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Abstract Background To evaluate the effects of serial intravitreal injections (IVI) on the ocular surface and meibomian glands in patients with neovascular age-related macular degeneration (nAMD). Methods Patients receiving anti-vascular endothelial growth factor (anti-VEGF) agent injections for unilateral nAMD were included. Untreated fellow eyes served as the control group. All participants followed a pre-IVI asepsis protocol with povidone-iodine (PI). Ocular surface diseases index (OSDI) questionnaire scores, first and average non-invasive tear break-up time (fNITBUT and avgNITBUT), Schirmer-1 test results, corneal staining score (according to Oxford scale), meibomian gland (MG) loss rates of lower and upper eyelids were recorded four weeks after the last IVI. Results Forty-two nAMD patients with a mean age of 63.3 ± 19.4 were included in the study. The mean OSDI score was 20.3 and the median of IVI number was 9 (6–22). There were no statistically significant difference between treated and untreated fellow eyes regarding fNITBUT (5.6 vs. 4.5, p = 0.872), avgNITBUT (6.2 vs. 7.2, p = 0.968), Shirmer-1 results (7 vs. 7, p = 0.854), corneal staining (0.3 vs. 0.2, p = 0.341), lower and upper MG loss rate (29.3 vs. 28.4, p = 0.162, and 27.1 vs. 26.9, p = 0.476, respectively). Only significant correlation was observed between age with lower and upper MG loss rate (r:0.396, p = 0.042, and r:0.365, p = 0.047). Conclusion The results of the present study demonstrated that serial IVI of anti-VEGF agents with PI asepsis is well tolerated by nAMD patients in terms of ocular surface, MG loss and DED measurements.

Objectives: In this study, we evaluated the long-term effects of botulinum toxin A (BTA) in patients diagnosed with benign essential blepharospasm (BEB) and hemifacial spasm (HFS) comparing the drug dose in early and late periods and mean duration of relief. Materials and Methods: The records of patients who were treated with BTA for BEB and HFS were analyzed retrospectively. The patients who had

A 43-year-old female patient presented to our eye clinic with blurred vision and redness in the right eye for 2 weeks. Biomicroscopic examination revealed peripheral ulcerative keratitis with corneal thinning. After prescribing topical fluorometholon, moxifloxacin, preservative-free artificial tears, and vitamin A ointment, the patient was referred to Rheumatology department. Based on clinical findings and systemic research, the diagnosis of Behçet’s disease was established, and oral systemic azathioprine, hydroxychloroquine, and prednisolone treatment was started. In this study, we presented a case of peripheral ulcerative keratitis, an ocular manifestation uncommonly seen in Behçet’s disease. (Turk J Ophthalmol 2014; 44: 484-5)

Abstract Swimming goggles (SG) are widely used in water sports, and this study aimed to evaluate the acute effects of wearing SG on intraocular pressure (IOP), anterior chamber biometrics, axial length (AL), and optic nerve head (ONH) morphology. Twenty-eight healthy young adults participated in this cross-sectional study, with assessed parameters including IOP, central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber angle (ACA), AL, and optical coherence tomography (OCT) imaging of the ONH, specifically Bruch membrane opening (BMO), Bruch membrane opening-minimum rim width (BMO-MRW), lamina cribrosa depth (LCD), and prelaminar tissue (PLT). Measurements were taken at four time points: before wearing SG, at the 1st and 10th minutes of wearing, and immediately after removal. The results showed a significant increase in IOP at the 1st and 10th minutes of SG wear compared to pre-wear and post-removal values. Additionally, decreases in CCT, ACD, and ACA, along with an increase in AL, were observed while wearing SG. However, these changes reverted to baseline after the goggles were removed. No significant alterations were detected in ONH parameters during the study. The findings suggest that wearing SG induces an acute rise in IOP and changes in anterior segment parameters, likely due to oculopression, but does not appear to affect ONH morphology in the short term. Further studies are needed to investigate any potential long-term effects.

Abstract Purpose Comparison of the efficacy of monthly anti-VEGF versus dexamethasone (DEX) implant in patients with diabetic macular edema (DME) whose macular edema persists despite three doses of anti-VEGF therapy. Materials and methods This retrospective study included 94 eyes of 94 patients with central macular thickness (CMT) > 300 μm despite previously receiving three doses of anti-VGEF (aflibercept or ranibizumab) injections between January 2014 and January 2019. The patients were divided into four groups. The first and second groups were the patients who received three more doses of initial anti-VGEF treatment after the initial anti-VGEF treatment. The third and fourth groups were patients switched to intravitreal dexamethasone implants. Patients were followed up every month for six months after the injection. The primary outcome measures were best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at six months. Results The mean age of the patients included in the study was 64.64 ± 7; there were 58 men (61.7%) and 36 women (38.3%). There was no statistically significant difference between the groups regarding age, stage of retinopathy, and lens status. When CMT, BCVA, and IOP were assessed among the four groups at the end of the sixth month, no statistical difference between the groups was found. There was no need for medical intervention despite the statistically significant increase in IOP at the end of the sixth month compared to the third month in the dexamethasone implanted groups. In contrast to the decrease in CMT, which was statistically significant in all four groups at the end of the sixth month compared to the third month, the increase in BCVA was not statistically significant in any of the four groups at the end of the sixth month. Conclusion According to the results of our study, there is no superiority between continuing with existing anti-VEGF or switching to a dexamethasone implant after three doses of anti-VEGF.

Abstract Background This population based cross sectional study was conducted to detect amblyopia risk factors and myopia in a rural district of Northwestern Turkey by using PlusoptiX S12R (Photoscreener PlusoptiX Inc., Nuremberg, Germany). Methods Children from 38 rural schools in Caycuma district of Zonguldak Turkey underwent vision screening in their school using PlusoptiX S12 photoscreener. Data were analyzed using the factory default level 5 referral criteria targeting 80% sensitivity and 95% specificity. Referral, unable readings, and positive predictive value (PPV) were reported. Results Data from 2846 children were analyzed. Mean age was 7.9 years (±0.8) (range 36 months to 11 years). Three hundred ten (11%) were referred of whom 32% were read as ‘unable’. 150 children (48% of the referred) received a gold standard examination. Positive predictive value of PlusoptiX was 69%. PPV was 83% when unable readings were excluded. 93 children with amblyopia risk factors were identified. Only 26% (n = 25) had received glasses priorly. 49 children had amblyopia of whom 33 were newly diagnosed. Conclusions PlusoptiX showed a reasonable level of positive predictive value in community setting and the device could be a useful tool for vision screening in preschoolers and schoolers. We found most of the amblyogenic refractive errors were underdiagnosed in rural school children leading to a call for action on vision screening.

Atilla Alpay, Suat Hayri Ugurbas, Berktug ErdoganDepartment of Ophthalmology, Faculty of Medicine, Zonguldak, Karaelmas University, Zonguldak, TurkeyPurpose: To compare various techniques of pterygium surgery including bare sclera, intraoperative mitomycin C application, conjunctival flap reconstruction, and conjunctival autografting technique.Methods: This study is designed to compare 4 currently used techniques in order to determine the complication and recurrence rates after pterygium exision. Included in the study were 77 eyes from 60 patients. Bare sclera technique was used to treat 21 primary pterygia; mitomycin C was used to treat 20 (16 primary, 4 recurrent) pterygia; 18 (17 primary, 1 recurrent) pterygia were treated by conjuntival flap reconstruction; and 18 (9 primary, 9 recurrent) pterygia were treated by conjunctival autografting technique. All patients who underwent surgery were followed up for between 6 months and 2 years.Results: Eight recurrences (38.09%) were observed in the bare sclera group whereas there were 5 (25%) recurrences in the mitomycin C group. In the conjunctival flap reconstruction group, 6 (33.33%) recurrences were detected. In the conjunctival autografting group, 3 recurrences were observed. There were no major complications threatening visual ability in the surgical patients.Conclusion: A comparison of the groups demonstrated that the recurrence rate was highest in the bare sclera group, and lowest in conjunctival autografting and mitomycin C treatment groups respectively. Although the conjunctival autografting technique is a more difficult and time consuming technique than the others, cosmetic and surgical results were found to be superior. We advise conjunctival autografting for the treatment of pterygium in view of the high recurrence rates of other techniques, and the possible complications of mitomycin C treatment for benign disease.Keywords: pterygium, comparing, techniques, mitomycin C