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This article discusses a case of traumatic optic neuropathy (TON) caused by high-pressure sound waves from a bomb explosion. TON is a condition characterized by severe visual loss due to axonal damage. The patient, a 23-year-old male, experienced painless vision loss in his right eye after the explosion. He was treated with intravenous methylprednisolone followed by oral prednisolone, which resulted in gradual improvement in visual acuity. This case is significant because TON caused by high-pressure sound waves is rare, and the successful treatment with steroids can provide guidance for similar cases. [Extracted from the article]

For a correct spectacle prescription, accommodation spasm should not be overlooked in the measurements made using an autorefractometer. Although this can be easily understood with cycloplegia, it is not practical. Therefore, investigating practical methods that can predict excess accommodation will be useful in clinical practice. To evaluate the performance of a photoscreener in detecting pseudo-myopia due to accommodation spasm and whether it eliminates the need for cycloplegia. Study was conducted in Van Training and Research Hospital. The manifest refraction of the patients was measured using an by an autorefractometer followed by a photoscreener before cycloplegia. Cycloplegic refraction errors were detected using an autorefractometer. Patients with pseudo-myopia due to accommodation spasm were diagnosed by observing a significant hyperopic shift in cycloplegic autorefractometer values compared to the non-cycloplegic values and were included in study. Cycloplegic autorefractometer and non-cycloplegic photoscreener measurements were compared. The mean non-cycloplegic autorefractometer values were as follows: -−6.34 ± 1.29D, −0.42 ± 0.58D, and −6.55 ± 1.36D for spherical, cylindrical, and spherical equivalents, respectively. These values were 0.23 ± 0.63D, −0.21 ± 0.41D, and 0.11 ± 0.73D for cycloplegic autorefractometer measurements, respectively. Cycloplegic autorefractometer values showed a significant hyperopic shift of 6.57 ± 1.26D and 6.67 ± 1.34D for spherical and spherical equivalents, respectively, compared to non-cycloplegic values (p < 0.001 for both). There was no significant difference between non-cycloplegic photoscreener and cycloplegic autorefractometer measurements for spherical, cylindrical, and spherical equivalents (p = 0.126, p = 0.078, and p = 0.053, respectively).. There was agreement between the measurements in the Bland-Altman graph. There was consistency between non-cycloplegic photoscreener and cycloplegic autorefractometer measurements in patients with pseudomyopia due to accommodation spasm. Therefore, photoscreener measurements can be a fast, practical, cost-effective examination method for screening these patients without the need for cycloplegia. [ABSTRACT FROM AUTHOR]

Copyright of MN Opthalmology / MN Oftalmoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate the usability of CHADS2 and CHA2DS2-VASc scores in clinical practice for age-related macular degeneration (AMD) and their effects on treatment prognosis in wet-type AMD. Materials and Methods: Ninety patients with dry-type AMD aged 65-90 years, 115 patients with wet-type AMD, and 90 controls without any retinal disease were included in the study. Best-corrected visual acuity (BCVA) values and previously administered intravitreal anti-VEGF injection (IVI) treatments were recorded. The ejection fractions of the patients were measured and evaluated for the diagnosis of congestive heart failure (CHF). The presence of diabetes mellitus (DM), hypertension (HT), history of stroke, and vascular diseases (VD) was questioned. Results: A significant difference was observed between the AMD groups only in terms of DM and VD (p=0.032 and 0.011, respectively). There was also a significant difference between the groups in terms of CHADS2 and CHA2DS2-VASc scores, but these two scoring systems were not superior to each other in ROC analysis. When the wet-type AMD cases were compared according to the number of injections, there was a significant difference in terms of CHF, DM, stroke, and VD. (p=0.001, 0.01, 0.02, and 0.01, respectively). When the treatment groups were compared in terms of the CHADS2 and CHA2DS2-VASc scores, a statistically significant difference was found (p=0.01 and 0.05, respectively), and as the number of intravitreal injections required for treatment increased, the score increased for both systems. Conclusions: CHADS2 and CHADS2-VASC clinical scoring systems can be predictors of AMD. They can also indicate the numbers of injections needed for treatment. [ABSTRACT FROM AUTHOR]

Clinical relevance: Since acne vulgaris is a disease of the sebaceous glands, it may have potential effects on the ocular surface and tear homoeostasis, which are essential for good vision. Optometrists should be aware of ocular surface pathologies when prescribing glasses or contact lenses for the visual rehabilitation of these young patients. Background: To evaluate the ocular surface features, meibomian glands, and tear parameters of patients with acne vulgaris. Methods: The right eyes of 70 individuals (34 patients with acne vulgaris, 36 healthy volunteers) were evaluated. The tear break-up time of participants was measured, and the Schirmer test was performed. Then, to determine ocular surface characteristics, samples were taken from the conjunctiva for impression cytology. Finally, the loss rates of the upper and lower eyelid meibomian glands were determined by taking meibography (Sirius, CSO, Florence, Italy). Results: Tear break-up time was significantly lower in the study group compared to the control group (p < 0.001). No statistically significant difference was determined between the groups in respect of Nelson grade in the conjunctival impression cytology (p = 0.141). Grade 3 cytological changes were not observed in either group. The median value of the loss rate in the meibomian glands in the upper eyelid of patients with acne vulgaris was 19.10% (IQR: 18%), while it was 8.75% (IQR: 9.53%) in the control group (p = 0.001). The median value of the loss rate in the meibomian glands in the lower eyelid was 15.70% (IQR: 15.13%) and 7.70% (IQR: 6.53%) in the acne vulgaris and control groups, respectively (p < 0.001). Conclusion: Our study shows that patients with acne vulgaris may have a predisposition to meibomian gland damage and tear instability. Therefore, we consider that a more detailed ophthalmologic examination should be performed in patients with acne vulgaris. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether the C-reactive protein (CRP)/albumin ratio (CAR) in patients with uveitis during an attack is a marker that can give information about the activity, severity and prognosis of the disease.Methods: This study included 35 patients with an uveitis attack and 35 healthy volunteers. The localization and severity of uveitis were recorded. Patients' complete blood count (CBC) during the attack, CRP, CAR, erythrocyte sedimentation rate(ESR), neutrophil/lymphocyte ratio(NLR), and platelet/lymphocyte ratio(PLR) were recorded.Results: The mean age was 34.1 ± 12.5 years for the 35 uveitis cases and 30.1 ± 4.1 years for the healthy volunteers. CRP and CAR were significantly higher in uveitis patients (p = .015 and 0.011, respectively). While CRP and CAR were significantly higher in severe anterior uveitis than mild anterior uveitis (p = .036 and 0.022, respectively), only CAR was significantly higher in severe posterior and panuveitis than mild ones(p = .017).Conclusion: CAR may be an important parameter in determining the activation of the uveitis. [ABSTRACT FROM AUTHOR]

Copyright of MN Opthalmology / MN Oftalmoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A response from the author of the article "Evaluation of choroidal thickness changes after phacoemulsification surgery" in the 2016 issue is presented.

Purpose: To investigate whether type 2 diabetes causes retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) thinning that might indicate neuronal damage and to evaluate the relationship between this damage and possible causative factors. Materials and Methods: In this prospective study 60 eyes of 60 diabetic patients and 40 eyes of 40 healthy subjects were enrolled. Diabetic patients were divided into two subgroups as patients with no diabetic retinopathy (group 2) and patients with mild retinopathy (group 3). RNFL and GCC thicknesses were measured using RTVue (Optovue) spectral-domain optical coherence tomography. Multiple lineer regression analysis was performed to determine the relationship between the RNFL and GCC thickness measurements and diabetes duration, blood glucose, HbA1c, DR status and age. Results: Mean RNFL thickness measurements were different between the groups (p=0.03) and superior and inferior RNFL thicknesses were reduced in diabetic patients with retinopathy. Superior GCC thickness was significantly thinner in group 3 compared to group 1 (p=0.044). Regression analysis showed that only DR status had a significant association with GCC and RNFL thinning. Conclusions: Retinal neuronal damage accompanies microvascular damage in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Purpose: To compare the anterior segment measurements derived from optical low coherence reflectometer (Lenstar LS 900, Haag-Streit AG) and combined Scheimpflug-Placido disk topographer (Sirius, CSO Inc.). Material and Methods: This study comprised of sixty eyes of 30 healthy subjects. Central corneal thickness (CCT), aqueous depth (AD:corneal endothelium to lens), anterior chamber depth (ACD: corneal epithelium to lens), keratometry measurements (K in the steepest and flattest meridian) and white-to-white (WTW) distance derived from both devices were compared. All measurements were repeated five times for Lenstar and three times for Sirius by the same physician and mean of these measurements were used for comparisons. Results: The CCT measurements were significantly higher whereas AD and ACD measurements were lower with Lenstar (p<0.05). Mean differences for CCT, AD, and ACD were 3.93±6.65 µm, -0.08±0.04 mm, and -0.07±0.03 mm, respectively. There were no statistically significant differences between the devices for the steep and flat K values and mean WTW distance (p>0.05). Pearson correlation analysis showed high correlation between the 2 devices for all measurements (r>0.90, p<0.05). On Bland-Altman analysis, 95% limits of agreement for all measurements were within clinically acceptable limits and there was good agreement between the 2 devices. Conclusion: Anterior segment parameters evaluated with Lenstar LS 900 optical biometer and Sirius anterior segment analysis system were correlated well with each other and measurement differences between the devices were clinically negligible. Therefore, it was concluded that both devices can be used interchangeably for the most clinical purposes. [ABSTRACT FROM AUTHOR]

Elevation of intraocular pressure is one of the most important problem that developing after intravitreal triamsinolon asetonid (İVTA) injection. A 56 years old patient with diabetes admitted because decrease in visual acuity one day after İVTA injection. İn the right eye examination visual acuity was one meters finger count, İOP 67 mm Hg, cornea was edematous and iris was dished. Anterior chamber depth was narrow in central and insignificant in perifery. We diagnosed pupillary blocking glaucoma. İOP decreased 16 mm Hg and anterior chamber depth increase 60 minutes after Nd: YAG laser iridotomy which mad efor aquose drenating. Our case is important for that showing elevetion of İOP in the early time after İVTA injection. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the contribution of preloaded intraocular lenses (IOL) to phacoemulsification surgery times. Material and Methods: In this prospective comparative study, Physiol IOLs with preloaded system in 20 patients of group 1 and Acriva IOLs with manual cartridge-injector system in 20 patients of group 2 were implanted. The period from the beginning to the IOL implantation stage was recorded in groups as A1 and A2 respectively. Afterwards from that time to the end of the surgery were also determined as B1 and B2 based on real time video recordings. Mean total operation times were determined as C1 and C2 by summing up these times. Results: While A1 and A2 were compatible with each other (p=0.787), avarage B1 time, including IOL implantation stage, was 193.3+20.6 sec and B2 was 212.9+49.1 sec (p=0.448). Cl and C2 showing mean total operation times were 625.7+99.8 sec and 654.7+184.8 sec (p=0.833) respectively. Conclusion: When compared with the manual loaded cartridge-injector IOL systems, preloaded IOLs reduced the operation time, whereas this reduction was not statistically significant. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy of topical meropenem and cefepime treatments with respect to moxifloxacin as new treatment options in an experimental Pseudomonas keratitis model., Methods: Twenty-four rabbits in which keratitis are induced using Pseudomonas aeruginosa were divided into four groups according to treatment options. A solution of 50 mg/mL meropenem was prepared and topically applied to the first group, 50 mg/mL cefepime solution to the second group, topical 0.5% moxifloxacin drop to the third group, and topical isotonic (0.9% saline) solution to the fourth (control) group. The eyes were examined before and after treatment to score the clinical severity. After the subjects were sacrificed, their corneas were excised. To determine the efficacy of treatments, clinical score, bacterial load, and histopathological and immunohistochemical findings were evaluated., Results: When the three treatment groups were compared, there was a significant difference in the colony-forming unit (CFU) value, polymorph-nuclear leukocyte (PMNL) infiltration, and matrix metalloproteinase (MMP)-9 immunoreactivity (P=0.022, P=0.038, and P=0.037, respectively). The CFU values, PMNL infiltration scores and MMP-9 immunoreactivity were significantly lower in the meropenem and moxifloxacin groups compared with the cefepime group (P<0.05 for all). There was no significant difference between the meropenem and moxifloxacin groups in respect of the CFU values, PMNL infiltration, and MMP-9 immunoreactivity (P=0.842, P=0.784, and P=0.699, respectively)., Conclusion: The results of our study indicate that topical meropenem is at least as effective as topical moxifloxacin in the treatment of Pseudomonas keratitis. The meropenem and moxifloxacin are safer and suitable in the limited corneal invasion than cefepime. Thus, topical meropenem may be an alternative drug in the treatment of this condition. Clinical studies are needed to be conducted to assess this possibility more accurately., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2020 Contact Lens Association of Ophthalmologists.)