The patients with IDA had significantly thinner choroidal thicknesses than those of the healthy children. Choroidal thinning in childhood may be an early sign of deterioration in the ocular blood circulation, without any risk of atherosclerosis in advanced age in the patients with IDA.

SIGNIFICANCE We determined decreases in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in all quadrants. Our findings show that the choroid and RNFL are affected before the emergence of ocular symptoms in malnourished children. PURPOSE We aimed to determine whether the RNFL, a component of the neuronal structure, and the choroid, supplying the retina, are affected in children with malnutrition using spectral-domain optical coherence tomography. METHODS One hundred twenty-six malnourished patients without ocular symptoms, aged between 5 and 10 years, and 116 healthy children were included in the study. Age, sex, weight-for-age (WFA) z score, height-for-age z score, body mass index–for–age z score, and spectral-domain optical coherence tomography data were recorded. RESULTS Average RNFL thickness was 96.5 μm (82.0 to 128.0 μm) in the malnutrition group and 111.0 μm (95.0 to 128.0 μm) in the control group (P < .001). Retinal nerve fiber layer thickness was statistically significantly lower in all quadrants in malnourished patients compared with the control group. Median choroidal thickness in the foveal center was 304.0 μm (250.0 to 375.0 μm) in the malnutrition group and 345.0 μm (280.0 to 403.0 μm) in the control group (P < .001). Choroidal thickness in all quadrants was also statistically significantly lower in malnourished patients. Positive correlation was determined between average RNFL thicknesses and WFA z score. Average RNFL thickness decreased as WFA z score decreased (r = 0.730 and P < .001). Positive correlation was also observed between choroidal thickness in the foveal center and WFA z score. Foveal center choroidal thickness decreased in line with WFA z score (r = 0.786 and P < .001). CONCLUSIONS Our results show that the retinal nerve fiber layer and choroidal thickness decreased in malnourished children without clinically reported ocular symptoms. A decreased retinal nerve fiber layer and choroidal thickness may be an important clue to the prevention of retinal pathologies that may develop at later ages if the malnutrition is not addressed.

B eta talasemi majör, en sık görülen genetik kökenli hematolojik hastalıklardan biridir. 1 Ülkemizde taşıyıcı sıklığının ülke genelinde %2-2,5 arasında olduğu, ancak bazı bölgelerde %10'lara ulaştığı bil

Objective To conduct an evaluation of the effects of irregular astigmatism on the retinal nerve fiber layer (RNFL) and the retinal layers observed using spectral-domain optical coherence tomography (SD-OCT) in patients who had keratoconus (KC). Materials and Methods A total of 255 eyes from 255 individuals, comprising 72 eyes of KC patients, 70 eyes of patients with astigmia, and 113 eyes of healthy controls were included in the analysis. RNFL scan maps (comprising global, temporal, superotemporal, inferotemporal, nasal, inferonasal, and superonasal maps) and macular thickness (MT) maps of a standard from the Early Treatment Diabetic Retinopathy Study (ETDRS) grid were assessed. The measurements were segmented automatically using Spectralis software, and included the RNFL, inner and outer plexiform layers (IPL, OPL), inner and outer nuclear layers (INL, ONL), ganglion cell layer, retinal pigment epithelium (RPE) in the central 6-mm ETDRS subfield. Results The RNFL thickness in the KC group was lower when compared with the other two groups; however, statistically significant differences were noted in the global, temporal, superotemporal, and inferotemporal sectors (p < 0.05 for all). All of the central MT parameters showed significant variation among the groups, while a statistically significant decrease was noted in the KC group, except in the inferior outer sector (p = 0.741). In the segmentation analysis, the KC group had the significantly lowest IPL, ONL, RPE, and outer retinal layer (ORL) thickness among the groups (p < 0.05 for each). The astigmatic group was similar to the control group with regard to these parameters (p > 0.05 for each). Conclusion The eyes in the KC group appeared to have a thinner RNFL and MT when compared to those in the astigmatic and control groups. The ORLs, especially the ONL and RPE, were the most affected component of the macula in the KC group.

Background: To investigate of the effect of vitamin D (Vit-D) deficiency on the tear film in children and compare it with that of healthy subjects. Methods: This prospective and cross-sectional study comprised 75 eyes of children who had Vit-D deficiency (Group 1) and 85 eyes of age- and gender-matched healthy children (Group 2). The tear-film break-up time (TF-BUT) and Schirmer test values, as well as the Ocular Surface Disease Index (OSDI) scores were recorded for the participants in all of the groups. Measurement of the tear meniscus area (TMA) and tear meniscus height (TMH) was performed 2 times in the same day via the use of anterior segment-optical coherence tomography (AS-OCT). Results: The mean age of the participants in Group 1 was 12.42±3.40 years, while in Group 2, it was 12.59±2.32 years (P=0.758). Group 1 comprised 43 females and 32 males, while Group 2 comprised 44 females and 41 males (P=0.250). The mean TMH, TMA, and Schirmer test values were determined to be significantly lower in children with Vit-D deficiency (Group 1) than in healthy children (Group 2), with P < 0.05 for all the values. It was determined that there was no significant difference concerning the value for the mean TF-BUT and OSDI scores (P=0.029 and P = 0.596). Conclusion: The children with Vit-D deficiency were determined to have lower TMH, TMA and Schirmer test values. The alterations that were observed in these parameters were more prominent in the participants who had lower Vit-D levels. Key words: dry eye sendrome, tear meniscus area, tear meniscus height, vitamin D deficiency ZUSAMMENFASSUNG Hintergrund: Es sollte die Wirkung von Vitamin D (Vit-D)-Mangel auf den Tränenfilm bei Kindern untersucht und mit der von gesunden Probanden verglichen werden. Methoden: Diese prospektive Querschnittsstudie umfasste 75 Augen von Kindern mit Vit-D-Mangel (Gruppe 1) und 85 Augen von alters- und geschlechtsangepassten gesunden Kindern (Gruppe 2). Die Aufreißzeit des Tränenfilms (TF-BUT) und Schirmer-Testwerte sowie die Werte des Ocular Surface Disease Index (OSDI) wurden für die Teilnehmer in allen Gruppen aufgezeichnet. Die Messung der Tränenmeniskusfläche (TMA) und der Tränenmeniskushöhe (TMH) wurde 2 Mal am selben Tag unter Verwendung einer optischen Kohärenztomographie des vorderen Segments (AS-OCT) durchgeführt. Ergebnisse: Das Durchschnittsalter der Teilnehmer in Gruppe 1 betrug 12,42 ± 3,40 Jahre, während es in Gruppe 2 12,59 ± 2,32 Jahre betrug (p = 0,758). Gruppe 1 umfasste 43 Frauen und 32 Männer, während Gruppe 2 44 Frauen und 41 Männer umfasste (p = 0,250). Die mittleren TMH-, TMA- und Schirmer-Testwerte waren bei Kindern mit Vit-D-Mangel (Gruppe 1) signifikant niedriger als bei gesunden Kindern (Gruppe 2), mit P < 0,05 für alle Werte. Es wurde festgestellt, dass es keinen signifikanten Unterschied bezüglich des Werts für die mittleren TF-BUT- und OSDI-Scores gab (P = 0,029 und P = 0,596). Schlussfolgerung: Bei den Kindern mit Vit-D-Mangel wurden niedrigere TMH-, TMA- und Schirmer-Testwerte festgestellt. Die bei diesen Parametern beobachteten Veränderungen waren bei den Teilnehmern mit niedrigeren Vit-D-Spiegeln ausgeprägter.