Umut Asli Dinc

Anterior segment optical coherence tomography measurement of anterior chamber depth and angle changes after phacoemulsification and intraocular lens implantation.

PURPOSE: To use anterior segment optical coherence tomography (AS‐OCT) to evaluate anterior chamber depth (ACD) and angle after phacoemulsification and intraocular lens (IOL) implantation. SETTING: Department of Ophthalmology, Yeditepe University, Istanbul, Turkey. METHODS: Forty‐seven eyes (37 patients) had uneventful phacoemulsification and IOL implantation through a clear corneal incision. Anterior segment OCT was performed preoperatively and 1 week and 1 month postoperatively. The angle‐referenced (ACD1), pupil‐referenced (ACD2), and lens‐referenced (ACD3) ACDs, crystalline lens rise (CLR), pseudophakic posterior chamber depth (PPCD), and nasal and temporal iridocorneal angles were measured. Statistical analysis was by a 1‐way analysis of variance and Pearson correlation analysis. RESULTS: The mean age of patients was 70 years ± 10.17 (SD). The mean ACD1 (mean increase) was 3.06 ± 0.25 mm preoperatively, 3.16 ± 0.22 mm at 1 week (0.1 mm), and 3.16 ± 0.19 mm at 1 month (0.1 mm); the mean ACD2, 2.76 ± 0.47 mm preoperatively, 3.62 ± 0.24 mm at 1 week (0.86 mm), and 3.63 ± 0.20 mm (0.87 mm) at 1 month; and the mean ACD3, 2.54 ± 0.46 mm preoperatively, 3.97 ± 0.28 mm at 1 week (1.43 mm), and 3.91 ± 0.25 mm at 1 month (1.37 mm). The mean CLR was 0.497 ± 0.363 mm and the mean PPCD, 0.322 ± 0.150 mm. The increase in nasal and temporal iridocorneal angles was statistically significant at both postoperative examinations (P<.01). CONCLUSION: Deepening of the anterior chamber and widening of the nasal and temporal angles after cataract extraction was shown on AS‐OCT.

Alterations in ocular surface and corneal thickness in relation to metabolic control in patients with chronic renal failure

Aim:  Ocular surface changes and ocular symptoms may be encountered in patients with chronic renal failure (CRF) undergoing haemodialysis. The ocular surface changes and its relationship with metabolic control in CRF patients were aimed to be emphasized in this study.

Assessment of Anterior Chamber Depth Using Visante Optical Coherence Tomography, Slitlamp Optical Coherence Tomography, IOL Master, Pentacam and Orbscan IIz

Aims: To assess and compare the anterior chamber depth (ACD) by different anterior segment imaging techniques. Methods: Eighty healthy eyes of 40 patients were recruited, and 3 consecutive measurements of ACD were determined prospectively utilizing Visante optical coherence tomography (OCT), slitlamp (SL) OCT, IOL Master, Pentacam and Orbscan IIz. The statistical significance of interdevice differences between measurements was evaluated by one-way ANOVA and Bland-Altman analysis. The repeatability of 3 consecutive measurements was analyzed by repeated-measures ANOVA. Results: The mean ACD was 2.98 ± 0.29, 2.85 ± 0.29, 3.33 ± 0.42, 2.93 ± 0.30 and 2.80 ± 0.29 mm with Visante OCT, SL-OCT, IOL Master, Pentacam and Orbscan IIz, respectively. All devices displayed a high intrasession repeatability (repeated-measures ANOVA, p > 0.05). ACD measurements obtained by the IOL Master were significantly greater compared to other devices. ACD values detected by Visante OCT and SL-OCT, Pentacam and Orbscan IIz were not clinically interchangeable, even though no statistically significant difference was detected. Conclusion: Although noncontact ACD measurements using all modalities were easy to handle and demonstrated good repeatability, the tested devices were not regarded as compatible. Hence, the clinician should take the different modalities into consideration during ACD assessment using various devices.

Fundus autofluorescence in acute and chronic central serous chorioretinopathy

Background:  A prospective evaluation of the pattern of fundus autofluorescence in cases of acute versus chronic central serous chorioretinopathy (CSR).

Assessment of macular function by microperimetry in intermediate age-related macular degeneration

Purpose To evaluate retrospectively macular function by microperimetry (MP) in intermediate age-related macular degeneration (AMD). Methods Thirty eyes of 30 patients with intermediate AMD and a visual acuity of 20/32 or better were enrolled in the study. Macular function in patients with intermediate AMD and age-matched control group were carried out with MP1 microperimeter. Mean sensitivity (MS), mean defect (MD) parameters, fixation patterns, and localizations were evaluated. Mann-Whitney U test was used for the comparison of macular function parameters between the intermediate AMD group and the control group. Results MS was 12.7±2.8 dB and MD was detected as −6.2±2.2 dB in the intermediate AMD group by MP. Fixation patterns were stable in 22 eyes, relatively unstable in 7 eyes, and unstable in 1 eye. Fixation location was predominantly central in 19 eyes, poor central in 5 eyes, and predominantly eccentric in 6 eyes. In the control group MS was 18.0±0.6 dB and MD was −1.9±0.6 dB. When compared with control group, the decrease in MS and the increase in MD were statistically significant in the intermediate AMD group (p=0.001 and p=0.001, respectively). Conclusions Assessment of retinal sensitivity with MP1 microperimeter is a rapid, safe and noninvasive diagnostic method. Early macular function loss in intermediate AMD can be precisely detected by MP1 microperimeter before significant visual impairment is established and it is also useful for demonstrating the shift in the localization and the stability of fixation prior to progression of intermediate AMD to advanced and exudative stage.

Atypical Presentation of Multiple Evanescent White Dot Syndrome (MEWDS)

Purpose: To present fundus autofluorescence (FAF), indocyanine green angiography (ICGA), and microperimetry (MP) findings of a patient with multiple evanescent white dot syndrome (MEWDS). Methods: Observational case report. Results: A 30-year-old woman with blurry vision was referred for evaluation. Fundus examination revealed only foveal granularity. FAF showed hyperautofluorescent spots, although they were not visible clinically. On ICGA, matching areas were hypofluorescent. Microperimetry revealed mean sensitivity decrease. The resolution of the symptoms was followed by disappearance of these spots in FAF and ICGA and increase of mean macular sensitivity in MP. Conclusion: FAF is a noninvasive imaging technique that might help in the differential diagnosis of chorioretinal pathologies.

Short-term effects of a single intravitreal bevacizumab injection on retinal vessel calibre

Purpose:  The aim was to investigate the short‐term effects of a single intravitreal bevacizumab injection on the retinal vessel calibre in patients with neovascular age‐related macular degeneration and in patients with diabetic macular oedema.

Anterior Segment Optical Coherence Tomography Findings of Acute Hydrops in a Patient with Keratoconus

The authors describe the anterior segment optical coherence tomography (AS-OCT) findings of a 25-year-old patient with acute hydrops associated with keratoconus. The patient presented with decreased visual acuity, pain, and redness in the left eye. The symptoms, clinical presentation, and topographical findings of the right eye confirmed this condition to be acute corneal hydrops. The patient was closely followed up with hyper-osmotic (NaCl 5%) and nonsteroidal anti-inflammatory (ketorolac tromethamine 0.5%) topical treatment. At the initial examination and during follow-up, the evaluation of the anterior segment was performed using optical coherence tomography. Changes in the stroma and Descemets membrane during the healing process of acute hydrops could be demonstrated by high-resolution AS-OCT.

Assessment and comparison of anterior chamber dimensions using various imaging techniques.

BACKGROUND AND OBJECTIVE To assess and compare the horizontal dimensions of the anterior chamber by different anterior segment imaging techniques. PATIENTS AND METHODS Eighty eyes of 40 patients without any ocular disease or previous ocular surgery were recruited and three consecutive measurements of internal anterior chamber diameter and white-to-white distance (WTW) parameters were determined. RESULTS Mean internal anterior chamber diameter was 11.80 +/- 0.39, 11.56 +/- 0.47, and 11.61 +/- 0.58 mm with Visante-OCT, SL-OCT, and Pentacam, respectively. Mean WTW distance was 11.87 +/- 0.35 and 11.65 +/- 0.32 mm by IOLMaster and OrbscanIIz, respectively. There was no significant difference between Visante-OCT and Pentacam, IOLMaster, and OrbscanIIz (P = .125, .918, and .314). However, detection of mean internal anterior chamber diameter was significantly greater by Visante-OCT than SL-OCT (P = .026). All devices displayed a high intrasession repeatability (repeated measured ANOVA, P > .05). CONCLUSION Internal anterior chamber diameter measurements using Visante-OCT, SL-OCT, and Pentacam, and WTW measurements using IOLMaster and OrbscanIIz were easy to handle and demonstrated good repeatability. Although similar results of horizontal anterior chamber diameter were determined by Visante-OCT, Pentacam, IOLMaster, and OrbscanIIz, the inter-device differences should be considered during clinical practice.

Comparison of IOP measurement by ocular response analyzer, dynamic contour, Goldmann applanation, and noncontact tonometry

Purpose To assess the agreement among ocular response analyzer (ORA), dynamic contour tonometry (DCT), Goldmann applanation tonometry (GAT), and noncontact tonometry (NCT), and to determine the effects of central corneal thickness (CCT) and corneal hysteresis (CH) on intraocular pressure (IOP) measurements with these devices. Methods Sixty healthy volunteers were recruited. The average of ORA (corneal compensated IOP [IOP-ORAcc] and Goldmann-correlated IOP [IOP-ORAg]), DCT, GAT, and NCT levels were compared and the devices were examined with respect to CCT and CH. One-way analysis of variance and Pearson correlation tests were used for statistical analysis. Results Mean CCT was 543.28±36.2 μm and mean CH was 10.87±1.27 mmHg. Mean IOP obtained using DCT was 16.4±2.9 mmHg, whereas those provided by ORA were 15.8±2.9 mmHg for IOP-ORAcc and 15.1±2.8 mmHg for IOP-ORAg. The mean IOPs obtained using GAT and NCT were 14.8±3.1 mmHg and 14.7±2.8 mmHg. The differences between the measurements of DCT and GAT, NCT, and IOP-ORAg were statistically significant (p=0.002, p=0.002, and p=0.015, respectively), but not between DCT and IOP-ORAcc (p=0.263). We did not detect a significant correlation between DCT and CCT, and IOP-ORAcc and CCT (p=0.081 and p=0.093). No correlation was observed between IOP-ORAg and CCT (p=0.067). We found a significant correlation between GAT and CCT, and NCT and CCT (p=0.004 and p=0.001). CH was detected to be correlated only to IOP-ORAcc (p=0.017). Conclusions IOP readings detected by DCT and IOP-ORAcc were not found to be clinically interchangeable with GAT and NCT readings. IOP-ORAcc and DCT readings may be regarded as comparable and independent of CCT, in the range of the normal IOP.