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Objectives: This study aimed to evaluate superficial peripapillary vascularization qualitatively and quantitatively in patients with acute non-arteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCT-A). Materials and Methods: Eleven patients with acute NAION and 14 controls were evaluated retrospectively. Complete ophthalmologic examination with best corrected visual acuity, peripheral visual field test, and disc angiography with OCT-A were performed. Quantitative optic disc perfusion indexes were evaluated by the device with automatically segmentation and qualitative comparison of choroidal, retinal, and en-face peripapillary perfusion angiogram images. Results: In the NAION and control groups, mean age was 57.55±12.34 years and 50.79±4.67 years (p=0.110), the proportion of women was 7/11 (63.6%) and 9/14 (60%), and best corrected visual acuity was 0.95±0.63 and 0.00±0.0 LogMAR (p=0.001), respectively. Visual field defect was present in 10/11 (91%) eyes in the NAION group. In 6 patients, visual field defects were correlated with areas of peripapillary and optic nerve head hypoperfusion. In the patient group, optic nerve head capillary density was significantly decreased (p=0.008) and radial peripapillary capillary density was significantly decreased in all sectors except the inferonasal sector. Conclusion: In our study, we observed that visual field evaluations were partially correlated with optic nerve head and peripapillary capillary perfusion assessed by OCT-A. Being practical and non-invasive, OCT-A is a useful and up-to-date method for evaluating perfusion in NAION. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of chronic obstructive pulmonary disease (COPD) in the dry eye status in men and to determine whether the hypoandrogenic status has any concomitant impact. Materials and Methods: We enrolled 80 patients with stable COPD and healthy volunteers individually matched on the basis of body mass index (BMI), age, and sex. Ocular surface testing included ocular surface disease index (OSDI) questionnaire, evaluation of meibomian gland dysfunction (MGD), tear fluorescein break-up time (TF-BUT), ocular surface staining with lissamine green (LG), Schirmer test with topical anesthesia, and Sirius meibographic analysis of meibomian gland area (MGA) loss. Bioavailable testosterone and free testosterone were measured using the measured total testosterone (TT), albumin, and sex hormone binding globulin (SHBG) levels. Results: Patients with COPD had lower levels of circulating androgens, decreased TF-BUT, and lower Schirmer score and greater LG staining score, MGD grade, and MG area loss than healthy controls (p<0.01). Forced expiratory volume in 1-second (FEV1), FEV1/forced expiratory vital capacity (FVC), and circulating androgen levels were inversely correlated to the OSDI score, LG staining, MGD grade, and MGA loss and showed positive correlation with TF-BUT and Schirmer score in COPD patients (p<0.01). However, when adjusted for androgen levels, FEV1 and FEV1/FVC ratio were negatively correlated to the Schirmer score (p<0.05). Conclusion: Male COPD patients had worse tear film parameters, and this finding was more notable in patients with lower androgen levels. Hypoandrogenic status in COPD patients attributes to the dry eye status of the patients, irrespective of their FEV1 and FEV1/FVC status. [ABSTRACT FROM AUTHOR]

Objective: To compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular volume in patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and healthy controls. Materials and Methods: This study used spectral domain-optical coherence tomography to measure pRNFL and the volume of retinal layers at the macula. Forty patients with MS or NMOSD and 19 healthy controls were enrolled. Results: After at least one clinical episode of optic neuritis, the average pRNFL for NMOSD [60 µm (34-105)] and patients with MS [85 µm (41-109)] were lower than in healthy controls [99 µm (88-109)], and patients with NMOSD had significantly lower pRNFL compared with patients with MS (p = 0.002). Foveal volume did not differ between optic neuritis eyes of patients with NMOSD and MS (NMOSD 1.18±0.3 mm³, MS 1.82±2.07 mm³). The mean pRNFL values in seronegative NMOSD eyes [58 µm (range, 47-111)] tended to be thinner compared with seropositive NMOSD eyes [76 µm (range, 42-105)]. This finding was not considered to be statistically significant. Conclusion: Our study revealed that both foveal (area in a 1.5 mm ETDRS ring) and total macular volume (area in a 6 mm ETDRS ring) were lower in both patients with MS and NMOSD compared with healthy controls. Optic neuritis of NMOSD is associated with a thinner average RNFL compared with MS, suggesting earlier axonal injury in the affected optic nerves. [ABSTRACT FROM AUTHOR]

Objectives: T o assess the effects of anti-vascular endothelial growth factor (VEGF) drugs on retinal pigment epithelium cell culture. Materials and Methods: Aflibercept (0.5 mg/mL), bevacizumab (0.3125 mg/mL), and ranibizumab (0.125 mg/mL) were applied to retinal pigment epithelium cell cultures isolated from the enucleated eyes of New Zealand white rabbits. Viability, apoptosis, proliferation, and senescence of the cells were evaluated in control and drug-treated cultures at the end of 72 hours. Results: Cells treated with aflibercept showed increased viability and decreased apoptosis compared to the control culture and both the bevacizumab- and ranibizumab-treated groups (p<0.05). Statistically increased apoptosis and decreased viability were found in the bevacizumab and ranibizumab-treated groups compared with the control group (p<0.05). There were no statistically significant differences in cell proliferation and senescence between the groups (p>0.05). Conclusion: Anti-VEGF drugs did not affect senescence or proliferation of retinal pigment epithelium cells. Aflibercept was found to decrease apoptosis and increase cell viability, while ranibizumab and bevacizumab increased apoptosis and reduced cell viability in retinal pigment epithelium culture. [ABSTRACT FROM AUTHOR]

A 69-year-old female with unilateral proptosis for 1 year presented at our ophthalmology clinic. She had degenerative myopia and a history of low vision for several years. A radiographic imaging revealed a right orbital mass causing bone lysis and invading the intracranial space. Total resection of the mass was performed, and the findings of a histopathological examination were consistent with those for follicular or papillary thyroid carcinoma. Total thyroidectomy with modified radical lymph node dissection revealed a follicular variant of papillary carcinoma. The patient was referred to the nuclear medicine department for further radioiodine therapy. Although extremely rare, thyroid should be carefully examined as a part of the systemic workup when assessing the primary diagnosis of orbital metastasis. Further, patients with pathologic myopia should be carefully examined for signs of orbital mass when suspected because of overlapping symptoms, such as pseudoproptosis and low vision. [ABSTRACT FROM AUTHOR]

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Limbal stem cell deficiency (LSCD) is a complex ocular condition with difficulty in corneal epithelialization, persistent epithelial defects, corneal neovascularization, and corneal conjunctivalization. The reason underlying this condition could be either primary or secondary. Chemical and thermal burns, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trauma, aniridia, ectodermal dysplasia, and iatrogenic mechanism are in the etiologic scope of the disease. Management of LSCD remains a controversial issue of ophthalmology. There are several treatment alternatives regarding the mechanism of the disease. These options include surface reconstruction with amniotic membrane, autologous and allogeneic limbal stem cell (SC) transplantation, and keratoplasty. There has not been a consensus on the choice of the treatment procedure, although more recently, cultivated SC transplantation has been shown to be a promising treatment modality in the management of LSCD. This review aims to give the readers up-to-date information on LSCD. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of the relationship between macular optical coherence tomography (OCT) parameters with visual functions in patients with retinitis pigmentosa (RP). Materials and Methods: Demographic data and parameters of spectral domain-OCT of patients with RP whom applied to our clinic were evaluated retrospectively. One hundred and fifty-three eyes of 79 patients were included into the study. Mean visual acuity of the patients were converted to logMAR values. Vitreoretinal surface abnormalities, presence of cystoid macular edema (CME) and integrity of the outer retinal layers were evaluated, and central macular thickness (CMT) was calculated with OCT. Results: Mean visual acuity was 1.2 ± 0.9 logMAR. Median CMT was 154 μm (41-873) in RP group. This value was 267 (173-873) μm in cases with CME, and 140 μm (41-296) when cases with CME were withdrawn. There was a negative correlation between the patients' ages and visual acuities with their CMT. Twelve of the eyes (8%) had epiretinal membrane while 9 eyes (6%) had macular hole. All patients had disintegrity of outer retinal layers of varying degrees. Conclusion: With the aging and progression of the disease, visual acuity tend to decrease, central macula thins and disintegrity in the outer retinal layers increases. Patients have a significant correlation between OCT changes and visual functions. Optical coherence tomography is very helpful in determining retinal structure, morphological abnormalities and assessing the prognosis in patients with RP. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate optical coherence tomography (OCT) and multifocal electroretinogram (mfERG) findings in patients with central serous chorioretinopathy (CSC) Methods: Sixty-two eyes of 31 patients with unilateral treatment naive CSC were included in the study. All subjects underwent complete ophthalmologic examination including best-corrected visual acuity (BCVA), subfoveal and parafoveal choroidal thickness (CT), central foveal thickness (CFT), macular volumes with OCT, and also mfERG responses. Correlation analyses were performed between BCVA, OCT parameters, and mfERG responses. Results: There was significant increase in subfoveal and parafoveal CT in both affected and fellow eyes of CSC compared to healthy subjects. There was significant decrease in the N1, P1, and N2 amplitudes and increase in N1 implicit times for all rings in both affected and fellow eyes of CSC patients compared to control subjects. Correlation analysis revealed that BCVA was significantly correlated with N1, P1, and N2 amplitudes for Ring 1 (p<0.05). No significant correlations between BCVA and various OCT parameters were found. Conclusion: Our study showed significant correlations between BCVA (logMAR) and mfERG amplitudes in CSC patients. Furthermore, no significant correlations between BCVA and various OCT parameters were found. Our findings point out that mfERG and OCT could both serve as noninvasive tools for functional and anatomical assessments of CSC patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate pain scores of patients during intravitreal (IV) aflibercept versus ranibizumab injections. Materials and Methods: In this interventional study, 88 eyes of 88 patients who received IV anti-vascular endothelial growth factor (anti- VEGF) therapy were included. Fourty three patients received IV 2.0 mg/0.05 ml aflibercept injection with 30-gauge needle and 45 patients received IV 0.05 mg/0.05 ml ranibizumab injection with 30-gauge needle. The diagnoses of the patients were: 40 age related macular degeneration, 39 diabetic macular edema, 4 central and 5 branch retinal vein oclusion. Immediately after the injection, patients were asked to grade their pain using the visual analog scale (VAS) of 0 (no pain) to 10 (unbearable/ worst pain). The main outcome measure was the pain score assessment. Additional parameters recorded included demographics (age, gender, education level) and clinical characteristics (indication for the injection, number of previous IV injections). Results: The VAS pain scores in the aflibercept and ranibizumab groups were 1.67± 0.81 (range, 0-7) and 1.24 ± 1.15 (range, 0-6), respectively (p = 0.10). Multivariable regression analysis revealed that pain perception was significantly lower in patients of older age, male patients, with higher number of previous injections and higher educational status. Conclusions: Pain associated with both aflibercept and ranibizumab IV injection is generally mild, and may be associated with epidemiologic factors and the number of previous IV injection. [ABSTRACT FROM AUTHOR]