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Objective: To evaluate the ocular effects of "Bonzai", a synthetic cannabinoid (SC), in seropositive and seronegative users., Methods: Sixty eyes of 60 consecutive male patients with a history of "Bonzai" use and 30 eyes of 30 age-matched male healthy controls were enrolled in this case-control study. Patients with past "Bonzai" use were grouped as seropositive (n:30) and seronegative (n:30) according to urine toxicology tests. All groups were compared for blood pressures, intraocular pressure, foveal and parafoveal retinal thicknesses, subfoveal and parafoveal choroidal thicknesses, measurements of the peripapillary retinal nerve fibre layer (RNFL), and macular ganglion cell complex (GCC), subfoveal total choroidal, luminal and stromal areas, and choroidal vascularity index (CVI)., Results: No differences were noted in blood pressures between the groups (p > 0.05). The mean intraocular pressure was significantly lower in the seropositive group than in the other groups (p < 0.001). Foveal and retinal thicknesses, RNFL, and GCC measurements did not differ between the groups (p > 0.05). Subfoveal and parafoveal choroidal thicknesses and areas were lower in the seropositive group than in the other groups (p < 0.001, for all). CVI increased in both groups with "Bonzai" use compared to the control group (p < 0.001, for all)., Conclusions: This study indicates that intraocular pressure may decrease, and choroidal changes may be observed in SC users. Further clinical studies with a larger sample size, especially using purified SC for therapeutic purposes, are needed to confirm the present findings, and further histopathologic studies are required to clarify the changes in the choroid despite SC seronegativity., Clinical Trial Id: NCT06235346., (© 2024. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Purpose: To assess macular sensitivity and fixation pattern obtained by microperimetry and ganglion cell complex (GCC) obtained by optical coherence tomography (OCT) in cases with unilateral amblyopia and to compare with control., Methods: The study was conducted with 30 patients with amblyopia, aged 5-18 years, and 30 control eyes of healthy children in the same age group. Participants underwent full ophthalmological examination. Macular sensitivity, stabilization, and location of fixation values were measured using microperimetry. The GCC values were obtained by OCT. Measurements were compared between amblyopic eyes, fellow eyes, and controls. Any correlation between GCC, macular sensitivity, and fixation was investigated. P < 0.05 was considered statistically significant., Results: The mean age was 10.13 ± 3.49 years in the amblyopia group and 11.53 ± 2.7 years in the control group. Three groups were formed: amblyopic eyes (Group 1, n = 30), fellow eyes (Group 2, n = 30), and control eyes (Group 3, n = 30). The macular sensitivity values were found highest in the control group (P = 0.007). Bivariate contour ellipse area 1, which is the numerical value of fixation stabilization, was measured to be the lowest in the control group (P < 0.0001). In the analysis among the three groups, no significant difference was observed in terms of the GCC (P = 0.229). In the correlation analyses, a significant correlation was detected between macular sensitivity and GCC values in amblyopic eyes., Conclusion: In amblyopic eyes, the macular sensitivity was significantly lower and the GCC thickness was found to be in a positive correlation with macular sensitivity., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: To quantify microvascular vessel density in the optic disc using optical coherence tomography angiography (OCTA) in patients with systemic sclerosis (SS); to determine whether there is a difference in values between patients and controls; and to correlate the OCTA measurements with disease activity, damage risk, and drug usage., Methods: Patients aged 20 - 76 years who were followed up after a diagnosis of SS and age- and gender-matched controls. The patients underwent RTVue-XR AngioVue OCTA imaging in this cross-sectional observational study., Results: A total of 61 eyes of 61 consecutive SS patients and 60 eyes of 60 controls were investigated. There was no statistically significant difference between the patients and control groups regarding the average RNFL (retinal fiber layer) and radial peripapillary capillary (RPC) vessel density (VD) measurements (p = 0.35, p = 0.25, respectively). As the antinuclear antibody (ANA) titer increased, RNFLsuperior (p = 0.01, r = - 0.327), RPCwhole (p = 0.029, r = 0.279), RPCperipapillary (p = 0.037, r = - 0.267), RPCsuperior (p = 0.003, r = - 0.371), and RPCinferior (p = 0.02, r = 0.297) values decreased with statistical significance. The RPCinside values were lower in anti-Scl-70-positive patients compared to patients negative for anti-Scl-70 (topoisomerase I) (p = 0.021). The RNFLnasal (p = 0.03, r = - 0.278) value decreased as the years of disease increased. The RPCinside value was higher in patients using hydroxychloroquine and calcium channel blockers than those who did not use them (p = 0.021 and p = 0.027, respectively). The RPCwhole, RPCperipapillary, and RPCnasal values were higher, with statistical significance in corticosteroid users than in those patients who did not use corticosteroids (p = 0.043, 0.030, and 0.033, respectively)., Conclusion: There was no significant difference between the patients and control groups regarding the average RPC VD measurements. However, since this is the first study to analyze optic disc vessel density in SS patients, optic nerve blood flow changes in scleroderma with OCTA could be studied., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Aim: : To evaluate any abnormalities on retinal examination and retinal microvascularity in patients recovered from COVID-19., Materials and Methods: : Cross-sectional, case- control study. Patients between 18 and 65 years old with PCR-confirmed SARS-CoV-2 infection and age matched controls were included. Macular and retinal nerve fiber layer thickness, vessel density of the superficial (SCP) and the deep retinal capillary plexus (DCP) and the foveal avascular zone (FAZ) were measured and compared with controls., Results: : This study included 200 eyes of 200 cases totally. Of them 105 cases were patients and 95 cases were controls. Retinal abnormalities were detected by indirect ophthalmoscopic examination in ten patients of 105 cases (10.5%). There was no statistically significant difference in the vessel density of the SCP and the DCP and the mean FAZ measurements., Conclusion: : There isn't any relevant difference between early post-COVID-19 patients and general population in terms of retinal microvascularity.

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.

Purpose: To evaluate the serum levels of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) after intravitreal injection of aflibercept (IVA) and the transition of aflibercept into systemic circulation in infants with severe retinopathy of prematurity (ROP)., Study Design: Prospective study., Methods: This single-centered prospective cohort study included infants who received IVA for the treatment of type 1 ROP in zone I and posterior zone II. Blood samples were collected before IVA and at 1 day and 1, 2, 4, and 8 weeks after IVA. VEGF, IGF-1 and aflibercept levels were measured., Results: Thirty eyes of 15 infants received IVA of 1 mg/0.025 mL. Serum VEGF levels decreased significantly at 1 day and 1, 2, 4, and 8 weeks after IVA compared with baseline (P < 0.05). Serum aflibercept levels decreased significantly 1, 2, 4, and 8 weeks after IVA compared with the level at 1 day after IVA (P < 0.05) and increased significantly at 1 day, 1, 2, and 4 weeks after IVA compared with the baseline level (P < 0.05). No significant difference was detected between serum IGF-1 levels any time in any infant (P > 0.05)., Conclusion: Serum VEGF levels are suppressed for at least 8 weeks, and aflibercept could be detected in the systemic circulation at 4 weeks after injection. Clinicians should be cautious about changes in systemic VEGF levels and passage of the agent into systemic circulation after IVA in infants., (© 2021. Japanese Ophthalmological Society.)

Purpose: To evaluate the retinal nerve fiber layer (RNFL) thickness, the ganglion cell complex (GCC) and vessel density of the radial peripapillary capillary (RPC) plexus of eyes with regressed papilledema in idiopathic intracranial hypertension (IIH) patients using optical coherence tomography angiography (OCT-A) and comparing the results with healthy controls., Materials and Methods: Fifty-one eyes of 31 patients diagnosed with IIH and 52 eyes of 52 healthy subjects were enrolled in this study. All patients underwent a complete ophthalmological examination and a 4.5 × 4.5 mm peripapillary OCT-A scanning. The quantitative results of the peripapillary RNFL and GCC thicknesses and vessel density of the RPC were analyzed., Results: The vessel density in the inferior, superior nasal, and inferior nasal sectors of the patients with IIH significantly exceeded the vessel density of the healthy controls (P = 0.008, P = 0.008, and P = 0.000, respectively). The RNFL and GCC thickness measurements were comparable in both groups., Conclusions: Patients with IIH show vascular abnormalities in the inferior nasal region, which can be detected with OCT-A. As a noninvasive imaging modality, OCT-A could provide a new perspective for understanding the pathophysiology of IIH and could also be useful in the follow-up of these patients., (Copyright © 2021. Published by Elsevier B.V.)

Purpose: To evaluate the effects of a single dose of oral 5-mg tadalafil on macular microcirculation as measured using optical coherence tomography (OCT) and angiography (OCTA) in healthy volunteers. Methods: Twenty-two healthy, middle-aged, sexually active, and male health care worker volunteers were included in this prospective study. All volunteers have a history of occasionally using off-label 5 mg tadalafil to enhance sexual performance. Superficial and deep capillary plexus vascular densities, foveal avascular zone parameters, outer retina, and choriocapillaris flow areas were performed using the OCTA, and subfoveal-choroidal thickness (CT) was performed by using the OCT. Measurements were performed preintake, 30 min, 1, 4, 24 h, 2, 3, 4, and 7 days after the intake of tadalafil off-label. Results: Twenty-two eyes of 22 male volunteers were included in the study. The mean age was 37.16 ± 4.52 years. At 30 min, 1 h, and 4 h after intake, a statistically significant increase was observed in the choriocapillaris flow area and CT compared with preintake ( Friedman test , P  = 0.034 and P  < 0.001, respectively). Conclusion: This study showed that a single dose of oral 5-mg tadalafil causes an increase in choriocapillaris flow and CT. To evaluate the effects of tadalafil on the retina and choroid, an OCTA assessment may be helpful.

Purpose: To examine the retinal, peripapillary, choroidal microvascularization and the choroid thickness (CT) of the patients with polycystic ovary syndrome (PCOS) using optical coherence tomography angiography (OCT-A) and compare the results to measurements obtained from healthy controls., Methods: In total, 47 eyes of 47 patients recently diagnosed with PCOS and 47 eyes of 47 age-matched healthy women were included in this study. An RT XR Avanti instrument with AngioVue software was used for the OCT-A imaging using 6 × 6 mm macular and 4.5 × 4.5 mm optic nerve head scans. Quantitative vessel density results of superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillaries (RPC); flow area and flow density of choriocapillaris; and foveal avascular zone (FAZ) area were analyzed. CT was evaluated by using the measurements obtained from the subfoveolar area., Results: No significant differences were detected between the groups for any of vessel density results for the SCP, DCP, and RPC as well as the FAZ area. The difference in the choriocapillaris flow area and flow density between the groups was not statistically significant. The choroid was significantly thicker in women with PCOS than in the healthy group (p = 0.002)., Conclusion: Retinal and choroidal microvascularization was comparable between the women who were evaluated early after diagnosed with PCOS and age-matched healthy controls. Choroid was found thicker in patients with PCOS than in healthy women. OCT-A, as a new and noninvasive imaging method, may help in understanding the effect of PCOS on the posterior segment of the eye.

Purpose: This study aimed to compare the vessel density of the optic nerve head and radial peripapillary capillary in the eyes with early-stage primary open angle glaucoma and pseudoexfoliation glaucoma and control eyes., Methods: With visual field mean deviation scores >-6.0 dB, 54 eyes from 37 patients diagnosed with primary open angle glaucoma (n=18) and pseudoexfoliation glaucoma (n=18) and healthy controls (n=18) were enrolled in this cross-sectional observational study. Retrieved from optical coherence tomography angiography, vessel density for the optic nerve head and radial peripapillary capillary were analyzed according to the distribution of the data and appropriate tests. The diagnostic accuracy of vessel density parameters was also assessed., Results: The whole-image vessel density of the radial peripapillary capillary and inside-disc vessel density of the optic nerve head were significantly lower in eyes with primary open angle glaucoma and pseudoexfoliation glaucoma compared to those in the control eyes (p<0.05). Compared to that in pseudoexfoliation glaucoma, the inside-disc vessel density of the optic nerve head was significantly lower in primary open angle glaucoma (p<0.05). Inferotemporal sector vessel density of the optic nerve head for both primary open angle glaucoma and pseudoexfoliation glaucoma was significantly lower than that of the controls (p=0.009). In discrimination of primary open angle glaucoma vs. control and pseudoexfoliation glaucoma vs. control, area under the receiver operating characteristic curve values for inside-disc vessel density of the optic nerve head were 0.855 and 0.731, respectively (p<0.001, p=0.018). However, in discrimination of primary open angle glaucoma vs. pseudoexfoliation glaucoma, area under the receiver operating characteristic curve values for whole-image and inside-disc vessel densities of the optic nerve head were 0.707 and 0.722 (p=0.034, p=0.023)., Conclusions: Vessel densities of the optic nerve head and radial peripapillary capillary were significantly lower in eyes with primary open angle glaucoma and pseudoexfoliation glaucoma compared to healthy control eyes. In the early stage of glaucoma, the inside-disc vessel density of the optic nerve head slab may be lower in eyes with primary open angle glaucoma eyes compared to eyes with pseudoexfoliation glaucoma.

Background: To evaluate retinal thickness, area of foveal avascular zone (FAZ), flow area and flow density of choriocapillaris, vessel density of both superficial capillary plexus (SCP) and deep capillary plexus (DCP) of eyes with adult-onset foveomacular vitelliform dystrophy (AOFVD) using optical coherence tomography angiography (OCT-A) and compare the results with healthy controls., Methods: 17 eyes of 14 patients diagnosed with AOFVD and 17 eyes of 17 healthy subjects were enrolled in this study. All patients underwent a complete ophthalmological examination and a 6 x 6 mm macular OCT-A scanning. Quantiative results of retinal thickness, retinal vessel density of SCP and DCP, FAZ area, flow area and flow density of choriocapillaris were analyzed., Results: No statistically significant differences were noted in the vessel density of the SCP, except for the parafoveal nasal sector (P = 0.048). Similarly, no statistically significant differences were observed in the vessel density of the DCP, except for the parafoveal (P = 0.037) and the parafoveal temporal (P = 0.048) sectors. The choriocapillaris flow area and the flow density were significantly lower in the patients with AOFVD than in the healthy controls (P = 0.001 for both). The mean FAZ area and the retinal thickness measurements were comparable in both groups., Conclusions: Patients with AOFVD show vascular abnormalities that can be detected with OCT-A. OCT-A, as a noninvasive imaging modality, could provide a new perspective for understanding the pathophysiology of AOFVD and could also be useful in the follow-up of these patients and in the management of the disease progression., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose : To quantify and compare the foveal avascular zone (FAZ) and the whole, parafoveal and foveal vessel density of superficial (SCP) and deep capillary plexus (DCP) in amblyopic eyes of adults and age-matched controls. Methods : This cross-sectional study involved 52 eyes from 34 subjects aged 18 to 45 years. Optical coherence tomography angiography (OCTA) was performed to all participants and SCP, DCP and FAZ were evaluated. SPSS (Statistical Package for the Social Sciences) 23 was used for data analysis. Results : Eighteen of 34 subjects (52,9%) were amblyopic and 16 (47,1%) of them controlled. Mean subject age was 31.2 years in the amblyopia group and 28.3 years in the control group. The mean FAZ measurements were 0.28 ± 0.08 in amblyopic eyes, 0.29 ± 0.08 in fellow eyes and 0.3 ± 0.11 in control eyes. The whole, foveal and parafoveal vessel density of SCP in both 3x3-mm and 6x6-mm scans were not statistically different in amblyopic eyes, fellow eyes and control eyes. In 6x6-mm scans, the whole, and parafoveal vessel density of DCP were significantly lower in amblyopic eyes than controls. There was no statistically significant difference in 3x3-mm scans about DCP. Conclusion : OCTA revealed lower vessel density in DCP of amblyopic eyes than fellow eyes and controls in adults.

Purpose : To evaluate qualitative optical coherence tomography (OCT) findings and quantitative parameters, such as central macular thickness (CMT) and subfoveolar choroidal thickness (SFCT), in the eyes of preeclamptic women. Methods : The prospective, comparative, cross-sectional study included 52 eyes of 52 preeclamptic (PE) women and 54 eyes of 54 healthy pregnant women in their second or third trimester. Central macular thickness (CMT), subfoveolar choroidal thickness (SFCT), were evaluated in relation to presence of positive qualitative OCT findings such as any subretinal or intraretinal fluid, irregularity on the external photoreceptor and RPE layer, or presence of pigment epithelial detachment. Results : No significant difference was detected between the PE group and the healthy pregnant group with respect to CMT ( P = 0.905), but the mean SFCT value was significantly higher in the PE group than in the healthy pregnant group (391.4 ± 71.1 vs 331.5 ± 53.8 µm, P < 0.001). Receiver operating characteristic analysis revealed that SFCT could predict qualitative OCT findings in preeclampsia, and the optimal cut-off value was 400 µm with a sensitivity of 91% and a specificity of 85%. Conclusion : The eyes of preeclamptic women, and particularly those with positive qualitative OCT findings, showed significantly increased SFCT values. A preliminary cut-off level of 400 µm for SFCT is proposed for the prediction of severe preeclampsia.

Purpose: Fumagillin has been previously used to treat corneal microsporidial keratitis and also identified as an angiogenesis inhibitor. This study aimed to evaluate efficacy of fumagillin bicyclohexylamine on the rat model of corneal neovascularization induced by silver nitrate cauterization., Methods: Twenty-four Albino Wistar rats (n = 24) were divided into three groups. Following silver nitrate-induced corneal injury, eyes in Group 1 received one drop of 5 mg/mL topical fumagillin bicyclohexylamine four times daily for 10 days. Group 2 received subconjunctival injection of 0.1 mL fumagillin bicyclohexylamine (2.5 mg/mL) on day 1 and day 5. Group 3 received artificial tears and lubricants four times daily for 10 days as control. On day 10, animals were sacrificed. Corneal specimens were obtained and prepared to assess vascular endothelial growth factor (VEGF-C) levels and corneal angiogenic microvessel density., Results: There was no significant difference in VEGF-C levels between the groups (P = 0.994). Assessment of angiogenic microvessel density for peripheral corneal zone also did not reveal significant difference between the groups (P = 0.113). However, mean vascular density in Group 1 and Group 2 was significantly higher for both midperipheral and central corneal zones in comparison with Group 3 (P = 0.003, P = 0.015)., Conclusions: Previously proved to be effective for treatment of microsporidial keratitis in humans, topical and subconjunctival concentration or dosing of fumagillin bicyclohexylamine failed to reduce corneal neovascularization induced by silver nitrate in this study. Further studies comparing different concentrations and dosing may detect inhibitory effects of fumagillin on corneal neovascularization without inducing toxicity.

Purpose: To quantify the foveal avascular zone and the whole, parafoveal, and foveal vessel density of superficial and deep capillary plexus in amblyopic eyes and age-matched controls and to compare the measurements., Methods: This cross-sectional study involved 49 eyes from 17 patients with amblyopia and 21 healthy children (aged 6 to 16 years). Optical coherence tomography angiography was performed for all participants and superficial capillary plexus, deep capillary plexus, and foveal avascular zone were evaluated. Data from amblyopic eyes, fellow eyes with unilateral amblyopia, and control eyes were compared using the Mann-Whitney U test., Results: The mean patient age was 8.6 ± 2.5 years in the amblyopia group and 9.6 ± 2.9 years in the control group. The mean foveal avascular zone measurements were 0.251 ± 0.1 mm 2 in the amblyopia group and 0.291 ± 0.1 mm 2 in the control group. The whole, foveal, and parafoveal vessel densities of superficial capillary plexus were 48.8% ± 3.7%, 23.8% ± 8.8%, and 50.9% ± 4.6% in the amblyopia group and 48.4% ± 2.5%, 19.3% ± 5.4%, and 51.3% ± 2.7% in the control group. The whole, foveal, and parafoveal vessel densities of deep capillary plexus were 51.8% ± 4.3%, 37.6% ± 5.8%, and 54.8% ± 4.2% in the amblyopia group and 54.4% ± 3.2%, 34.9% ± 7.4%, and 56.8% ± 3.2% in the control group. No statistically significant difference was detected in all measurements., Conclusions: Assessment of the foveal avascular zone and vessel density of superficial capillary plexus and deep capillary plexus with optical coherence tomography angiography revealed no difference between amblyopic eyes, controls, and fellow eyes of patients with unilateral amblyopia. [J Pediatr Ophthalmol Strabismus. 2019;56(1):55-59.]., (Copyright 2018, SLACK Incorporated.)

Purpose: To evaluate the course of the changes in anterior chamber (AC) parameters using a Scheimpflug-Placido disc topographer before and through 6 months after laser peripheral iridotomy (LPI)., Materials and Methods: A total of 109 eyes of 56 consecutive patients classified as primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG) were included in this prospective, interventional, observational case series. Anterior chamber volume (ACV), central anterior chamber depth (CACD), and anterior chamber angle (ACA) were measured by Scheimpflug photography preoperatively and at 1, 3, and 6 months after LPI. With respect to the parameters above, alterations in the measurements were assessed to determine whether the effects induced by LPI on AC morphology persisted with time., Results: At 1 month after LPI, mean ACV, CACD, and ACA increased significantly in all groups (P<0.05). However, in eyes with PACG, significant reductions at 3 months in ACA [0.00 (-1.00 to 0.00) degrees, median (Md) [quartile 1 (Q1) to quartile 3 (Q3)], P=0.032] and at 6 months in ACV [-1.00 (-2.25 to 1.00) μL, P=0.043) and CACD (-0.01 (-0.02 to 0.00) mm, P=0.006) were shown. On analysis of all eyes together, a weak correlation was found between axial length and the change in CACD (r=0.266, P=0.007). Eyes with ACA≤25 degrees widened by 6.6±2.8 degrees versus 4.9±2.4 degrees in eyes with ACA>25 degrees at 1 month after the procedure (P=0.002)., Conclusions: Scheimpflug-Placido disc topographer detected significant changes in the AC parameters after LPI in all groups. However, compared with PACS and PAC, the PACG showed significant alterations in the AC parameters through 6 months.