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Paracentral acute middle maculopathy (PAMM) is an optical coherence tomography (OCT) finding secondary to retinal ischemia. In this presentation, we describe the diagnosis of hereditary thrombophilia caused by multiple gene mutation, based on the PAMM finding on OCT, in a patient with no known disease who presented with unilateral scotoma. Hematological evaluation has an important role in young PAMM cases without systemic and ocular disease. Patients with thrombophilic mutations may be first recognized with ocular symptoms by ophthalmologists. It may be life-saving to reveal the risks of patients such as cardiovascular disease and thromboembolism at an early age. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the relationship between serum endocan levels and diabetic retinopathy (DR) severity in diabetic patients. Material and Method: The study included 72 patients with diabetes mellitus (DM) and 28 volunteer control patients without any systemic disease. Patients with no systemic disease were the 1st group (n=28), diabetic patient without DR were the 2nd group (n=21), patients with non-proliferative DR were 3rd group (n=24) and patients with proliferative DR were 4th group (n=27). BMI, serum endocan levels, HbA1c, urea, creatinine levels and macular thickness were measured. Results: Serum endocan levels were 170.05±85.67, 333.91±13.41, 340.42±105.07, 472.83±147.40 ng/L, respectively. BMI was 23.11±1.37 in the 1st group, 28.05±4.62 in the 2nd group, 29.00±5.69 in the 3rd group, and 28.85±5.88 in the 4th group. HbA1c levels were 4.83±0.55 in 1st group, 6.60±1.15 in 2nd group, 8.49±1.24 in 3rd group, and 8.89±1.30 in 4th group. Macular thickness measured with OCT was 216.96±11.64, 253.29±23.62, 274.88±61.11, 352.93±120.08µm in the right eye and 218.96±11.93, 240.65±17.57, 283±62.89, 334.78±127.71µm in the left eye, respectively. Conclusion: In our study, there was a relationship between serum endocan level and DR stage. Serum endocan level can reveal important information about the severity and stage of DR such as serum creatinine and HbA1c level. There is a potential need for further research to demonstrate whether endocan is involved in DR pathogenesis. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the thickness of retinal nerve fiber layer (RNFL) in diabetic and hypertensive patients using spectral-fi eld optical coherence tomography (SD-OCT). Methods: In this study, 30 eyes of 15 patients without diabetic retinopathy and 28 eyes of hypertension without hypertensive retinopathy were included. Twenty-two eyes of 11 patients who were referred to our clinic with refractive complaints as control group were evaluated. OCT was performed for the RNFLthickness in both eyes of all patients and the control group. Results: The mean RNFL thickness measured in both eyes was 89.09 ± 11 µm in diabetic patients and 104.52 ± 11 µm in healthy controls. The mean RNFL thickness measured in both eyes was 90 ± 13 µm in hypertensive group. When the diabetic group was compared with the control group, the thinning of the RNFL (p-value = 0.002) was observed in the superior and inferior area around the optic disc. Hypertension and RNFL thinning correlation was lower than the diabetic group (p-value = 0.04). Conclusions: In this study, decreased RNFL in diabetic patients compared to the control group suggests that neurodegeneration is an important component in the early stage of diabetic retinopathy. There was no significant change in hypertension on RNFL. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the result of topical brinzolamide treatment in patients diagnosed with X-linked juvenile retinoschisis (XLRS). Subjects and Methods: Files of 16 patients with XLRS diagnosed between January 2010 and January 2016 were reviewed retrospectively and 16 eyes of 8 patients who were on topical brinzolamide treatment for at least 12 months or more were included into the study. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated. Results: Mean age of the subjects was 12.8±4.2 years (Range: 6-18 years) and the mean follow-up time was 36.0±24.0 months (Range: 12-84 months). Median BCVA with Snellen chart was 0.2 (Range: 0.1-0.6) and mean CMT was 509.3±124.7 micron (Range: 215-646 micron) at the baseline. Topical brinzolamide was prescribed as tid in all patients. Median BCVA was 0.25 (Range: 0.1-0.7) and mean CMT was 457.8±135.6 micron (Range: 202-714 micron)) at the last visit. There was a statistical difference in baseline and final BCVA and CMT (p<0.05). The BCVA improved more than one line in 9 eyes, unchanged in six eyes and was worsened more than one line in one eye despite the decrease of CMT. A reduction of at least 20% in CMT were achieved in 4 eyes, 10-20% in 4 eyes, under 10% in 5 eyes at the end of follow-up. Increase of CMT was observed in 3 eyes despite the topical brizolamide treatment. Conclusion: In patients with XLRS, topical brinzolamide administration may provide some improvement in visual acuity and relative stabilization in central macular thickness. [ABSTRACT FROM AUTHOR]

Purpose: To compare macular photoreceptor(PR), retina pigment epithelium(RPE) and choroidal thickness by enhanced depth optic coherence tomography(EDI-OCT) in healthy subjects with positive family history for age related macular degeneraton(AMD) in first degree relative and control subjects. Materials and Methods: 106 eyes of 53 healty subjects with positive family history for moderate or advanced stage dry or wet type AMD in one of their parents(group 1) and 166 eyes of 83 age matched control subjects(group 2) were included to study. All subjects underwent a comprehensive ophthalmologic examination. PR, RPE and choroidal thickness measurements were taken at fovea, at 500 μm, 1000 μm and 2000 μm nasal or temporal to the fovea center by EDI-OCT(Heidelberg Engineering, Germany). Results: There was no significant difference between two groups according to age, sex, axial length and introocular pressure (p>0.05). Mean PR thickness was significantly thinner in group 1 than group 2 except at 2000 μm temporal to the fovea (p=0.132 for 2000 μm temporal to the fovea, p<0.05). Mean RPE thickness was significantly thinner in group 1 than group 2 except at 500 μm nasal to the fovea (p=0.450 nazal 500 μm, p<0.05). Mean choroidal thickness was significantly thinner in group 1 than group 2 at all locations (p<0.05) Conclusion: PR, RPE and choroidal thinning may occur in healthy subjects with positive family history for AMD in first degree relative before AMD signs are seen. So further studies are needed to evaluate if healthy subjects with positive family history for AMD tend to be AMD [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the vitreoretinal interface with spectral domain optical coherence tomography (SD-OCT) in patients with asteroid hyalosis. Materials and Methods: Fourty-nine eyes of 40 patients who were diagnosed with asteroid hyalosis in our clinic between January 2012 and May 2014 were included in the study. Cases with previously diagnosed pathologies that may cause any vitreoretinal interface abnormalities such as uveitis, retinal vein occlusion and diabetic retinopathy as well as those who had a history of ocular laser, surgery and trauma were excluded from the study. A detailed ophthalmologic examination including SD-OCT scan was performed in all study participants and any vitreoretinal interface abnormalities were noted. Results: Mean age of the study group was 69.5±8.8 years (Range, 49-86 years) at the time of diagnosis, twenty eight were men (70%) and twelve female (30%). Bilateral involvement was present in 9 patients (22.5%). Of the total 49 eyes, vitreoretinal interface was normal in 23 eyes (46.9%); while interface abnormality was found in 26 eyes (53.1%). Among 49 eyes, 15 (30.6%) had epiretinal membrane, 9 (18.4%) vitreomacular adhesion, and 2 (4.1%) vitreomacular traction. Conclusion: There may be vitreoretinal interface abnormalities in patients with asteroid hyalosis. Asteroid bodies may limit the clear view of the macula and vitreomacular interface. As vitreoretinal interface abnormalities may be the main cause of visual deterioration in eyes with asteroid hyalosis, optic coherence tomography should be performed in such cases. [ABSTRACT FROM AUTHOR]

Purpose: To investigate macular thickness changes after uneventful cataract surgery performed with phacoemulsification method using optical coherence tomography. Materials and Methods: This prospective study was carried out on 30 eyes of 30 patients (15 men, 15 women, mean age 62.63±7.15 years) who underwent phacoemulsification surgery. A complete ophthalmic examination and OCT were performed to all patients preoperatively and at 1 month, 3 month, and 6 month postoperatively. The obtained data were statistically evaluated. Results: The mean values of preoperative and postoperative best corrected visual acuity were statistically different (p<0.01). The mean values of preoperative and postoperative intraocular pressure were not statistically different (p>0.05). Mean macular thickness and central macular thickness measurements were performed before surgery and postoperatively at month 1,3,6. Preoperative mean macular thickness was not statistically different from postoperative 1 month mean macular thickness (p=0.09). There was no difference in mean macular thickness between OCT measurements preoperative and postoperative at 1 month, while mean macular thickness at 3 month and 6 month were significantly higher than properative values(p= 0.006 and 0.007 respectively). Central macular thickness values were not different preoperatively and postoperative at month 1,3, and 6, by OCT examinations. Conclusion: Macular thickness changes were detected after phacoemulsification surgery. To detect pathologic conditions which come from these changes further studies required. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the significant prognostic factor on the final visual outcome for epiretinal membrane (ERM) surgery with spectraldomain optical coherence tomography (SD-OCT). Materials and Methods: Sixty-one eyes of 61 patients with epiretinal membrane that were followed-up in Ulucanlar Eye Training and Research Hospital between January 2010-June 2012 were respectively evaluated in this study. The best corrected visual acuity (BCVA logMAR), intraocular pressure, slit-lamp biomicroscopy, macular thickness and macular structure obtained with OCT images were evaluated at baseline and postoperative 6th months. Macular structures, including morphology of photoreceptor inner segment/outer segment junction, foveal contour, central macular thickness (CMT) were investigated as predictors visual outcome of the surgery. The cases were divided into two subgroups:Group-A was including patients with idiopathic ERM, group-B with secondary ERM. Results: The mean BCVA was 0.81±0.28,0.47±0.31 logMAR respectively at preoperative and postoperative 6th months for group-A, and 0.93±0.34, 0.65±0.32 logMAR for group-B. The difference between BCVA before, after surgery was statistically significant in both groups (for group-A p=0.000, for group-B p=0.001). The mean CMT was 468.33±111.30 at baseline, 398.57±78.60 µm at the 6th month for group- A. These values were 485.26±159.52, 326.31±94.58 µm for group-B, respectively. The reduction in the mean CMT was significant in both groups, (for group-A p=0.000, for group-B p=0.001). The association between macular structure and visual outcomes, the IS/OS junction disruption was statistically significant (p<0.05). Conclusions: Regularity and uninterrupted IS/OS junction on preoperative SD-OCT images was found to be an important predictor of better visual outcomes after epiretinal surgery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate spectral domain optical coherence tomography (SD-OCT) in differentiating optic disc edema (ODE) due to papilledema and other optic neuropathies from optic nerve head drusen (ONHD). Material and Methods: Optical coherence tomographic images from 42 subjects (18 with ONHD: group 1, 24 with ODE: group 2,) were examined qualitatively and quantitatively. Qualitative criteria for ODE were an elevated optic nerve head with smooth internal contour and subretinal hyporeflective space (SHYPS) with recumbent "lazy V" pattern. Optic nerve head drusen showed a "lumpybumpy" internal optic nerve contour and a rapid decline in SHYPS thickness. Quantitative comparisons included optic nerve head thickness (ONHT) and SHYPS thickness. Results: All of the eyes matched the qualitative criteria for ONHD in group 1 and for ODE in group 2. The mean age of group 1 was 27.44±15.01 and in group 2 was 32.66±11.48 and there was no significance between groups (p>0.05). The mean ONHT measurement was 747.33±50.35 µm in group 1, and 820.07±150.78 µm in group 2. Although the ONHT was greater in ODE patients, there was not a statistically significant difference between groups (p>0.05). When we evaluate the SHYPS thickness, the mean value was 478.77±53.77 µm in group 1 and 596.01±126.37 µm in group 2. The difference between the measurements was statistically significant (p<0.005). Conclusions: SD-OCT is a viable instrument to differentiate optic nerve pathologies. The qualitative criteria and SHYPS as a quantiatative measurement seems to be useful for differentiation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate effects of serum parathormone level on retinal thickness and choroidal thickness in non-diabetic predialysis chronic renal disease (CRD) patients. Materials and Methods: Sixty-five eyes of 45 non-diabetic predialysis CHD patients and 20 healthy subjects were included in this cross-sectional study. Twenty-five CHD patients had high serum PTH levels and 20 CHD patients had PTH levels within normal limits. Spherical equivalent, central corneal thickness (CCT), intraocular pressure (IOP), retinal and choroidal thicknesses of CHD patients and healthy control subjects were measured. Serum creatinine, calcium, phosphor, C-reactive protein (CRP), vitamin D3 and PTH levels were recorded. Statistical analysis of data was carried out using independent samples t test, one-way analysis of variance and Pearson correlation analysis. Results: There was no statistically significant difference in serum calcium, phosphor, vitamin D3 and CRP levels (range of p values: 0.117-0.412) except for serum PTH levels (p<0.001). There was no statistically significant difference in age, spherical equivalent, CCT, and IOP measurements of groups (p values were ranging between 0.067-0.792). There was statistically significant difference in nasal and temporal retinal segment thicknesses between CHD patients and healthy control subjects (p values were 0.044 and 0.024, respectively). Patients with high serum PTH levels had thicker choroid than other 2 groups for all the measured segments, however this difference was not statistically significant (range of p values: 0.438-0.794). Conclusions: Retinal thickness decreased in non-diabetic predialysis CHD patients and high serum PTH levels might affect choroidal thickness in this group of CHD patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the factors effecting visual acuity in patients treated with intravitreal ranibizumab for macular edema (ME) due to branch retinal vein occlusion (BRVO). Material and Methods: Twenty-eight eyes of twenty-eight patients who were treated with intravitreal 0.5 mg (0.05 ml) ranibizumab (Lucentis, Genentech Inc., USA) for macular edema due to branch retinal vein occlusion were included in this study. The medical records were analysed retrospectively. Age, sex, laterality, systemic disorders, number of injections, follow-up period and best-corrected visual acuity (BCVA) before and after treatment were recorded. Spectral OCT findings such as central macular thickness (CMT), type of edema, presence of IS/OS and ELM damage, vitreomacular pathologies were evaluated. Also fluorescein angiographies (FA) were analyzed in order to detect macular or peripheral ischemia. The relationship between these parameters and BCVA was analysed. Results: There were 12 males and 16 females in our study. The mean follow-up time was 12 (3-35) months. Ischemia was detected in 36% of the patients in FA. The mean number of injections was 2.8 (1-7). The mean BCVA at the end of the follow-up (0.56±0.44 logMAR) was significantly better than that at baseline (0.76±0.48 logMAR; p<0.05). The mean CMT improved from 614.6±246.6 pm at baseline to 250±171.6 pm at the end of the follow-up (p=0.000). The efficacy of intravitreal ranibizumab was similar among the sub-groups which were formed considering presumed prognostic factors (p>0.05). Intact foveal IS/OS line (p=0.025) and ELM (p=0.033) at baseline correlated with good final visual outcome but the type of edema showed no difference among all sub-groups (p>0.05). Conclusion: Intravitreal ranibizumab therapy leads to improvement of BCVA and CMT in patients with macular edema due to retinal vein occlusion. Intact IS/OS line and ELM on OCT indicate good visual prognosis before treatment. [ABSTRACT FROM AUTHOR]

Posterior scleritis is scleral inflammation beyond the equator. The most common presenting signs are pain and visual loss in any age group. These nonspecific complaints and a wide spectrum of clinic features may cause difficulties in diagnosis. Posterior scleritis is often idiopathic but can also be related to systemic diseases. In this report, three posterior scleritis cases diagnosed with fundus fluorescein angiography, optic coherence tomography and magnetic resonance imaging techniques are analyzed. Furthermore, the diagnostic and therapeutic approach to posterior scleritis is discussed. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the retina nerve fibre layer (RNFL) thickness with Heidelberg retinal topography (HRT) and optic coherence tomography (OCT) in patients who were use antimalarial drugs Materials and Methods: This case-control study included 92 eyes of 46 patients that were on systemic hydroxychloroquine and chloroquine therapy for systemic lupus erythematosus(n=18), discoid lupus erythematosus (n=5), rheumatoid arthritis (n=8), Sjögren's syndrom (n=9) and connective tissue disorders (n=6). The control group was comprised of 25 female and seven male. Peripapillary RNFL measurements obtained with HRT and OCT were compared between two groups. Results: Mean age of patient and control groups were 46.8±14.9 and 51.4±9.3 years respectively. RNFL thickness measurement in the patient's group with HRT at the onset, sixth and 12 th month for the right eye was 0.26±0.06, 0.27±0.05, 0.27±0.05 mm and for the left eye it was 0.27±0.07, 0.28±0.06, 0.26±0.06 mm respectively. RNFL thickness with HRT in the control group for the right and left eye was 0.27±0.09 and 0.25±0.05 mm respectively. Average RNFL thickness measurement in the patient's group with OCT at the onset, sixth and 12 th month for the right eye was 105.3±12.3, 104.5±11.08, 100.6 ±11.5 ?m and for the left eye was 104.8±12.2, 103.9±13.17, 100.0±8.9 ?m respectively. In the control group for the right eye and the left eye was 99.5 ±11.5 and 97.12±11.3 ?m respectively. Conclusion: The RNFL thickness measured with both OCT and HRT didn't change in patients that were on antimalarial drugs therapy during the study course. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of intravitreal injection of triamcinolone acetonide (IVTA) for refractory diabetic macular edema with optic coherence tomography-3 (OCT-3). Materials and Methods: 4mg triamsinolone acetonide was injected into the vitreous of the 20 eyes and 20 patients (10 female, 10 male) whom were treated with argon laser previously for diabetic macular edema, aged 45 to 76 years (average 59.55). The mean central macular thickness was measured with OCT-3 before, 1 weeks after and 1, 3 and 6 months after IVTA. Best-corrected visual acuity and findings of ocular examinations were recorded. The differences between the central macular thickness at the baseline and follow-up examinations were analysed with variance test and the visual acuity by Wilcoxon test with a Bonferroni correction. Results: The mean central macular thickness before, 1 weeks after, and 1, 3 and 6 months after IVTA were 417.75, 373.55, 250.65, 251.3 and 360.4 μm respectively. At the 1st month the visual acuity of 11 eyes improved, 7 eyes remained the same and 2 eyes were worsened. At 6th month, the visual acuity of 8 eyes improved, 3 eyes worsened and 9 eyes remained the same. Intraocular pressure exceeded 25 mmHg in 4 eyes, and were controlled by topical medication. One eye showed cataract development. The difference between the relative changes in macular thickness and the visual acuity were significant at 1 month and 3 months (p<0.001) (p<0.0125) respectively. Conclusion: Intravitreal injection of triamcinolone effectively reduces macular thickening due to diabetic macular edema in short term but after 6 months recurrent edema develops and the improvement of visual acuity is no longer permanent. [ABSTRACT FROM AUTHOR]