough ophthalmologic examination. Spectral domain (SD) optical coherence tomography (OCT) was performed to assess macular retinal thickness and standard central 30-2 threshold test was used as visual fi eld test. The visual fi eld responses, matching to mfERG, were estimated by calculating average value for 5 concentric rings. Correlation analysis was performed among CVA, macular retinal thickness, visual fi eld and mfERG responses. Results: Forty-four eyes of 22 patients were included in the study. The mean age was 30.6±13.0 (range 17 to 52) years in the study population. The CVA ranged from 0.05 to 1. In our study, there was a positive correlation between CVA, macular retinal thickness (r=0.668, p<0.01), visual fi eld (r=0.578, p<0.01) and mfERG responses for ring 1 (r=0.511, p<0.01). Conclusion: In addition to ophthalmologic examination, visual fi eld, SD-OCT and mfERG are important tests in the follow-up of patients with RP. We think that ophthalmologic examination together with anatomical and functional tests will be useful in the clinical follow-up of these patients

Anti-demodex effect of commercial eyelid hygiene products

Purpose To investigate in vitro effects of active ingredients in eye cleansing wipes and solutions on the life span of Demodex. Methods Demodex mites were extracted by eyelash epilation method from volunteers who were found to have chronic demodex blepharitis during an ophthalmological examination. Preparations with three or more motile, live adult Demodex parasites were included in the study. Two drops of the test solution were dropped on the samples: saline, 2% tea tree oil (TTO; Osto (R), AKD Medical products, Turkey), 7.5% TTO (Blefaritto (R), Jeomed, Turkey), and 0.5% terpinen-4-ol (T4O; Blefastop plus (R), NTC, Italy). Under light microscopy at 100x and 400x magnification, samples were examined and followed. The average killing time of Demodex was noted for each preparation. Results The study was analyzed on 120 patient samples. In the control group with saline, the average killing time of Demodex had an average of 323.5 +/- 21.1 min. In other groups, an average mean of 95.9 +/- 25.2 min in the 2% TTO group, 67.1 +/- 21.8 min in the 7.5% TTO group, and 27.3 +/- 6.0 min in the 0.5% T4O group was observed. It was found that the 0.5% T4O group was significantly more effective than the other groups. Conclusion Chronic Demodex blepharitis treatment is quite difficult in ophthalmology practice. It appears that, even at very low concentrations, T4O has an effective anti-Demodex effect

Tekrarlayan Pterjiyumlu Olgularda Konjonktival Otogreft Transplantasyonu ile Kombine Amniyotik Membran Transplantasyonu Cerrahisi Sonuçları

Aim: To evaluate the results of conjunctival autograft transplantation (CAT) combined with amniotic membrane transplantation (AMT) surgery in recurrent pterygium cases.Methods: This is a retrospective interventional case series involving patients admitted to our clinic with recurrent pterygium. Patients' examination and postoperative findings were taken through standard slit-lamp examinations. Fourteen eyes of 14 patients were included in the study. All cases were treated with excision, followed by CAT combined with AMT. Corneal recurrence was evaluated as the main result. Fibrovascular proliferation greater than 1 mm on the cornea was accepted as recurrence after surgery.Results: The mean age of patients was 56.4 ± 7.5 (range: 40 – 65) years. During the mean follow-up period of 24.9 ± 10.7 (range: 12 – 50) months, pterygium and symblepharon recurred in only one eye (7.1%) after 4 months.Conclusion: In this study, it was seen that acceptable results were obtain and low recurrence rates could be achieved with the combination of CAT and AMT for the treatment of recurrent pterygium.Amaç: Tekrarlayan pterjiumlu olguların tedavisinde konjonktival otogreft transplantasyonu (KOT) ile kombine amniyotik membran transplantasyonu (AMT) sonuçlarını değerlendirmekMetot: Bu çalışma kliniğimize tekrarlayan pterjiyum ile başvuran hastaları içeren retrospektif girişimsel bir vaka serisidir. Hastaların muayeneleri ve postoperatif bulgular standart yarık lamba biomikroskopi ile yapıldı. Çalışmaya 14 hastanın 14 gözü alındı. Tüm olgularda pterjium eksizyonunu takiben KOT ile kombine AMT yapıldı. Ana sonuç olarak korneal nüks değerlendirildi. Kornea üzerinde 1 mm'den fazla fibrovasküler proliferasyon ameliyat sonrası rekürrens olarak kabul edildi.Bulgular: Hastaların ortalama yaşı 56.4 ± 7.5 (aralık: 40- 65) yıldı. Ortalama 24.9 ± 10.7 (aralık: 12- 50) aylık takip süresi sonunda sadece bir gözde (% 7.1) 4 ay sonra pterjium ve symblepharon tekrarladı.Sonuç: Bu çalışmada, tekrarlayan pterjium tedavisi için KOT ve AMT kombinasyonu ile kabul edilebilir sonuçlar alındığı ve düşük nüks oranları sağlanabileceği görüldü

Comparison of visual outcomes of two trifocal IOLs

PURPOSE:To compare the visual outcomes of bilateral im-plantation of two commercially available trifocal intraocular lenses (IOLs) (AcrySof IQ PanOptix IOL; Alcon Laboratories, Inc and AcrivaUD Trinova IOL; VSY Biotechnology). METHODS:This comparative, investigator-initiated, single-center randomized trial was conducted by the Department of Ophthal-mology of the Medipol Mega University Hospital in Istanbul, Tur-key. Adult patients were randomized in a 1:1 ratio using a block randomization program to undergo cataract surgery and receive the implantation of either the PanOptix or Trinova IOL in both eyes. Outcome measures including binocular uncorrected and cor-rected visual acuities at distance, intermediate (66 cm), and near (40 cm), defocus curve, refractive outcomes, contrast sensitivity, glare and halos, and patient satisfaction were assessed at a mini-mum of 3 months following bilateral IOL implantation. RESULTS:A total of 71 patients (142 eyes) were included, with 35 patients (70 eyes) in the PanOptix IOL group and 36 patients (72 eyes) in the Trinova IOL group. At the 3-month follow-up examination, mean distance-corrected intermedi-ate visual acuity (primary endpoint) was significantly better for the PanOptix IOL group (0.0 & PLUSMN; 0.09 logMAR) compared with the Trinova IOL group (0.01 & PLUSMN; 0.10 logMAR) (P = .0304). Mean logMAR uncorrected intermediate acuity (UIVA) and near (UNVA) visual acuity were also significantly better for the PanOptix IOL group (UIVA = 0.1 & PLUSMN; 0.10 logMAR; UNVA= 0.0 & PLUSMN; 0.09 logMAR) compared with the Trinova IOL group (UIVA = 0.2 & PLUSMN; 0.10 logMAR; UNVA = 0.2 & PLUSMN; 0.11 logMAR) (both P < .001). There were no statistically significant differences in all other outcomes between groups. No adverse events were reported in both groups. CONCLUSIONS:These results suggest that the PanOptix IOL provides better intermediate and near visual outcomes com-pared to the Trinova IOL and represents a good choice for pa-tients seeking to achieve spectacle independence.Alcon Laboratories, In

Central areolar choroidal dystrophy case

Central areolar choroidal dystrophy is a rarely seen, hereditary retinal disease which primarily affects macula. Here, we aimed to review clinical findings, ophthalmological imaging results and electrodiagnostic test results in a 43-years old man presented with visual impairment to our clinic and diagnosed as central areolar choroidal dystrophy