BackgroundPrimary open-angle glaucoma is a multifactorial serious disease characterized by progressive retinal ganglion cell death and loss of visual field.ObjectivesThe purposes of this study were to investigate shear wave elastography (SWE) use in the evaluation of the optic nerve (ON) and peripapillary structures, and to compare the findings between glaucomatous and control eyes.Patients and MethodsA case-controlled study, including 21 patients with primary open-angle glaucoma and 21 age-matched control subjects, was carried out. All of the participants had comprehensive ophthalmological exams that included corneal biomechanical measurements with ocular response analyzer. In vivo evaluation of the biomechanical properties of the ON and peripapillary structures were performed with SWE in all participants. The Kolmogorov–Smirnov test was used to analyze the normal distribution of data. Differences of parameters in ophthalmologic data and stiffness values of patients with and without glaucoma were evaluated using the Mann-Whitney U test.ResultsThere were no statistically significant differences between the glaucoma and control groups in terms of age (P > 0.05) and gender (P > 0.05). Corneal hysteresis was lower in the glaucoma group (P < 0.05). Corneal compensated intraocular pressure and Goldmann correlated intraocular pressure were higher in the glaucoma group (P < 0.0001 for both). The mean stiffness of the ON and peripapillary structures were significantly higher in glaucoma patients for each measured region (P < 0.05).ConclusionThe study evaluated the biomechanical properties of the ON and peripapillary structures in vivo with SWE in glaucoma. We observed stiffer ON and peripapillary tissue in glaucomatous eyes, indicating that SWE claims new perspectives in the evaluation of ON and peripapillary structures in glaucoma disease.

The purpose of this study was to investigate the efficacy and safety of the Toris K silicone hydrogel contact lens (SwissLens; Prilly, Switzerland) in keratoconus patients. A database with information on 50 keratoconus patients (64 eyes) fitted with Toris K soft contact lenses over a 2-year period was retrospectively reviewed. Demographic data, prefitting refraction, the reason for choosing the Toris K soft contact lens, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best-corrected visual acuity with a rigid gas permeable lens (BCVA RGP), best-corrected visual acuity with the Toris K lens (BCVA Toris K), and complications were evaluated. The mean age ± standard deviation at the time of fitting was 27.92 ± 9.86 years. The mean spherical refractive power was -4.62 ± 6.53 dioptres, and the mean cylinder was -3.78 ± 2.43 dioptres. The most common reason for using Toris K soft contact lenses was an inability to fit the patient with a RGP contact lens. There was a statistically significant difference between UCVA and BCVA Toris K (p = 0.0001), as well as between BSCVA and BCVA Toris K (p = 0.0001). However, there was no statistically significant difference between BCVA Toris K and BCVA RGP (p = 0.20). Superficial punctate keratitis and giant papillary conjunctivitis were the most common complications. The Toris K contact lens is a viable alternative for the optical management of all grades of keratoconus. The Toris K soft contact lens is a promising alternative for the visual rehabilitation of keratoconus patients who cannot tolerate RGP lenses or achieve a good fit.

PurposeTo evaluate the safety and efficacy of intravitreal dexamethasone (IVD) implants in eyes with diabetic macular edema that did not respond to previous treatment.MethodsWe included 46 eyes of 46 patients in this retrospective study. Each month, we recorded patient visual acuity with logarithm of the minimum angle of resolution using the Early Treatment Diabetic Retinopathy Study chart, central macular thickness measurements with optical coherence tomography, intraocular pressure (IOP), and posttreatment complication occurrence.ResultsThe mean follow-up time was 8.95 ± 1.33 months (range, 6 to 12). Best-corrected visual acuity improved significantly in the first 4 months after IVD, but no statistically significant change was observed over the following 2 months. Although a statistically significant decrease in central macular thickness was observed in the first 3 months, the change was not statistically significant in the following 3 months. There was a statistically significant increase in IOP in the first 2 months, but no statistically significant change was observed in the following months. IOP was controlled with medication in all patients with elevated IOP. Of the 26 phakic patients, two had cataracts requiring surgery.ConclusionsCases of refractory diabetic macular edema that did not respond to previous treatment, such as anti-vascular endothelial growth factor injections and laser photocoagulation, exhibited improvements in visual acuity and decreases in retinal thickness after IVD implantation. Both functional and anatomical effects were observed in the first 3 months after injection. Repeat injections and frequent examination might be required for continued improvement. Side effects, such as cataracts and elevation of IOP, may require medical or surgical treatment.

While consistency was observed in all methods in terms of sphere and spherical equivalence, consistency dropped in cylindrical values and no consistency was observed in axis values. It is important to take this point into consideration, especially in axis measurements.

Ö ÖZ ZE ET T AAm ma aç ç: :Kor ne a en do tel hüc re mor fo lo ji si, yo ğun lu ğu ve mer ke zi kor ne a ka lın lı ğı nın tip 2 di yabe ti olan has ta lar ile di ya be ti ol ma yan sağ lık lı gö nül lü ler le kar şı laş tı rıl ma sı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Bu pros pek tif kli nik ça lış ma da, tip 2 di a be tes mel li tus (DM)' lu 30 has ta nın 60 gö zü ile, di ya bet li ol ma yan 51 sağ lık lı gö nül lü nün 102 gö zü ça lış ma ya alın dı. Her bir di ya be tik ol gu için be den kit le in dek si he saplan dı, aç lık kan şeke ri (AKŞ) ve HbA1c dü zey le ri öl çül dü. Kon trol gru bu na, 2 kez ya pı lan AKŞ öl çü mü <100 mg/dL olan sağ lık lı bi rey ler dâhil edil di. En do tel hüc re yo ğun lu ğu (EHY), or ta la ma hüc re bo yutu (OHB), stan dart sap ma (SS), hüc re ala nı var yas yon kat sa yı sı (VK), hek za go na li te yüz de si (HEKY) ve mer ke zi kor ne a ka lın lı ğı (MKK), spe kü ler mik ros kop ile öl çül dü. B Bu ul l g gu u l la ar r: : Tip 2 DM'li grup ile sağ lık -lı kon trol le rin yaş or ta la ma la rı (±stan dart sap ma) sı ra sıy la 54,8±9,6 yıl ve 53,3±8,2 yıl idi. Grup lar yaş ve cin si yet açı sın dan ben zer di (sı ra sıy la p=0,454 ve p=0,672). Tip 2 DM'li ol gu lar ile sağ lık lı kon trol ler ara sın da EHY, OHB, SS, VK, HEKY ve MKK açı sın dan is ta tis tik sel ola rak an lam lı bir fark bu lun ma dı (sı ra sıy la p=0, 815, p=1,000, p=0,868, p=0,934, p=0,087, p=0,236). Di ya be tik ol gu lar da HbA1c ile MKK ara sın da po zi tif ko re las yon sap tan dı (r=0,297, p=0,026). On yıl dan uzun sü re di ya be ti olan lar da MKK, da ha kı sa sü re li DM'li ol gu la ra gö re da ha faz la ol ma eği li min de idi (sı ra sıy la 537,2±32,0 µm ve 519,0±28,2 µm). An cak bu fark is ta tis tik sel ola rak an lam lı de ğil di (p=0,066). S So o n nu uç ç: : Uzun sü re li ve kon trol süz di ya be ti olan has ta lar da kor ne a en do te lin de mey da na ge le bi le cek ya pı sal de ği şik lik ler, kor ne a kalın lı ğın da ar tı şa yol aça bi lir. Di ya be tik has ta lar DM komp li kas yon la rı açı sın dan iz le nir ken, kro nik hi perg li se mi nin kor ne a üze rin de ki et ki le ri de göz önün de bu lun du rul ma lı dır.

Objectives:To evaluate the effects and safety of intravitreal ranibizumab on visual acuity and anatomic results in the treatment of macular edema due to retinal vein occlusion (RVO).Methods:Forty Six eyes of 45 patients who were administered intravitreal ranibizumab because of macular edema due to Retinal Vein Occlusion (RVO) were included in this retrospective clinical study. During monthly follow-up, the best corrected visual acuity values in terms of LogMAR with The Early Treatment Diabetic Retinopathy Study (ETDRS) chart, central macular thickness (CMT), and complications were examined. Cases were classified as central retinal vein occlusion (CRVO), superotemporal branch retinal vein occlusion (BRVO), and inferotemporal BRVO. We only included RVO patients but using ETDRS chart for the vision measurement.Results:In all follow-up months, there was a significant increase in BCVA in all RVO cases and in superotemporal BRVO cases after the first injection of ranibizumab. Although there was no significant increase in the 1st month of follow-up period compared to pre-treatment, there was significant increase in 2-6 months in inferotemporal BRVO patients. There was no statistically significant increase in 1st and 2nd month follow-up periods compared to pre-treatment; however there was a significant increase in 3-6 months in the CRVO patients. There was a significant decrease in average CMT measurements in all follow-up months compared to pre-treatment in all RVO cases, in superotemporal and inferotemporal BRVO cases. There was no significant decrease in average CMT measurements in the 1st, 2nd, and 3rd months compared to pre-treatment although there was a significant decrease in 4-6 months in cases included in the CRVO patients.Conclusions:Intraocular ranibizumab injections provided rapid, effective treatment for macular edema due to RVO with low rates of ocular and nonocular safety events. However, repeated injections and frequent follow-up intervals may be required.

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Objectives: To evaluate the effect of corneal subepithelial infiltrates (SEIs) on tear film function and best-corrected visual acuity (BCVA) after persistent epidemic keratoconjunctivitis (EKC) and to compare the findings with controls. Methods: In this prospective, cross-sectional study, 38 patients with EKC and 42 healthy volunteers were enrolled. While patients with SEIs after EKC made up groups 1a (first involved eye) and 1b (second involved eye), healthy controls made up group 2. Best-corrected visual acuity, corneal subepithelial infiltrate scoring (CSIS), Fantes score, tear breakup time (TBUT), Schirmer test, and ocular surface disease index (OSDI) scores were measured. The Oxford grading system was used to score corneal staining. Results: The mean Fantes score was 1.8±0.8 for group 1a and 1.3±1.1 for group 1b (P=0.03). The mean CSIS was 2.9±1.3 for group 1a and 1.9±1.7 for group 1b (P=0.005). But there was no significant difference in terms of the mean BCVA, TBUT, Schirmer, OSDI, and Oxford grading (P=0.66, 0.9, 0.9, 0.9, and 1.0, respectively) between group 1a and group 1b. The mean BCVA, TBUT, Schirmer, and OSDI values were worse in group 1a and group 1b in comparison to group 2 (P=0.001). Conclusions: We showed that the first involved eyes of patients with SEIs may be affected more significantly, but this difference may not have a clinical reflection on the difference in tear film functions between two eyes. However, compared with the healthy eyes, tear film function and BCVA were equally compromised in both eyes of the patients with SEIs irrelevant to the involved eye.