Veysi Öner

Effect of refractive status on peripapillary retinal nerve fibre layer thickness: a study by RTVue spectral domain optical coherence tomography

Aim To evaluate the influence of axial length on retinal nerve fibre layer (RNFL) thickness in myopic, hyperopic and emmetropic eyes by spectral domain optical coherence tomography (OCT). Methods Subjects were divided into three groups: myopic (n=35), emmetropic (n=30) and hyperopic eyes (n=33). RNFL thickness was obtained from all octametric section parameters by RTVue OCT. Axial length and spherical equivalent values were determined for all patients. Results RNFL thickness values, except for lower and upper nasal sectors, were thinner in the myopic eyes than in the hyperopic eyes. Average RNFL thickness and the RNFL thicknesses of the superotemporal, superonasal, inferotemporal and lower temporal sectors were significantly different between the myopic and emmetropic eyes, and average RNFL thickness and the RNFL thicknesses of the upper temporal and inferonasal sectors were significantly different between the hyperopic and emmetropic eyes. The average peripapillary RNFL thickness had a negative correlation with axial length (r=−0.741, p<0.001). However, after correction of the magnification effect, the significant differences disappeared. Conclusions We have shown that axial length/refractive status affected the peripapillary RNFL thickness profile measured by RTVue OCT. To make a correct diagnosis for glaucoma, either the axial length-induced magnification effect should corrected by ophthalmologists or the RTVue OCT database should be improved by taking axial length into account.

Evaluation of Corneal Biomechanical Properties in Patients with Rheumatoid Arthritis: A Study by Ocular Response Analyzer

Abstract Purpose: To compare the corneal biomechanical properties of rheumatoid arthritis (RA) patients with those of healthy controls. Methods: Measurements of 39 eyes of 39 RA patients (patient group) were compared with those of 55 eyes of 55 healthy controls (control group). Corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (IOP), and corneal-compensated IOP (IOPcc) were obtained for each subject by the ocular response analyzer (ORA). Corneal thickness (CCT) was measured by ultrasonic pachymeter. Results: CH and CRF were significantly lower in the patient group than in the control group (p1 = 0.002, p2 = 0.019, respectively). The patient group had significantly higher IOPcc values than the control group (p = 0.024). There was no significant differences between the groups concerning CCT and IOP. Conclusions: RA patients had lower CH and CRF, but higher IOPcc values than healthy controls. RA should be considered when the corneal biomechanical properties measured by the ORA are used for diagnoses or therapies.

Anastomosis of both posterior and anterior flaps or only anterior flaps in external dacryocystorhinostomy.

Purpose: To evaluate the outcomes of external dacryocystorhinostomy (DCR) by using two different patterns of flap anastomosis; one only with anterior flap anastomosis and the other with both anterior and posterior flap anastomosis. Methods: One hundred and sixty-four patients were enrolled in the study. Patients were then randomly divided into two groups as follows: those who underwent DCR with both anterior and posterior flap anastomosis (Group 1) and those who underwent DCR with only anterior flap anastomosis (Group 2). Surgical success was defined as patient satisfaction, disappearance of epiphora and lacrimal patency up to 12 months after surgery. Results: After 12 months, the DCR with both anterior and posterior flap anastomosis had a success rate of 89.8% (71/79), while the DCR with only anterior flap anastomosis had a success rate of 89.4% (76/85). There was no statistically significant difference between the two groups (p < 0.05). Conclusion: Anastomosis of posterior flaps does not seem to affect success rate of external DCR. Creating only the anterior anastomosis is technically simpler and does not seem to negatively influence the outcome of DCR surgery.

Influence of Axial Length on Peripapillary Retinal Nerve Fiber Layer Thickness in Children: A Study by RTVue Spectral-Domain Optical Coherence Tomography

Abstract Purpose: To evaluate the influence of axial length on peripapillary retinal nerve fiber layer (RNFL) thickness in myopic, hyperopic and emmetropic children eyes by RTVue optical coherence tomography (OCT). Methods: One hundred twenty eyes of 120 children including 40 myopic, 40 emmetropic and 40 hyperopic eyes were enrolled in the study. Peripapillary RNFL thickness measurements were performed using spectral-domain RTVue OCT (Optovue, Fremont, CA). RNFL thickness parameters were obtained from all octametric sections: upper temporal (TU), superotemporal (ST), superonasal (SN), upper nasal (NU), lower nasal (NL), inferonasal (IN), inferotemporal (IT) and lower temporal (TL). Spherical equivalent refractive error was determined via cycloplegic auto-refraction (Topcon, Tokyo, Japan). The axial length was measured using IOLMaster (Carl Zeiss MEDITEC). Littmann formula was used for correction of axial length-related ocular magnification effect. Results: Peripapillary RNFL thicknesses were significantly different among the three groups in all sectors except for NU and IT sectors. RNFL thicknesses in all sectors except for TU and TL sectors had significant negative correlations with axial length. However, these differences (excluding TU and TL sectors) and correlations disappeared after correction of magnification effect. Conclusion: In conclusion, axial length influences peripapillary RNFL thickness as measured by RTVue OCT. However, this appears to be due to the ocular magnification effects associated with axial length and can be corrected for with the application of the Littman formula.

Intravitreal Dexamethasone Implant for Treatment of Refractory Behçet Posterior Uveitis: One-year Follow-up Results.

ABSTRACT Purpose: To investigate the results of dexamethasone (DEX) implant in the treatment of eyes with refractory Behçet posterior uveitis. Methods: A total of 17 eyes of 12 patients with active Behçet posterior uveitis were enrolled in the study. A single intravitreal injection of DEX implant was applied to each eye. Best corrected visual acuity (BCVA), central macular thickness (CMT), vitreous haze score, and intraocular pressure (IOP) were determined, at baseline and control visits of months 1, 3, 6, and 12. Results: The mean BCVA was significantly increased from baseline at each control visit (all p < 0.05). The mean CMT and vitreous haze score were significantly decreased from baseline at each control visit (all p < 0.05). Three eyes showed IOP spikes requiring topical anti-glaucomatous treatment. Conclusions: A single injection of DEX implant was safe and effective, as an additional treatment to systemic immunomodulatory drugs, in the treatment of refractory Behçet posterior uveitis, for a 6-month period.

Systemic arterial stiffness in patients with pseudoexfoliation glaucoma.

Aim:To evaluate carotid-femoral pulse wave velocity (CF-PWV) values of patients with pseudoexfoliation (PEX) glaucoma in comparison with healthy subjects. Methods:Twenty-five consecutive patients with PEX glaucoma (PEXG group) and 25 controls (control group) were included in the study. CF-PWV was assessed by a noninvasive device by the measurements of pulse transmit time and the distance between 2 recording sites. Results:The mean age was 64.7±7.3 (range, 55 to 79) years the in PEXG group and 63.8±6.6 (range, 51 to 77) years in the control group. There were 8 men (32%) and 17 women (68%) in the PEXG group and 11 men (44%) and 14 women (56%) in the control group. The CF-PWV of the PEX group was significantly higher than that of the control group (P<0.001). Conclusions:We have revealed an association between PEXG and increased CF-PWV. Also, increased CF-PWV may be considered as a risk factor for the development of PEXG.

Effect of axial length on retinal nerve fiber layer thickness in children.

Purpose: To investigate the effect of axial length on peripapillary retinal nerve fiber layer (RNFL) thickness in myopic, hyperopic, and emmetropic eyes in children by Cirrus HD spectral-domain optical coherence tomography (OCT). Methods: Subjects were divided into 3 groups according to their refractive status: myopic (n = 36), emmetropic (n = 30), and hyperopic (n = 28) eyes. The RNFL thickness measurements were taken from the superior, inferior, nasal, and temporal quadrants in the peripapillary region by Cirrus HD OCT. Axial length was also determined for each patient. Results: The myopic eyes had thinner average RNFL and RNFLs of temporal, superior, nasal, and inferior quadrants than the hyperopic eyes (p1<0.001, p2 = 0.004, p3 = 0.011, p4 = 0.006, p5 = 0.033, respectively). In addition, average peripapillary RNFL thickness and RNFL thicknesses of all quadrants had significant negative correlations with axial length. On the other hand, after applying modified Littmann formula for correction of magnification effect, the differences among the 3 groups disappeared (all p>0.05). Conclusions: We have shown that axial length and accordingly refractive status influenced peripapillary RNFL thickness measurements by Cirrus HD OCT in children. Therefore, to make a correct diagnosis of glaucoma or other optic neuropathies in children, either axial length—induced magnification effect should be corrected by ophthalmologists or the current Cirrus HD OCT database should be revised taking axial length into consideration.

Effect of Pterygium Surgery on Tear Osmolarity

Purpose. To investigate changes of dry eye test results in patients who underwent pterygium surgery. Methods. Seventy-four patients who underwent primary pterygium surgery were enrolled in this study. At the baseline, 3-, 12-, and 18-month visits, measurements of tear osmolarity, BUT, and Schirmer test were performed. The patients were divided into 2 groups: Group 1, which consisted of patients in whom pterygium did not recur, and Group 2, which consisted of patients in whom pterygium recurred after surgery. Results. The patients in Group 1 had lower tear osmolarity levels after surgery than those at baseline (all P < 0.001). In Group 2 the tear osmolarity levels did not differ from baseline after 18 months (P = 0.057). The prevalence rates of dry eye syndrome (DES) were lower than that at baseline and 18 months after surgery in Group 1 (P = 0.002). In Group 2, the incidence of DES was lower after 3 months than at baseline (P = 0.03) but was similar to the baseline rate after 12 and 18 months (both P > 0.05). Conclusions. Anormal tear film function associated with pterygium. Pterygium excision improved tear osmolarity and tear film function. However, tear osmolarity deteriorated again with the recurrence of pterygium.

Influence of Pterygium on Corneal Biomechanical Properties

ABSTRACT Purpose: To evaluate the influence of pterygium on corneal biomechanical properties as measured by the ocular response analyzer (ORA). Methods: ORA measurements of 48 eyes with primary nasal pterygium were compared with those of healthy fellow eyes. The mean age of the patients was 46.6 ± 18.9 years. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) were obtained for each subject by using the ORA (Reichert Ophthalmic Instruments, Depew, NY). Results: CH and CRF were significantly lower in the eyes with pterygium than in the healthy fellow eyes (p1 = 0.011, p2 = 0.014, respectively). On the other hand, there were no significant differences between the eyes with pterygium and healthy fellow eyes concerning IOPg and IOPcc (p1 = 0.948, p2 = 0.129, respectively). Conclusions: The present study showed that biomechanical properties measured by ORA were affected by pterygium. The eyes with primary nasal pterygium had lower CH and CRF than healthy fellow eyes. Therefore, the effect of pterygium should be taken into account in order to make correct diagnoses by ORA.

Follow up of retinal nerve fiber layer thickness with optic coherence tomography in patients receiving anti-tubercular treatment may reveal early optic neuropathy

Abstract Purpose: To evaluate the effect of anti-tubercular treatment on retinal nerve fiber layer (RNFL) thickness and the efficiency of optic coherence tomography (OCT) on early diagnosis of optic neuropathy. Methods: Twenty patients diagnosed with either pulmonary or extra-pulmonary tuberculosis which were treated with anti-tubercular treatment (isoniazid (INH), rifampicin, ethambutol (ETM), and pyrazinamide) were enrolled in the study. RNFL thicknesses of the patients were measured via OCT, at baseline (before starting anti-tubercular treatment) and after the two-month treatment period. Standard ophthalmologic examinations were also performed. Results: Compared to baseline values, after the two-month treatment period, thinning was detected in the right eye’s average and superior quadrant RNFLs (p = 0.024 and p = 0.006 respectively) and in the left eye’s average, superior quadrant, and inferior quadrant RNFLs (p = 0.001, p = 0.008, p < 0.001, respectively). Conclusion: We displayed that patients receiving INH and ETM, which were the basic medicines of anti-tubercular treatment, experienced thinning in RNFL after the two-month treatment period. Patients receiving these drugs can be followed via OCT in terms of reduction in RNFL thicknesses for early diagnose of INH and ETM toxicity.