Serdar Aktas

Evaluation of the Choroid, Fovea, and Retinal Nerve Fiber Layer in Patients with Rheumatoid Arthritis

ABSTRACT Purpose: To evaluate the effect of rheumatoid arthritis (RA) on choroid, retinal nerve fiber layer (RNFL), and foveal thickness using spectral domain optical coherence tomography (OCT). Methods: Fifty patients with RA and forty-one healthy volunteers were enrolled in this study. The subfoveal, perifoveal choroidal, RNFL, and foveal thicknesses were measured by spectral domain OCT. Results: The mean subfoveal, nasal, and temporal choroidal thicknesses in RA individuals were significantly higher than those in the control group (p ˂ 0.05). However, there was no significant difference between the RA and healthy group regarding RNFL and foveal thickness (p ˃ 0.05). A significant correlation was found between rheumatoid factor (RF) and the subfoveal temporal choroidal thickness. Conclusion: Choroidal thickness in RA patients was higher than that in healthy participants. Choroidal thickening showed a positive correlation with RF, which may be an indicator for systemic vasculitis.

Tear function in patients with chronic renal failure undergoing hemodialysis.

Abstract Objectives: To evaluate dry eye symptoms and clinical tear film alterations in patients with chronic renal failure (CRF). Materials and methods: Thirty-five non-diabetic CRF patients undergoing hemodialysis, and 31 healthy individuals were enrolled. An ocular surface disease index questionnaire (OSDI) was administered, and after a complete ocular examination, Schirmer and tear break-up time (TBUT) tests were performed. Results: OSDI scores were significantly higher (p < 0.01) and TBUT tests were significantly lower (p = 0.01) in CRF patients than in the control group. Schirmer test results were also lower in the CRF patients group, but lacked statistical significance (p = 0.20). Conclusion: Patients with CRF should be advised to obtain an ophthalmic examination, especially for dry eye.

Mean Platelet Volume is Associated with Diabetic Macular Edema in Patients with Type-2 Diabetes Mellitus

ABSTRACT Aim: To evaluate the effect of the platelet indices on the stage of diabetic retinopathy (DR) and diabetic macular edema (DME). Methods: In this retrospective study, the mean platelet valume (MPV), Plateletcrit (PCT), platelet (PLT), and platelet distribution width (PDW) of 199 diabetic patients and 76 healthy subjects were enrolled. The participants were divided into four groups. The first group was healthy control; the second group consisted of diabetic patients without DR; the third group was nonproliferative DR (NPDR); and the fourth group was proliferative DR (PDR). Results: Significant differences were found only in MPV and PCT values between patients with diabetes and healthy participants (8.6±0.96 fL vs 8.32±0.9 fL, P=0.011, 0.216± 0.58 vs 0.202±0.52, P=0.038). Comparing the groups, a statistically significant difference in MPV values was found between groups 4 and 1 (8.91±.7 fL vs 8.32±0.9 fL P=0.001) and between groups 4 and 3 (8.91±.7 fL vs 8.42±0.9 fL P=0.014). The MPV values of patients with DME were significantly higher than those of diabetic patients without DME (8.87±0.80 fL vs 8.45±0.97 fL). Conclusion: High MPV values may be an important risk factor for the development of PDR and DME in patients with diabetic retinopathy.

Thiol Disulfide Homeostasis in Pseudoexfoliation Syndrome

ABSTRACT Purpose: To determine the serum thiol disulfide homeostasis in patients with pseudoexfoliation (PEX) syndrome. Method: Thirty-five patients with PEX syndrome and forty healthy subjects were included in this observational case-control study. Serum native thiol, total thiol, disulfide, and native thiol/disulfide ratio were determined using a novel and automated assay. Results: The mean serum total thiol and native thiol levels were significantly lower in patients with PEX syndrome compared to healthy controls (p = 0.001). The mean serum disulfide level was significantly higher in patients with PEX syndrome compared to healthy controls (p = 0.023). The serum native thiol/disulfide ratio was lower in patients with PEX syndrome compared to healthy subjects (16 ± 10.1 vs 22.3 ± 11.5, respectively, p = 0.014). Conclusion: Our findings provide evidence that the dynamic native thiol/disulfide ratio is lower in PEX syndrome, which shows a reduction in the natural cell reductive capacity reservoir.

Assessment of Anterior Suspended Flaps Modification for External Dacryocystorhinostomy

Aim:The aim of this study was to evaluate the functional and/or anatomic success rate as well as complications of anterior suspended flaps modification for external dacryocystorhinostomy (DCR). Methods:This is a retrospective study that included 50 eyes of 47 patients who underwent anterior suspended flap external DCR surgery for nasolacrimal duct obstruction. Diagnosis of nasolacrimal duct obstruction was made through irrigation of the nasolacrimal drainage system. Anterior flaps of lacrimal sac and nasal mucosa, as large as possible, were created in all patients. Posterior flaps of lacrimal sac and exposed nasal mucosa were excised. After suturing the anterior flaps with two 6-0 Vicryl sutures, the third suture was passed through the orbicularis oculi at the subcutaneous level on 1 edge of incision, then from the middle of the anterior flaps and the other edge of the incision to the suspended anterior flaps. Results:The success rate of 50 surgeries was 96%. In 37 eyes, no problems were reported during the surgery and the modified external DCR was performed successfully. The success rate of the modified external DCR was 100% in those patients. The average operation time was 34 ± 8.2 minutes. Conclusions:These results suggest that anterior suspended flap external DCR is a simple, safe technique with a very high success rate and a satisfactory surgical time.

Unilateral hemorrhagic macular infarction associated with marijuana, alcohol and antiepileptic drug intake.

Abstract A 55-year-old male presented with a complaint of a painless and sudden loss of vision in the right eye. Fundus photography revealed loss of transparency and edema in the central macular region. Optical coherence tomography showed increased reflectivity and diffused swelling in the inner retinal layers. Fluorescein angiography revealed a large area of capillary non-perfusion with a pronounced hypofluorescent area with distinct borders. To our knowledge, this is the first report of a hemorrhagic macular infarction associated with marijuana and pregabalin misuse.

Refractive Results Using a New Optical Biometry Device: Comparison With Ultrasound Biometry Data

AbstractThe aim of the study was to compare the measurements of optical (AL-Scan; Nidek Co., Ltd.) and ultrasonic (Echo Scan US-800; Nidek Co., Ltd.) biometry devices and to assess refractive results after cataract surgery.Eighty-one cataractous eyes of 81 patients were included in this study. Biometry was performed using the AL-Scan and an ultrasonic biometer (USB). Axial length (AL), keratometry (K) data, and intraocular lens (IOL) power calculations using the SRK/T formula were compared. Bland–Altman analysis was used to assess the extent of agreement between AL-Scan and USB data in terms of AL measurement and IOL power calculation. The K measurements of the AL-Scan were compared to autorefractor data (Canon Autorefractor RK-F1).The AL-Scan assessed the AL as longer (average difference 0.06 ± 0.18 mm; ICC = 0.987; P < 0.001) and the IOL power as greater (average difference 0.19 ± 0.66 D; ICC = 0.964; P < 0.001) than the USB. The AL-Scan also measured average K values (average difference 0.25 ± 0.25 D; ICC = 0.985; P < 0.001) greater than those given by the autorefractor. The postoperative mean absolute error was +0.30 ± 0.04 D (minimum: −0.51 D, maximum +1.04 D). The postoperative mean K value change was 0.36 ± 0.29 D (P < 0.05).The differences between measurements afforded by the AL-Scan and USB may be clinically acceptable. Keratometric changes that develop after cataract operations compromise the attainment of good refractive outcomes.

Retrospective analysis of the effect of aflibercept loading dose on the retinal vessel diameters in patients with treatment-naive neovascular AMD*

Abstract Background: To evaluate the effects of intravitreal aflibercept (IVA) on retinal vessel diameters in patients with neovascular age-related macular degeneration (AMD). Design, setting, and participants: A retrospective study conducted at the Kutahya Dumlupinar University Faculty of Medicine included 15 eyes of 15 patients with treatment naive neovascular AMD. Methods: All eyes received IVA injections once per month for 3 months; untreated contralateral eyes were used as controls. The central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery-vein ratio (AVR) values were measured using a computer-based program before the first IVA injection and 30 days after the first, second, and third injections. The main outcome measurements were the central macular thickness (CMT), best-corrected visual acuity (BCVA), choroidal thickness, CRAE, CRVE, and AVR. Results: Significant vasoconstriction of the retinal arterioles was observed in all eyes treated with IVA when compared to baseline (p = 0.009). However, no significant differences were found for CRVE or AVR throughout the study period in treated eyes. In the control group, all parameters measured during each visit were similar to baseline measurements (p > 0.05). The mean BCVA significantly improved at the end of the loading dose of IVA, when compared to baseline (p = 0.006). After the IVA injections, the mean CMT and choroidal thickness were significantly reduced at all visits, compared to baseline (p < 0.001). Conclusions: The current study showed that IVA led to significant retinal arteriolar vasoconstriction and choroidal thinning, which may cause reduced retinal blood flow.

Regarding Comments by Kaya et al. on “Evaluation of the Choroid, Fovea and Retinal Nerve Fiber Layer in Patients with Rheumatoid Arthritis”

We thank Kaya et al.1 for their interest and contribution in our recent article2 about the choroid, fovea, and retinal nerve fiber layer in patients with rheumatoid arthritis (RA).The choroid is a ...

Impact of Smoking on the Ocular Surface, Tear Function, and Tear Osmolarity

ABSTRACT Purpose: This study evaluated the effects of cigarette smoking on the ocular surface, tear function, and tear osmolarity. Materials and Methods: A total of 50 smokers with at least 5 years of heavy smoking (defined as 1 pack/day) and 51 nonsmoking, healthy individuals were enrolled. Tear osmolarity was measured with an osmometer (TearLab™ Osmolarity System). Ocular surface examinations involved corneal fluorescein staining, measurement of the tear film breakup time (TBUT), the Schirmer 1 test, measurement of corneal sensitivity with a Cochet–Bonnet esthesiometer, and conjunctival impression cytology. Dry eye symptoms were scored using the Ocular Surface Disease Index (OSDI) questionnaire. The results were compared with those from an age and sex-matched control group. The Chi-squared and independent sample t-tests were used for statistical analyses. Results: The smokers had significantly higher tear osmolarity values (305.38 ± 9.81 vs. 301.14 ± 7.04 mOsm/L; p = 0.014) and OSDI scores (34.13 ± 16.58 vs. 18.09 ± 9.61; p < 0.001) than the healthy controls. However, the TBUT, corneal sensitivity, and goblet cell density were significantly lower in smokers compared to healthy controls, but the fluorescein staining and Schirmer 1 test results were not statistically different between the smokers and controls. Conclusion: Smoking results in increased osmolarity of the tear film, which can damage the ocular surface and tear function.