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Purpose: The purpose of this study was to evaluate prediabetic patients for microvascular changes using optical coherence tomography-angiography (OCT-A) and compare with diabetic patients and healthy controls., Methods: OCT-A images of 60 eyes of 30 patients with diabetes mellitus (DM), 72 eyes of 36 prediabetic patients, and 108 eyes of 54 healthy controls were retrospectively evaluated and compared in this study. A swept-source OCTA (Triton, Topcon) instrument was used for collecting OCT-A images. Duration of the diabetic or prediabetic period, glycated hemoglobin, fasting blood glucose level, postprandial glucose (PPG) level, high-density lipoprotein, low-density lipoprotein, triglyceride, and creatinine values of all participants were recorded., Results: Microaneurysm, nonperfusion areas, perifoveal capillary disruption, and capillary network disorganization were detected in both prediabetics and diabetics but statistically more common in diabetic patients. Neovascularization and intraretinal microvascular anomalies were detected only in diabetic patients., Conclusions: OCT-A seemed to be effective in detecting microvascular changes in diabetic patients. More importantly, results showed us that in prediabetic patients, microvascular changes can be seen before the onset of DM and before or concurrently with neurodegenerative changes., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Oman Ophthalmic Society.)

Background and Aim: Retinopathy of prematurity (ROP), is a vasoprolipherative disorder of the immature retina and a major cause of preventable blindness in childhood. Although the development of ROP is multifactorial, the main reasons are lower gestational age and birth weight. However, in twins their gestational ages were the same, ROP development can be discordant. This study aims to evaluate the etiologic factors of discordant ROP development in twins., Methods: We reviewed the last 5 years' records and found the twins whose discordant ROP development. This discordance was; 1. Different stages of ROP, 2. One sibling treated the other is not, 3. One sibling has aggressive posterior ROP the other is not, 4. one sibling has more influenced area as zones the other is not. We documented some data of these twins, as birth order, birth weight, resuscitation at birth, morbidities, the number of hemotransfusion, age of regaining birth weight, relative weight gain at 28 weeks., Results: A total of 26 cases of 13 twins were evaluated. The mean gestational age and birth weight of the whole study group were 27.7 ± 2, and 1053 ±  364 grams, respectively. We found that more transfused preterm baby in twins is more likely to show severe ROP. Additionally, sepsis and the duration of mechanical ventilation may be risk factors for more severe ROP in twins., Conclusions: We can reduce discordant retinopathy in less than 32-weeks premature twins by using methods such as cord milking and by improving non-invasive ventilation modalities.

Background: We aimed to evaluate dry eye diseases (DED) in patients with newly diagnosed depression and anxiety patients., Methods: Forty newly diagnosed depression, 35 anxiety patients, and 37 controls without any history of taking psychiatric drugs (or before the beginning of psychiatric medication) and topical ophthalmic drop use, were included in the study. All depression and anxiety diagnoses were performed by an experienced psychiatrist. Beck depression and anxiety tests were used to measure disease severity. Tear film break up time (TBUT), Schirmer's test, Oxford scores and ocular surface disease index (OSDI) were admiinistered to participants. Anterior segment optical coherence tomography was used to measure tear meniscus heights (TMH), tear meniscus depths (TMD) and tear meniscus areas (TMA)., Results: In anxiety and depression groups, Schirmer's test (mm) (7.24 ± 6.02, 6.58 ± 4.9 and 18.79 ± 4.9 respectively, p  < 0.05) and TBUT (s) (5.62 ± 3.1, 5.6 ± 3.5 and 13.37 ± 1.7 respectively, p  < 0.05) were significantly lower than control group. In addition, OSDI and Oxford scores were significantly higher than controls. OSDI scores were 28.01 ± 19, 30.43 ± 18.49, 14.38 ± 8.14 respectively ( p  = 0.002) and Oxford scores were 1.9 ± 0.7, 2.1 ± 0.6 and 0.7 ± 0.4 respectively ( p  = 0.001). TMD, TMH and TMA values were significantly lower in anxiety and depression groups compared with control groups. Correlations between disease inventory scores and dry eye tests were detected., Conclusions: This study showed a relation between DED and newly diagnosed anxiety and depression patients with no history of psychiatric drug use. The presence of correlation between dry eye tests and disease inventory scores strengthens this association. This is an important knowledge that need to be evaluated in these patients before starting psychiatric medication., Competing Interests: Competing interestsThe authors declare that they have no competing interests.

Purpose. Age related macular degeneration (ARMD) remains a serious cause of vision loss in elderly people worldwide. The purpose of the study is to investigate the fellow eye of the patients with exudative ARMD using optical coherence tomography angiography (OCTA). Methods. We conducted a retrospective study from the data of patients with exudative ARMD. Patients undergoing intravitreal anti-VEGF treatment for one eye were selected. OCTA images of both eyes with choroidal neovascularization (CNV) and the fellow eyes were evaluated retrospectively. Midchoroid, choriocapillaris (CC), retina pigment epithelium (RPE), and outer retina levels were evaluated using RTVue XR AVANTI OCTA. Results. There were 5 male and 5 female patients included in this study. We detected drusen and pigment epithelial detachments (PED) in fellow eyes. Six fellow eyes had vascularized PED. Four of them were acute flat irregular type; two of them were chronic dome shaped type. Four patients had soft drusen that had shown signal loss on choriocapillaris level. Conclusion. The follow-up of both eyes of the patients with ARMD is very important. OCTA seems a promising non-invasive method in order to detect subclinical early stage CNV and distinguish among types of PEDs., (©Romanian Society of Ophthalmology.)

Purpose: To assess probable structural changes using spectral domain optical coherence tomography (SD-OCT) on sickle-cell disease (SCD) and beta thalassemia major (B-TM) patients, without any retinal abnormalities., Methods: This cross-sectional study included 32 B-TM, 34 SCD patients, and 44 healthy controls. One of the eyes of all participants was evaluated for SD-OCT and choroidal thickness, retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), ganglion cell complex (GCC)., Results: Age, gender, and intraocular pressure (IOP) were not statistically different between the three groups. Hemoglobin (Hgb), hematocrite (Htc), and ferritin levels were not statistically different between the SCD and B-TM groups. Choroidal thickness at the subfoveal region was statistically higher in the control group (353.79 ± 71.93) than in the B-TM (317.41 ± 53.44) and SCD (283.21 ± 63.27) groups. In addition, it was statistically higher in the B-TM group than the SCD group ( P  = 0.05). CMT did not differ among the three groups, average RNFL was only significantly thinner in SCD than in controls, and GCC thickness was significantly thinner in SCD than in controls and B-TM., Conclusion: In both diseases, we can show early structural changes even if proliferative or non-proliferative retinopathy or other ocular manifestations were not developed yet.

Purpose: To evaluate and compare choroidal thickness in patients with fibromyalgia (FM) and healthy controls., Methods: In this prospective, cross-sectional study, forty eyes of 40 patients with FM and 40 eyes of 40 age- and sex-matched healthy subjects were enrolled. FM was diagnosed according to the American College of Rheumatology criteria. The choroidal thickness measurements of the subjects were obtained using spectral-domain optical coherence tomography (RTVue-100, Optovue). Widespread pain index (WPI), symptom severity scale (SSS), and fibromyalgia impact questionnaire (FIQ) scores were recorded. The choroidal thickness measurements of the groups were compared, and correlations among the WPI, SSS, and FIQ scores and these measurements were calculated., Results: Choroidal thicknesses at 1500 μm nasally were 198.5 ± 46.7 μm and 306.3 ± 85.4 μm; at 1000 μm nasally were 211.7 ± 50.2 μm and 310.05 ± 87.26 μm; at 500 μm nasally were 216 ± 55.05 μm and 311.5 ± 83.4 μm; at subfoveal region were 230.9 ± 58.4 μm and 332.4 ± 91.3 μm; at 500 μm temporally 227.5 ± 58.1 μm and 318.15 ± 92.3 μm; at 1000 μm temporally 224.5 ± 57.07 μm and 315.1 ± 84.2 μm; at 1500 μm temporally 212.5 ± 56.08 μm and 312.9 ± 87.8 μm in the FM and control groups, respectively (P < 0.001). Choroidal thicknesses were thinner at all measurement location, except temporal 1000 and 1500 in patients with FIQ score ≥50 than in FIQ score <50., Conclusion: The results of this study demonstrated that choroidal thickness decreases in patients with FM and correlated with disease activity. This choroidal changes might be related with the alterations in autonomic nervous system functioning. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and FM., Competing Interests: There are no conflicts of interest.

Nonarteritic ischemic optic neuropathy is characterized by sudden, painless, unilateral vision loss. A case of an acute NAION patient who was treated with subtenon methyl prednisolone acetate was presented. The patient, a 65-year-old male, presented vision loss for two days. The total ophthalmologic examination, fundus photography, and automated perimetry were applied to the patient before and after 1, 3, and 6 months from injection. The visual acuity increased from 0,1 to 0,3 in the first month and to 0,7 at the last visit, the visual field defect being mostly improved. This case showed that 40 mg of subtenon methyl prednisolone acetate injection was an effective and safe treatment method for acute NAION. However, a large randomized controlled trial is needed to assess the efficacy of subtenon methyl prednisolone acetate as a treatment for NAION.

Purpose: The primary objective of haemodialysis (HD) was to correct the composition and volume of body fluids. The aim of this study was to evaluate the acute effect of HD on mean arterial pressure changes and on retina and optic nerve with optical coherence tomography (OCT)., Methods: Fifty-three eyes of 28 patients were enrolled in this study. The patients' retinal and RNFL thicknesses were measured by OCT and mean arterial pressure alterations were recorded before and immediately after HD session., Results: The results show that while there was a reduction at central foveal thickness and ganglion cell layer thickness, central subfield and RNFL thickness were increased with HD session. But none of them were statistically significant ( p  = 0.320, p  = 0.792, p  = 0.744, p  = 0.390). The mean arterial pressure of the patients decreased significantly ( p  < 0.05) but it was not correlated with retinal and RNFL values., Conclusion: The changes in retinal and RNFL findings were not significant. But these alterations may effect the long term follow-up of the patients with retinal and optic nerve disease. Therefore it is important to pay attention HD session time for these patients' measurements.

Purpose: To present a case of iatrogenic Horner's syndrome seen together with the heterochromia in the post-thyroidectomy period., Methods: A 23-year-old female patient was admitted to our clinic with complaints of low vision in the eye and difference in eye color that developed over the past two years. In the left eye, myosis and minimal ptosis (∼1 mm) was detected, and the color of the iris was lighter than the right eye., Results: The pre-diagnosis of left iatrogenic Horner's syndrome was finalized after 0.5% topical apraclonidine test., Conclusion: Heterochromia can be observed in iatrogenic Horner's syndrome.

Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1-92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p = 0.012) and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients' comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied.

The purpose of the study was to compare the results of panretinal photocoagulation (PRP) using the pattern scan laser (PASCAL) in a single setting versus multiple sessions of standard YAG laser in patients with proliferative diabetic retinopathy. Charts of 35 eyes that were treated with the PASCAL and an equal number of eyes that were treated with conventional laser were retrospectively reviewed. The whole PRP treatment was performed in one session in the PASCAL group, whereas all the patients in the conventional-laser group completed the entire PRP treatment in two or three sessions. Persistence and/or recurrence of neovascularization, complications encountered, total number of laser spots, and mean power used were compared. Patients treated with the PASCAL received significantly higher number of laser spots than those treated with conventional laser (2885 vs. 1642, p < 0.001). The PASCAL and conventional-laser systems required an average power of 650 mW and 330 mW, respectively (p < 0.001). Patients treated with the PASCAL showed similar rates of treatment failure within 12 months of follow-up compared with patients treated with conventional laser (14% vs. 11%, p > 0.05). In the PASCAL group, vitreous hemorrhage, neovascular glaucoma, retinal hemorrhage, and choroidal detachment were reported in two, two, one, and two patients, respectively, whereas only one each vitreous hemorrhage and neovascular glaucoma were encountered in the conventional-laser group. Our study reports that single-session PRP with the PASCAL has similar efficacy compared with conventional laser, and has a favorable side-effect profile., (Copyright © 2015. Published by Elsevier Taiwan.)

Background: The aim of this study was to compare spherical equivalents (SE) and spherical equivalents with cycloplegic (CSE) values of migraine patients with and without visual aura, with those patients without migraine complaints., Material/methods: We included patients over the age of 18 years, who had 20/20 uncorrected vision, and who did not have ocular pathology in their examination. The patients were divided into 3 groups: Group 1: 86 eyes of 43 migraine patients without aura, Group 2: 38 eyes of 19 migraine patients with aura, and Group 3: 60 eyes of 30 patients without migraine. Spherical equivalents and spherical equivalents with cycloplegic from the auto-refractometrical values of the patients were compared., Results: The mean age of the migraine and control patients was 34.2±8.3 and 33.6±10.8 years, respectively. Forty-three (69%) of 62 migraine patients had migraine without aura and 19 (31%) had migraine with aura. The right and left eyes of the patients were evaluated together and a significant correlation was found between the groups. To evaluate the impact of cycloplegia in patients, SE and CSE values were obtained and differences between these values were evaluated. It was found that the change in Group 2 patients was significantly lower than the change in Group 3 patients (p=0.024)., Conclusions: We found that the cycloplegic spherical equivalents values of our patients with aura were lower than control patients. We need further studies to reveal whether migraine with aura is the trigger or the result of those attacks.

The occipital condyle (OC) is an important area in craniovertebral surgery, but neither its anatomical features nor the procedures concerning the OC have been detailed yet. The morphological analysis of the structures were made in totally 704 sides of the occipital bones of adult skulls by 3D-Doctor Demo version. The length and width of the OC were found to be 23.9 ± 3.4 (right), 24 ± 3.3 (left) and 11.9 ± 2.3 (right), 10.7 ± 2.3 mm (left), respectively. The mean anterior intercondylar distance and the posterior intercondylar distance were measured as 20.9 ± 3.6 and 43.1 ± 4 mm, respectively. The sagittal intercondylar angle was observed as 68.7 ± 10.6º. The sagittal condylar angle was observed to be 32.9 ± 7.6º and 38.2 ± 7.3º in the right and left, respectively. The head circumference was observed to be 65.6 ± 7.8 and 64.4 ± 7.2 mm in the right and left, respectively. The head area was measured as 231.9 ± 53.3 and 214.9 ± 45.1 mm² in the right and left, respectively. The most common type was oval-like (59.67%), whereas the most unusual one was two-portioned condyle (0.32%). In Pearson correlation analysis, it was significant that a statistically strong relation was noticed between the length and area, and the circumference and area. The findings suggest that the oval type was more successful to work with, while the triangular, circular and two-portioned types were highly risky for the fixation resonance as the surface got quite smaller. As a result, we suggest that by resecting nearly half of the OC, the border of the hypoglossal canal can be involved.