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Objectives: The aim of the study was to evaluate the patients who received simultaneous subretinal tissue plasminogen activator (tPA) and bevacizumab for submacular hemorrhages secondary to neovascular age-related macular degeneration. Methods: This retrospective study included patients who underwent pars plana vitrectomy (PPV) with simultaneous subretinal tPA and subretinal bevacizumab with 18% SF6 tamponade. Anatomical and functional results of the patients before surgery and at the 1st, 6th, and 12th months after surgery, additional treatments, and complications after PPV were evaluated. Results: Eight eyes of eight patients were included in the study. The mean age of the patients was 72.38±92.3. The mean time from the onset of symptoms to treatment was 5.13±1.88 days. The patients' mean best-corrected visual acuity (BCVA) was 2.23±0.14 logMAR at baseline. Mean BCVA increased significantly at 1st, 6th, and 12th months to 1.68±0.47 logMAR, 1.58±0.49 logMAR, and 1.51±0.58 logMAR, respectively (p=0.001 at all). The mean central foveal thickness (CFT) in measurable patients was 836.8±627.02 µm at baseline. Mean CFT decreased significantly to 370.13±66.13 µm in the 1st month, 373.38±78.33 µm in the 6th month, and 367.75±116.43 µm in the 12th month (p<0.05). The maximum measurable subretinal hemorrhage height at baseline was 814.2±556.45 µm. The mean number of anti-VEGFs performed for 12 months after surgery was 4.13±2.1. At month 12, the ellipsoid zone could not be detected in 6 (75%) patients. Conclusion: Administration of subretinal bevacizumab and subretinal tPA effectively removes subretinal hemorrhage under the fovea. Intravitreal anti-VEGF treatment must be continued, as choroidal neovascular membrane activity continues after surgery. [ABSTRACT FROM AUTHOR]

A 16-year-old type 1 diabetic female patient was consulted to our clinic for acute bilateral painless vision loss with a 2-week history in the right eye and a 1-week history in the left eye. At the initial visit, the best-corrected visual acuity was 0.2 in the right eye and 0.05 in the left eye. In fundus examination, both optic disks were pale and slightly swollen. In both eyes, superficial telangiectatic vessels were extending from the optic disk to the retina. Telangiectatic vessels disappeared within 10 days with systemic hypertension regulation and without any ocular treatment. [ABSTRACT FROM AUTHOR]

Purpose: To report our treatment approaches and results in patients whose retinopathy progressed to advanced diabetic eye disease during the pandemic period. Materials and Methods: In this single-centered, retrospective case series, medical records were reviewed for patients who could not come to the controls and not receive treatment, and whose retinopathy progressed to advanced diabetic eye disease during the pandemic period. Anatomical and functional results, and complications after treatments were evaluated. We recorded the data from the initial visit to last followup 3rd month visit after treatments. Results: Seventeen eyes of 16 patients were included in the study. Before the pandemic, 4 (23.5%) eyes had severe NPDR and 13 (76,5%) eyes had mild, moderate or high risk PDR. These patients did not want to come to the hospital and have their treatments because of the danger of COVID-19, although we called them by phone. In post-pandemic visit nine eyes (52.9%) had grade 3-4 vitreous hemorrhage, 5 (29.4%) had neovascular glaucoma, 1 (5.8%) eye had neovascularization iris without glaucoma. Two (11.7%) eyes had macular tractional retinal detachment. Visual acuity increased significantly in eyes with vitreous hemorrhage, but in eyes with neovascular glaucoma and tractional retinal detachment, visual acuity did not increase significantly in the 3rd month when compared to before the pandemic (p = 0.001, p = 0.65, p=0.052). Conclusion: In some of the patients with diabetic retinopathy who could not have their controls and treatments due to pandemic, permanent vision loss developed. Patients with diabetic retinopathy should be adequately informed about the complications of diabetes and should be encouraged to have their treatments during the pandemic period. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate and compare the effects of hybrid contact lenses (HCLs) and mini-scleral contact lenses (MSCLs) on visual acuity, spherical equivalent, topographic astigmatism, and higher-order aberrations (HOAs) in eyes with advanced keratoconus. Methods: We reviewed the medical records of 43 eyes of 27 patients diagnosed with advanced keratoconus fit hybrid contact lenses (AirFlex®) and mini-scleral contact lenses (Mini-misa®). Pre-fitting examinations included best corrected visual acuity (BCVA), spherical equivalent, topographic findings (topographic astigmatism, maximum keratometry, mean keratometry, central corneal thickness, thinnest corneal thickness, and corneal HOAs. Post-fitting examinations included lens corrected visual acuity, spherical equivalent, topographic astigmatism, corneal HOAs, and contact lens-related discomfort symptoms. Results: Mean BCVA (log MAR) improved significantly from 0.65±0.27 to 0.14±0.09 with HCL and 0.58±0.25 to 0.15±0.13 with MSCL (p<0.05). The mean spherical equivalent and topographic astigmatism measurements decreased significantly in both groups (p<0.05). Eight patients in the HCL group experienced lens-related discomfort. Root-mean square HOA decreased significantly in both groups (p<0.05). Conclusion: Significant improvements in visual acuity, spherical equivalent, topographic astigmatism, and HOAs were observed with both lenses. However, higher patient comfort with scleral lenses may lead to higher compliance in patients with advanced keratoconus. [ABSTRACT FROM AUTHOR]

A 24-year old female patient presented to our clinic with bilateral visual impairment since birth. Best corrected visual acuity was light perception in both eyes. At fundus examination there were mulberry-like, yellowish-white nodules along the peripapillary margins. There was attenuation of retinal vasculature, bone-spicule-like pigment deposition in the general fundus, macular edema in the right eye and macular atrophy in the left eye. Fundus autofluorescence (FAF) imaging of the bilateral peripapillary retina and optic nerve head showed increased autofluorescence. It is important to clinically detect retinal astrocytic hamartoma (RAH). It may be with Leber's Congenital Amaurosis and optic nerve drusen. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of intraocular tamponade use on anatomic and functional results and complications in pars plana vitrectomy (PPV) performed simultaneously with sutureless intrascleral lens implantation. Methods: Patients were divided into two groups according to the type of tamponade used in surgery. Group-1 included patients who underwent 23G PPV with simultaneous 27G needle-assisted sutureless three-piece intrascleral lens implantation and intraocular silicone tamponade. Group-2 included patients who underwent 23G PPV with simultaneous 27G needle-assisted sutureless three-piece intrascleral lens implantation and intraocular C3F8 tamponade. Best corrected visual acuities (BCVA), centralization and stabilization of the intraocular lens, and complications were compared between the two groups. Results: 15 eyes of 15 patients were included in Group-1, and 14 eyes of 14 patients in Group-2. Preoperative BCVA of Group-1 was 1.82 logMAR, and significantly increased to 0.71 logMAR at the 6th month (p = 0.022). Preoperative BCVA of Group-2 was 1.92 logMAR, and significantly increased to 0.67 logMAR at the 6th month (p = 0.029). There was no significant difference between the visual acuities of both groups at 6 months (p = 0.09). At sixth month, intraocular lens in both groups was centralized and stabilized in biomicroscopic examination and cycloplegic refraction. The most common early complication was increased intraocular pressure, and developed in 4 (26.6%) patients in Group-1 and 3 (21.4%) patients in Group-2. Conclusion: 23G PPV with silicone or C3F8 tamponade can be performed simultaneously with 27G needle-assisted sutureless intrascleral lens implantation. [ABSTRACT FROM AUTHOR]

Axenfeld-Rieger syndrome (ARS) is a genetic disease affecting multiple organ systems. In the eye, it is associated with anterior segment dysgenesis with a high risk for glaucoma. Dental anomalies, cardiovascular malformations, hypospadias, and craniofacial abnormalities are other associated systemic conditions. Five years old monozygotic twin brothers with ARS were referred to Umraniye Training and Research Hospital, ophthalmology clinic for iris abnormalities. At presentation, pathognomonic components of ARS were found in both patients, including iris anomaly (corectopia, iris hypoplasia, and iris strands in Scwalbe’s ring), oligodontia, hypodontia, hypospadias, and periumbilical skin fold. Intraocular pressure was within normal ranges in both of the patients. Patients were followed up in the glaucoma unit. [ABSTRACT FROM AUTHOR]

Optic nerve avulsion is a rare form of anterior traumatic optic neuropathy. Usually severe and permanent vision loss develops in the affected eye. In this case report I showed a partial optic nerve avulsion case with 12 months follow-up with pictures. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate correlation between visual field indices and spectral domain optical coherence tomography (SD-OCT) parameters and correlation among SD-OCT parameters to have a better understanding of role of SD-OCT parameters in clinical practice. Materials and Methods: This is a retrospective controlled clinical study. Three hundred forty-three eyes (91 healthy, 80 ocular hypertension, 97 preperimetric glaucoma and 75 early glaucoma eyes) were analyzed. Retinal nerve fiber layer (RNFL), macular, optic nerve head (ONH) parameters were measured with SD-OCT. Correlation between visual field indices and SD-OCT parameters and correlation among SD-OCT parameters were calculated. Results: Average RNFL showed the best correlation with both mean deviation (MD) (r = 0.624) and pattern standard deviation (PSD) (r = 0.614). Other RNFL parameters, ganglion cell complex (GCC) parameters and total retina (TR) parameters showed moderate correlation whereas outer retina (OR) and ONH parameters showed poor correlation with MD. Correlation between RNFL and GCC parameters was strong. Correlation between RNFL and TR parameters was moderate. Poor correlation were found between OR parameters and both RNFL and GCC parameters. Moderate correlation was found between average RNFL and both rim area and rim volume. Other correlations with ONH parameters were poor. Conclusion: Good structure function relationship is present between visual field indices and SD-OCT parameters like RNFL and GCC parameters. These parameters reflect the severity of glaucoma and can be used for glaucoma monitoring. TR and some ONH parameters like rim area and volume can give supplementary information to use in clinical practice. [ABSTRACT FROM AUTHOR]

A 45-year-old female patient consulted our hospital for bilateral visual loss. She was receiving hemodialysis for 15 years. At presentation ophthalmologic examination, her visual acuity was hand movements in the right eye and light perception negative in the left eye. The direct light response was weak in the right eye and absent in the left eye. A total afferent pupillary defect was detected in the left eye. Fundoscopy revealed bilateral sectorial pale, sectorial hyperaemia and swollen optic discs. On the left papilla, there were splinter haemorrhages. At the right eye, there was pale edema at superior maculo-papillary bunch that coherent with occlusion of the cilioretinal artery. She was diagnosed as non-arteritic ischemic optic neuropathy based on the clinical and funduscopic examination. Methylprednisolone intravenous 1000mg/day for three days, then, oral methylprednisolone 1 mg/kg/day were administered for one week. Simultaneous acetylsalicylic acid 325 mg/day and hydration with 0.9% 1000cc isotonic solution treatment started. After two months, visual acuities did not change in both eyes, and both optic disks were pale. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of low, moderate, and high myopia on the thickness of the retinal nerve fiber layer (RNFL) and Ganglion cell complex (GCC) measured by Spectral Domain Optical Coherence Tomography (SD-OCT) in non-glaucomatous subjects.Methods: The subjects were divided into three groups: low (n = 81, 35.6%), moderate (n = 79, 34.8%), and highly myopic eyes (n = 67, 29.5%). The RNFL thickness profile, including the average, superior, nasal, inferior, and temporal quadrant and each of the eight directional thicknesses, was measured. GCC parameters, including the average, superior, and inferior values, the focal loss volume (FLV), and the global loss volume (GLV), were measured. The correlation between the OCT measurements and the axial length was evaluated.Results: The average, superior, inferior, and nasal RNFL thicknesses of low and moderate myopic eyes were found to be significantly higher than those of highly myopic eyes. The temporal RNFL thicknesses were not different among the three groups. The average, superior, and inferior ganglion cell complex values of low and moderate myopic eyes were significantly higher than those of highly myopic eyes. The FLV and GLV of low and moderate myopic eyes were significantly higher than those of highly myopic eyes (p = 0.001 for all). In the moderate and high myopia groups, the average RNFL thickness and GCC thickness were both negatively correlated with the axial length.Conclusion: Highly myopic subjects tend to have thinner RNFL and GCC thicknesses than subjects with low and moderate myopia. [ABSTRACT FROM AUTHOR]

Purpose: To identify any patterns in the cause of anterior uveitis in a Turkish population and compare them with results from previous studies. Methods: The clinical records of 75 patients between January 2009 and January 2010 were retrospectively analyzed and classified as anterior uveitis according to Standardization of Uveitis Nomenclature criteria. Complete blood count, sedimentation rate, chest radiography, purified protein derivative skin test, and venereal disease research laboratory test were done on all patients. Additional serologic and radiographic tests were performed when indicated. Results: Forty-one (54.6%) were male and 34 (45.3%) were female patients. The mean age at presentation was 39.1 ± 12.6 years. Fifty-six (74.6%) had unilateral and 19 (25.3%) had bilateral disease at presentation. A specific diagnosis was able to be established in 54 (72%) patients. The most common diagnoses were anterior uveitis associated with human leukocyte antigen B27 (14.6%) and Fuchs uveitis syndrome (14.6%). The second most common diagnosis was uveitis associated with herpes simplex virus (13.3%), followed by Behcet's uveitis (6.6%). Systemic disease associations were noted in 15 (20%) patients, and the most commonly associated systemic disease was Behcet's disease (6.6%). Conclusion: Fuchs uveitis syndrome and anterior uveitis associated with human leukocyte antigen B27 were the most common form of anterior uveitis in this study. Using a systematic approach, a diagnosis was able to be established in 72% of the anterior uveitis cases. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of Acute Retinal Necrosis (ARN)-developed nephrotoxicity during intravenous acyclovir treatment and toxic hepatitis during oral valacyclovir treatment. Design: Interventional case report. Methods: Retrospective chart review. Results: A 45-year-old male with ARN treated with intravenous acyclovir developed nephrotoxicity. After switching to oral valacyclovir, toxic hepatitis developed. Both renal and liver function tests returned to normal levels after drug cessation Conclusions: Although rare, clinicians should be aware of the potential nephrotoxic and hepatotoxic side effects of antiviral therapy during ARN treatment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate and compare the effects of hybrid contact lenses (HCLs) and mini-scleral contact lenses (MSCLs) on visual acuity, spherical equivalent, topographic astigmatism, and higher-order aberrations (HOAs) in eyes with advanced keratoconus., Methods: We reviewed the medical records of 43 eyes of 27 patients diagnosed with advanced keratoconus fit hybrid contact lenses (AirFlex®) and mini-scleral contact lenses (Mini-misa®). Pre-fitting examinations included best corrected visual acuity (BCVA), spherical equivalent, topographic findings (topographic astigmatism, maximum keratometry, mean keratometry, central corneal thickness, thinnest corneal thickness, and corneal HOAs. Post-fitting examinations included lens corrected visual acuity, spherical equivalent, topographic astigmatism, corneal HOAs, and contact lens-related discomfort symptoms., Results: Mean BCVA (log MAR) improved significantly from 0.65±0.27 to 0.14±0.09 with HCL and 0.58±0.25 to 0.15±0.13 with MSCL (p<0.05). The mean spherical equivalent and topographic astigmatism measurements decreased significantly in both groups (p<0.05). Eight patients in the HCL group experienced lens-related discomfort. Root-mean square HOA decreased significantly in both groups (p<0.05)., Conclusion: Significant improvements in visual acuity, spherical equivalent, topographic astigmatism, and HOAs were observed with both lenses. However, higher patient comfort with scleral lenses may lead to higher compliance in patients with advanced keratoconus., Competing Interests: Conflict of Interest: None declared., (Copyright: © 2022 by Beyoglu Eye Training and Research Hospital.)

Purpose: To compare the outcomes of treatment with intravitreal bevacizumab (IVB) versus observation in central serous chorioretinopathy (CSCR)., Methods: In a retrospective comparative study, records of 45 patients with CSCR were reviewed. Twenty-two patients received IVB (1.25 mg/0.05 ml) while 23 subjects were observed. All subjects underwent measurement of best corrected visual acuity (BCVA) and intraocular pressure (IOP), dilated fundus examination and optical coherence tomography (OCT) imaging at baseline and follow up visits. Outcome measures included central macular thickness (CMT) and BCVA in logarithm of minimum angle of resolution (logMAR) notations., Results: Mean age was 44.1 ± 9.3 (range: 24 to 64) years and mean follow-up period was 10.4 ± 11.2 (range: 3 to 43; median: 6) months. All patients demonstrated resolution of neurosensory detachment and improvement in visual acuity. At final visit, there was no significant difference in mean CMT between the IVB and observation groups (275 vs 284 μm, P> 0.05). Mean baseline logMAR visual acuity was 0.38 ± 0.24 in the IVB group which improved to 0.24 ± 0.31 at final follow-up (P = 0.011); mean baseline logMAR visual acuity was 0.42 ± 0.28 in the observation group and improved to 0.12 ± 0.18 (P = 0.001). Visual improvement was more marked in the observation group (0.30 vs 0.14 logMAR, P< 0.05) and mean final visual acuity was also significantly better (P = 0.05)., Conclusion: There was no significant difference between IVB injection and observation in terms of anatomical outcomes of treatment for CSCR. In terms of visual outcomes, observation was superior to IVB injection.