The aim of this study was to compare the effectiveness of intravitreal ranibizumab (IVR) injections for the treatment of diabetic macular edema (DME) in eyes with and without previous vitrectomy. The medical records of 28 eyes (11 vitrectomized and 17 nonvitrectomized) of 28 patients (mean age, 59.0 ± 9.6 years; male to female ratio 1 : 1) who were diagnosed with DME and had received IVR treatment were reviewed retrospectively. The indications of vitrectomy in 11 vitrectomized eyes were intravitreal hemorrhage (n = 8) and epiretinal membrane (n = 3). The best-corrected visual acuity (BCVA), central macular thickness (CMT), and total macular volume (TMV) were measured at baseline and at months 6, 12, 18, and 24 of the follow-up. The number of IVR injections, the duration between diagnosis of DME and IVR injection, and the hemoglobin A1c (HbA1c) level at baseline were also recorded. Baseline demographics, HbA1c, BCVA, CMT, and TMV values were similar between two groups (p>0.05). The duration between diagnosis of DME and IVR injections was similar in both groups (16 ± 5 months vs. 13 ± 4 months, respectively; p=0.11). IVR injection was performed 6.3 times in vitrectomized eyes and 6.1 times in nonvitrectomized eyes during the 24-month period (p>0.05). The mean BCVA improved significantly during the 24-month period in both groups. The improvements in BCVA, in CMT, and in TMV were more significant at month 6 (p=0.036) group, at month 12 (p=0.013), at month 12 (p=0.021), and month 24 (p=0.021) in nonvitrectomized eyes, respectively, while there was no difference in improvements of BCVA, CMT, and TMV in vitrectomized group at each visit. Treatment effected by time in terms of BCVA, CMT, and TMV values in all groups (p=0.0004, p<0.0001, p<0.0001, respectively), not by time-group interaction and group (all p values >0.05). In conclusion, IVR treatment for DME is equally effective in both groups. However, the response to treatment is seen earlier in nonvitrectomized eyes compared to vitrectomized eyes.

Objectives:To evaluate the efficacy and safety of dexamethasone (DEX) implants as mono or combination therapy for macular edema in retinal vein occlusion (RVO) with real-life conditions, and to detect factors that influence final visual acuity.Materials and Methods:Twenty-five eyes with macular edema secondary to RVO underwent assessments for central macular thickness (CMT), best-corrected visual acuity (BCVA), adverse events, and also morphologic changes in optical coherence tomography at an interval of 4-8 weeks after at least one DEX implant.Results:Seventeen eyes with branch RVO and 8 eyes with central RVO were eligible for the study. The mean follow-up duration was 17 months (range, 12-26 months). Both mean BCVA (p=0.009) and CMT (p=0.006) improved significantly, and visual gains of ≥3 lines were achieved in 32% and ≥2 lines in 52% at the end of the follow-up period. The most powerful individual predictor of final visual acuity was baseline BCVA (r2=0.611, p<0.001, stepwise multiple regression), but the most efficient model was the combination of the ellipsoid zone (EZ) integrity and baseline BCVA (r2=0.766, p<0.001, stepwise multiple regression). Complication rates were very low after repeated DEX implants.Conclusion:DEX implant seems to be an effective and safe treatment for macular edema in RVO despite negative real-life factors, and visual outcomes are associated with baseline visual acuity and EZ integrity.

Objective Obstructive sleep apnea syndrome has been identified as a possible risk factor for optic nerve pathology such as glaucoma, nonarteritic ischemic optic neuropathy, and optic disk edema. Accordingly, we aimed to evaluate structural changes of the apparently normal optic nerve in obstructive sleep apnea syndrome patients with effects of its severity. Materials and methods In this prospective case–control study, 47 eyes of 47 obstructive sleep apnea syndrome patients diagnosed with polysomnography and 40 eyes of 40 healthy subjects were included. Spectral-domain optical coherence tomography was used to evaluate the peripapillary retinal nerve fiber layer thickness, optic nerve head topographic parameters, and retinal ganglion cell-inner plexiform layer thickness. Results The average peripapillary nerve fiber layer thickness was lower in obstructive sleep apnea syndrome patients than in controls (90.74 ± 7.98 vs 94.93 ± 6.13 μm; p = 0.008). The average cup/disk ratio and the vertical cup/disk ratio in patients with OSAS were significantly higher compared to the controls (both p < 0.001). However, no significant difference in retinal ganglion cell-inner plexiform layer thickness was found. Conclusion Even if the retinal ganglion cell-inner plexiform layer thicknesses did not significantly differ between the obstructive sleep apnea syndrome and control groups, obstructive sleep apnea syndrome patients showed a decreased peripapillary nerve fiber layer thickness and increased optic nerve head parameters. These findings can be used as an indicator of optic nerve damage in the early diagnosis of obstructive sleep apnea syndrome patients.

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