Objective To evaluate changes in retrobulbar ocular blood flow parameters by using Colour Doppler Imaging (CDI) and changes in foveal microvasculature by using Optical Coherence Tomography Angiography (OCTA) in pediatric obese patients and to compare them with a group of healthy children. Methods Children diagnosed with obesity without hypertension and diabetes (39 subjects, obese group) and age-matched healthy controls (26 subjects, control group) underwent CDI and OCTA imaging. Peak systolic velocity, end-diastolic velocity and resistivity index from ophthalmic, central retinal and posterior ciliary arteries on CDI; superficial and deep capillary plexus vascular density and foveal avascular zone area on OCTA imaging were obtained in each group. Central foveal and subfoveal choroidal thicknesses were also measured. CDI and OCTA parameters were compared between two groups. Results Peak systolic and end-diastolic velocities were found to be significantly lower in obese children than in controls in all three examined arteries (p < 0.05). Resistivity index values were similar between the groups. OCTA imaging did not reveal significant changes in superficial and deep capillary plexus vascular densities and foveal avascular zone area across analysed retinal regions between the groups. Subfoveal choroid was thicker in obese group than in control group (325.89 ± 52.77 µm vs. 304.52 ± 21.76 µm, p = 0.04). Conclusion An apparent decrease was present in retrobulbar hemodynamics in obese children. This arises the possibility of early ocular macrovascular compromise rather than retinal microvascular impairment in childhood obesity.
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.
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