Phakic Pattern Pseudoexfoliation Material Accumulation on Intraocular Lens Surface

Pseudophakic pseudoexfoliation is the accumulation of pseudoexfoliation material on the intraocular lens. Most of the cases have showed scattered flecks of pseudoexfoliation material on the surface of the intraocular lens. However, the phakic pattern consisting of classic three-zone on the intraocular lens is rarely observed. In this case report, we describe a phakic pattern pseudoexfoliation material on the intraocular lens surface 8 years after cataract extraction. (Turk J Ophthalmol 2014; 44: 156-7

Surgical Results in Unilateral Superior Oblique Muscle Palsy

Objectives: To evaluate the surgical treatments and results of the patients with superior oblique muscle palsy (SOMP). Materials and Methods: Clinical charts of the patients with unilateral SOMP who were operated in our clinic between 1999 and 2009 were evaluated retrospectively. Patients’ demographics, preoperative signs, surgical procedure, complications, and final results were recorded. Results: Thirty-seven patients were included in the study, [21 (59%) male, 15 (41%) female]. The mean age was 20.6 years at the time of operation. The mean time interval between diagnosis and operation was 7.3 years. Postoperative follow-up period was 2.04 (ranging 1-10) years. Diplopia was determined in seven (18.9%) patients, and abnormal head position in 36 (97.3%) patients. Only inferior oblique tenotomy with distal muscle resection was performed in 25 patients. In addition, five patients had recession of the contralateral inferior rectus muscle and two patients had recession of the ipsilateral superior rectus muscle additional to inferior oblique tenotomy. Abnormal head position was completely improved in all of the patients postoperatively. The preoperative average score of the inferior oblique muscle (IOM) overaction was +3.3±0.8, and postoperative overaction was found in only two patients (+1.5). There was statistically significant difference between the two periods (p<0.001). The average score of the superior oblique muscle hypofunction was -2.18 preoperatively, and in only three patients, the score was found -1.0 postoperatively. Difference between the two periods was statistically significant (p<0.001). While the preoperative average vertical deviation was 22 PD in primary position, none of the patients had hyperdeviation postoperatively. Diplopia was resolved in all seven affected patients postoperatively. Contralateral IOM hyperfunction was the most common complication (13.5%). Adherence syndrome was seen in none of the patients. Conclusion: It was found that to weaken the IOM solely was satisfactory in the patients with hyperdeviation secondary to unilateral SOMP in this study. (Turk J Ophthalmol 2014; 44: 293-6

Choroidal thickness measurement in healthy pediatric population using Cirrus HD optical coherence tomography

<div><p> Purpose: To investigate the association between central choroidal thickness (CT), axial length (AL), age, gender, and refractive error in a healthy pediatric population using optical coherence tomography (OCT). Methods: This institutional study involved 137 healthy children (57 boys, 80 girls) aged between 4 and 18 years. Each child underwent a dilated eye examination, cycloplegic refraction, and AL measurement using a Nidek AL-Scan optical biometer. The central foveal thickness (CFT) and CT were measured using Cirrus high definition (HD)-OCT. The right eye of each subject was selected for analysis. Results: The mean age of the children was 10.0 ± 4.7 years (range, 4-18 years). The mean spherical equivalent (SE) was -0.24 ± 1.24 diopters (D) (range, -2.00 D to +2.25 D). The mean AL was 23.1 ± 1.2 mm (range, 20-27 mm). The mean central CT was 388.2 ± 50.0 μm and was not correlated with age, gender, AL, or refractive error. Conclusion: The data provide a pediatric normative database of CT using enhanced depth imaging OCT. This information may be useful in the diagnosis and monitoring of retino-choroidal diseases in children.</p></div

Obez çocuklarda ganglion hücre iç pleksiform ve retina sinir lifi tabakası kalınlıklarının ve obezite şiddeti ve süresi ile birlikteliğinin değerlendirilmesi

Aim: To evaluate the macular ganglion cell-inner plexiform layer (GC-IPL) and the retinal nerve fiber layer (RNFL) thicknessesmeasured by high-definition optical coherence tomography (HD-OCT) in children with obesity and to determine whether thicknessparameters are correlated to disease severity and duration.Materials and Methods: This prospective study involved 40 obese and 40 age and sex-matched non-obese children aged between 6 and17 years. Following the measurement of body mass index (BMI), cycloplegic auto-refraction, intraocular pressure, and axial length (AL)was measured. OCT scans were performed using Cirrus HD-OCT (Carl-Zeiss Meditec, Dublin, CA, USA). Right eye of each subjectwas selected for analysis.Results: The study included 40 healthy children and 40 children with obesity. The RNFL thickness measurements revealed thinner inthe obesity group compared to controls for all quadrants however, the only statistically difference were for the average and superiorquadrants (P < 0.05). All GC-IPL thickness parameters were statistically thinner in the obese subjects compared to the controls (P< 0.05). Average peripapillary RNFL and macular GC-IPL thicknesses and some quadrants and sectors are inversely correlated withdisease severity and duration.Conclusions: Macular GC-IPL and peripapillary RNFL thicknesses were significantly lower in obese children than controls and anegative correlation between the severity and duration of obesity and both the GC-IPL and RNFL thicknesses could indicate that obesitycontrol in children may be a crucial strategy for prevention of glaucoma.Amaç: Obez çocuklarda maküler gangliyon hücre iç pleksiform tabakası (GH-IPT) ve retina sinir lifi tabakası (RSLT) kalınlıklarının yüksek çözünürlüklü optik koherens tomografi (OKT) ile değerlendirilmesi ve kalınlık parametrelerinin hastalık şiddeti ve süresi ile korele olup olmadığını belirlemek. Gereç ve Yöntemler: Bu prospektif çalışmaya, 6 ve 17 yaşları arasında 40 obez çocuk ve 40 obez olmayan eşit yaş ve cinsiyette sağlıklı çocuk dahil edildi. Vücut kitle indeksi (VKI) ölçümünü takiben, sikloplejik oto-refraksiyon, göz içi basıncı (GİB) ve aksiyel uzunluk (AU) ölçüldü. OKT taramaları Cirrus HD-OCT (Carl-Zeiss Meditec, Dublin, CA, ABD) kullanılarak yapıldı. Analiz için her bireyin sağ gözü seçilmiştir. Bulgular: Çalışmaya 40 sağlıklı çocuk ve 40 obez çocuk alındı. RSLT kalınlığı ölçümleri obezite grubunda tüm kadranlar için kontrollere kıyasla daha ince bulundu, ancak istatistiksel olarak tek fark ortalama ve üst kadranlar için idi (P <0.05). Tüm GH-IPT kalınlık parametreleri obez olgularda kontrollere göre istatistiksel olarak daha düşüktü (P <0.05). Ortalama peripapiller RSLT kalınlığı ve maküla GH-IPT kalınlığı, bazı kadranlar ve sektörler hastalık şiddeti ve süresi ile ters orantılıdır. Sonuç: Maküler GH-IPT ve peripapiller RSLT kalınlıkları obez çocuklarda kontrollere göre anlamlı olarak düşüktü. Hem GH-IPT hem de RSLT kalınlıkları ile obezitenin şiddeti ve süresi arasında negatif bir korelasyon vardı. Çocuklarda glokomun önlenmesi için obezite kontrolünün çok önemli bir strateji olabileceğini düşündürdü

Normative Spectral Domain Optical Coherence Tomography Data in Healthy Turkish Children

<p><i>Purpose</i>: To determine the normative database of macular and retinal nerve fiber layer (RNFL) thickness parameters in healthy Turkish children by OCT. <i>Methods</i>: 318 eyes of 318 children (138 boys, 183 girls) aged between 3 and 17 years were evaluated. The children were scanned by Cirrus HD-OCT (Carl Zeiss Meditec) to measure the macula, RNFL, and optic nerve head parameters. <i>Results</i>: Axial length (AL) (<i>p</i> < 0.001, R²= 0.08), spherical equivalent (SE) (<i>p</i> < 0.001, R²= 0.12), and rim area (<i>p</i> < 0.001, R²= 0.15) were the strongest predictors of RNFL thickness. All of the macular measurements were significantly related to age (<i>p</i> < 0.001, R²> 5%). Average macular thickness (<i>p</i> < 0.01) and outer macula (<i>p</i> = 0.002) showed significant relationship with the AL and SE. <i>Conclusion</i>: This study ensures an age-adjusted pediatric normative database using OCT to diagnose and monitor macular diseases, optic nerve diseases, and glaucoma in children.</p