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ÖZET Makula, retinada arka kutbun merkezinde yaklaşık olarak 5mm çapında yuvarlak bölgeye verilen addır. Görme duyusunun oluşması için makula bölgesinin sağlıklı olması büyük önem taşımaktadır. Makula bölgesinde meydana gelen hastalıklar görmeyi önemli ölçüde azaltabilmektedir. Bu hastalıkların tanısı ve takibi bu yüzden oldukça önem taşımaktadır. Fakat bölgenin çok küçük olması değerlendirmeyi oldukça zorlaştırmaktadır. Optik koherens tomografi (OKT) retina yapışırım yüksek çözümlemeli çapraz kesitli tomografisini in-vivo olarak sağlayabilen yeni bir görüntüleme yöntemidir. Bu cihaz sayesinde makulanm anatomik durumu ve niceliksel özellikleri hakkında ayrıntılı bilgi edinilebilmektedir. Mart 2001 ile Ocak 2003 tarihleri arasında Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Ana Bilim Dalı'nda çeşitli hastalıklar nedeni fundus muayenesi sırasında makula tutulumu gösterilen 91 olgunun 160 gözü çalışma kapsamına alındı. Bu olgulardan, 43 'ü Yaşa Bağlı Makula Dejenerasyonu, 11 'i Makula Deliği, 12'si Epiretinal Membran, 12'si Makula Distrofisi, 2'si Retinoskizis, 3'ü Santral Seröz Korioretinopati, 3'ü Optik Disk Pit'ine bağlı Makulopati, l'i Serpijinöz Korioretinopati, l'i Eksudatif Retina Dekolmanı, l'i Vogt- Kayanagi-Harada, l'i Anjioid Streaks, l'i, l'i ise Travmaya bağlı makula çekintisi ve makula ödemi idi. Olguların makula bölgeleri optik koherens tomografi ile incelendi. Elde edilen görüntüler ve veriler kendi içlerinde gruplandınlarak girişimsel vaka serileri olarak incelendi. Yaşa Bağlı Makula Dejenerasyonu'nun Kuru tipinde oftalmoskopiye ek bilgi alınamadı. Yaş tipte ise OKT'nin sıvı birikimini göstermede etkili olduğu görüldü. Ayrıca PED Terin ayırımında başarılı bulundu. KNV Terin ortaya çıkarılmasında ise ancak yardımcı tetkik olarak kullanılabileceği düşünüldü. 48Optik Koherens Tomografi ile özellikle erken evre Makula Delik' lerine kolayca tanı koyulabildiği ayrıca deliklerinin morfolojik şekillerinin, çaplarının ve evrelerinin, retina içi ödemin, beraberinde bulunan retina altı sıvının, vitreus-retina ilişkilerinin, sebep olan makula hastalıklarının özelliklerinin rahatlıkla ortaya çıkanlabildiği gözlendi. Bu sebeple Makula Delik'lerinin değerlendirilmelerinde OKT'nin yararlı olduğu belirlendi. Epiretinal membranlarda, OKT'nin membranı gösterme oranı oftalmoskopiden daha düşük bulunurken eşlik eden durumların göstermede etkili bulundu. Bu hastalığın tanı ve takibinde OKT yardımcı tetkik olarak önerildi. Makula distrofilerinin, Santral seröz retinopatinin. Optik Disk Pit'ine bağlı makulopatinin, Jüvenil Retinoskizis, Vogt-Kayanagi-Harada, Serpijinöz Koroidopati ve Travmatik makula çekintisi - makula ödemi'nin tanısında OKT'nin yararlı olduğu, Makroanevrizma rüptürü, Eksudatif Retina Dekolmanı ve Angioid Streaks'te OKT'nin oftalmoskopiye ek bilgi sağlamadığı belirlendi. Sonuç olarak optik koherens tomografi, kesitsel özelliklerin belirlenmesi, niceliksel ölçümlerin yapılabilmesi ve uygulama kolaylığı nedeniyle çeşitli makula hastalıklarının tam ve takibinde yararlıdır. 49 60

Objectives: to evaluate the effect of anterior segment depth (ASD; sum of anterior chamber depth and lens thickness) on the accuracy of 7 intraocular lens formulas calculated in patients with axial length (AL) between 22.5 and 24.5 mm.Materials and Methods: in this retrospective study, patients who underwent cataract surgery were divided into three groups based on their ASD measurements (Group I: ASD 7.90 mm). The mean predictive error (MPE), mean absolute error (MAE), and median absolute error (MedAE) values of each group were compared. The effect of ASD on the predictive error (PE) of each lens formula was additionally tested in subgroups based on mean keratometry (K) values (Subgroup I: K 44.5 D). Results: the study included 184 eyes of 184 patients. In Group I, all formulas except Olsen OLCR and Barrett II had clinically myopic MPEs. In Group II, the MPEs of all lens formulas except Barrett II were statistically non-different from zero (p>0.05). In Group III, the MPEs of all lens formulas were found to be statistically hyperopic. In Group III, all formulas except Olsen OLCR were significantly shifted to more hyperopic results when compared with Groups I and II (p7,90 mm). Her grubun ortalama prediktif hata (OPH), ortalama mutlak hata (OMH) ve ortanca mutlak hata (OtcMH) değerleri karşılaştırıldı. ÖSD’nin lens formüllerinin prediktif hataları (PH) üzerindeki etkisi, ilaveten ortalama keratometri (K) değerlerine göre belirlenmiş alt gruplarda sınandı (alt Grup 1: K 44,5 D). Bulgular: çalışma 184 hastanın 184 gözünü kapsadı. Grup 1’de Olsen OLCR ve Barrett II haricindeki tüm formüller klinik miyopik OPH’ye sahipti. Grup 2’de Barrett II haricindeki tüm formüller istatistiksel olarak sıfırdan farksızdı (p>0,05). Grup 3’te tüm formüllerin OPH’leri istatistiksel olarak hipermetropik bulundu. Grup 3’te Olsen OLCR haricindeki tüm formüllerin Grup 1 ve 2’ye kıyasla istatistiksel olarak daha hipermetropik sonuçlara kaydığı bulundu (p, NA

Introduction: Clear corneal incision (CCI) architecture in modern microincision cataract surgery (MICS) plays an undeniable role in postoperative refraction. The goal of this study was to evaluate the effect of hinge incision prior to two-step CCI on postoperative refractive astigmatism after cataract surgery and to demonstrate the schematic presentation of these postoperative astigmatic changes via double-angle polar plots. Methods: this study involved a consecutive case series of patients who had MICS. The first incision was performed as a two-step CCI, whereas the second was made as a hinge incision prior to 2-step CCI. The preoperative corneal and postoperative refractive astigmatism and surgically induced astigmatism (SIA) were calculated by vectorial analysis. Hotelling’s T2 test was performed to compare the centroid values of preoperative and postoperative corneal astigmatism. Results: a total of 63 eyes from 57 subjects were evaluated. Group I consisted of 27 eyes with the two-step CCI, and Group II included 36 eyes with the hinge incision prior to two-step CCI. No significant difference was found between the groups in terms of age, sex, axial length, keratometry readings, implanted intraocular lens power, and postoperative spherical equivalent. The centroids of corneal astigmatism postoperatively increased to 0.21 D at 87.6°±0.61 with no significance in Group I (p=0.525) and to 0.70 D at 90.6°±0.47 with significance in Group II (p=0.032). The difference in postoperative centroids between the two groups was also significantly different (p=0.043). Finally, the centroids of SIA were 0.12 D at 85.5°±0.50 and 0.22 D at 91.1°±0.49 for Group I and Group II, respectively, with no significance. Discussion and conclusion: A hinge incision did not have an unfavorable effect on postoperative refractive astigmatism; therefore, it may be preferred for controlled entrance to the anterior chamber, NA

Introduction: this study analyses if a translated version of the CatInfo tool increases the knowledge of Serbian-and Turkish-speaking patients about cataract surgery. Methods: in total, 61 cataract patients, literate in Serbian or Turkish, were randomly allocated into two groups. Via an interactive computer-based tool (""CatInfo""), patients either saw a detailed audio-visual presentation about cataract surgery (study group) or a ""placebo""video (control group). Afterwards, all participants had a face-to-face discussion with an ophthalmologist. Immediately after the interview and on the day of surgery, all patients had to fill out a questionnaire including knowledge and demographic questions. Patients in the study group were further asked about their satisfaction with the CatInfo tool and the usefulness of such a device before other interventions. Results: patients in the study group answered significantly more questions correctly compared to the control group, and this information gain remained stable over a 1-week period. There was a significant low negative correlation between educational level and the test results, whereas age and computer habits of the participants did not have an influence on correct answers. Satisfaction with the CatInfo tool was high in the Serbian and the Turkish group (96% and 84%, respectively), and 92% of Serbian patients as well as 62% of the Turkish patients rated that they could imagine to use such a device before any other surgery. Discussion/Conclusion: the translated version of the CatInfo tool improved patients' knowledge, and this information gain remained stable until the day of the surgery., NA

Purpose: diagnose keratoconus by establishing an effective logistic regression model from the data obtained with a Scheimpflug-Placido cornea topographer. Methods: topographical parameters of 125 eyes of 70 patients diagnosed with keratoconus by clinical or topographical findings were compared with 120 eyes of 63 patients who were defined as keratorefractive surgery candidates. The receiver operating character (ROC) curve analysis was performed to determine the diagnostic ability of the topographic parameters. The data set of parameters with an AUROC (area under the ROC curve) value greater than 0.9 was analyzed with logistic regression analysis (LRA) to determine the most predictive model that could diagnose keratoconus. A logit formula of the model was built, and the logit values of every eye in the study were calculated according to this formula. Then, an ROC analysis of the logit values was done. Results: Baiocchi Calossi Versaci front index (BCVf) had the highest AUROC value (0.976) in the study. The LRA model, which had the highest prediction ability, had 97.5% accuracy, 96.8% sensitivity, and 99.2% specificity. The most significant parameters were found to be BCVf (p=0.001), BCVb (Baiocchi Calossi Versaci back) (p=0.002), posterior rf (apical radius of the flattest meridian of the aspherotoric surface in 4.5 mm diameter of the cornea) (p=0.005), central corneal thickness (p=0.072), and minimum corneal thickness (p=0.494). Conclusions: the LRA model can distinguish keratoconus corneas from normal ones with high accuracy without the need for complex computer algorithms., NA

It has been established that many chemotherapeutic agents are associated with a variety of ocular side effects. As an antineoplastic agent, 5-fluorouracil (5-FU) is the chemotherapeutic agent that is frequently linked with cicatricial ectropion. Capecitabine is a prodrug of 5-FU and has a more favorable side effect profile than 5-FU. Frequent side effects of capecitabine include gastrointestinal events and hand-foot-mouth syndrome; cicatricial ectropion is rather uncommon. Enzyme deficiencies affecting the capecitabine metabolism have been reported to be associated with exaggerated generalized systemic and cutaneous side effects; however, there are no cases in the literature reporting capecitabine-induced isolated bilateral-progressive ectropion. Although cessation of the agent is frequently sufficient for the treatment of ectropion, close follow-up is indicated in such patients as permanent damage may occur if the problem is left untreated. We report a case of capecitabine-induced bilateral cicatricial ectropion refractory to treatment cessation, ultimately requiring surgical treatment., NA

Purpose: to compare the functional outcomes and astigmatic tolerability after implantation of multifocal intraocular lenses (IOLs) with a +2.5, +3.0, and +3.75 diopter (D) addition power. Methods: this study included 122 eyes of 61 patients who had bilateral cataract extraction and implantation of diffractive aspheric multifocal acrylic IOLs with +2.5 D (+2.5 group), +3.0 D (+3.0 group), and +3.75 D (+3.75 group) addition powers. 1-year after surgery, distance corrected near (DNVA) and intermediate (DIVA) visual acuities at 32, 40, 45, 50, 55, and 60 cm; and contrast sensitivity measurements under photopic, mesopic and mesopic with glare conditions; spherical and astigmatic defocus testing; distance-intermediate-near vision patient satisfaction levels; spectacle dependance; patient-reported outcomes were assessed binocularly. Results: the +2.50 D group had better DIVA than both +3.0 group and +3.75 groups at 45 cm, 50 cm, 55 cm, and 60 cm (p < 0.05). The +3.75 group had better DNVA than both +2.5 and +3.0 IOL groups at 32 cm (p < 0.05). There was no significant difference in mean contrast values at all frequencies between three IOL groups (p > 0.05). The +2.50 D group showed better astigmatic tolerability than +3.00 group (at 2.00 D) and +3.75 group (at 1.50 D, and at 2.00 D) (p < 0.05). Conclusion: multifocal IOLs with +2.5 add power have better intermediate vision, but worse near vision compared to multifocal IOLs with +3.00 D and +3.75 D add power. Multifocal IOLs with +2.50 D add power tend to have better astigmatic defocus tolerability than multifocal IOLs with +3.00 D and +3.75 D add powers., NA