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Purpose:To assess dry eye disease characteristics of pediatric patients with diabetes.Twenty-one patients with type-1 diabetes mellitus (DM), 20 with type-2 DM, 19 with maturity-onset diabetes of the young (MODY), and 20 control participants were included in the study. Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test with anesthesia, and conjunctival impression cytologic analysis were performed.In Group 1, the Schirmer test and TBUT values were lower than the control group. In groups 1 to 3, OSDI scores were higher than the control group. In Groups 1 and 2, the goblet cell density was lower than the control group.Dry eye parameters of all three diabetic groups were adversely affected in favor of dry eye disease. Children with MODY have increased OSDI scores. Alterations in the conjunctival impression cytology were observed more prominently in patients with type-1 DM.This was a prospective, cross-sectional study. This study included 21 patients in group 1 who had been diagnosed with type-1 DM, 20 patients in group 2 who had been diagnosed with type-2 DM, 19 patients in group 3 who had been diagnosed with MODY, and 20 healthy participants in the control group. This study was conducted in collaboration with the departments of ophthalmology, pediatric endocrinology and metabolism, and histology embryology in a tertiary hospital. The study was designed considering the stipulations given by the Declaration of Helsinki, and appropriate approval was obtained from the ethics committee (approval code 2021/07-33). The parents or legal guardians of the patients or participants provided written informed consent before they participated in the study. Patients with diabetes were selected from among ophthalmology clinic patients who had been referred by the pediatric endocrinology and metabolism clinic to undergo routine eye screening. The control group consisted of healthy participants who did not have any systemic or ocular

Article; Early Access, Purpose:To investigate choroidal vascularity in children with attention-deficit/hyperactivity disorder (ADHD) who were not receiving therapy, children with ADHD who were regularly taking methylphenidate (MPH), and healthy controls.Methods: The study included three groups: patients with newly diagnosed ADHD without treatment, patients diagnosed as having ADHD who were already being treated with oral MPH, and controls. Both choroidal vascularity index (CVI) and choroidal thickness were measured using an enhanced-depth imaging mode of spectral-domain optical coherence tomography (EDIOCT) (Spectralis; Heidelberg Engineering GmbH).Results: There was a significant difference in CVI and stromal area between groups. Post-hoc univariate analysis showed that CVI was significantly lower in patients with ADHD treated with MPH compared with the other groups (P .001, for each); however, there was no difference between the treatment-free ADHD group and controls (P = .305). In contrast, stromal area was significantly higher in patients with ADHD treated with MPH than the other groups (P .001, for each group). The correlation of CVI with MPH treatment duration in patients with ADHD treated with MPH showed a significant, moderate negative correlation (P = .01, r = - 0.66).Conclusions: CVI is reduced in patients with ADHD treated with MPH, and the decrease in CVI becomes significant with increasing duration of MPH treatment. This result reflects an indirect effect of MPH treatment on choroidal vascular structures.[J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.]

GİRİŞ VE AMAÇ:İki farklı protokolde uygulanan hızlandırılmış kornea çapraz bağlama (KÇB) tedavisinden sonra yüksek sıralı aberasyonlar ve en iyi düzeltilmiş görme keskinliğindeki (EDGK) değişiklikleri belirlemek ve karşılaştırmak. YÖNTEM:Progresif keratokonus sebebiyle hızlandırılmış KÇB tedavisi uygulanmış olan (10 dk,9Mw/cm2 ve 5dk,18mW/cm2) 43 hastanın (30 erkek, 13 kadın) 65 gözü retrospektif olarak incelendi. Hastalar hızlandırılmış KÇB tedavi protokolüne göre grup 1 (10 dk,9mW/cm2, 21 hastanın 32 gözü) ve grup 2 (5dk,18mW/cm2,22 hastanın 33 gözü) olarak ikiye ayrıldı. Topografik bulgular (santral kornea kalınlığı, düz ve dik K değerleri) ve düzeltilmemiş görme keskinliği ve EDGK değerleri (logMAR) preoperatif ve postoperatif 6. ay değerleri kaydedildi. Yüksek sıralı aberasyonların preoperatif ve postoperatif 6. ay değerleri Pentacam yardımıyla elde edildi. BULGULAR:Her 2 grupta da düzeltilmemiş görme keskinliği ve EDGK düzeylerinde preoperatif ve postoperatif 6. ay arasında anlamlı düzelme saptandı (sırasıyla Grup 1; p:0.000001, p:0.000001 ve Grup 2; p:0.000001, p: 0.000008). Grup 1’de horizontal ve vertikal trefoil değerlerinde preoperatif ve postoperatif 6.ay sonuçları karşılaştırıldığında anlamlı fark saptanmadı (sırasıyla p: 0.16, p:0.62). Horizontal koma önemli ölçüde azalmış olmasına rağmen (p:0.00054) vertikal komada anlamlı fark saptanmadı (p:0.34). Grup 2’de horizontal ve vertikal trefoil değerlerinde preoperatif ve postoperatif 6.ay sonuçları karşılaştırıldığında anlamlı fark saptanmadı (sırasıyla p: 0.85, p:0.14). Horizontal komada anlamlı farklılık saptanmamasına rağmen (p:0.96) vertikal komada anlamlı fark saptandı (p:0.02). TARTIŞMA VE SONUÇ:Her iki hızlandırılmış KÇB protokolü keratokonusun ilerlemesini engellemekle birlikte görme keskinliği ve topografi bulgularında önemli iyileşme sağladı. Bununla birlikte horizontal komadaki iyileşme grup 1’de (9Mw/cm2) grup 2’den (18mW/cm2) daha iyiydi.

Aim: To compare the outcomes of non-invasive break-up time (NI-BUT) test and the other conventional dry eye tests. Methods: The right eyes of 170 subjects were included in the study. In order to evaluate the tear quality of the patients, NI-BUT levels were measured by the Scheimplug-Placido disk system (Sirius topography). Tear osmolarity test was performed with TearLab Osmolarity System. Topical anesthesia-assisted type I Schirmer test and topical anesthesia-assisted BUT were lastly applied to all patients in order not to affect other measurements. Results: The mean NI-BUT value was 9.59 ± 4.37 sec, tear osmolarity was 292.93 ± 9.30 mOsm/L, Schirmer test was 15.32 ± 6.05 mm/5 min, and biomicroscopic BUT value was 8.98 ± 3.79 sec. The Schirmer test results were statistically significantly correlated with biomicroscopic BUT and NI-BUT values (p = .019, r = 0.180 and p = .030, r = 0.166; respectively). It was also found that tear osmolarity was strongly and inversely correlated with biomicroscopic BUT and topographic NI-BUT values (p .001, r = ?0.554 and p .001, r = ?0.528; respectively). There was no significant correlation between Schirmer test and tear osmolarity. Conclusion: It is important to use a sensitive, reproducible and non-invasive method in the evaluation of tear functions. We think that the objective and noninvasive topographic NI-BUT measurements and the minimally invasive osmolarity measurements should be used more frequently in practice because they are correlated with the measurements obtained by invasive methods and should be widespread in clinics.

Background: Corneal cross-linking treatment is the unique treatment method that can cease the progression of keratoconus disease. Because of the long duration of conventional treatment, accelerated cross-linking treatment methods are being developed. Aims: To compare two different accelerated corneal cross-linking protocols in terms of postoperative visual acuity and topographic findings (higher-order aberrations and keratometry values). Study Design: Retrospective comparative study. Methods: Sixty-five eyes of 43 patients (30 men and 13 women) who underwent two different accelerated corneal cross-linking protocols (10 min, 9 mW/cm2 and 5 min, 18 mW/cm2) for progressive keratoconus were retrospectively analyzed. Patients were divided into two groups according to the accelerated corneal cross-linking treatment protocol: group 1 (10 min, 9 mW/cm2, 32 eyes of 21 patients) and group 2 (5 min, 18 mW/cm2, 33 eyes of 22 patients). Uncorrected visual acuity and best-corrected visual acuity values and topographic findings (central corneal thickness and flat and steep keratometry values) were recorded preoperatively and 6 months after corneal cross-linking treatment. High-order aberration values measured with Pentacam preoperatively and 6 months after corneal cross-linking were also recorded. Results: In both groups, a significant improvement was detected in the uncorrected visual acuity and best-corrected visual acuity levels preoperatively and 6 months postoperatively (group 1: p=0.001, p=0.001 and group 2: p=0.001, p=0.001, respectively). In addition, central corneal thickness values decreased significantly in both groups (p=0.006 and 0.001). Trefoil values showed no significant difference preoperatively and 6 months postoperatively in group 1 (p=0.160 and 0.620, respectively). In groups 1 and 2, coma values were found to decrease significantly in the 6th postoperative month compared with preoperative values (p=0.001 and 0.020, respectively). There was no significant diffe

Aim: To compare the outcomes of non-invasive break-up time (NI-BUT) test and the other conventional dry eye tests. Methods: The right eyes of 170 subjects were included in the study. In order to evaluate the tear quality of the patients, NI-BUT levels were measured by the Scheimplug-Placido disk system (Sirius topography). Tear osmolarity test was performed with TearLab Osmolarity System. Topical anesthesia-assisted type I Schirmer test and topical anesthesia-assisted BUT were lastly applied to all patients in order not to affect other measurements. Results: The mean NI-BUT value was 9.59 ± 4.37 sec, tear osmolarity was 292.93 ± 9.30 mOsm/L, Schirmer test was 15.32 ± 6.05 mm/5 min, and biomicroscopic BUT value was 8.98 ± 3.79 sec. The Schirmer test results were statistically significantly correlated with biomicroscopic BUT and NI-BUT values (p = .019, r = 0.180 and p = .030, r = 0.166; respectively). It was also found that tear osmolarity was strongly and inversely correlated with biomicroscopic BUT and topographic NI-BUT values (p .001, r = ?0.554 and p .001, r = ?0.528; respectively). There was no significant correlation between Schirmer test and tear osmolarity. Conclusion: It is important to use a sensitive, reproducible and non-invasive method in the evaluation of tear functions. We think that the objective and noninvasive topographic NI-BUT measurements and the minimally invasive osmolarity measurements should be used more frequently in practice because they are correlated with the measurements obtained by invasive methods and should be widespread in clinics.

Background: Corneal cross-linking treatment is the unique treatment method that can cease the progression of keratoconus disease. Because of the long duration of conventional treatment, accelerated cross-linking treatment methods are being developed. Aims: To compare two different accelerated corneal cross-linking protocols in terms of postoperative visual acuity and topographic findings (higher-order aberrations and keratometry values). Study Design: Retrospective comparative study. Methods: Sixty-five eyes of 43 patients (30 men and 13 women) who underwent two different accelerated corneal cross-linking protocols (10 min, 9 mW/cm2 and 5 min, 18 mW/cm2) for progressive keratoconus were retrospectively analyzed. Patients were divided into two groups according to the accelerated corneal cross-linking treatment protocol: group 1 (10 min, 9 mW/cm2, 32 eyes of 21 patients) and group 2 (5 min, 18 mW/cm2, 33 eyes of 22 patients). Uncorrected visual acuity and best-corrected visual acuity values and topographic findings (central corneal thickness and flat and steep keratometry values) were recorded preoperatively and 6 months after corneal cross-linking treatment. High-order aberration values measured with Pentacam preoperatively and 6 months after corneal cross-linking were also recorded. Results: In both groups, a significant improvement was detected in the uncorrected visual acuity and best-corrected visual acuity levels preoperatively and 6 months postoperatively (group 1: p=0.001, p=0.001 and group 2: p=0.001, p=0.001, respectively). In addition, central corneal thickness values decreased significantly in both groups (p=0.006 and 0.001). Trefoil values showed no significant difference preoperatively and 6 months postoperatively in group 1 (p=0.160 and 0.620, respectively). In groups 1 and 2, coma values were found to decrease significantly in the 6th postoperative month compared with preoperative values (p=0.001 and 0.020, respectively). There was no significant diffe