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Purpose: The aim of the present study is to evaluate the effects of uncomplicated cataract surgery on microvascular structure of fovea, parafovea, optic disc, and peripapillary area with optical coherence tomography angiography (OCTA).Methods: The study included 53 eyes of 53 patients, who undergone uncomplicated cataract surgery. The day before cataract surgery and at the 1st week, 1st month, 3rd month after surgery, best-corrected visual acuity, foveal avascular zone, acircularity index, superficial and deep foveal density, superficial and deep parafoveal density, central macular thickness, peripapillary retinal nerve fiber layer thickness value, and peripapillary vascular density were measured with OCTA.Results: The mean age of the patients was 62.1 ± 7.2 years (range, 42–69 years) and the sex of the patients was 25 male and 28 female. The foveal avascular zone value was decreased compared to the preoperative value (p < 0.05). There was no significant change in acircularity index postoperatively (p > 0.05). There was a significant increase in superficial and deep foveal density and superficial and deep parafoveal density (p < 0.05). According to preoperative period, peripapillary retinal nerve fiber layer and inside disc capillary density of optic disc increased significantly (p < 0.05). There was no significant change in peripapillary vascular density postoperatively (p > 0.05).Conclusions: Changes in the vascular density of the retina were detected with OCTA in eyes without ocular or systemic disease, which underwent uncomplicated cataract surgery. In the postsurgical period, OCTA provides important information in the evaluation and follow-up of these changes.

To evaluate changes in the peripapillary, macular, and choroidal microvasculature in the eyes of patients with deficiency of adenosine deaminase 2 (DADA2) and no clinical signs of ocular involvement.The study included 12 eyes of 12 patients with DADA2 and 24 eyes of 24 healthy subjects. The foveal avascular zone (FAZ), macular vessel densities (VDs) in the superficial and deep retinal capillary plexuses, peripapillary VDs, and choroidal thickness were evaluated by optical coherence tomography angiography (OCTA). Measurements were compared between DADA2 patients and healthy controls.The median age was 17 (8-25) years in DADA2 patients and 17.5 (7-23) years in control group at the OCTA visit (p = 0.934). FAZ area did not differ between the groups (p = 0.224). In the superficial capillary plexus, whole-image, foveal, and parafoveal VD values were slightly lower in DADA2 patients than in controls (p = 0.054, p = 0.052, p = 0.117). In the deep capillary plexus, whole-image and parafoveal VD values were significantly lower in DADA2 patients than controls (p = 0.010, p = 0.001). VD in the radial peripapillary capillary plexus was also lower in DADA2 patients, with significantly lower peripapillary VD (p = 0.002). Subfoveal choroidal thickness was significantly higher in patients with DADA2 (p0.001).This OCTA study demonstrates that both retinal and choroidal involvement may occur in DADA2 patients before the emergence of evident clinical findings.

Purpose: To investigate the presence of virus in the aqueous humor and vitreous of patients undergoing elective combined cataract and pars plana vitrectomy during the Coronavirus disease 2019 (COVID-19) pandemic. Materials and methods: In this prospective cross-sectional study, of the patients to undergo elective surgery, those who had a negative severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2) nasal swab test 24-72 hours prior to the surgery and who were asymptomatic were included. SARS-CoV-2 IgG antibodies were evaluated in blood samples taken 24-72 hours before the operation. 0.1 cc of aqueous humor and 0.1 cc of vitreous fluid were aspirated at the beginning of the surgery. The presence of SARS-CoV-2 viral ribonucleic acid (RNA) was evaluated by real-time reverse transcriptase polymerase chain reaction (RT-PCR). Results: Of 66 participants, 39 were male (59.1%) while 27 were female (40.9%). Twenty five patients (37.8%) had a history of COVID-19 between 20 days - 60 days (mean 49 days) before the surgery. There were 58 patients (87.9%) with a history of vaccination before the operation and 8 patients (12.1%) without a history of vaccination. No SARS CoV 2 RNA was detected in the aqueous humor and vitreous samples of any patient. IgG against SARSCoV-2 was detected in 3 patients who had not been vaccinated against COVID-19 before and had no known history of COVID-19. Conclusion: We did not find any SARS-CoV-2 viral genetic material in the aqueous and vitreous fluids of asymptomatic participants whose nasal swab test was negative, even if they recently had COVID-19.

Objective: Aim of this study is to evaluate the changes in peripapillary vessel density (VD) and peripapillary nerve fiber layer thickness (PPRNFL) after intravitreal anti-VEGF injections in patients with Branch Retinal Vein Occlusion (BRVO) with macular edema. Material and Methods: Sixty eyes of 30 patients with unilateral macular edema due to BRVO who underwent 3 dose loading anti-VEGF treatments were included in the study. The peripapillary capillary vessel density (RPCVD) and PPRNFL were evaluated with optical coherence tomography angiography (OCTA). The measurements were done before and at least one month after a loading dose of anti-VEGF. The measurements of BRVO eyes before treatment were compared with the healthy fellow eyes and the values measured after treatment. Results: There was a statistical difference between the pre-injection and post-injection periods at the inside disc and peripapillary VD parameters (p

Pur po se: To evaluate the etiological factors, diagnosis, follow-up and treatment procedures in cases of orbital cellulitis. Ma te ri al and Met hod: A retrospective review was performed on medical records of patients with orbital cellulitis treated between 2009 and 2011 in our clinic. The patients were studied for age, ophthalmologic examination features, laboratory and radiology results, treatment modalities and the response to these treatments. Re sults: Eleven patients (7 male, 4 female) having an average age of 9.7 years (6 months-25 years) participated in the study. All patients had eyelid oedema, hyperemia and ocular pain; with chemosis in 3, gaze restriction in 6, relative afferent pupillary defect and proptosis in 4 cases. Orbital cellulitis was observed to occur secondary to paranasal sinusitis in 10 patients (90.9%) and 1 patient had only history of superior respiratory tract infection. Sinus infection was localized in ethmoid and maxillary sinuses in all except one case. Laboratory tests showed leukocytosis in 8 patients. Surgical drainage was performed in 7 of 8 patients with abscess formation observed with radiological imaging. The remainder of the patients were followed with sole medical treatment. All patients recovered without any vision loss or life-threatening complication. Dis cus si on: Orbital cellulitis cases must be followed with radiologic imaging for any complication that may occur and patients with abscess should be evaluated for surgical drainage besides antimicrobial treatment.(Turk J Ophthalmol 2012; 42: 284-7)

Seksen yaşında, erkek hasta, iki yıldır sağ gözde kütle ve batma, sulanma şikayeti ile klini- ğimize başvurdu. Yapılan muayenede sağ gözde iç kantus bölgesinde, prolabe şekilde kon- junktiva altında, yaklaşık 3x1 cm boyutunda, pembe renkli kütle saptandı. Orbita manyetik re- zonans görüntülemede orbita iç kantüsde hipointens solid kütle tespit edildi. Eksizyonel bi- yopsi planlandı. Kütlenin histopatolojik değerlendirilmesi ekstranodal marjinal zon Non- Hodgkin lenfoma olarak belirlendi. Sistemik araştırmaya yönelik yapılan tetkikler sonucunda Non-Hodgkin lenfoma lehine bulgu saptanmadı. Hasta primer oküler adneks lenfoma olgusu olarak takibe alındı. A 80-year-old male patient was admitted to our clinic with complaints of a mass, stinging and tearing on the right eye. In ophthalmologic examination, there was a subconjunctival, ap- proximately 3x1 cm sized pink colored mass, that was prolapsed at the medial canthus. On orbital magnetic resonance, hypointense solid mass was detected at the medial canthal region. Excisional biopsy was planned. Histopatholojical examination revealed the diagnosis as extranodal marjinal zone Non-Hodgkin's lymphoma. As a result of investigations made for systemic disease, there was no evidence of Non-Hodgkin's lymphoma. The patient is followed as a primary ocular adnexa lymphoma.

Amaç: Çeşitli nedenlere bağlı konjunktival kitle eksizyonlarında fibrin yapıştırıcı olan Tisseel-Lyo kullanılarak yapılan amniyon membran transplantasyon sonuçlarını bildirmek. Gereç ve Yöntem: Kliniğimizde konjunktival kitle varlığı nedeniyle takip edilen ve eksizyon uygulanan 5 hastanın tıbbi kayıtları değerlendirildi. Konjunktival kitlelerin lokalizasyo- nu, boyutları belirlenip, ön segment fotoğrafları çekildi. Bulgular: Üçü erkek, 2’si kadın 5 hastanın yaş ortalaması 53.4 yıl (34-77 yıl) idi. Lezyonların lokalizasyonları değerlendirildiğinde;1 hastada nazal kadranda, 1 hastada nazal ve tem- poral kadranda pterjiyum mevcuttu. Bir hastada medial kantal bölgede hiperpigmentasyon gösteren lezyon mevcuttu. Bir hasta nazal konjunktivada, bir hasta da temporal konjunktiva- da yüzeyden kabarık, vaskülarize kitleye sahipti. Peribulber anestezi altında tüm hastalara kitle eksizyonu uygulandı. Konjunktival açıklık doku yapıştırıcısı kullanılarak amniyon mem- bran ile kapatıldı. Eksize edilen lezyonların histopatolojik incelenmesi; 2 hastada pterjium, 1 hastada kompound nevüs, 1 hastada orta-ağır derece displazi, 1 hastada kronik iltihap, solar dejenerasyon olarak değerlendirildi. Hastaların 6 aylık takiplerinde amniyon membranının lokalizasyonunu koruduğu ve nüks gelişiminin olmadığı izlendi. Sonuç: Konjunktival kitlelerin eksizyonu sonrası oluşan doku defektlerinin kapatılmasında epitel iyileşmesini hızlandırması bakımından amniyon membran transplantı sıklıkla uygulanmaktadır. Fibrin yapıştırıcı kullanılarak yapılan amnion membran transplantasyonu sütür gerektirmeyen, uygulanımı kolay, güvenilir ve etkili bir yöntemdir. Aim: To report the results of amniotic membrane transplantation by using fibrine adhesive Tisseel-Lyo, at conjunctival mass excisions due to various reasons Material and Method: The medical records of five patients who underwent conjunctival mass excision in our clinic were evaluated. The localizations and sizes of the lesions were de- termined and anterior segments were photographed. Results: The mean age of five patients (three male, two female) was 53.4 (34-77) years. When localization of the lesions were appraised; there was pterjium in one patient at the nasal quadrant and in one patient at the nasal and temporal quadrant. In one patient there was hiperpigmente lesion at the medial canthal region. Two patients have lesion that is elevated from the surface and vascularized one of them at the nazal conjunctiva and the other one at the temporal conjunctiva. Under peribulber anesthesia, all patients underwent mass excision. Conjunctival wound was closed with amniotic membrane using fibrine adhesive. The histopathological findings of the lesions were; two pterygium, one compound nevus,one is medium-severe grade dysplasia and the last one is chronic inflammation, solar degeneration. Protecting the amniotic membrane localization and no recurrence was observed 6 months fol- low- up of patients. Conclusion: Amniotic membrane transplantation that accelaretes healing is commonly used for closure the conjunctival wound after mass excision. Amniotic membrane transplantation by using fibrin adhesive is a method that does not require suturing, dependable, simple and effective.

Sol gözünden 3 yıl önce mitomisin-C ile pterjium ameliyatı geçiren 65 yaşında erkek hasta 6 aydır gözünde şiddetli ağrı ve görme keskinliğinde azalma nedeniyle kliniğimize başvurdu. Yapılan oftalmolojik muayenede pterjium eksizyon alanında sklerada incelme ve bu alanda konjonktivayı da içine alan aktif inflamasyon mevcuttu. Altta üveal refle belirginleşmişti. Hastaya nekrotizan sklerit tanısı ile sistemik kortikosteroid ve steroid olmayan antiinflamatuar tedavi başlandı. Medikal tedaviye rağmen bulgularda gerileme olmayınca hastaya nekrotik doku debridmanı ve kornea-skleral yama grefti ameliyatı uygulandı. Operasyon sonrası inflamasyonda gerileme görüldü. İki yıllık takiplerde herhangi komplikasyon izlenmedi A 65-year-old man had undergone nasal pterygium excision with mitomycin-C on the left eye 3 years ago, applied to our clinic with decreased visual acuity and severe ocular pain for 6 months. In ocular examination; the sclera, at the site of prior pterygium excision, showed significant thinning with uveal show. There was active inflammation adjacent to the site of thinning, including conjunctiva. A diagnosis of necrotizing scleritis was made and prompt treatment was started with systemic corticosteroids and non-steroidal antiinflammatory drugs. Although medical treatment, the symptoms were not decreased and the patient underwent debridement of necrotic tissue and corneal-scleral patch graft. After surgery, the conjunctival and scleral inflammation had decreased. Any complication was not observed 2 year follow- up of patient

Malign periferik sinir kılıf tümörleri nadir görülen, saldırgan seyir gösteren yumuşak doku sarkomlarıdır. Bu tümörler ya periferik sinirlerden yada sinir kılıfı ile ilişkili hücrelerden köken alır. Tercih edilen tedavi cerrahidir. Gövde ve ekstremiteler en sık tutulan bölgelerdir. Malign periferik sinir kılıf tümörlerine baş ve boyun bölgesinde nadiren rastlanır. Burada orbitada hızlı büyüme gösteren kitle ile başvuran olguyu bildirmekteyiz. Biyopsi materyalinin histopatolojik incelemesi malign mezenkimal tümör olarak değerlendirildi. Hastaya tümörün total rezeksiyonu ameliyatı ve ameliyatı sonrası adjuvan radyoterapi uygulandı Malignant peripheral nerve sheath tumors are uncommom aggressive soft tissue sarcomas that originate from peripheral nerves or cells associated with the nerve sheath. The treatment of choice is surgery. Trunk and extremities are the commenest sites involved. Malignant peripheral nerve sheath tumors are rarely encountered in head and neck region. Here, we report a patient presented with a mass at orbit very short history of progression. Histopatholojical examination of biopsy material revealed the diagnosis as malignant mesenchymal tumor. The patient underwent gross total removal of the tumor with adjuvant radiotherapy postoperatively

Amaç: Retina ven tıkanıklığı olgularında risk etkenlerinden, göz içi basınç bulgularını ve aksiyel uzunluğun etkisini araş- tırmak. Gereç ve Yöntem: Çalışmaya retina ven tıkanıklığı tanısı olan 120 olgu dahil edildi. A-scan ultrasonografi ile aksiyel uzunluk ölçümleri yapıldı. Olguların hasta gözleriyle sağlam gözlerinin aksiyel uzunlukları ve kontrol grubunun aksiyel uzunlukları karşılaştırıldı. Çalışmamızda olguların yaşı, cinsiyeti, retina ven tıkanıklığının tipi, göz içi basınç değeri, eşlik eden sistemik hastalıklar değerlendirildi. Bulgular: Olguların 57’si kadın, 63’ü erkek olup yaş ortalaması 61.9±9.4 yıl idi. Santral retinal ven tıkanıklığı olan 49 olgunun 15‘inde (%30.6), retina ven dal tıkanıklığı olan 71 olgunun 7‘sinde (%9.9) göz içi basınç yüksekliği mevcuttu. Olgu- ların retina ven tıkanıklığı geçiren gözlerinde ortalama aksiyel uzunluk değeri22.2±0.9 mm iken diğer gözlerinde ortalama 22.6±0.9 mm olarak ölçüldü. Kontrol grubunun ortalama aksiyel uzunluk değeri 22.8±0.9 mm olup hasta gözler ile kontrol grubu arasındaki fark istatistiksel olarak anlamlı idi (p

Amaç: Bu klinik çalışmada Goldmann applanasyon tonometresi (GAT), Rebound tonometre (İcare), Dinamik kontur tonometre (Pascal DKT) ve TonoPen XL (TP) ile yapılan göz içi basınç ölçümlerinin (GİB) karşılaştırılması ve İcare, Pascal DKT, TP ile yapılan göz içi basınç ölçümleri üzerine santral kornea kalınlığının etkisini değerlendirmek amacıyla planlanmıştır. Gereç ve Yöntem: Otuz dokuz sağlıklı birey çalışmaya dahil edildi. Olguların sırasıyla İcare, Pascal DKT, TP ve GAT ile GİB ölçümleri ya- pıldı. Ultrasonik pakimetri kullanılarak santral kornea kalınlığı (SKK) değerleri elde edildi. Ölçümlerin karşılaştırılması için yüzde değişim analizi, Pearson korelasyon analizi ile ortalama, standart sapma değerleri ve minimum-maksimum değerleri hesaplandı. İki farklı metod arasındaki uyumluluk Bland-Altman metodu kullanılarak değerlendirildi. Bulgular: Çalışmaya dahil edilen olguların ortalama yaşı 38±4 (30-45) idi. Ortalama SKK 528±16 ?m (483-555 ?m). Ortalama GİB; İcare ile ortalama 13.8±2.1 mmHg, Pascal DKT ile ortalama 14.0±2.2 mmHg,TP ile 14.0±3.4 mmHg, GAT ile ortalama 13.8±2.4 mmHg, olarak ölçüldü. Ölçümler arasında anlamlı farklılık görülmedi. İcare, Pascal DKT, TP ile yapılan ölçümlerin yüzde kaçının GAT ile elde edilen değerlerin ±3 mmHg aralığında olduğu araştırıldığında sırasıyla %66.6, %61.5, %56.4 değerler elde edildi. Bland-Altman analizinde düzeltilmiş GAT değerleri ile diğer tonometreler arasında uyum mevcuttu. SKK ile GİB değerleri arasında korelasyon saptanmadı. Sonuç: Çalışmamızda tüm tonometrelerle elde edilen GİB değerleri arasında anlamlı farklılık saptanmadı. İcare topikal anestezi gerektirmemesi, kullanımının kolay olması, ölçümün hızlı olması nedeniyle klinikte uygun bir tonometre yöntemi olarak kullanılabilir. Purpose: This clinical study was conducted to compare intraocular pressure (IOP) measurements by Goldmann applanation tonometry (GAT), Rebound tonometry (Icare), Dynamic Contour tonometer (Pascal) and TonoPen XL (TP), to evaluate the effect of central corneal thickness (CCK) on IOP measurements. Materials and Methods: The study included 39 healthy subjects. IOP measurements were taken using Icare, Pascal, TP and GAT, respec- tively. CCK was measured with ultrasound pachymetry. To compare the measurements; the analysis of percentage change and Pearson correlation, the average, median, standart deviation and minimum-maximum values were calculated. The agreement between 2 different devices was assessed by use of the Bland-Altman method. Results: The average CCK was 528±16 µm (483-555 µm). The mean IOP, with Icare was 13.8±2.1 mmHg, with Pascal DCT was 14.0±2.2 mmHg, with TP was 14.0±3.4 mmHg, with GAT was 13.8±2.4 mmHg. There was no significant difference statistically between the IOP measurements of all methods (p>0.05). The percentage of the Icare, Pascal DCT and TP readings, which were all within ±3 mmHg of the GAT readings were respectively 66.6%, 61.5%, 56.4%. There was an agreement between corrected GAT values and the other tonometry values on the Bland-Altman graphs. There was no correlation between IOP measurements and CCT. Conclusion: In our study, there was no significant difference between the four methods of IOP measurements. Icare tonometry does not require topical anesthesia, is easy to use, the measurement is fast. So, it can be used as a relevant tonometry in clinical setting.

Amaç: Orbital selülit olgularında etyolojik faktörlerin, tanı, takip ve tedavi yöntemlerinin değerlendirilmesi. Gereç ve Yöntem: Kliniğimizde 2009-2011 yılları arasında orbital selülit tanısıyla takip edilen olguların tıbbi kayıtları retrospektif olarak incelendi. Hastaların yaşları, oftalmolojik muayene bulguları, laboratuar ve görüntüleme tetkik sonuçları, hastalara uygulanan tedavi yöntemleri ve tedavi sonuçları değerlendirildi. Sonuçlar: Yaş ortalamaları 9,7 yıl (6 ay-25 yıl) olan, 7’si erkek 4’ü kadın toplam 11 hasta çalışmaya alındı. Hastaların tümünde ilk başvuruda kapak ödemi, kızarıklık ve oküler ağrı mevcuttu; buna 3 hastada kemozis, 6 hastada bakış kısıtlılığı, 4 hastada relatif afferent pupil defekti ve proptozis eşlik ediyordu. Orbital selülitin, 10 hastada (%90,9) paranazal sinüzite ikincil geliştiği tespit edildi, kalan 1 hastada sadece üst solunum yolu enfeksiyonu öyküsü vardı. Sinüs enfeksiyonu biri hariç hepsinde etmoidal ve maksiler sinüste lokalizeydi. Laboratuar tetkiklerinde 8 hastada lökositoz mevcuttu. Radyolojik görüntülemede abse oluşumu izlenen 8 hastanın 7’sinde cerrahi drenaj uygulandı. Diğer hastalar sadece medikal tedaviyle takip edildi. Hastaların tümü görme kaybı ya da hayati komplikasyonlar gelişmeden iyileşti. Tart›flma: Orbital selülit olguları, ortaya çıkabilecek komplikasyonlar bakımından mutlaka görüntüleme tetkikleri ile takip edilmeli, abse tespit edilen hastalar antimikrobiyal tedavinin yanında cerrahi tedavi açısından da değerlendirilmelidir. (Turk J Ophthalmol 2012; 42: 284-7) Purpose: To evaluate the etiological factors, diagnosis, follow-up and treatment procedures in cases of orbital cellulitis. Material and Method: A retrospective review was performed on medical records of patients with orbital cellulitis treated between 2009 and 2011 in our clinic. The patients were studied for age, ophthalmologic examination features, laboratory and radiology results, treatment modalities and the response to these treatments. Results: Eleven patients (7 male, 4 female) having an average age of 9.7 years (6 months-25 years) participated in the study. All patients had eyelid oedema, hyperemia and ocular pain; with chemosis in 3, gaze restriction in 6, relative afferent pupillary defect and proptosis in 4 cases. Orbital cellulitis was observed to occur secondary to paranasal sinusitis in 10 patients (90.9%) and 1 patient had only history of superior respiratory tract infection. Sinus infection was localized in ethmoid and maxillary sinuses in all except one case. Laboratory tests showed leukocytosis in 8 patients. Surgical drainage was performed in 7 of 8 patients with abscess formation observed with radiological imaging. The remainder of the patients were followed with sole medical treatment. All patients recovered without any vision loss or life-threatening complication. Discussion: Orbital cellulitis cases must be followed with radiologic imaging for any complication that may occur and patients with abscess should be evaluated for surgical drainage besides antimicrobial treatment.(Turk J Ophthalmol 2012; 42: 284-7)