The Effect of ND:YAG Laser Posterior Capsulotomy Size on Refraction, Intraocular Pressure, and Macular Thickness

Purpose. The aim of this study is to examine the influence of capsulotomy size on, spherical equivalent (SE), intraocular pressure (IOP), and macular thickness. Materials and Methods. Sixty-eight patients were examined preoperatively and 1, 4, and 12 weeks after Nd:YAG capsulotomy. Patients were divided into two groups based on the postoperative capsulotomy size. Changes in SE, IOP, and macular thickness were compared between two groups. Results. We found a higher hyperopic shift in large capsulotomy group. In both groups 1 and 2, IOP increased 1 week postoperatively. Intraocular pressure rise in group 2 was higher than in group 1. Both groups had increased macular thickness at 1 week postoperatively. The degree of macular thickening was similar in group 1 and group 2. Comment. Patients who underwent a larger capsulotomy have a higher hyperopic shift and IOP elevation. Rise in macular thickness was similar in large and small capsulotomy groups

Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome:one year follow-up results

AIM:To investigate the retinal nerve fiber layer (RNFL) thickness changes in patients with obstructive sleep apnea syndrome (OSAS) for one year follow-up. To discuss the possibility of detecting tendency of glaucoma in this population by using spectral domain optical coherence tomography (3D-OCT-2000 Spectral domain).METHODS:After polysomnographic study, all subjects (64 OSAS patients and 40 controls) underwent detailed ophthalmological examination. After these examinations, patients with glaucoma and patients who had ophthalmological and/or systemic disease were excluded from the study. Totally, 20 patients in OSAS group and five patients in controls were excluded from the study in the first examination and follow-up period. The RNFL thickness was assessed with OCT. Forty-four OSAS patients and 35 control subjects were followed up 12mo. RNFL thickness change and OSAS patients were evaluated for severity of disease by Apnea-Hypopnea Index (AHI).RESULTS:Forty-four OSAS patients and 35 controls were enrolled in the study. Statistically significance was found between OSAS patients and controls at the 12th mo. Average RNFL thickness was found to be significantly lower in last measurements in OSAS patients when compared with first measurements and control subjects (P<0.001, 0.002, respectively). There was a statistically significant correlation among AHI, and RNFL thickness (P<0.05).CONCLUSION:The results suggest that the patients with OSAS were related with a proportional decrease in the RNFL thickness. These patients should be followed up regularly for glaucomatous changes. Detecting more RNFL thinning in severe OSAS was important

Comparison of the Retinomax hand-held autorefractor versus table-top autorefractor and retinoscopy

<b>AIM:</b>To compare noncycloplegic and cycloplegic results of Retinomax measurements with findings achieved after cycloplegia using table-top autorefractor and retinoscopy.<b>METHODS:</b> The study included 127 patients (mean age 96.7mo, range 21 to 221). Retinomax (Rmax) (Nikon Inc., Japan) was used to obtain noncycloplegic refraction. Under cycloplegia, refraction was measured with Rmax, table-top autorefractor (TTR) (Nikon NRK 8000, Inc., Japan) and retinoscopy. The values of sphere, spherical equivalent, cylinder and axis of cylinder were recorded for Rmax, TTR and retinoscopy in each eye. All results were analyzed statistically.<b>RESULTS:</b> The mean spheric values (SV), spherical equivalent values (SEV) and cylindrical values (CV) of the noncycloplegic Rmax (SV:0.64 D, SEV:0.65 D and CV:0.03 D, respectively) were found to be significantly lower than cycloplegic TTR (1.43 D, 1.38 D and 0.3 D; <i>P=</i>0.012, <i>P=</i>0.011 and <i>P=</i>0.04, respectively) and retinoscopy (1.34 D, 1.45 D and 0.23 D; <i>P=</i>0.04, <i>P=</i>0.002 and <i>P=</i>0.045, respectively). Mean cycloplegic SV, SEV, CV were not significantly different between Rmax and TTR, Rmax and retinoscopy, TTR and retinoscopy. Cycloplegic or noncycloplegic axis values were not different between any method.<b>CONCLUSION:</b> Rmax may be used successfully as a screening tool but may not be accurate enough for actual spectacle prescription. Cycloplegic Rmax measurements may be able to identify refractive error in children because of approximate results to retinoscopy

Correlation of Peripapillary Choroidal Thickness and Retinal Nerve Fiber Layer Thickness in Normal Subjects and in Patients with Glaucoma

Purpose: This study was designed to compare the normal and glaucomatous eyes regarding retinal nerve fiber layer (RNFL) thickness and peripapillary choroidal thickness (PCT), and to investigate the correlation of RNFL thickness and PCT. Subjects and Methods: Subjects were selected as a convenience sample of those from a tertiary referral practice of glaucoma. Thirty-two glaucomatous eyes were accepted as group 1; 30 normal eyes were accepted as group 2. Groups were compared for RNFL thickness and PCT. Correlations of RNFL thickness and PCT were assessed for each peripapillary location. Results: Mean inferior and superior RNFL thickness in group 1 were significantly lower than the control group; mean thicknesses of temporal and nasal quadrants were not different in the two groups. Mean PCT at 500 mu m distance in the inferior, at 1500 mu m distance in the superior, at 500, 1000, and 1500 mu m distance in the temporal, and at 1000 and 1500 mu m distance in nasal quadrants were found to be significantly thinner in the glaucoma group compared with the control group. Retinal nerve fiber thickness was strongly correlated with PCT at all points of inferior quadrants at 500 mu m distance in the superior. There was no correlation between RNFL thickness and PCT at any point in the control group. Conclusion: Peripapillary choroidal thickness was thinner in glaucomatous eyes compared with normal eyes. Correlation of PCT and RNFL thickness found in patients with glaucoma did not exist in normal subjects

The Relationship Between Obstructive Sleep Apnea Syndrome and Glaucoma

Objective: In this study, we investigated the prevalence of glaucoma in patients with obstructive sleep apnea syndrome (OSAS). Material and Methods: Sixty-four patients with OSAS and 32 control subjects comprised the study group. Detailed ophthalmological examinations, computerized visual field analysis and imaging of the optic nerve head with Optical Coherence Tomography were performed. Diurnal intraocular pressure measurements were made on patients with OSAS. Patients with OSAS were divided into three groups (mild, moderate and severe) for severity of the disease based on their apnea-hypopnea indexes (AHI). Results: There was a statistically significant correlation among AHI, mean deviation and retinal nerve fiber layer thickness (p<0.05). Glaucoma was diagnosed in seven patients with OSAS (10.9%). One patient had primary open angle glaucoma and six patients had normal tension glaucoma. Five of the patients with glaucoma were in severe OSAS group. Conclusion: The results of this study show that OSAS is associated with glaucoma. Patients with OSAS should be followed regularly for glaucoma development and progression

Choroidal Thickness Changes in Rheumatoid Arthritis and the Effects of Short-term Hydroxychloroquine Treatment

Purpose: The objective of this study is to evaluate choroidal thickness (CT) in patients with rheumatoid artritis (RA) and the effects of short-term hydroxychloroquine (HCQ) treatment.Methods: Thirty RA patients (group 1) and 30 normal subjects (group 2) were enrolled in the study. Group 1 was further divided into two subgroups as follows: group 1A (Before HCQ treatment) and group 1B (1 year after HCQ treatment). The CTs were measured using optical coherence tomography (EDI-OCT).Results: The mean subfoveal choroidal thickness (SFCT) (mu m) was 335.70 64.58 in group 1A, 341.85 +/- 63.95 in group 1B, and 358.51 +/- 63.83 in group 2. SFCT was significantly lower in groups 1A and 1B than in group 2 (p = 0.020 and p = 0.028, respectively). Group 1B presented statistically significant thicker SFCT than group 1A (p = 0.033).Conclusions: CT was significantly lower in RA patients than in normal subjects. HCQ treatment may, however, cause a statistically significant increase in SFCT. This increase is clinically negligible

The Relationship Between Obstructive Sleep Apnea Syndrome and Glaucoma

Objective: In this study, we investigated the prevalence of glaucoma in patients with obstructive sleep apnea syndrome (OSAS). Material and Methods: Sixty-four patients with OSAS and 32 control subjects comprised the study group. Detailed ophthalmological examinations, computerized visual field analysis and imaging of the optic nerve head with Optical Coherence Tomography were performed. Diurnal intraocular pressure measurements were made on patients with OSAS. Patients with OSAS were divided into three groups (mild, moderate and severe) for severity of the disease based on their apnea-hypopnea indexes (AHI). Results: There was a statistically significant correlation among AHI, mean deviation and retinal nerve fiber layer thickness (p<0.05). Glaucoma was diagnosed in seven patients with OSAS (10.9%). One patient had primary open angle glaucoma and six patients had normal tension glaucoma. Five of the patients with glaucoma were in severe OSAS group. Conclusion: The results of this study show that OSAS is associated with glaucoma. Patients with OSAS should be followed regularly for glaucoma development and progression

Olfactory Neuroblastoma: A Rare Cause of External Ophthalmoplegia, Proptosis and Compressive Optic Neuropathy

Olfactory neuroblastoma (ONB), which is a neuroectodermal tumor of the nasal cavity, is a rare and locally aggressive malignancy that may invade the orbit via local destruction. In this study, we report a patient with proptosis, external ophthalmoplegia, and compressive optic neuropathy caused by ONB. A detailed clinical examination including ocular imaging and histopathological studies were performed. The 62-year-old female patient presented to our clinic with complaints of proptosis and visual deterioration in the left eye. Her complaints started 2 months prior to admission. Visual acuity in the left eye was counting fingers from 2 meters. There was relative afferent pupillary defect. She had 6 mm of proptosis and limitation of motility. Fundus examination was normal in the right eye, but there was a hyperemic disc, and increased vascular tortuosity and dilation of the retinal veins in the left eye. Computerized tomography and magnetic resonance imaging of the brain and orbits demonstrated a large heterogeneous mass in the left superior nasal cavity with extensions into the ethmoidal sinuses as well as into the left orbit, compressing the medial rectus muscle and optic nerve. Endoscopic biopsy of the lesion was consistent with an ONB (Hyams' grade III). Orbital invasion may occur in patients with ONB. Therefore, it is important to be aware of this malignancy because some patients present with ophthalmic signs such as external ophthalmoplegia, proptosis, or compressive optic neuropathy

Spontaneous resolution of macular edema after silicone oil removal

AIM:To investigate the macular changes in eyes filled with silicone oil (SO) and course of these changes after SO removal.METHODS:A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal.RESULTS:Mean duration of SO tamponade was 3.6±1.0mo (range:3-7mo). Cystoid macular edema (CME) was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal. Resolution of CME and submacular fluid was achieved 1mo after SO removal in all eyes. Mean best corrected visual acuity (BCVA) was 1.15±0.65 (range, hand movement to 0.2) before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82±0.23, 0.76±0.21, and 0.70±0.19, all of which were significantly better than baseline (P=0.030, 0.017, 0.006 respectively). In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline (P=0.037).CONCLUSION:Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal

ACUTE EFFECT OF CAFFEINE ON MACULAR MICROCIRCULATION IN HEALTHY SUBJECTS An Optical Coherence Tomography Angiography Study

Purpose: To evaluate the acute effects of caffeine on macular microvasculature using quantitative optical coherence tomography angiography analysis