The first use of ultrasound biomicroscopy (UBM), which is an important method for monitoring and evaluating the anterior segment and the anterior chamber angle in ophthalmology, was made by Pavlin et al. (1) in the early 1990s. Sound energy is used in the high-frequency spectrum in UBM. With this spectrum, tissue penetration occurs to a depth of about 5 mm, which is more or less on the surface. UBM is a tool that enables the identification of not only anterior segment structures but also pathologies located in posterior segment structures such as the peripheral retina and ciliary body. It is an important imaging modality in the treatment of vitreoretinal diseases by cross-sectional imaging of the peripheral retina, pars plana, and vitreous base, which cannot be seen even via indirect ophthalmoscopy performed using a scleral buckling method.The most important advantage of UBM compared with anterior segment optical coherence tomography is that posterior chamber structures such as the ciliary body, lens zonules, and anterior choroid can also be displayed without dilating the pupils (2).In many vitreoretinal diseases, pars plana vitrectomy (PPV) is applied as the standard surgical approach. Many complications related to PPV may be encountered postoperatively. Some of these complications are related to the anterior segment.The aim of this study was to investigate by UBM postoperative changes in the morphology of the anterior segment in phakic patients in whom tamponade was not used during PPV. MethodsBetween March 2012 and October 2015, phakic patients for whom PPV was planned were included in the study prospectively. Patients on whom cataract surgery was performed along with PPV and/or gas or silicone oil was used as intraocular tamponade were excluded from the study, and 21 eyes of 21 patients were statistically included in the evaluation.The study was performed in accordance with the Helsinki Declaration. All patients who were included in the study were given information regarding the intervention and written informed consent was received. Approval of the local ethics committee was obtained for the execution of the work. Appraisement of Anterior Segment Changes caused by Vitrectomy without Internal Tamponade using Ultrasonic Biomicroscopy in Phakic EyesObjective: Our study aimed to investigate morphological changes using ultrasonic biomicroscopy (UBM) in the anterior segment after phakic pars plana vitrectomy (PPV) without tamponade.Methods: PPV surgery planned phakic patients were prospectively studied between October 2012 and March 2015. PPV patients who did not undergo cataract surgery and in whom intraocular tamponade was not used were included in the study. UBM measurements were taken a few days before and 10 days after the surgery. Through axial images of the anterior segment, the anterior chamber depth (ACD) and lens thickness (LT) were measured. Through the temporal quadrant over the radial cross-section images, the trabecular network-iris angle (TIA), ciliary body thickness (CBT), scleral thickness (ST),...
Objective. To evaluate the morphological changes of the anterior segment using ultrasonic biomicroscopy (UBM) imaging in pseudophakic patients who underwent pars plana vitrectomy (PPV) with silicone oil or gas (C3F8) internal tamponade agent injection. Method. This prospective study included pseudophakic patients with planned PPV, divided into two groups according to internal tamponade agent: those in which silicone oil was used (n = 27, Group 1) and those in which gas (C3F8) was used (n = 24, Group 2). UBM measurements were performed in the supine position before and one week after surgery. Results. In patients of Group 1, postoperative trabecular meshwork-ciliary process distance (T-CPD) and iris-ciliary process distance (I-CPD), according to preoperative values, were found to be statistically significantly reduced, and postoperative mean value of scleral thickness (ST) and intraocular pressure (IOP), according to preoperative value, was found to be statistically significantly increased. In patients of Group 2, postoperative mean values of anterior chamber depth (ACD), ciliary body thickness (CBT), T-CPD, I-CPD, and IOP, according to preoperative values, were found to be statistically significantly reduced. Preoperatively, in Group 2 patients, according to Group 1 patients, TIA and IOP were found to be statistically significantly increased. Preoperative and postoperative IOP between the measured parameters with UBM showed no statistically significant correlation. Conclusions. Gases cause more morphological changes in the anterior segment structures. It is thought that complications such as increased intraocular pressure can be seen more frequently for this reason.
Purtscher- like retinopathy may occur as a complication of endonasal dacryocystorhinostomy. Intravitreal tissue plasminogen activator may help relieve the embolization that occurs in Purtscher-like retinopathy.
Background and aim Cat-scratch disease (CSD) is a systemic bacterial infection caused by Bartonella henselae. The disease is typically characterized by regional lymphadenopathy developing after scratches from domestic or feral cats. Rarely, systemic involvement may be observed. The co-occurrence with glomerulonephritis and positive antinuclear antibody (ANA) tests have been reported before. In these cases, the disease can be misdiagnosed as systemic lupus erythematosus. Ocular involvement occurs in 5%–10% of the cases with CSD, and neuroretinitis is among the common manifestations. Administration of corticosteroids (CSs) in addition to antibiotics has been shown to improve prognosis in neuroretinitis cases. However, the optimal dose and duration, remain ill-defined. Case report In this article, we present an 11-year-old girl with CSD and neuroretinitis with a positive ANA test and hematuria, who benefited from high-dose methyl-prednisolone and antibiotics. Conclusion Further research is warranted in order to determine the dose and duration of CSs in the treatment of Bartonella neuroretinitis.
PurposeTo compare optic nerve head parameters, the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL), the macular retinal nerve fiber layer (mRNFL), the ganglion cell complex (GCC), and the ganglion cell–inner plexiform layer (GCIPL) in macrodisks and normal-sized healthy disks using spectral domain optical coherence tomography.Patients and methodsA total of 88 healthy eyes (42 macrodisks and 46 normal-sized disks) were prospectively enrolled in the study. Optic nerve head parameters as well as pRNFL, mRNFL, GCC, and GCIPL thicknesses were measured in all subjects. Optic disk areas (ODAs) >2.70 mm2 were defined as macrodisks. All spectral domain optical coherence tomography parameters were compared between normal-sized disks and macrodisks.ResultsThe mean age of the participants was 49.4±5.7 years in the normal size group and 51.55±6.3 years in the macrodisk group (P=0.65). The average ODAs were 2.23±0.29 mm2 and 3.30±0.59 mm2 in the normal size and the macrodisk groups, respectively. ODA (P<0.001), cup area (P<0.001), cup disk area ratio (P<0.001), horizontal cup disk ratio (P<0.001), vertical cup disk ratio (P<0.001), horizontal disk diameter (P<0.001), vertical disk diameter (P<0.001), and cup volume (P<0.001) were significantly higher in the macrodisk group. The inferior mRNFL thickness was significantly lower (P=0.042), and the GCC inferior and GCIPL inferior thicknesses were found to be lower with low significance (P=0.052, P=0.059, respectively) in the macrodisk group. Rim volume (P=0.622), total pRNFL (P=0.201), superior pRNFL (P=0.123), inferior pRNFL (P=0.168), average macular thickness (P=0.162), total mRNFL (P=0.171), superior mRNFL (P=0.356), total GCC (P=0.080), superior GCC (P=0.261), total GCIPL (P=0.214), and superior GCIPL (P=0.515) thicknesses were similar in both groups.ConclusionOptic disk topography and retinal structures show different characteristics in healthy eyes with macrodisks. These disk size-dependent variations suggest that large optic disks may be more susceptible to glaucomatous damage.
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