The correlation of choroidal thickness and ocular pulse amplitude in non-exudatıve age-related macular degeneration

Introduction: The choroid is involved in the pathogenesis of various retinal diseases, including age-related macular degeneration (AMD). The ocular pulse amplitude (OPA) gives useful information about intraocular blood flow and is an indirect indicator of choroidal perfusion. In this study, we aimed to assess the correlation between the OPA and choroidal thickness (CT) in the eyes of healthy individuals and of individuals with non-exudative early stage AMD. Materials and Method: Fourty-four eyes of 44 non-exudative AMD patients and 41 age-matched eyes of 41 healthy individuals were included in the study. All eyes underwent a detailed ophthalmic evaluation, including axial length (AL) and ocular pulse amplitude (OPA) measurements. The CT was measured using optical coherence tomography. Parameters were compared between the two groups and correlation between OPA and CT was assessed. Results: The mean subfoveal, foveal, and parafoveal CT were 245.82 +/- 24.29 mu m, 230.66 +/- 23.44 mu m, 219.55 +/- 25.39 mu m in AMD group, respectively. The corresponding values were 278.44 +/- 34.18 mu m, 263.76 +/- 32.45 mu m, and 253.79 +/- 34.81 mu m in control group, respectively. The mean ages of groups were 69.6 +/- 8.97 years, and 65.0 +/- 5.89 years, respectively. The mean OPA was 3.43 +/- 1.14mmHg and 3.49 +/- 1.12mmHg, respectively. The average CT in AMD patients were significantly lower than the control group in all three regions (subfoveal- foveal- parafoveal) (all p<0,001). In controls, there was a moderate positive correlation between the OPA and CT in the three segments (p=0.002, 0.009, and 0.003; respectively). However only the foveal CT showed significant positive correlation with the OPA in AMD group (p=0.047). Conclusion: Our results showed a considerable correlation between ocular pulse amplitude and choroidal thickness in healthy subject. In non-exudative AMD group, there was a weak correlation between them. It can be hypothesized that; in patients with AMD, degeneration and/or thinning of choroidal pattern is a reason for this result

Santral Seröz Koryoretinopati Şeklinde Prezente Olan Multipl Geçici Beyaz Nokta Sendromu

A 28-year-old man presented to the clinic with metamorphopsia, central scotoma, and visual loss in his right eye. After detailed ophthalmicexamination, fundoscopy showed localized elevation of the macula,and optical coherence tomography also showed subretinal serofi brinousaccumulation temporal to the fovea. He was evaluated as idiopathic central serous chorioretinopathy (CSCR). At the fi fth day of presentationhe was seen by the retinal consultant with fl uorescein angiography (FA) and indocyanine green angiography (ICGA) which were characteristicof multiple evanescent white dot syndrome (MEWDS) in the right eye. The diagnosis was changed as MEWDS presenting that as CSCR, andit was seen that the serofi brinous elevation began to decline after the fi rst week of presentation. Symptoms and visual disturbance recoveredwithout any further treatment at sixth month in this case.Yirmisekiz yaşında erkek hasta metamorfopsi, santral skotom ve görme kaybı ile kliniğimize başvurdu. Detaylı oftalmolojik muayenede fundusta makulada lokalize seröz dekolman, optik koherens tomografi ile de foveanın temporalinde subretinal seröfi brinöz birikim tespit edildi ve hastamız idiopatik santral seröz koryoretinopati (SSKR) tanısı ile retina bölümüne yönlendirildi. Beşinci günde tekrar görülen hastanın fundus fl öresein ve indosiyanin yeşili anjiografi sinde multipl geçici beyaz nokta sendromuna (MGBNS) karakteristik bulgular saptandı. Hastanın tanısı SSKR şeklinde prezente olan MGBNS olarak değiştirildi. Birinci haftadan sonra seröfi brinöz elevasyon azalmaya başladı. Semptomlar ve görme bozukluğu 6. ayın sonunda hiçbir tedavi gerektirmeden tamamiyle düzeldi

Multiple evanescent white dot syndrome presenting that as central serous chorioretinopathy

A 28-year-old man presented to the clinic with metamorphopsia, central scotoma, and visual loss in his right eye. After detailed ophthalmicexamination, fundoscopy showed localized elevation of the macula,and optical coherence tomography also showed subretinal serofi brinousaccumulation temporal to the fovea. He was evaluated as idiopathic central serous chorioretinopathy (CSCR). At the fi fth day of presentationhe was seen by the retinal consultant with fl uorescein angiography (FA) and indocyanine green angiography (ICGA) which were characteristicof multiple evanescent white dot syndrome (MEWDS) in the right eye. The diagnosis was changed as MEWDS presenting that as CSCR, andit was seen that the serofi brinous elevation began to decline after the fi rst week of presentation. Symptoms and visual disturbance recoveredwithout any further treatment at sixth month in this case

Determination of Some Trace Elements in Food and Soil Samples by Atomic Absorption Spectrometry After Coprecipitation with Holmium Hydroxide

The determination of trace elements in food and soil samples by atomic absorption spectrometry was investigated. A coprecipitation procedure with holmium hydroxide was used for separation-preconcentration of trace elements. Trace amounts of copper(II), manganese(II), cobalt(II), nickel(11), chromium(III), iron(III), cadmium(II), and lead(II) ions were coprecipitated with holmium hydroxide in 2.0 M NaOH medium. The optimum conditions for the coprecipitation process were investigated for several commonly tested experimental parameters, such as amount of coprecipitant, effect of standing time, centrifugation rate and time, and sample volume. The precision, based on replicate analysis, was lower than 10% for the analytes. In order to verify the accuracy of the method, the certified reference materials BCR 141 R calcareous loam soil and CRM 025-050 soil were analyzed. The procedure was successfully applied for separation and preconcentration of the investigated ions in various food and soil samples. An amount of the solid samples was decomposed with 15 mL concentrated hydrochloric acid-concentrated nitric acid (3 + 1). The preconcentration procedure was then applied to the final solutions. The concentration of trace elements in samples was determined by atomic absorption spectrometry

Unilateral sequential papillophlebitis and central retinal artery occlusion in a young healthy patient

A 23-year-old girl presented to the clinic with metamorphopsia and photopsia in her left eye. After detailed ophthalmic examination, central retinal vein occlusion with optic disc edema was detected in that eye. Three days after diagnosis, the patient returned to our clinic with visual acuity decrease. Central retinal artery occlusion sparing cilioretinal artery was detected. All the laboratory tests were normal except for heterozygous methylenetetrahydrofolate reductase mutation (A1298C genotypes) and an indefinite Lyme disease seropositivity. Symptoms and visual disturbance recovered without any further treatment other than acetylsalicylic acid for prophylaxis

Effect of Topical Nepafenac on Macular Thickness in Eyes with Diabetic Macular Edema without Previous Treatment

Amaç: Diyabetik maküla ödemi olan hastalarda topikal nepafenak damla kullanımının maküla kalınlığına etkisinin optik koherans tomografi ile değerlendirilmesi.Gereç ve Yöntem: Mart 2011- Haziran 2015 tarihleri arasında retina biriminde değerlendirilen ve ilk kez makulopati tanısı konan intravitreal enjeksiyon ya da lazer tedavisini kabul etmeyen/uygun olmayan ve günde 4 kez topikal %0,1'lik nepafenak damla başlanılan tip 2 diyabetli hastalar çalışmaya dahil edildi. Yaşa bağlı maküla dejenerasyonu, glokom, üveit ve oküler cerrahi öyküsü olan hastalar ile optik koherans tomografi ölçümleri alınamayanlar ve ödemi maküla santrali dışında olanlar çalışma dışı bırakıldı. Hastalara tam kapsamlı oftalmik muayene, optik koherans tomografi ve gerekli durumlarda flöresein anjiyografi yapıldı. Topikal tedavi öncesi ve sonrasındaki 1.,3. ve 6. ay bulguları değerlendirildi. Bulgular: Yirmisekizi erkek, 48 hastanın 48 gözü çalışmaya dahil edildi. Topikal tedavi öncesi en iyi düzeltilmiş görme keskinliği ortalaması 0,61±0,33, tedavi sonrası 1.,3. ve 6. ay görmeleri sırasıyla 0,61±0,32; 0,59±0,30 ve 0,57±0,30 idi. Değerler arasında istatistiksel olarakanlamlı fark yoktu. Tedavi öncesi ve sonrası 1.,3. ve 6. ay takiplerde santral fovea kalınlığı sırasıyla 323,81±92,94, 33,56±107,36,335,93±105,55 ve 326,58±99,70 µm idi. Değerler arasında istatistiksel olarak anlamlı fark yoktu (p=0,562). Diğer kadranlarda da kalınlık değerleri takipler esnasında anlamlı farklılık göstermedi (p>0,05). Sonuç: Santral tutulumlu diyabetik maküla ödeminde topikal nepafenak kullanımı 6 aylık takipte maküla kalınlığında ve görme düzeyindeherhangi bir değişimle sonuçlanmamıştır. Kalınlıkta artışın olmaması kan şekeri regülasyonuyla birlikte topikal NSAİ damla kullanımının uygun tedavi uygulanamayan hastalarda güvenli ve denenebilir olduğunu göstermektedir.Objective: Evaluation of the effect of topical nepafenac on macular retinal thickness in eyes with diabetic macular edema via optical coherence tomography. Material and Method: This study included patients who were admitted to our retinal disease section between 2011 March and 2015 June with type 2 diabetes that had been diagnosed as having macular edema for the first time. All patients received topical nepafenac (qid) treatment as they did not accepted or had suitable health conditions for intravitreal injections and laser treatment. Patients that had age related macular degeneration, glaucoma, uveitis, edema not involving fovea and cases that lack optical coherence tomography accurate reports due to media opacities were excluded. All cases had complete ophthalmic and optical coherence tomography examinations at the initial evaluation and in the 1st, 3rd and 6th month during treatment. Fluorescein angiography was performed if necessary. Results: One eye of 48 patients (28 male, 20 female) were evaluated, the mean best corrected visual acuity was 0.61&plusmn;0.33, 0.61&plusmn;0.32; 0.59&plusmn;0.30, and 0.57&plusmn;0.30 at the initial examination and 1st, 3rd and 6th month during treatment respectively. There was no statistical significant difference between best corrected visual acuity values. Mean central foveal thicknesses on optical coherence tomography were 323.81&plusmn;92.94, 33.56&plusmn;107.36, 335.93&plusmn;105.55, and 326.58&plusmn;99.70 &micro;m at the initial examination and 1st, 3rd and 6th month during treatment respectively. There was no statistical significant difference between foveal thickness values (p= 0.562). Also no statistical significant changes were found during the study in the outer macular quadrants in terms of retinal thickness values (p&gt;0.05). Conclusion: No significant changes were found in terms of macular thicknesses or visual acuity in eyes with diabetic macular edema with topical nepafenac treatment during 6 months follow-up. The lack of edema progression suggests that topical nonsteroidal anti-inflammatory treatment together with systemic regulation of diabetes may be a safe alternative in patients that other treatment modalities cannot be applied

Correlation of ocular pulse amplitude, choroidal thickness, and internal carotid artery doppler ultrasound findings in normal eyes

Introduction: The choroid receives about 65-85% of ocular blood flow, which comes from the ophthalmic artery (OA), the first branch of the internal carotid artery (ICA). In the foveal avascular zone, there is no retinal vascular supply; therefore, choroidal blood supply plays a significant role in this subfoveal region. The ocular pulse amplitude (OPA) provides useful information about intraocular blood flow and is an indirect indicator of choroidal perfusion. In this study, we aimed to assess the correlation between the OPA, subfoveal choroidal thickness (CT), and ICA Doppler ultrasound findings in healthy eyes. Methods: In total, 48 eyes of 48 healthy volunteers were included in this study. All eyes underwent detailed ophthalmic evaluation, including slit-lamp biomicroscopy, fundus examination, axial length, OPA measurements, and optical coherence tomography (OCT) with enhanced depth imaging mode. Carotid Doppler ultrasound examination was performed by the radiologist. The correlation between the OPA, subfoveal CT, and ICA Doppler findings [peak systolic velocity (PSV) and enddiastolic velocity (EDV)] were evaluated, considering gender and age. Results: The mean OPA was 3.06 +/- 1.34 mmHg. The mean subfoveal CT was 305.85 +/- 33.98 mu m. The mean PSV and EDV of ICA were 73.25 +/- 23.63 cm/s and 26.93 +/- 13.42 cm/s, respectively. A moderate positive correlation was found between OPA and subfoveal CT (p = 0.001; rho = 0.481). This relationship was present in both men and women. While a positive correlation was found between the OPA and subfoveal CT in subjects under the age of 50 years, there was no correlation in those over the age of 50 years. Conclusions: A fair correlation was found between the OPA and subfoveal CT in healthy subjects under the age of 50