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BackgroundLiterature on the effects of second-generation H1-antihistamines on angiogenesis is limited.ObjectivesTo investigate the effects of cetirizine, desloratadine, and rupatadine (second-generation H1-antihistamines commonly used in dermatology clinics) on angiogenesis in an in vivo chick chorioallantoic membrane (CAM) model.MethodsThe study was approved by the local ethics committee on animal experimentation. Forty fertilized specific pathogen free eggs were incubated and kept under appropriate temperature and humidity control. Drug solutions were prepared in identical concentrations by dissolving powders in phosphate-buffered saline (PBS). On the third day of the incubation, a small window was opened on the CAM and 0.1 mL desloratadine (1.5 mu g/0.1 mL) in the first group, 0.1 mL cetirizine (1.5 mu g/0.1 mL) in the second group, 0.1 mL rupatadine in the third group (1.5 mu g/0.1 mL), and PBS (0.1 mL) in the fourth group were administered by injection. On the eighth day of incubation, the vascular structures of the CAMs were macroscopically examined and standard digital photographs were taken. The digital images were analyzed and data including mean vessel density, thickness, and number were compared between groups. p < 0.05 was considered statistically significant.ResultsVessel densities were similar in the desloratadine, cetirizine, and control groups, whereas they were significantly less in the rupatadine group (p = 0.01). Furthermore, the rupatadine group had significantly lower vessel thickness and number compared with the other groups (p < 0.05 for both).ConclusionsRupatadine showed anti-angiogenic effects in the chick CAM model, compared with desloratadine and cetirizine. The anti-angiogenic effect of rupatadine could be due to its platelet-activating factor (PAF) receptor inhibition. Thus, rupatadine could be a treatment agent in pathological processes in which angiogenesis is responsible. Further studies with larger series are needed to clarify this potential., Afyon Kocatepe University Scientific Research Foundation; [17.KARIYER.172], Afyon Kocatepe University Scientific Research Foundation (17.KARIYER.172) provided financial support for the conduct of the research.

Aims: To evaluate the long-term surgical success of transcanalicular dacryocystorhinostomy (TCDCR) with diode-laser in the treatment of epiphora due to isolated naive nasolacrimal duct obstruction (NLDO) in adults. Methods: This retrospective study included patients with isolated naive NLDO, who underwent diode laser-assisted TCDCR. No patients had pathology in the nasal region detected by an otorhinolaryngologist. The included patients had documented information about epiphora evaluation with lacrimal system irrigation with fluorescein dye, and annual direct imaging of osteotomy patency with nasal endoscopy. Success was defined as no postoperative epiphora, conjunctivitis or dacryocystitis, an open passage in the lacrimal system lavage, and patient satisfaction. Results: The study included 116 patients [mean age: 49.6±11.4 years, female: 67 (57.8%)]. The success rate was 84.5% in the first year, 80.2% in the second year, and 76.7% in the third year. Following the operation, 9 (7.8%) patients had epiphora, 8 (6.9%) patients were not satisfied, and 1 (0.8%) patient developed conjunctivitis/dacryocystitis in the first year. Three (2.6%) patients had dissatisfaction and 2 (1.7%) patients had the complaints of epiphora correlated with nasolacrimal lavage obstruction in the second year. Two (1.7%) patients were dissatisfied and 2 (1.7%) patients had epiphora complaints confirmed with nasolacrimal lavage in the third year. Conclusions: The present study showed that the treatment of epiphora due to isolated NLDO with diode laser-assisted TCDCR can provide long-term success in major outcomes in adult patients.

To investigate the effects of bimatoprost, latanoprost and travoprost on angiogenesis in the chick chorioallantoic membrane (CAM) model in ovo.Fifty fertilized specific-pathogen-free chick eggs were used in this preclinical, prospective, experimental embryo study. Eggs were randomly distributed into 5 groups of ten eggs. Eggs were placed in the incubator after disinfection of their shells with alcohol and monitored appropriate temperature and humidity. On the 3rd day of incubation, a small window was opened on the eggshell. Bimatoprost in group 1, latanoprost in group 2, travoprost in group 3, bevacizumab in group 4, phosphate-buffered-saline (PBS) used in group 5 was applied by injection to CAM. The sterile film was glued onto the broken part of the shell and the eggs were placed in the incubator again. On the 8th day of incubation, eggs were opened and vascular structures on CAMs were examined. Digital photographs were taken, analysed in the ImageJ open source image processing software and differences between groups were evaluated. Thereafter, VEGF (Vascular endothelial growth factor) levels were measured appropriately in the embryo samples.All embryos in the prostaglandin groups and the PBS control group were observed to have life signs confirmed by heart rate. In 8 embryos in the bevacizumab group, no life signs were confirmed, while 2 embryos with life signs showed severe hypoplasia. Vascular density, number of vessels and VEGF levels in the bimatoprost, latanoprost and travoprost groups, there were statistically significantly higher than the PBS control group.This study demonstrates that topical prostaglandin drops increase angiogenesis in the chick CAM model in ovo.

Purpose: To determine the levels of serum oxidative, antioxidative markers and inflammatory cytokines in patients diagnosed with diabetic macular edema (DME) whose hyperreflective spots (HRS) were detected by optical coherence tomography (OCT). Methods: In this prospective cross-sectional clinical study included a total of 88 patients; 31 patients (group-1) with DME and HRS detected by OCT, 29 patients (group-2) with DME without HRS, and 28 patients (group-3) diagnosed with diabetes mellitus (DM) without any diabetic retinopathy findings. The main outcomes were best-corrected visual acuity (BCVA), CMT (central macular thickness), CMV (central macular volume), TMV (total macular volume), CT (choroidal thickness), serum TAS (total antioxidant status), TOS (total oxidant status), VEGF (vascular endothelial growth factor), FGF (fibroblast growth factor) and IL-1b levels. OCT parameters and biochemical measurements were compared statistically between the three groups. Results: A total of 88 patients (43 females (48.9%) and 45 males (51.1%)) were included in the study. The mean age was 56.29 ± 9.23 years. There was no difference between the three groups in age-and-sex. In group-1 and 2, BCVA(LogMAR) was statistically higher than group 3. CMT, CMV, TMV, TAS, TOS, VEGF and FGF were significantly higher in group-1 than in group-3. CMT, CMV, TMV, VEGF and FGF were significantly higher in group-2 than group 3. TOS and VEGF were significantly higher in group-1 than group-2. Conclusions: This study demonstrates that in patients with DME and HRS, TOS and VEGF levels were higher than those without HRS. Hence, hyperreflective spots may be an inflammatory biomarker.

It was aimed to assess the role of thiol-disulphide homeostasis and ischemia-modified albumin (IMA) level in the development of diabetic macular edema (DME) in patients with diabetes mellitus type 2 (T2DM).Sixty-six study patients were divided into two groups. Group I included 43 patients with T2DM and DME, and Group 2 included 23 patients with T2DM without eye involvement. A novel colorimetric method was used to assess thiol-disulphide homeostasis. Between the two groups IMA, total anti-oxidant, and total oxidant levels were measured and compared.In Group 1, total and native thiol levels and disulphide levels were lower compared to Group 2 (The disruption in thiol/disulphide homeostasis, increased IMA and oxidative stress have an impact on the development of diabetic macular edema.

This study aimed to compare pain scores of patients during intravitreal aflibercept, ranibizumab or dexamethasone implant injection procedures.This study included 162 eyes of 162 patients, who received intravitreal ranibizumab, aflibercept or dexamethasone implant injections at our clinic. Following the injection, patients were asked to rate their pain from 0 (no pain) to 10 (worst pain) using a visual analogue pain score survey (VAS). VAS was evaluated according to age, sex, indication for the injection, number of previous intravitreal injections, and lens status in the study eye.The mean VAS in the ranibizumab, aflibercept or dexamethasone implant groups was 3.38 ± 2.31, 3.82 ± 2.46, and 3.61 ± 2.94, respectively. Female patients reported a higher average pain score than male patients (p = 0.02). Also, phakic patients reported a higher average pain score than pseudophakic patients (p = 0.01). Pain did not significantly correlate with indication for the injection, number of injections, and injection drugs (p 0.05).Pain associated with intravitreal injection is generally mild and associated with sex, age, and lens status. There was no significant difference in pain between intravitreal injections of dexamethasone implant, ranibizumab or aflibercept.

Purpose: To compare the strength of the relationship between the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio(PLR) results of patients with or without open globe injury (perforation and penetration) in the acute period of orbital trauma. Materials and Methods: Forty patients with open globe injuryand twenty-five patients without open globe injury in the acute period of orbital trauma were enrolled in this retrospective study. Complete blood count measurement results of all subjects were assessed. Results: There was a significant difference in neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio between orbital trauma with open globe injury group and without open globe injury group (p=0.001, p=0.006). Conclusion: Our results of the blood count measurements suggest that the NLR and PLR at first three hours may predict ocular perforation/penetration and the clinicians have to alert are a risk factor of open globe injury.

Purpose: To evaluate the effects of intravitreal aflibercept (IVA) treatment on retinal vein parameters and choroidal thickness used in the treatment of diabetic macular oedema (DME).Method...

The etiopathogenesis of steroid-induced cataracts is unknown. One hypothesis is that the higher reactive oxygen species (ROS) levels play an important role in the pathogenesis of several disorders, including the evolution of cataracts. This study investigated the antioxidant effects of piperine in our steroid-induced chick embryo lens model.The study included 36 specific pathogen-free (SPF) fertilized eggs divided into six groups: phosphate buffer saline (PBS, pH 7.4 Saline Solution (0.9%) isotonic) group (G1), hydrocortisone succinate sodium (HC)-treated group (G2), 100 mg/kg piperine and HC treated group (G3), 50 mg/kg piperine and HC treated group (G4), 25 mg/kg piperine and HC treated group (G5), and 10 mg/kg piperine and HC treated group (G6). On the 15th day of incubation, the SPF eggs in the six groups were removed from the incubator; all were injected using insulin injectors into the chorioallantoic membrane. On day 17, all of the chick embryos were removed from the eggs and all lenses were dissected from the embryos. Cataract formation was evaluated in all lenses, and total antioxidant status (TAS), total oxidant status (TOS), reduced glutathione (GSH), and lipid peroxidation (MDA, malondialdehyde) levels were measured in all lens.The lenses in the G1 group had higher levels of GSH and TAS (p 0.01), and lower levels of MDA and TOS than the G2 group (p 0.05 and p 0.01, respectively). Group 3 had higher levels of GSH and TAS (p 0.001 and p 0.001 respectively), and lower levels of MDA and TOS than the G2 group (p 0.01 and p 0.001, respectively).Steroid therapy causes a decrease in GSH and TAS levels and an increase in TOS and MDA levels in lens tissues, indicating increased oxidative stress. Piperine exerts its effects as an antioxidant substance, in increasing doses.

Aim: The aim of the study was to investigate effectiveness of corneal collagen cross-linking treatment in patients with progressive keratoconus. Patients and Methods: Ten patients (6 female and 4 male) who showed progression in the parameters of Keratoconus were included in the study. Complete ophthalmological examinations including uncorrected and best-corrected visual acuities (UCVA and BCVA), slit-lamp anterior and posterior segment investigation and intraocular pressure was performed in all patients. Corneal topographic measurements were done by Sirius Corneal Topography system. All patients underwent an intervention of corneal collagen cross-linking procedure with riboflavin and UV-A. Results: Sim K max value of all patients in topographic measurement decreased (mean 0,95±0,22 D) after 6 month follow-up. The value of sim K min decreased (mean 0.39 D) in 8 patients, while it showed no change in 2 patients (20%). A decrease of mean of 10,1±1,37μm central corneal thickness was observed. In 6 eyes (60%), BCVA showed improvement when compared to the baseline values, while BCVA in 4 (40%) eyes remained stable during the follow-up period. Conclusion: Corneal collagen cross-linking treatment as a first applications of our clinic using Apollon device seems to be effective in prevention of keratoconus progression according to our experience in our small series. Long-term, prospective, large studies are needed to display the long-term effectiveness of this treatment.

Purpose Folic acid is an essential vitamin participating in DNA synthesis and repair. Recently folic acid has been shown to stimulate DNA-repair capacity in dermal fibroblasts in response to injury. Thus, the present study aimed to investigate the effects of topical folinic acid, a 5-formyl derivative of tetrahydrofolic acid, on wound healing using rat wound model. Materials and methods A rat wound model was established, and the wound healing was evaluated by macroscopic and histological analyses among vehicle control, 2.5% folinic acid, 1% folinic acid, and dexpanthenol treatment groups. While an image-analysis program was used to evaluate macroscopic wound closure, connective tissue properties, mast cell numbers, and the expressions of matrix metalloproteinase 1 (MMP-1) and 9 (MMP-9) were evaluated by microscopy. Results The 2.5% folinic acid-treated group exhibited enhanced wound healing by increased reepithelialization, neo-vessel formation, inflammatory cell migration, collagen deposition and progressive mast cell increase. Furthermore, 2.5% folinic acid induced higher expressions of MMP-1 and MMP-9. Conclusions Folinic acid enhances both macroscopic and microscopic wound healing in rat wound model.

The exact etiopathogenesis of steroid-induced cataracts (SIC) is not known. Although oxidative stress is one of the most acceptable hypotheses, the exact molecular events in steroid-induced oxidative events in the lens need to be clarified. In addition, to the best of our knowledge, the innate immune system components in SIC formation have not been studied previously. The aim of the present study was to study the oxidative system and the innate immune system components in the cataractous lenses of a developing chick embryo SIC model.The study included 20 specific pathogen-free (SPF) fertilized eggs divided into two groups, with one hydrocortisone (HC)-treated group (G1) and one non-HC-treated control group (G2). On the 15th day of incubation, the SPF eggs in the two groups were removed from the incubator; HC was injected into G1, and phosphate-buffered saline (PBS) was injected into G2 using insulin injectors into the chorioallantoic membrane. On day 17, all of the chick embryos were removed from the eggs, and all lens and liver tissues were dissected from the embryos. Cataract formation was evaluated in all lenses, and total antioxidant status (TAS), total oxidant status (TOS), reduced glutathione (GSH), oxidized glutathione (GSSG), interleukin-6 (IL-6), and interleukin-1β (IL-1β) levels were measured in all lens and liver tissues.The lenses in the SIC group had lower levels of GSH, GSSG, TAS, and IL-6 (p = 0.016, 0.022, 0.000, 0.000, respectively), and higher levels of TOS (p = 0.000) than the control group. Furthermore, the liver tissues in the SIC group had decreased levels of TAS and IL-6, and increased levels of TOS compared to the control tissues (p = 0.000). Although the IL-1β levels in the lens and liver tissues in the HC-induced cataract group were lower than in the control group, these differences were not statistically significant. In addition, the GSH levels in the liver tissues did not statistically differ between the two groups despite the significant GSH difference in the lens tissues.Steroid therapy causes a decrease in GSH, GSSG, and TAS levels and an increase in TOS levels in lens tissues, which means there is increased oxidative stress and decreased antioxidant defence. Furthermore, lenses with SIC have lower IL-6 levels compared to non-cataractous lenses. The interaction between lenticular IL-6 and antioxidant defence needs to be further studied.

After the revolutionary effect of optical coherence tomography (OCT) on ophthalmology practice, recent OCT-based technology OCT angiography (OCT-A) also has rapidly gained a wide clinical acceptance. OCT-A is a noninvasive, depth-resolved imaging tool for the evaluation of retinal vascular changes. Since its introduction, the understanding of retinal vascular diseases, pacychoroid spectrum diseases, and other diseases have been enriched in many ways. More importantly, OCT-A provides depth-resolved information that has never before been available. The whole spectrum of neuro-ophthalmological diseases shows consistent peripapillary and macular capillary changes with structural and functional correlation. The superficial and deeper retinal and choroidal vasculatures are affected depending on the nature of the disease process. Therefore, OCT-A play an important role in the diagnosis and management of optic nerve-related diseases as well. In this review, we summarized existing literature on the use of OCT-A in neuro-ophthalmological diseases such as arteritic anterior ischemic neuropathy, nonarteritic anterior ischemic neuropathy, papillitis, papilledema, multiple sclerosis. Currently, OCT-A has an important position as a useful, noninvasive tool in the evaluation of neuro-ophthalmologic diseases; however, OCT-A has several limitations regarding its technical capabilities in challenging neuro-ophthalmic cases. With the improvement in the technical capacity of OCT-A, it will have a more important place in the diagnosis and follow-up of neuro-ophthalmological diseases in future.

To compare the thicknesses of the retinal layers in smokers with those of nonsmoking healthy subjects using spectral-domain optical coherence tomography (SD-OCT).One hundred and eight subjects were included in the study. Two groups were separated as smokers and nonsmokers. Both groups were chosen to be similar in terms of age and gender. SD-OCT images were generated with Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). An automated algorithm was developed to segment the macular retina into eight layers and quantitate the thickness of each layer for the fovea, parafovea and perifovea.The mean smoking history was 18.33 ± 8.45 years (range: 10-40). The mean number of pack-years was 22.22 ± 15.51 (range: 10-80). No significant difference was observed regarding retinal layer measurements between the smoker and nonsmoker groups. Also, no significant difference was observed for central macular thicknesses at 1000, 3000, and 6000 μm between two groups.The thickness of retinal layers in healthy smokers was similar to those of healthy individuals.

Purpose: This study was conducted to evaluate visual function and changes in the central macular thickness of patients with unresponsive neovascular age-related macular degeneration who were switched from ranibizumab (Lucentis®) to aflibercept (Eylea®) treatment at 30 months. Methods: This retrospective study examined patients with neovascular age-related macular degeneration who were switched to aflibercept after ≥6 previous intravitreal ranibizumab injections at 4- to 8-week intervals. All patients were switched to intravitreal aflibercept (2.0 mg) and analyzed after 3 consecutive injections followed by a prore nata dosing regimen and after 30 months of treatment. Best corrected visual acuity, biomicroscopic examination, intraocular pressure, fundus examination, and central macular thickness were recorded at the start of treatment, before the transition to intravitreal aflibercept treatment, and at 6, 12, 18, 24, and 30 months of intravitreal aflibercept treatment. Results: A total of 33 eyes met the inclusion criteria. The median age of the patients was 73.57 ± 7.98 years, and 21 (61.8%) patients were males and 12 (35.3%) were females. Before the transition, the patients received a mean of 16.8 ± 8.8 ranibizumab injections (range 6-38).After the transition to intravitreal aflibercept treatment, the mean number of aflibercept injections was 9.09 ± 3.94. No significant differences were observed in best corrected visual acuity after the aflibercept switch in any of the months. The central macular thickness was significantly decreased at 6, 12, 18, and 30 months (p=0.01, p=0.03, p=0.05, p=0.05, p

Anterior chamber dislocation of an Ozurdex (Allergan plc, Dublin, Ireland) implant from the vitreous cavity is unusual. The risk factors for dexamethasone implant migration into the anterior chamber include a defective posterior lens capsule, aphakia, and a prior history of pars plana vitrectomy. Presently described is a case of corneal toxicity occurring after the migration of a dexamethasone implant into the anterior chamber.

OBJECTIVE: It was aimed to find out the factors affecting the operation time in patients undergoing pterygium surgery and to determine the precautions that can be taken.MATERIAL AND METHODS: The study included 53 patients who were operated for pterygium in our clinic between January 2014 and February 2017. The reasons for delaying the surgery were asked to the patients. Five groups were formed between 1-5 according to the answers. The groups were as follows: 1. Patients who don’t feel uncomfortable even though knowing the pterygium disease, 2. Patients who are unaware of pterygium disease, 3. Patients who want to wait for the pterygium tissue to grow a little more, 4. Patients who are concerned about recurrence because they had undergone pterygium surgery previously from the same eye, 5. Patients who are afraid of any surgery.RESULTS: The most common reason for delaying pterygium surgery was that the patient was not feeling uncomfortable even though they knew that they had the pterygium disease. The second reason was to be afraid of any surgery. The distribution of reasons for delaying surgery was as follows: Group 1: 23 (43.4%), Group 2: 8 (15.09%), Group 3: 8 (15.09%), Group 4: 7.55% Group 5: 10 patients (18.87%).CONCLUSIONS: Patient-related delay in pterygium surgery may affect surgical success and results. Informing patients about the operation and providing psychological-social support to alleviate patients' worries may prevent delays of surgery., AMAÇ: Pterjium cerrahisi yapılan hastalarda ameliyat zamanını etkileyen faktörleri bulmak ve alınabilecek önlemleri tespit etmek amaçlanmıştır.GEREÇ VE YÖNTEM: Ocak 2014-Şubat 2017 arası kliniğimizde pterjium nedeniyle cerrahi yapılan 53 hastanın 53 gözü çalışmaya alındı. Hastaların bilgileri, ameliyatı bekleme sebepleri ve cerrahi öyküsü sorgulandı. Hastaların cevaplarına göre gruplandırma yapıldı: Hastalığını bildiği halde çok fazla rahatsızlık duymamak (grup 1), hastalığının farkında olmamak (grup 2), ameliyat olmak için pterjiumun biraz daha ilerlemesini beklemek (grup 3), pterjium cerrahisi daha önce geçirip yine tekrarlamasından endişe etmek (grup 4) ve ameliyattan korkmak (grup 5).BULGULAR: En çok karşılaşılan pterjium ameliyatı geciktirme nedeni; hastalığını bildiği halde çok fazla rahatsızlık duymamak idi. İkinci sırada ise, ameliyat olmaktan korkmak olduğu tespit edildi. Cerrahiyi geciktirme nedenleri dağılımı şu şekilde idi: 1.Grup 23 (%43.4), 2.grup 8 (%15.09), 3.grup 8 (%15.09), 4.grup 4 (%7.55), 5.grup 10 (%18.87) hasta.SONUÇ: Pterjiumda hasta kaynaklı ameliyat zamanı gecikmesinin ameliyat başarısını ve sonuçlarını etkileyebileceği, yapılacak ameliyatla ilgili hastaların bilgilendirilmesi, hastaların endişelerinin giderilmesinde psikolojik-sosyal destek verilmesi ameliyat olma zamanında gecikmeleri önleyebilir.

BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores.

Aim: This study aimed to evaluate the clinical and pathological features of ocular adnexal lymphoma (OAL) and the treatment results in an eye care service center in Turkey.Materials and Methods: The data sets of the patients diagnosed with OAL acquired between January 2008 and January 2016 were collected and analyzed.Results: Fifteen patients were included in our study. The mean age was 55.80 ± 17.85 years. The age range was 7–85 years. Most of the lesions originated from orbital tissue, and histopathological and immunohistochemistry examinations of the lesions were consistent with non‑Hodgkin’s lymphoma in 14 patients and Hodgkin’s lymphoma in 1 patient. The most common subtype of OAL, accounting for 40% of cases, is extranodular marginal zone lymphoma of mucosa‑associated lymphoid tissue (MALT) type.Conclusion: Most of our patients’ histopathological and immunohistochemistry examinations are non‑Hodgkin’s type and also involve the orbits. Ocular adnexal lymphomatosis is not a rare disorder and could be treated if there is no systemic involvement at first diagnosis.Keywords: Adnexal Lymphoma, Non-Hodgkin’s lymphoma, tumour

The purpose of this study was to review unilateral acute maculopathy associated with hand-foot-mouth disease with a representative case. Clinical course of a 24-year-old male case with unilateral acute idiopatic maculopathy documented by multimodal imaging is presented, and a review of similar cases is given. On initial examination, best-corrected visual acuity was 20/200 in the left eye. Fundoscopy revealed grayish-yellowish subretinal exudate, and fluorescein angiography demonstrated irregular mottled hyperfluorescence at the central macula. Spectral domain optical coherence tomography demonstrated disruption of ellipsoid layer, which partially resolved on follow-up examinations. Best-corrected visual acuity increased to 20/20 at 3 months, with persistent retinal changes, and mild disruption of ellipsoid layer and persistent mild metamorphopsia. Although hand-foot-mouth disease is usually benign and self-limited in childhood, it may be rarely associated with unilateral vision loss due to maculopathy, especially at early adulthood in both sexes. Vision loss associated with this eruption is acute and reversible in most cases, despite some residual pigmentary and scarring changes in all cases and persistent mild visual loss in some cases. Exact pathophysiology, the causes of variability of clinical features, adulthood onset, unilateral involvement, and role of multimodal imaging are issues which need to be clarified with further research.

Iris melanomlarinin cogu daha once var olan iris nevusleri uzerinden gelismektedir. Iris melanomlarinin enukleasyon, metastaz ve fonksiyonel kayba neden olma riskleri nedeniyle erken tanilari oldukca onemlidir. Iris nevusunden melanom gelisimini kestirecek klinik parametrelerin farkinda olunmasi melanom gelisimi acisindan riskli nevus grubunun belirlenmesini ve iris melanomlarin erken tespitini kolaylastiracaktir. Bu derlemede iris nevuslerinin ve melanomlarinin klinik ozellikleri ve ayirt edici klinik parametreler sunuldu. Boylelikle bu hastalara klinik yaklasimda yardimci olunmasi amaclandi.

To assess clinical findings of eye examination in children having attention deficit hyperactivity disorder (ADHD) administered with methylphenidate hydrochloride.Fifty-seven consecutive patients diagnosed of ADHD and administered with oral methylphenidate hydrochloride treatment for at least one year were involved in this study (Group 1). Sixty healthy subjects (Group 2) having demographic features similar to group 1 were involved as a control group. All patients underwent detailed ophthalmological examination.One hundred and seventeen consecutive subjects with a mean age of 11.2 ± 2.4 years (7-18 years) were enrolled. Fifty-seven consecutive patient (32 males, 25 females) under oral methylphenidate hydrochloride treatment (Group 1) and 60 healthy control subjects (30 males, 30 females) (Group 2)) were recruited for this prospective study. The mean methylphenidate hydrochloride dosage was 0.9 ± 0.1 mg/kg/day and the mean duration of methylphenidate hydrochloride usage was for 2.73 ± 0.73 years (1-7 years). High intraocular pressure was not observed in any of the patients in our study. We detected lens opacities in five eyes of five patients in group 1 (p = 0.019). The patient with the highest degree of cataract formation had been using MPH for 84 months and this patient's cataract score was P4.Long-term use of methylphenidate may cause lens opacities. In particular, patients who have been using methylphenidate for more than two years should go for regular eye examination.

AIM There are significant increases in the survival rates of premature babies owing to rapid developments in medical technology. As the number of premature babies that can survive in neonatal intensive care increases, so does the frequency of complications due to prematurity. The aim of this study was to investigate the depressive and anxiety symptom levels, and factors affecting these, in mothers of infants who were followed up owing to a diagnosis of premature retinopathy (ROP). METHODS This study involved 78 consecutive mothers of premature babies, who applied to the ophthalmology clinic between February and May 2016. The mothers completed the Sociodemographic Information Form, Symptom Check List (SCL-90-R), Edinburgh Postnatal Depression Scale (EPDS), and State-Trait Anxiety Scale (STAI). RESULTS The mean scores of SCL-90-R Depression, Anxiety, and Global Severity Index (GSI) subscales, as well as STAI-1 and STAI-2 were higher in mothers of ROP-diagnosed babies. Factors affecting maternal depression and anxiety levels were the absence of maternal social support and the level of premature retinopathy. Mothers whose babies are diagnosed with ROP may have high levels of depression and anxiety. CONCLUSION The psychiatric follow-up, treatment, and social support provided to the mother, and regular follow-up of the baby after birth are important both for the mental health of the mother and the healthy development of the baby. Further research is needed to understand the role of parental mental health problems on the development and treatment processes of infants with premature retinopathy.

Although topical prostaglandin analogs (PGAs) have been previously associated with periocular skin hyperpigmentation, studies using objective clinical methods are lacking. Furthermore changes in periocular skin erythema indexes associated with topical PGAs have not been reported previously.The purpose of the present study was to evaluate periocular melanin and erythema indexes in patients treated with topical PGA using an objective clinical method - Mexameter.About 45 glaucoma patients treated with topical PGA therapy, and 30 age-, and sex-matched controls were enrolled in the study. Demographic data, medical history including duration of therapy, PGA type, involved eye (unilateral, bilateral) were noted, and skin phototypes were evaluated. Melanin and erythema indexes on medial and lateral upper and lower eyelids, and normal skin from the upper cheeks were measured using Mexameter MX-18. The index of difference for lower/upper eyelid was calculated. Reading results of patients and controls were compared.Melanin and erythema indexes of upper/lower eyelids, and the index of differences for upper/lower eyelids were significantly higher in patients despite similar clinical findings (p 0.05). Duration of therapy and type of PGA were not associated with skin changes (p 0.05).Both periocular melanin and erythema indexes increased in both upper and lower eyelids due to PGA therapy compared to controls, despite similar clinical findings. Mexametric evaluation is more sensitive than clinical evaluation, and may be used as an objective, sensitive clinical method to evaluate periocular skin changes, even smallest changes, in such patients.

Background & objectives: Cataract is one of the leading causes of blindness in the world. The aim of the present study was to investigate anticataractogenic effect of betaine in chick embryo hydrocortisone (HC)-induced cataract model. Methods: The study included 60 fertilized eggs divided into six groups each having 10 eggs: one group treated with only HC (HC group); three treated with both HC and different doses of betaine (HC/B 1.00, HC/B 0.50 and HC/B 0.25 groups) and two non-HC groups treated with only phosphate-buffered saline (PBS group) or betaine (B group). After the injections, lenses of the embryos were removed and classified into five stages according to the lens opacification. The amounts of reduced glutathione (GSH) in the removed lenses were measured. Results: All the lenses in non-HC-treated groups were clear, whereas in the HC-treated group, 90 per cent of the lenses had cataract (stages 4 and 5). The mean score of lens opacity was significantly lower in all HC/B groups compared to HC group (2.4-3.5 vs. 4.4, P

Purpose: The aim of this study was to present an experimental optical coherence tomography (OCT)–guided anterior segment (AS) imaging chick embryo model. Through this model, we aimed to reveal similarities and differences between human cornea, AS tissues, and chick embryo tissues by quantitative image analysis. Methods: Ex vivo, the chick embryos' globes were determined by detailed AS camera of spectral-domain (SD)-OCT in 10 fertilized specific pathogen-free eggs on the 20th day. Quantitative image analysis of anterior chamber tissues was performed with SD-OCT in detail. After imaging, cross sections of the chick embryo globes containing cornea with anterior chamber were histologically examined and compared with human tissues. The similarities of our model with data in the human cornea and AS studies in the literature were compared. Results: SD-OCT imaging was able to successfully delineate the AS tissues of chick embryos such as the cornea, iris, lens, pupil, conjunctiva, ciliary body, anterior chamber, and lens. Quantitative semi-automated measurements showed the following: mean central corneal thickness: 213.4 ± 7.05 μm (197–223 μm), mean anterior chamber depth: 878.9 ± 41.74 (804–919 μm), mean anterior chamber area: 2.43 ± 0.16 mm2 (2.17–2.73 mm2), mean corneoscleral junction (limbal) thickness: 322.8 ± 20.05 μm (289–360 μm), and mean iris thickness: 230.4 ± 13.27 μm (203–245 μm). In addition, detailed histological comparisons of the AS tissues with human tissues were evaluated to be very similar. Conclusion: In conclusion, this chick embryo model mimics human tissues and it can be considered as a platform for the study of teratogen-induced malformations and AS dysgenesis during gestation of AS tissues. In addition, this study demonstrates the feasibility of SD-OCT in the quantitative assessment of AS structures in chick embryo model.

Purpose: The purpose of this study is to evaluate anterior segment measurements obtained using CSO Sirius Topographer® (CSO, Firenze, Italy) and Nidek Axial Length (AL)-Scan® (Nidek CO., Gamagori, Japan). Methods: A total of 43 eyes of 43 patients were included in this prospective study. The central corneal thickness (CCT), anterior chamber depth (ACD), white-to-white distance (WTW), flat keratometry (K1), steep keratometry (K2), and mean keratometry (K) values were randomly measured three times with each device by the same examiner. The intraclass correlation coefficient of repeatability was analyzed. The compatibility of both devices was evaluated using the 95% limits of the agreement proposed by Bland and Altman. Results: Examiner achieved high repeatability for all parameters on each device except the WTW measured by Sirius. All measurements except WTW and K1 taken with the Sirius were higher than that taken with the Nidek AL-Scan®. The difference in CCT, ACD, and WTW values was statistically significant. Conclusion: High repeatability of the measurements was achieved on both devices. Although Km, K1, and K2 measurements of the Sirius and the AL-Scan® showed good agreement, WTW, CCT, and ACD measurements significantly differed between two devices. Thus, anterior segment measurements except for Km, K1, and K2 cannot be used interchangeably between Sirius and Nidek AL-Scan® devices.

Dacryops is a lacrimal ductal cyst. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Diplopia due to dacryops has not been reported previously. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops.