Ercan Ozsoy

Evaluation of peripapillary retinal nerve fiber layer, macula and ganglion cell thickness in amblyopia using spectral optical coherence tomography

AIM To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS The mean global thicknesses of the RNFL were 113.22±21.47, 111.57±18.25, 109.96±11.31µm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P=0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57µm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P=0.06). The GCC was investigated into two parts: superior and inferior. The mean thicknesses of superior GCC were 102.57±13.32, 103.32±10.64, 100.52±5.88µm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82±12.60, 107.82±12.33, 105.86±10.79µm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P=0.63, P=0.46). CONCLUSION The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.

Is There Any Relation Between Pseudoexfoliation Syndrome and Alzheimer's Type Dementia?*

Abstract Purpose: To investigate the frequency of Alzheimer-related dementia in patients with pseudoexfoliation syndrome (PEX). Methods: Sixty-seven patients with PEX and 67 age-, gender-, and educational-background-matched control subjects were compared for the presence of Alzheimer-related dementia according to DSM- IV-TR. The effects of cataract, glaucoma, additional ocular and systemic disease on the dementia incidence were also evaluated in patients with PEX and the control group. Results: The frequency of Alzheimer-related dementia was higher in patients with PEX (p = 0.0001). The frequency of dementia in patients who had cataract was higher than in patients without cataract (p = 0.003). There was also an association between additional ocular disease and dementia (p < 0.05). However, there was no association between systemic disease and dementia (p > 0.05). Furthermore, there was no difference for the frequency of dementia between patients who had glaucoma or not among patients with PEX (p = 0.953). Conclusion: The increased frequency of Alzheimer-related dementia in patients with PEX is important and a possible association between PEX and Alzheimer’s disease could be present.

Changes in Anterior Chamber Parameters with the Pentacam Rotating Scheimpflug and Axial Length Measurements by Ultrasound in Patients Who Use Isotretinoin

Purpose: Evaluation of changes in anterior chamber parameters with the Pentacam rotating Scheimpflug and axial length measurements (Alx) by ultrasound in patients who use isotretinoin for the treatment of acne vulgaris. Methods: Twenty-nine eyes of 29 patients (15 men, 14 women) were evaluated with the Pentacam before the treatment, and at the 3rd and 6th months of treatment. The axial length was evaluated by ultrasound biometry. The non-parametric paired t-test was used to compare pretreatment and 3rd and 6th month anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) width, central corneal thickness (CCT), lens thickness (LT), pupil size, axial length measurement (Alx) and mean keratometry values (K). Results: The mean age of the patients was 21.82 ± 4.14 years. The differences between the pretreatment and 3rd and 6th month ACD, ACV, CCT, Alx, LT and mean K values were statistically significant (p < 0.05). The differences between the pretreatment and 3rd and 6th month pupil size measurements were not statistically significant (p > 0.05). The differences between the pretreatment and 3rd month ACA measurements were statistically significant (p > 0.05), but there was no statistically significant difference with 6th month values (p < 0.05). Conclusions: Isotretinoin treatment causes statistically significant changes in most anterior segment parameters during treatment.

Results of scleral fixated intraocular lens implantation

Aim: To evaluate the results of scleral fixated intraocular lenses (SFIOLs) implantation in eyes that had lost capsular support. Material and methods: Eyes of twenty patients who had lost their capsular support due to various causes included in this study. This study involved 5 females and 15 males. Eight eyes were included following complicated cataract surgeries, five eyes were patients in trauma, three eyes were with subluxated intraocular lens, three aphakic eyes which underwent congenital cataract surgeries and one eye that had beginning of bullous keratopathy due to anterior chamber lens were operated. The secondary SFIOLs implantation were performed in all eyes. Preoperative and postoperative best corrected visual acuities were compared. Results: The mean age of patients was 61.4±15.04 years. The mean follow-up time was 3.12±0.7 months. The best corrected mean preoperative and postoperative visual acuities of patients were found as 0.16±0.02 and 0.38±0.07; respectively, using the Snellen chart. In our study; in two patients corneal edema, in one patient pupillary irregularity and in one patient increased intraocular pressure were observed. There was a statistically significant difference between the mean preoperative and postoperative visual acuities of patients according to the Wilcoxon test (p=0.01). Conclusion: SFIOLs implantation have still maintained its importance for correction of aphakia in patients without adequate capsular support despite all new developments.

Evaluation of central macular thickness after penetrating keratoplasty

Aim: To evaluate the changes in central macular thickness after penetrating keratoplasty. Material and Methods: A total of 24 eyes of 24 patients who had undergone penetrating keratoplasty were included in the study. This study was performed retrospectively by reviewing the charts of the patients. Postoperative 1st week, 1st month, 3rd month, 6th month and 12th month mean total macular volume, central macular thickness, parafoveal area and perifoveal area thickness and retinal nevre fiber layer (RNFL) thickness results obtained with optic coherence tomography were compared. ANOVA test was used for statistical analysis. Results: The postoperative 1st week, 1st month, 3rd month, 6th month and 12th month mean total macular volume measurements were 7.03±0.2 mm³, 7.05±0.4 mm³, 7.0±0.6 mm³, 7.02±0.5 mm³ and 6.12±0.6 mm³, respectively. Mean central macular thickness measurements were 227.6±4.6 μm, 228.7±5.5 μm, 227.2±4.6 μm, 227.5±7.1 μm, 226.3±5.1μm respectively; mean parafoveal area thickness measurements were 290.2±3.7 μm, 289.9±7.8 μm, 288.7±6.3 μm, 288.8±4.7 μm, 288.6±8.3 μm respectively, mean perifoveal area thickness measurements were 261.1±4.2 μm, 261.4±1.9 μm, 260.4±3.6 μm, 259.8±2.7 μm, 259.3±4.7 μm respectively, and mean RNFL thickness measurements were 106.54±11.28 μm, 107.28±8.75 μm, 107.45±13.64 μm, 105.62±9.27 μm, 105.16±12.74 μm; respectively. Conclusion: No significant change was seen in macular thickness after penetrating keratoplasty. Although the macular thickness increases in the early postoperative stage, it decreases in time.

Evaluation of Anterior Segment's Structures in Tilted Disc Syndrome

Purpose. To evaluate anterior segments structures by Pentacam in patients with tilted disc syndrome (TDS). Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups. Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (p = 0.625, p = 0.830, p = 0.234, and p = 0.850). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (p = 0.001, p = 0.0001, p = 0.003, and p = 0.001). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (p = 0.130, p = 0.910, and p = 0.057). Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc.

Corneal structure in tilted disc syndrome

Purpose: To evaluate the central corneal thickness (CCT), corneal volume (CV), and anterior and posterior corneal surfaces using the Scheimpflug imaging system in patients diagnosed with tilted disc syndrome (TDS). Methods: The study group (Group 1) and the control group (Group 2) comprised 35 eyes of 35 age-, sex-, and refraction-matched cases. All cases underwent a full ophthalmic examination that included cycloplegic refraction, axial ocular length measurement, and Scheimpflug imaging. Results: The mean age was 34.68 ± 15.48 years in Group 1 and 34.11 ± 12.01 years in Group 2 (p=0.864). The gender distribution was 18 males and 17 females in Group 1 and 16 males and 19 females in Group 2 (p=0.618). All subjects were Caucasian. The spherical equivalent was 3.62 ± 1.75 D in Group 1 and 3.69 ± 1.51 D in Group 2 (p=0.850). There was no significant difference in age, sex, race, or spherical equivalent between groups. There was no significant difference in mean keratometric value and CV3 (the CV in the central 3 mm) between groups (p=0.232 and 0.172, respectively). There were statistically significant differences in CCT, CV5, and CV7 (CV in the central 5 and 7 mm3, respectively) and total CV between groups (p=0.008, 0.003, 0.023, and 0.019, respectively). The values of all parameters were lower in the study group than in the control group. There was also a statistically significant difference in the anterior elevation parameters of the cornea between groups (p<0.05). The mean values of Group 1 were higher than those of Group 2. There were statistically significant differences in the two parameters referring to the posterior elevation of the cornea between the two groups (p<0.05). Conclusion: The results of this study showed that eyes with TDS have thinner CCT, lower CV, and different anterior corneal curvature than normal eyes.