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Clinical relevance: Retinopathy of prematurity is a preventable blinding disorder worldwide. Laser photocoagulation is said to be the gold standard care of treatment. However, various factors are k...

To investigate both the possible effects of both idiopathic epiretinal membrane (IERM) itself and surgery on macular microvascular structure using optical coherence tomography angiography (OCT-A) and to determine the associations with structural and visual outcomes. Twenty-four eyes of 24 patients with IERM and 24 eyes of 12 healthy controls were included. Vascular parameters, including the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were evaluated by OCT-A prior to and 6 months after ERM removal. The foveal avascular zone (FAZ, mm2) area, parafoveal vascular density (VD, %) and flow area (mm2) measurements were used to evaluate the macular vascular integrity. The mean preoperative vascular density (VD) of both plexuses was lower in eyes with IERM than in healthy eyes (both p = 0.0001). The mean preoperative flow area of the DCP in eyes with IERM was significantly lower than that in the control eyes (p = 0.016). There was no significant difference in the VD or flow area in either superficial or deep capillary plexuses as a result of surgery (SCP; p = 0.957, p = 0.97, DCP; p = 0.861, p = 0.6, respectively). Both the parafoveal DCP-VD and flow area in DCP were negatively correlated with best-corrected visual acuity (logMAR) at 6 months postoperatively (r = −0.46, p = 0.03; r = −0.52, p = 0.01, respectively). Epiretinal membranes may cause dynamic microvascular changes at the macula. However, the effect of surgery on microvasculature may be more limited than that on anatomical and visual recovery. OCT-A may serve as a useful tool in understanding the pathophysiological basis of diseases.

Background In-transit metastasis is considered a locoregional disease in cutaneous melanoma (CM) patients. Isolated limb perfusion (ILP) is among the treatment options in selected cases. The aim of this study was to determine the success of pre- and post-perfusion mSIS values in predicting the potential complications and the prognosis of the disease by investigating the early and long-term results of mSIS values calculated before and after ILP in CM cases with in-transit metastases. Materials and methods Patients who underwent ILP within the period from 2014 to 2020 in our department were retrospectively scanned. A total of 20 patients were found to undergo ILP. The scores obtained from modified inflammation score (mSIS) were formulated according to albumin (Alb) and lymphocyte to monocyte ratio (LMR) scores. Results The mean follow-up time was 20.47 months. Complications requiring surgical intervention developed in three patients. According to the Wieberdink local toxicity classification, the majority (70%) of the patients were found to be grade II. Based on pre-perfusion mSIS values, 8 patients were classified as mSIS 0 while six patients were classified as mSIS 1 and 2. Based on post-perfusion mSIS values, 14 patients and one patient were classified as mSIS 2 (70%) and mSIS 0, respectively. Accordingly, univariate analysis showed that mSIS 1 and mSIS 2 were negative prognostic factors for mean survival in the pre-perfusion period (HR 0.162, 95% CI 0.036–0.729; p = 0.018 and HR: 0.223, 95% CI 0.049–1.019; p = 0.053) whereas albumin (Alb) and lymphocyte to monocyte ratio (LMR) were not independent prognostic factors for mean survival. Conclusion The mSIS values calculated in the pre-perfusion period can give an opinion about the OS of the patients whereas post-perfusion mSIS values may predict potential surgical complications and local toxicities.

To evaluate the retinal and choroidal microstructural changes at fovea after half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (CSC), using optical coherence tomography (OCT).The study included 35 eyes with unilateral chronic CSC treated with half-dose PDT. The foveal outer nuclear layer (ONL) and subfoveal choroidal thickness (SFCT) in the affected eyes were compared with baseline measurements at month 1, 3, and 6 after half-dose PDT, and those of the healthy contralateral eyes.The mean baseline ONL thickness of the affected eyes was thinner compared to unaffected fellow eyes (66.9 ± 16.5 μm vs 111.5 ± 11.6 μm, p0.001), and increased significantly to 68.6 ± 17.0 μm at month 3 and 68.9 ± 17.3 μm at month 6 after treatment (p = 0.025 and p = 0.014 respectively). The mean baseline SFCT of the affected eyes was thicker compared to unaffected fellow eyes (399.9 ± 87.0 μm vs 338.2 ± 75.4 μm, p0.001), and decreased significantly after treatment at month 1, 3, and 6 (374.0 ± 84.8 μm, 369.7 ± 81.8 μm, 367.3 ± 80.8 μm respectively, p0.001 for all). The responder group (n = 26), in which subretinal fluid was completely resorbed, showed a significant increase in ONL thickness and decrease in SFCT after treatment, whereas in the non-responder group (n = 9) ONL thickness and SFCT did not differ after treatment.In CSC patients, significant changes are observed in foveal ONL thickness and SFCT after half-dose PDT. ONL thickness and SFCT are suggested to be considered in the OCT examinations of CSC patients.

Clinical relevance: Pivotal studies are based on strict treatment regimens of vascular endothelial growth factor blocking drugs in neovascular age-related macular degeneration. However, looser regi...

Background: To analyze the microvascular parameters using optical coherence tomography angiography (OCTA) in non-infectious posterior uveitis (PU) patients. Methods: In this cross-sectional study, OCTA images of patients with non-infectious PU were evaluated. The vessel densities (VD) in the superficial and deep capillary plexuses (SCP & DCP), foveal avascular zone (FAZ) area were measured and compared to healthy controls. Results: The study cohort comprised 64 patients with age and gender-matched groups. The VD in the SCP was 43.9±3.9% in the whole image; 18.4±4.8% in the fovea, 43.9±4.6% in the parafoveal area, and 43.4±9.7% in the perifoveal zone, in eyes with uveitis. These were respectively 48.8±2.9%, 22.9±6.9%, 50.9±3.0%, and 49.2±3.1% in the control group (p=0.0001, 0.043, 0.0001, 0.01, respectively). The changes in the DCP in eyes with uveitis were not significant. In the uveitis group, the FAZ was significantly enlarged compared to controls (0.37±0.1 microns vs. 0.24±0.2 microns, p=0.046). Conclusion: OCTA depicted significant changes including decreased VD in the SCP and enlarged FAZ in non-infectious PU.

To report the epidemiology, etiology, ocular characteristics, management, and visual outcomes of pediatric uveitis patients in Southern Turkey. The clinical records of pediatric patients with a diagnosis of uveitis under the age of 16 years and followed up longer than 6 months were analyzed retrospectively. The study included 102 patients and 173 affected eyes. The mean age at presentation was 11.4 ± 3.7 years. Uveitis was predominantly bilateral (69.6%), anterior (45.1%), and chronic (58.8%). The leading diagnoses were idiopathic uveitis (38.2%), pars planitis (19.6%), and juvenile idiopathic arthritis-associated uveitis (14.7%). Infectious uveitis accounted for 12.7%, and toxoplasmosis was the most common cause (10.8%). At least one complication was observed in 76.3% of the eyes, and optic disk edema (37%) was the most frequent. Corticosteroids were used in 97.1% and systemic immunomodulatory agents in 49% of the patients. Ocular surgery was performed in 17.3% of the eyes, and cataract extraction was the most common (8.7%). The mean BCVA was 0.39 ± 0.66 LogMAR at baseline and 0.25 ± 0.53 LogMAR at the last recorded visit. Pediatric uveitis is a challenging disease that requires meticulous management. Anterior uveitis is the most frequent form. Despite a changing trend for an increase in diagnostic variety, idiopathic cases still constitute the majority. A significant number of patients receive systemic therapy, develop complications, and require surgical intervention. Early diagnosis and appropriate treatment might improve visual outcomes and reduce the risk of visual loss.

Behcet Disease (BD) is a systemic vasculitis, first described with a triad of oral aphthous ulcers, genital ulcers, and uveitis. The authors aimed to share the clinical properties and utilities of three distinct classification criteria for BD in this study.This case-control study was conducted in pediatric BD patients, diagnosed between January 2012 and July 2019. The control group included 53 children with other rheumatic disorders. Sensitivity and specificity for International Study Group (ISG), International Criteria for BD (ICBD), and pediatric criteria for BD (PEDBD) criteria were tested.The mean age at symptom onset and diagnosis of the 16 BD patients (6 females, 10 males) were 11.2 ± 3.6 and 13 ± 3.1 years, respectively. The sensitivity and specificity of ISG criteria were 87.5% and 100%. Furthermore, ICBD criteria had a sensitivity and specificity of 93.7% and 98.1%, whereas the authors found sensitivity and specificity as 93.7% and 96.2% for PEDBD.ICBD and PEDBD reached higher sensitivity for pediatric BD diagnosis and ICBD had the highest specificity. The authors speculate that the utilization of ICBD may provide early diagnosis of BD in childhood, prevent related morbidities and misdiagnosis.

Dear EditorWe read with great interest the article entitled “Analysis of parafoveal microvascular abnormalities in Behcet’s uveitis using projection-resolved optical coherence tomographic angiograp...

To examine the content, quality and reliability of YouTube videos related to breast self-examination. A search of YouTube was made on 21.06.2018 using the keyword of “breast self-examination”. The videos were categorised by two doctors as useful information or misleading information. To evaluate the quality of the videos, a 5-point global quality scale was used (GQS: 1 = poor quality, 5 = excellent quality), for reliability a 5-point DISCERN scale was used, and for content an 8-point scale (higher points indicated greater reliability and better content). Of the 200 videos initially included in the study, 33 (37.9%) were classified as useful and 54 (62%) as misleading information. The reliability, content and quality scores of the videos in the useful information group were higher. The length (in seconds) of the videos in the useful information group (median 301, IQR 231–512) was longer than that of those in the misleading information group (median 163, IQR 94.8–231) (p = 0.003). The majority (70.6%) of the videos in the misleading information group had been uploaded by an individual user. The number of views per day of the videos in the misleading information group (median 58.6, IQR 18.5–298) was greater than that of the videos in the useful information group (median 49.7, IQR 16.3–268) (p = 0.276). The number of total views was higher for the misleading information group (median 83807 vs. 80237) but not at a level of statistical significance (p = 0.153). There were more videos explaining breast self-examination directed at women only, and there were determined to be few videos including men only or both genders. Although there are many videos in English related to breast self-examination on YouTube, a great many of these contain misleading information. Therefore, for public information, there is a need for videos with full and accurate information to be made by universities, healthcare organisations and doctors not benefitting from the outcomes, to be uploaded to YouTube, which is a currently important source of information for the general population.

WOS: 000446776000010, PubMed ID: 29750327, Purpose Inguinal hernia repairs are the most common interventions in adults in general surgery clinics. Depending on the type of mesh and repair, the incidence of mesh-related infection ranges from 0.6 to 8%. Methicillin-resistant Staphylococcus aureus is the most common microorganism causing graft infection. The aim of this study was to investigate the efficacy of nano-crystalline silver-coated polypropylene grafts against graft infection created with MRSA in rats. Methods A total of 60 female, Wistar albino rats were used in the study. Polypropylene grafts 1 x 1 cm in size were coated in silver ion-doped, calcium phosphate-based, antibacterial ceramic powder (NS-coated graft) to provide an antimicrobial effect. The MRSA seeding procedure was applied at the same time as surgery. In Group 1, normal graft was applied without MRSA seeding, in Group 2, normal graft with MRSA seeding, in Group 3, NS-coated graft without MRSA seeding, and in Group 4, NS-coated graft with MRSA seeding. For the groups which were to be infected, the bacteria were seeded in the surgical area during the operation. On the 7th day postoperatively, all the animals were killed. The grafts were removed and one from each group was examined under electron microscope and the others were implanted in culture medium and the number of colonies was counted after 24 h. Results In Groups 1 and 3, the incision site was seen t o have healed on day 3, no clinical surgical area infection was seen during follow-up, and in the exploration made on the 7th day, no findings of infection were observed. In Group 2, hyperemia and collection were seen to have formed on day 3, abscess had started to form in all the rats of this group on day 4, a purulent discharge in the wound site had started in 12 animals on day 5, separation of the wound site was observed in 6 on day 6, and in the exploration on day 7, there was seen to be a fibrin and pus-rich collection around the graft in all cases. In Group 4, there were hyperemia and collection in 6 animals on day 4, and in 3 of these, abscess was seen to have formed on the 5th day. No purulent discharge or wound separation was observed. In the exploration on the 7th day, it was seen that in the animals with abscess development, the formation was of a localized abscess. The results of the cultures of the grafts removed from Groups 1 and 3 showed no production, whereas production was seen in all the grafts removed from Groups 2 and 4. Clinical surgical area infection was seen to have developed in 100% of Group 2 and in 40% of Group 4. In the comparison of the number of colonies, a statistically significantly lower number of bacteria were determined in Group 4 compared to Group 2 (p < 0.05). In the SEM images taken of Group 2, bacteria clusters were seen attached to the graft. Conclusion Consistent with previous findings in the literature, the NS-coated polypropylene graft was seen to have a significantly better bactericidal effect than the normal polypropylene graft. Development of NS-coated grafts seems to be a reliable and applicable method to reduce the incidence of postoperative graft infection.

PubMedID: 30793798 Background: The purpose of this study was to investigate changes in best-corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SCT) after intravitreal aflibercept injections for neovascular age-related macular degeneration (NV-AMD). Methods: Eighty-nine eyes (48 treatment naive, 41 resistant) were included in this prospective study. All patients were treated with three consecutive monthly injections then every two months as required. BCVA, CMT and SCT were recorded and compared within and between the two groups. Results: The mean increase in BCVA after injections was 0.18 ± 0.34 logMAR in the naive group (p = 0.01) and 0.092 ± 0.38 logMAR in the resistant group (p = 0.131). The mean decrease in CMT was 200.3 ± 216.1 µm in the naive group and 183.3 ± 203.4 µm in the resistant group (p < 0.001 for both). The mean decrease in SCT was 22.1 ± 62.0 µm in the naive group (p = 0.014). The mean change in SCT was 22.28 ± 74.05 µm in the resistant group; this was not statistically significant (p = 0.061). Conclusion: BCVA, CMT and SCT decreased significantly after intravitreal aflibercept injections in naive patients with NV-AMD. Despite anatomic success, functional improvement was not reached and SCT did not significantly decrease after intravitreal aflibercept injections in resistant patients. © 2019 Optometry Australia

Background. With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This combined surgery offers several advantages besides limitations. The aim of this study is to assess the outcome and complications of phacoemulsification combined with pars plana vitrectomy (PPV). Patients and Methods. In this retrospective review, medical charts of patients undergoing phacovitrectomy for coexisting cataract and various vitreoretinal disorders were analyzed. Patient demographics, retinal diagnosis, visual acuities (VA) in logMAR, intraocular pressure (IOP), intraoperative and postoperative complications were assessed. Clear corneal phacoemulsification and 23-gauge transconjunctival PPV were administered in all cases. Results. Eighty-four eyes of 64 (76.2%) males and 20 (23.8%) females were enrolled. The average age of patients was 59.5 ± 13.8 (18–81). The average period of follow-up was 7.2 ± 7.5 months (1–36). The vitreoretinal diagnoses were as follows: 28 (33.3%) rhegmatogenous retinal detachment, 23 (27.4%) vitreous hemorrhage, 12 (14.3%) intraocular foreign body, 12 (14.3%) epiretinal membrane, 4 (4.8%) macular hole, 4 (4.8%) tractional retinal detachment, and 1 (1.2%) vitreomacular traction. The most common intraoperative complications were miosis and rupture of the posterior capsule (92.9% and 8.3%, respectively). In 8 (9.5%) cases, there was fibrin in the anterior chamber. Posterior synechia developed in 7 (8.3%) of cases. No severe increase in intraocular pressure was evident. Conclusion. Phacoemulsification combined with PPV is a safe and efficient way of management in cases where cataract coexists with vitreoretinal pathologies.

We present a very rare case of endogenous panophthalmitis in a postpartum patient. A 31-year-old woman was admitted with vision loss and pain in the right eye for two days that began the day after the delivery. Her ophthalmologic examination revealed panophthalmitis and she was hospitalized for treatment and investigation. Despite intensive medication corneal melting and spontaneous perforation occurred, so evisceration had to be performed. Sphingomonas paucimobilis, an opportunistic infection agent, was isolated in the conjunctival swab and evisceration specimen cultures of the patient. It is known that immune system is influenced and inflammatory responses are altered in pregnants and puerperants, so any symptom of eye infection should not be ignored in peripartum and puerperium periods., Bu çalışmada nadir görülen bir postpartum endojen panoftalmi olgusu sunulmuştur. Otuz bir yaşında kadın hasta, doğum yaptıktan bir gün sonra başlayan ve iki gündür devam eden sağ gözde ağrı ve görme kaybı yakınmasıyla başvurdu. Oftalmolojik muayenesinde panoftalmi bulguları izlenen hasta tetkik ve tedavi amacıyla yatırıldı. Yoğun tedaviye rağmen korneada incelme ve spontan perforasyon gelişmesi üzerine hastanın sağ gözüne evisserasyon uygulandı. Hastanın konjonktiva sürüntüsü ve evisserasyon örneği kültüründe fırsatçı bir enfeksiyon ajanı olan Sphingomonas paucimobilis izole edildi. Hamileler ve lohusalarda immun sistemin etkilendiği ve inflamatuar yanıtların değiştiği bilinmektedir, bu nedenle peripartum dönem ve lohusalıkta göz enfeksiyonları ihmal edilmemelidir.

PubMedID: 30605942 A 25-year-old female presented with a decrease of vision and redness in both eyes. She had a history of nodular melanoma in her right shoulder, which was excised surgically and she was under oral vemurafenib treatment. She was diagnosed with moderately severe bilateral panuveitis and hospitalized for systemic investigation and workup. The laboratory test results were unremarkable and systemic workup failed to reveal an etiology. The condition was considered vemurafenib-induced uveitis, as the drug is known to be associated with uveitis. After reevaluation with the oncology department, vemurafenib was stopped and topical and systemic corticosteroid therapy was started. The uveitis resolved and her vision returned to normal. No sign of recurrence was detected at 8-month follow-up. © 2018 by Turkish Ophthalmological Association Turkish Journal of Ophthalmology.

PubMedID: 25362536 Here, we describe a case of keratitis caused by Aspergillusterreus in an 80-year-old immunocompetent woman 1 month after uneventful cataract surgery. The patient presented with decreased visual acuity (20/50) and severe pain in her right eye. Examination revealed a 3.5 × 4.5 mm white-colored deep stromal infiltration located on the temporal corneal tunnel incision. Corneal scraping samples were obtained for cytological and culture examinations. The cinnamon-brown colonies consisting of a dense felt of conidiophores were identified as A. terreus using molecular data. Using CLSI M38-A2 microdilution method, minimum inhibitory concentration values of amphotericin B, itraconazole, voriconazole, and posaconazole were determined to be 2, 1, 0.25, and 1 µg/ml, respectively, and minimum effective concentration values of caspofungin and anidulafungin were ?0.03 and ?0.03, respectively, at 48 h for the A. terreus strain. Antifungal therapy was started as topical 1 % voriconazole drops hourly and 5 % natamycin ointment five times a day; however, corneal infection and melting progressed despite the ongoing intensive treatment and visual acuity dropped to the 20/200 level at the end of the first week. Amniotic membrane transplantation was performed to promote corneal healing. Topical medication was tapered and discontinued within 2 months based on the clinical features. The ulcer healed with scarring and vascularization, and visual acuity improved to 20/50. In conclusion, A. terreus is a very uncommon cause of mycotic keratitis and is especially rare after cataract surgery. We suggest that early and accurate diagnosis and appropriate treatment of A. terreus keratitis may have a major impact on preventing severe disease complications. © 2014, Springer Science+Business Media Dordrecht.

PubMedID: 24654996 Purpose: To report a case of bilateral central retinal artery occlusion as the primary ocular manifestation of Behçet disease.Methods: A 38-year-old patient, with no history of previous ocular complaints, admitted with bilateral sudden vision loss. His ophthalmologic examination revealed a visual acuity of no light perception in both eyes and the diagnosis of bilateral central retinal artery occlusion. A detailed systemic investigation was conducted.Results: With the history of recurrent oral and genital ulcers, and the presence of ocular and skin findings, the diagnosis of Behçet disease was made. Despite a potent immunosuppressive therapy the patient became absolutely blind.Conclusions: Even though retinal arteries are rarely affected in Behçet disease, in the cases of retinal artery occlusion, it should be considered among the differential diagnosis. To our knowledge this is the first reported case of bilateral central retinal artery occlusion as the primary ocular manifestation of Behçet disease. © 2015 Taylor & Francis Group, LLC.

PubMedID: 26426482 Purpose: To present two cases of acute endophthalmitis after intravitreal dexamethasone implant injection and discuss the management of intravitreal implant-associated endophthalmitis. Methods: Two patients, who underwent intravitreal dexamethasone implant injection for macular edema secondary to diabetic retinopathy in one and branch retinal vein occlusion in the other, were admitted with decreased vision, pain, and redness in their treated eyes, 3 days and 5 days after the injection, respectively. The clinical findings of both patients were consistent with acute endophthalmitis. Results: After obtaining aqueous and vitreous samples, the patients were treated with intravitreal antibiotic injection and topical fortified antibiotics. Both patients revealed favorable clinical response and functional vision was recovered. Conclusion: Intravitreal dexamethasone implant-associated endophthalmitis is an uncommon and a challenging situation. Intravitreal antibiotics may lead to favorable visual outcomes without the need for a pars plana vitrectomy and implant removal in selected cases. Copyringht © by Ophthalmic Communications Society, Inc.

Objectives: To determine the rate of infants with retinopathy of prematurity (ROP) requiring treatment, to investigate the relation of this rate with birth age and birth weight, and to discuss the screening criteria eligible for our country. Materials and Methods: Medical records of premature infants examined for ROP with birth weight ≤2000 gram (g) and/or gestational age ≤34 weeks were evaluated. Patients were grouped according to their birth weights as ≤1000 g, 1001-1500 g, >1500 g, and according to gestational age as ≤27 weeks, 28-31 weeks, ≥32 weeks. The rate of patients with treatment-requiring ROP was evaluated in these groups. The birth weights and gestational ages of these patients were analyzed. Results: Treatment requiring ROP stages were detected in 100 (8%) of 1250 infants. The mean gestational age and birth weight of these patients was 28.3±2.3 (24-34) weeks and 1152.2±396 (520-2120) g respectively, and both were found lower than those of nontreated infants (p1500 g required treatment. According to the gestational age, 33 (19.4%) of 170 infants ≤27 weeks, 59 (10.3%) of 572 infants between 28-31 weeks, 8 (1.6%) of 508 infants ≥32 weeks required treatment. Conclusion: The best way to avoid the vision loss due to ROP is to establish a regular screening program including every infant that may require treatment. So we recommend that screening criteria for our country should be wider than applied in developed countries, and babies having gestational age ≤34 weeks and/or birth weight ≤2000 g should be screened for ROP. (Turk J Ophthalmol 2014; 44: 42-6)

PubMedID: 26968412 To investigate the efficiency and safety of a single injection of intravitreal dexamethasone implant in eyes with persistent diffuse diabetic macular edema (DME). In this retrospective study, 25 eyes of 20 patients, who underwent a single injection of intravitreal dexamethasone implant for the treatment of persistent diffuse DME, were reviewed. Main outcome measures included the changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline at scheduled visits following injection. The mean BCVA showed improvement from baseline (0.97 ± 0.26 logMAR) at every visit; the difference was significant at day 7 (0.85 ± 0.3 logMAR, p = 0.003), month 1 (0.77 ± 0.32 logMAR, p

PubMedID: 27870799 Purpose: To investigate changes in choroidal thickness after intravitreal injection of a dexamethasone implant for macular edema due to retinal vein occlusion. Methods: Thirty-one eyes of 31 patients, treated with a single dose of a dexamethasone implant for retinal vein occlusion-associated macular edema, were included. Subfoveal choroidal thickness (SFCT) and central macular thickness of the affected eyes were compared with those of the normal contralateral eyes at baseline and 1, 3, and 5 months after injection. Results: The mean SFCT of the affected eyes (296.3 m ± 61.6 m) was significantly higher than that of the contralateral eyes (251.2 m ± 57.7 m; P < 0.001) at baseline. After injection, the mean SFCT was decreased compared with baseline in the treated eyes at months 1, 3, and 5. There was a correlation between SFCT and central macular thickness in the affected eyes at baseline (r = 0.397, P = 0.027). The change in SFCT was not correlated with the change in central macular thickness after injection. In the contralateral eyes, the mean SFCT did not change significantly. Conclusion: Subfoveal choroidal thickness in eyes with macular edema due to retinal vein occlusion was higher than that of the contralateral eyes. Intravitreal injection of a dexamethasone implant was associated with a reduction in the choroidal thickness of the treated eye.

PubMedID: 26902374 Purpose: To evaluate choroidal thickness (CT) and investigate the involvement of choroidal circulation in patients with systemic sclerosis (SSc). Methods: A total of 120 eyes of 60 SSc patients and 60 eyes of 30 healthy controls were evaluated. CT measurements were performed at the subfoveal region, 1000 µm nasal and 1000 µm temporal to the fovea, using enhanced depth imaging optical coherence tomography. CT measurements were compared between the patients and controls. Results: The average subfoveal, parafoveal nasal and parafoveal temporal CT were significantly thinner in SSc patients when compared with healthy controls (297.77 ± 60.8 µm vs 339.8 ± 50.4 µm; 267.32 ± 51.1 µm vs 308.65 ± 49.9 µm; 270.63 ± 46.3 µm vs 309.22 ± 42.4 µm, respectively; p

have been reported in the text. The authors have wondered whether there is a significant difference between the three groups (control, MS ON and MS non-ON). As we have mentioned in detail in the article, both MS ON and MS non-ON eyes had significantly reduced average-RNFL thickness measurements when compared with healthy controls, and the average-RNFL thickness measurements in MS ON eyes were significantly thinner than those in MS non-ON eyes. We believe that the measurement of RNFL thicknesses might be a useful parameter for the assessment of the axonal loss and for monitoring the effects of demyelination on visual pathway integrity as complementary tools to other functional markers in MS patients. Dear Editor We thank Yolcu and Ilhan [1] for their valuable contributions to our article entitled Evaluation of choroidal vascular changes in patients with multiple sclerosis using enhanced depth imaging optical coherence tomography [2] . In our study, we evaluated the choroidal thickness in multiple sclerosis (MS) patients with enhanced depth imaging optical coherence tomography to provide insight into the potential effects of the disease on vessel structure. We also evaluated the average retinal nerve fiber layer (RNFL) thickness and compared the measurements of MS eyes with optic neuritis (ON; MS ON), MS eyes without ON (MS non-ON) and controls. The average values and the statistical significance of differences between these three groups Received: November 20, 2015 Accepted: November 26, 2015 Published online: January 5, 2016

Delayed bleeding after hemoroidectomy is very rare. Hemorrhoidectomy with LigaSure® provides a better postoperative period than other methods. However, delayed bleeding may ocur after hemorrhoidectomy with LigaSure

PubMedID: 23941569 Diphtheroids were generally regarded as nonpathogenic contaminants, but recent clinical studies have emphasized that they may cause serious systemic and ocular disease mostly in patients with underlying medical conditions. In this study we present a case report of acute onset endogenous endophthalmitis associated with heavy growth of diphtheroids on the culture of anterior chamber fluid sample in a 46-year-old man with uncontrolled diabetes mellitus. He did well after appropriate treatment and a functional vision was restored. This case highlights the importance of proper management for the outcomes of patients with endogenous endophthalmitis. It is also significant to be cautious about a life-threatening medical status in a patient with such presentation. © Informa Healthcare USA, Inc.

In this study, a case with tubercular choroiditis showing severe macular edema and progression of choroidal lesions following initiation of antitubercular treatment is presented and the management of posterior uveitis associated with tuberculosis is evaluated. A 40-year-old female patient was admitted with decreased vision in her right eye and her fundoscopic examination revealed serpiginous choroiditis. It was learned from her medical history that she had taken antitubercular therapy 9 years ago. Mantoux tuberculin skin test showed an area of induration measuring 15 mm and a positive interferon-gamma release assay was documented. Additionally, sequelae lesions due to previous tubercular infection were remarkable on her chest imaging. By excluding other causes of uveitis, the patient was considered presumed ocular tuberculosis and a full standard course of 4-drug antitubercular therapy was initiated. On the seventh day of the treatment existing choroidal lesions showed progression, new foci of choroiditis appeared and severe macular edema occurred. After adding systemic corticosteroid to the treatment, the macular edema resolved and choroidal lesions began to inactivate. In patients with tubercular choroiditis, continued progression may develop after initiation of antitubercular therapy. This paradoxical worsening is thought to be a hyperacute immunologic reaction occurring against antigen load released after antitubercular therapy. This phenomenon may be suppressed by the addition of systemic corticosteroids to the treatment. © 2016, Turkish Ophthalmology Society. All rights reserved.

PubMedID: 25014150 Purpose: To report our experience in the treatment of intraepithelial neoplasia of the conjunctiva using topical bevacizumab. Methods: Ten eyes of 10 patients with conjunctival neoplasia received 25 mg/mL bevacizumab topically. Changes in the lesions were documented weekly using digital photography. After topical treatment, excisional biopsy was performed. Results: The mean age of the patients was 60.5 ± 12 (33-77) years. The mean duration of topical treatment was 7.8 ± 1.3 (5-14) weeks. The size and vascularity of the tumors reduced weekly. All patients underwent excisional biopsy, cryotherapy, and amnion membrane transplantation. The histopathologic diagnosis of the lesions was carcinoma in situ. No recurrence was observed during the follow-up of patients for 6 months. Conclusions: Topical bevacizumab is an effective treatment to reduce the tumor size before surgery and may be a good alternative for adjuvant therapy of conjunctival neoplasms. Copyright © 2014 by Lippincott Williams & Wilkins.

Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

PubMedID: 23410261 Objective: To investigate the clinical results of topical anesthetic drug (TAD) abuse and to evaluate the results in terms of preventive medicine and public health. Methods: Patients who had been followed in a cornea unit between March 2009 and November 2011 for TAD abuse keratopathy were included in the study. The demographics, duration of TAD use, symptoms, ocular findings, treatment modalities, visual acuities, complications and accompanying psychiatric problems data were obtained from medical records. Results: Twelve eyes of 8 patients (3 females and 5 males) were evaluated retrospectively. One of the patients was provided the drug with a primary care pratitioner's prescription and for the other 7 patients, it was available from pharmacies without prescription. According to their clinical history, 4 patients were suffering from exposure to welding flash with a corneal foreign body, 2 from lagophthalmus-related keratopathy, 1 from traumatic corneal abrasion, and 1 from exposure to silica dust at work. The mean duration of TAD usage was 14.8 ± 7.78 days. Slit-lamp examination revealed corneal epithelial defect in all eyes, stromal opacity in 11 eyes and ring-shaped infiltrates in 8 eyes. Conclusion: Uncontrolled overuse of TAD can lead to serious ocular morbidities. Similarity of the clinical signs of this abuse to those of infectious keratitis together with the fact practitioners and managers to take measures to prevent the ready supply of these drugs from pharmacies and to raise public awareness with education programs. © 2013 Informa Healthcare USA, Inc.

Purpose: The aim of this study is to determine risk factors associated with delayed regression of retinopathy of prematurity and prolonged vascular completion in patients not requiring treatment. Material and Methods: Patients with acute retinopathy of prematurity not requiring treatment were grouped as control and delayed vascularization groups, on condition that retinal vascularization had completed before postconceptional age of 50 weeks or not. Patients with retinopathy of prematurity requiring treatment constituted treatment group. A total of 17 possible risk factors that may affect the time course of retinal vascularization in patients with acute retinopathy of prematurity were evaluated. Results: Multivariate regression analysis showed that low Apgar score at fifth minute and blood transfusion were associated with an increased risk of delayed vascularization when compared with controls. Low gestational age and presence of patent ductus arteriosus were risk factors for retinopathy of prematurity that require treatment when compared with delayed vascularization group. Conclusion: Low Apgar score and blood transfusion might be predictive factors for prolonged retinal vascularization in patients with retinopathy of prematurity not requiring treatment. Having a higher gestational age and absence of patent ductus arteriosus, appeared as reducing the risk of progressing to serious disease requiring treatment for an infant with retinopathy of prematurity that undergo regression slowly.

Background Uveitis is inflammation of uvea (iris, ciliary body, choroid). Uveitis is classified as anatomically (anterior, intermediate, posterior, panuveitis) and etiologically (infectious, non-infectious and masquerade) (1). Objectives The aim of this study was to investigate etiology and clinical properties of uveitis in a tertiary center in Turkey. Methods Uveitis patients who admitted to our hospital from 2013 to 2015 were evaluated. Age, gender, type of uveitis, course of the attacks and etiology were noted. Results One hundred patients with uveitis (54% men, 46% women; age 40.01±14.1 years) were included in the study. The course of the disease was mostly acute (42%) followed by recurrent (36%) and chronic form (22%). Specific diagnosis was established in 68% of patients; whereas 32% of patients were evaluated as idiopathic. Etiology was spondiloartropathy (SpA) in 30%, Behcet9s disease in 16%, infectious in 13%, connective tissue disease associated in 6%, sarcoidosis in 2% and malignancy associated uveitis in 1% of the patients. 67% of the patients had unilateral and 33% of patients had bilateral uveitis. The characteristic properties of patients with SpA were as 56% men and 43% women; aged 43.57 ± 16.45 years. 60% of the patients with SpA had anterior, 40% had panuveitis. 46% of SpA patients had recurrent, 43% had acute and 10% had chronic uveitis. HLA B27 was positive in 50% of SpA patients. Sacroiliitis on MRI was detected in 76% of patients. There were 32 idiopathic uveitis patients (53.1% women). Panuveitis was the most common type (37.5%) among idiopathic uveitis patients, followed by posterior uveitis (34.4%), anterior uveitis (21.9%) and intermediate uveitis (6.2%), respectively. There were 16 patients with Behcet9s disease, 62.5% of them were men. 62.5% of patients with Behcet9s disease had panuveitis, 18.8% had anterior and 18.8% had posterior uveitis. Conclusions According to the literature posterior segment involvement is a rare presentation of SpA associated uveitis (2).The results of this study are noteworthy that higher incidence of panuveitis can be seen in SpA patients. References Deschenes J, Murray PI, Rao NA, Nussenblatt RB; International Uveitis Study Group. International Uveitis Study Group (IUSG): Clinical classification of uveitis. Ocul Immunol Inflamm. 2008 Jan-Feb;16(1):1–2. Ali A, Samson CM. Seronegative spondyloarthropathies and the eye. Curr Opin Ophtalmol. 2007 Nov;18(6):476–80. Disclosure of Interest None declared

Objective: To evaluate the choroidal thickness in patients with multiple sclerosis (MS) using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this observational comparative study, 68 eyes of 34 MS patients and 60 eyes of 30 healthy subjects were evaluated. All participants underwent complete ophthalmologic examination and OCT scanning. Choroidal thickness measurements were performed at seven points. Results: The mean subfoveal choroidal thickness was reduced significantly in MS patients (310.71 ± 61.85 μm) versus healthy controls (364.85 ± 41.81 μm) (p < 0.001). The difference was also significant at all six measurement points (p < 0.001 for all). Choroidal thickness measurements revealed no significant difference between MS eyes with a prior optic neuritis (ON) history (MS ON) and those without ON history (MS non-ON). Subfoveal choroidal thickness did not correlate with retinal nerve fiber layer and Expanded Disability Status Scale score, but reduced choroidal thickness was associated with longer disease duration (r = -0.28, p = 0.019) in MS patients. Conclusion: In MS patients, choroidal structural changes occur both in MS ON and MS non-ON eyes. The decreased choroidal thickness might provide evidence to support a potential role of vascular dysregulation in the pathophysiology of MS.