Purpose: To evaluate the 36 months changes in posterior corneal surface parameters in keratoconic eyes after accelerated corneal cross-linking and to compare the data with uncross-linked progressive and non-progressive keratoconic eyes. Methods: Thirty five cross-linked, 30 uncross-linked progressive, and 30 uncross-linked non-progressive keratoconic eyes were included. Maximum keratometry (Kmax), thinnest pachymetry, minimum radius of curvature back (Rminback), asphericity back, posterior elevation and corneal densitometry, back corneal higher order aberrations (HOAs), back surface deviation (Db), final D, posterior radius of curvature (PRC) and ‘B’ unit values were recorded at baseline and at the 12, 24, 36 months follow-up. Data were analyzed with repeated measures ANOVA and paired t-tests.Results: Kmax and thinnest pachymetry were significantly changed in the cross-linked and progressive uncross-linked groups. Rminback, asphericity back, and HOAs did not change in either group. Total posterior corneal densitometry improved; posterior elevation, Db and B unit worsened in the cross-linked group and did not change in the uncross-linked groups. PRC and final D worsened in the cross-linked and progressive uncross-linked groups, and did not change in the non-progressive group. Conclusion: Despite a decreased Kmax, the posterior corneal surface parameters, posterior elevation values were determined to have significantly worsened in the cross-linked group and this increase was higher than in progressive uncross-linked eyes.
Background: This study aimed to evaluate the clinical characteristics and changes in the number of patients receiving intravitreal injections (IVIs) at a tertiary hospital during the coronavirus disease 2019 (COVID-19) pandemic as compared to the pre-pandemic period. Methods: This retrospective, cross-sectional study included 3,211 patients with retinal disease, who received IVIs of anti-vascular endothelial growth factor (anti-VEGF) between January and May 2020. This 5-month period was divided into a pre-pandemic and a pandemic period. Clinical and demographic data were collected and were compared between the patients in each period. All COVID-19 infection precautions were implemented to minimize the potential transmission of COVID-19 to both healthcare workers and patients. Results: A total of 3,211 IVIs were administered to patients with diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and other retinal conditions. Diabetic retinopathy was the most common indication for treatment in the pre-pandemic as well as pandemic periods. Bevacizumab (Avastin, Roche) was the most common IVI type, followed by aflibercept (Eylea, Bayer). Of 3,211 IVIs, 2,943 (91.7%) were administered during the pre-pandemic period and 268 (8.3%) during the pandemic period. There was a statistically significant decrease in injections between the pre-pandemic and pandemic periods, with an overall reduction of 90.8% in IVIs (P < 0.05). No cases of confirmed transmission of COVID-19 orcomplications associated with IVIs were recorded. Conclusions: This study showed that the number of IVIs and patient visits decreased significantly, by more than 10-fold, during the lockdown period. These findings show that COVID-19 has turned the management of sight-threatening eye diseases into a challenging process and must be addressed if future healthcarerestrictions are imposed.
Background To determine the aqueous humor and vitreous levels of SCUBE-1 in patients with proliferative diabetic retinopathy (PDR). Methods A total of 21 patients with PDR and 11 patients with idiopathic epiretinal membrane (control) were included in this case-control study. The patients with PDR were divided into two groups: patients with vitreous hemorrhage (VH) and patients with tractional retinal detachment (TRD) due to an active fibrovascular membrane. Aqueous and vitreous samples obtained at the beginning of surgery were analyzed for SCUBE-1 levels. Results The mean aqueous humor SCUBE-1 value (ng/mL) was 0.82 ± 0.18 in the VH group, 0.87 ± 0.36 in the TRD group and 0.75 ± 0.29 in the control group. There was no significant differences between groups in terms of aqueous humor SCUBE-1 levels (p > 0.05, for all values). The mean vitreous SCUBE-1 value (ng/mL) was 1.95 ± 0.52 in the VH group, 1.17 ± 0.29 in the TRD group and 0.89 ± 0.21 in the control group. Vitreous SCUBE-1 values in the VH group were significantly higher than in the TRD and control groups (p = 0.034 and p = 0.027, respectively). The difference between the TRD group and control group was also significant in terms of vitreous SCUBE-1 values (p = 0.044). Conclusion Higher vitreous SCUBE-1 levels in patients with VH indicate that SCUBE-1 can be a valuable marker of retinal ischemia in diabetic patients. Further, the lower vitreous levels of SCUBE-1 in patients with TRD may suggest that SCUBE-1 is specifically involved in the angiogenesis phase. Further studies are needed to define the role of SCUBE-1 in the course of PDR.
Aim: To evaluate clinical characteristics and alterations in the of patients admitted to the ocular emergency department (ED) of a tertiary hospital during coronavirus disease period in 2019 (COVID-19) and pre-pandemic period. Also, we intended to share our strategy and experience to prevent disease transmission to health-care staff during patient submission. Material and Method: In this study, 45901 patients who applied to ED between January and May in 2020 were reviewed retrospectively for ocular manifestations. The five months divided into two groups as the pre-pandemic period and the pandemic period. Clinical and demographic data were collected. The proportion of urgent and non-urgent cases in the pre-pandemic and pandemic period was compared. Results: A total of 30,576 patients (66.6%) admitted to ED before COVID-19 and 15,325 patients admitted (33.4%) during COVID-19 era. Five hundred thirty-eight (1.8%) of cases admitted in the pre-pandemic period, and 395 (2.6%) of the cases admitted in the pandemic period were in the real urgent category. Conjunctivitis, blepharitis and hordeolum, dry eye diseases, corneal diseases were the most common conditions in both pre-pandemic and pandemic periods. Conclusion: This study showed that admissions to ED for ocular conditions during the pandemic period decreased significantly, and the rate of real urgent cases increased. Yet even during the pandemic period, non-urgent patients continue to come to the ED.
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