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Purpose: To compare the aqueous humor (AH) and serum levels of 4-hydroxynenal (4-HNE) and 8-hydroxy-2'-deoxyguanosine (8-OhdG) in patients with pseudoexfoliation syndrome (PES) and pseudoexfoliation glaucoma (PEG) with each other and with age- and sex-matched control group., Methods: This prospective study included 66 patients divided into three groups: PES (n = 24), PEG (n = 21), and a control group (n = 21). 4-HNE and 8-OhdG levels were analyzed using the enzyme-linked immunosorbent assay., Results: Aqueous and serum 4-HNE levels were significantly higher in the PEG (466.52 ± 62.12 pg/mL and 313.47 ± 47.41 pg/mL) and PES (290.69 ± 63.63 pg/mL and 201.53 ± 39.57 pg/mL) groups than the control group (144.02 ± 39.58 pg/mL and 99.10 ± 16.96 pg/mL; p < 0.001, for all). Both aqueous and serum levels of 4-HNE in the PEG group were significantly higher than in the PES group (p < 0.001, for both). Similar to 4-HNE, the AH 8-OhdG levels were higher in the PEG group (21.18 ± 2.23 ng/mL) compared to the PES (14.90 ± 3.37 ng/mL) and control (4.86 ± 1.94 ng/mL) groups (p < 0.001, for all). Serum 8-OhdG levels were significantly higher in the PEG and PES groups than the control (p < 0.001, for both); however, there was no significant difference between the PES and PEG groups (p = 0.097). There were strong significant correlations between the aqueous and serum levels of 4-HNE (p < 0.001, r = 0.857) and 8-OhdG (p < 0.001, r = 0.807) among all the patients., Conclusions: Aqueous humor and serum levels of 4-HNE and 8-OhdG increased in the PES and PEG patients. These findings are potentially significant and add to the growing body of evidence concerning oxidative stress in PES and PEG., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To evaluate the efficacy of sutureless amniotic membrane transplantation using a soft bioavailable ring in the management of ocular surface disorders., Methods: We present a modified technique using a soft, special designed bioavailable ring set (Amnioring) for sutureless amniotic membrane fixation to the ocular surface. A fresh amniotic membrane with a diameter greater than the outside diameter of the ring was folded inwardly over the ring such that the inner side of the ring was covered with the amniotic membrane. The ring was inserted onto the ocular surface., Results: The ring was inserted in 4 eyes of 4 consecutive patients with ocular surface disorders. The mean total operating time was 3 min. The ring fixated the amniotic membrane to the bulbar conjunctiva and provided a quick and easy sutureless placement of amniotic membrane. In all cases, pain was significantly relieved. The corneal epithelial defect and inflammation were markedly reduced., Conclusions: This novel ring designed for sutureless placement of amniotic membrane provided very good anatomic and functional outcomes in patients with ocular surface disorders. It is less invasive, less time consuming and allows placement in the office conditions with low cost., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose: To evaluate the relationship of tear osmolarity (TO) with tear meniscus curvature and contact angles by anterior segment optical coherence tomography (AS-OCT) in healthy subjects., Methods: The right eyes of 64 consecutive healthy subjects were included in the study. The eyes were scanned by AS-OCT for the measurements of upper and lower tear menisci. The geometrical components of the upper and lower menisci, including height, depth, area, and radius of the menisci, cornea-meniscus angle (α-angle), meniscus-eyelid angle (β-angle), and curvature angle (θ-angle) were measured. TO was obtained by TearLab. All participants were administered Ocular Surface Disease Index questionnaires (OSDI), and tear film break-up time (TBUT), Schirmer I and II test measurements were also performed., Results: There was no association of TO with height, depth, and area of both menisci while TO was negatively correlated to θ-angle and radius of the lower eyelid meniscus (r = - 0.41, P < 0.001 and r = - 0.40, P < 0.01, respectively). The θ-angle and the radius of the lower meniscus were also significantly associated with OSDI score, TBUT, Schirmer I and II (P < 0.01 for all). There was a statistically strong correlation between the θ-angle and the radius of the lower meniscus (r = 0.91, P < 0.001)., Conclusion: The curvature angle and radius of the lower meniscus are significantly associated with TO. The curvature angle of the lower meniscus is a useful non-contact measure that may provide information indirectly about the osmolarity and the quality of the tear., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Purpose:  To investigate the changes in the choroidal vascularity index (CVI) with age and to compare the effect of the binarised area on CVI in healthy eyes using spectral-domain optical coherence tomography (SD-OCT)., Materials and Methods:  Two hundred and twenty-four eyes of 224 healthy subjects were included in this prospective cross-sectional study. The eyes were divided into different age groups to analyse the possible age-related choroidal structural changes. Subfoveal choroidal thickness (SFCT), CVI, total choroidal area (TCA), stromal area (SA), luminal area (LA), and CVI within the central 1500 µm of the macula were analysed using enhanced depth imaging SD-OCT. The CVI was defined as the proportion of the LA to the TCA, and its values for the two binarised areas were compared (CVI total vs. CVI 1500 )., Results:  The mean age was 34.77 ± 20.97 (range: 5-70) years. The mean CVI total was statistically lower (66.71 ± 2.58%) than the mean CVI 1500 (67.54 ± 3.13%, p = 0.008) among all the healthy participants. TCA, LA, CVI total , and CVI 1500 were statistically higher in the ≤ 18-year-old group compared to the > 18-year-old group (p < 0.05), but SA was not significantly different between the groups (p = 0.327). Similarly, TCA, LA, CVI total , and CVI 1500 between the five studied age groups were statistically different (p < 0.001), showing larger figures in the 0-10-year-old group. However, this was not true for the stromal region (p = 0.139). CVI total exhibited a very strong positive correlation with CVI 1500 . No significant gender-related difference was observed in CVI., Conclusion: Decreased LA, TCA, and CVI were observed in healthy eyes with increasing age. CVI 1500 was higher than CVI total in a single B scan OCT. This result may provide valuable information about the choroid under different conditions, such as its physiological changes and disease pathophysiology.

Objectives: To evaluate the diagnostic capability of spectral domain optical coherence tomography (SD-OCT) in patients with potential diagnostic findings for polypoidal choroidal vasculopathy (PCV)., Materials and Methods: Ninety-three eyes with potential diagnostic findings for PCV were prospectively evaluated. Patients with multiple retinal pigment epithelial detachment (RPED), sharp RPED peak, RPED notch, hyporeflective lumen representing polyps, double-layer sign and the presence of hyperreflective intraretinal hard exudate were considered as PCV in SD-OCT. The sensitivity and specificity of SD-OCT in the diagnosis of PCV were determined by comparing SD-OCT-based diagnosis with indocyanine green angiography (ICGA)., Results: Sixty-nine (74.2%) of 93 eyes included in the study were confirmed with ICGA and diagnosed as PCV. The sensitivity and specificity of SD-OCT for the diagnosis of PCV were 75.3% and 75%, respectively., Conclusion: The SD-OCT-based method helps clinicians to develop appropriate diagnostic and treatment strategies for patients in whom ICGA cannot be used.

Purpose: To evaluate the effects of loteprednol etabonate on cornea and tear film in patients with seasonal allergic conjunctivitis by anterior segment optical coherence tomography (OCT)., Methods: The right eyes of 52 subjects with seasonal allergic conjunctivitis were evaluated in the study. Central corneal thickness (CCT), the thicknesses of central corneal epithelium (CET) and central non-epithelial cornea (CnET), and lower and upper tear meniscus areas were measured by spectral-domain OCT and ocular surface disease index (OSDI) were obtained at baseline. After topical use of loteprednol etabonate 0.5% eye drop three times a day for 1 week, the measurements were repeated. Paired T test was used for analysis., Results: Mean CCT and mean thicknesses of CET and CnET at baseline were 528.19 ± 34.47 µm, 64.10 ± 5.30 µm and 462.84 ± 33.43 µm, respectively, and these were 526.31 ± 33.37 µm, 64.65 ± 4.84 µm and 459.84 ± 32.11 µm after the treatment, respectively. OSDI score was 21.55 ± 4.40 at baseline and 13.13 ± 2.39 after 1 week. The lower and upper tear meniscus areas at baseline were 0.026 ± 0.017 mm 2 and 0.017 ± 0.007 mm 2 , respectively, and they were 0.017 ± 0.009 mm 2 and 0.016 ± 0.007 mm 2 , respectively, after the treatment. There is statistically significant difference between before and after values of CCT, CnET, lower tear meniscus area and OSDI score (p < 0.05)., Conclusion: There is no change in corneal epithelial thickness and upper tear meniscus area after 1-week treatment with loteprednol etabonate in patients with seasonal allergic conjunctivitis, but it may cause decrease in non-epithelial corneal thickness and lower tear meniscus area.

Purpose: To report on a case of Crohn's disease and unilateral retinal vasculitis, branch retinal artery occlusion and subsequent retinal neovascularization., Methods: We examined a 38-year-old woman with severe left visual loss and biopsy-proven Crohn's disease diagnosed four years prior to the ocular involvement. A Heidelberg scanning laser ophthalmoscope was used for fundus fluorescein angiography and indocyanine green angiography. Retinal neovascularization was detected during the follow-up., Results: Successful regression of retinal neovascularization was achieved after argon green laser panretinal photocoagulation in addition to oral steroid and salazopyrine., Conclusion: Retinal vascular involvement is a rare ocular feature of Crohn's disease and may result in retinal neovascularization that may necessitate prompt laser photocoagulation.