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Using OCTA, investigate the capillary network and retinal layers in granulomatosis with ANCA associated vasculitis (AAV) patients who did not manifest apparent ocular involvement and compare the findings with healthy subjects.The present study, which is designed as a prospective and case-control study, includes 22 AAV patients and 35 control participants. OCTA parameters were noted.In most of the regions, AMT, RNFL and GC-IPL thicknesses were significantly lower in the AAV group than in the control group. While the vascular indices were lower in the AAV group, except for the center 1 mm region, the FAZ parameters were similar between the two groups.In AAV patients, subclinical changes in the retinal layers and superficial vascular plexus have been shown. In the future maybe a non-invasive method such as OCTA will become available in scoring systems for prognosis determination in AAV.

The aim of the study was to investigate the long-term success rates of transcanalicular endolaser dacryocystorhinostomy (TC-DCR) surgery along with the factors that possibly affect surgical success.Patients (n = 300) who underwent unilateral TC-DCR operations in the department of ophthalmology of our university hospital between January 2011 and June 2021 were included in the study. The subjects were divided into 2 groups, with group 1 showing no recurrence (n = 205) and group 2 showing recurrence (n = 95).The mean follow-up period for the 300 patients was 26.7 ± 7.0 months (range, 11-33 months). The overall success rate was 205 of 300 (∼68%). Although, based on the univariate risk analysis, age, operative time, total laser power, tube removal time, septum deviation, fistulisation, and intraoperative hemorrhage were found to be risk factors, in multivariate risk analysis, only total laser power, septum deviation, and intraoperative bleeding were determined to be the main risk factors.The success rate of TC-DCR was lower than that of traditional external DCR, but because TC-DCR is a minimally invasive aesthetic surgery with a short operative time, it may become a preferred option by more ophthalmologists, especially for young patients without intranasal pathology and coagulation disorders and elderly patients at risk for general anaesthesia. It should be taken into account that the chances of success are relatively lower among patients with total laser power applied during surgery, intraoperative hemorrhage, fistulization, and septum deviation. In TC-DCR, bleeding control, short operative time, and low laser power are important to achieve a high success rate. Also, 1 year after TC-DCR, even the presence of anatomic drainage may lower the functional success of patients, so follow-up should be continued.

Purpose: To evaluate the inner retinal and choroidal thicknesses in patients with early retinitis pigmentosa. Methods: We analyzed spectral-domain optical coherence tomography images of 35 retinitis pigmentosa patients and 40 healthy individuals. We measured macular and ganglion cell complex thicknesses. We took choroidal thickness measurements in the subfoveal region and 500, 1,000, and 1,500 mm from the foveal center. Results: Patients with retinitis pigmentosa had significantly thinner macular thicknesses and choroidal thicknesses in all measurements, and their individual ganglion cell complex thickness measurements were lower than those in healthy individuals. The mean ganglion cell complex thickness was significantly lower in patients with retinitis pigmentosa than that in controls. The mean macular thickness was significantly correlated with the mean choroidal and mean ganglion cell complex thicknesses. (We found no correlation between the mean choroidal thickness and the mean ganglion cell complex thickness). Conclusions: The choroid was mildly affected in our patients with early retinitis pigmentosa. The tendency toward significance in the inner retina was possibly caused by a good visual acuity.

To evaluate the choroidal and retinal layers with optical coherence tomography (OCT) and retinal microvascular structures with optical coherence tomography angiography (OCTA) in systemic lupus erythematosus (SLE) patients. In this prospective, cross-sectional and comparative study, a total of 35 SLE patients and 35 healthy control participants were included. SLE patients who were using hydroxychloroquine (HCQ) and/or immunosuppressive agents are evaluated with OCT and OCTA. SLE patients who have no HCQ maculopathy observed in OCT were included in the patient group. Mean macular thickness and ganglion cell inner plexiform layer (GC-IPL) thicknesses were thinner in the patient group. When the parameters obtained with OCTA were evaluated, vessel (VD) and perfusion density (PD) were significantly lower in the patient group. Central foveal thickness and foveal avascular zone parameters were negatively correlated. In addition, VD and PD, and GC-IPL thicknesses were positively correlated. Application of OCTA for the evaluation of microvasculature in SLE patients may be useful in subclinical changes.

Objective: The aim of this study is to investigate how acute hyperglycaemic changes affect the choroid in patients with prediabetes. Material and Method: Each subject underwent a 75 g oral glucose tolerance test (OGTT) after overnight fasting. The measurement of choroidal thickness (ChT) was done with new generation spectral domain optical coherence tomography (SD-OCT). Results: Fasting Plasma Glucose (FPG) levels of the patients with only isolated Impaired Fasting Glucose (IGT) patients are higher (all p, Amaç: Akut hiperglisemik değişikliklerin prediyabetli hastalarda koroidi nasıl etkilediğini araştırmak. Gereç ve Yöntem: Hastalara en az 8 saat kalori alınmaması sonrası 75 g oral glukoz tolerans testi (OGTT) uygulandı. Koroid kalınlığı (ChT), yeni nesil spektral domain optik koherens tomografi (SD-OCT) ile ölçüldü. Bulgular: Koroid kalınlığındaki değişiklikler gruplar arasında farklılık göstermiştir. Prediyabetli bireylerde, foveaya 500 µm mesafedeki subfoveal, nazal ve temporal lokasyonların yanı sıra ortalama ChT’de geçici bir artış gözlenmiştir. OGTT’nin ilk saatinde; prediyabetik grupta subfoveal koroid kalınlığı farkı 1,52±4,11 µm (aralık, -11,00/24,00 µm) iken, kontrol grubunda subfoveal ChT farkı -0,22±1,74 µm (aralık -2,00/8,00 µm) olarak ölçüldü. Sonuç: Akut hiperglisemik değişikliklerin anlık ölçümlerle saptanması, hastalığın oküler yapılar üzerindeki etkisini daha iyi anlamamıza yardımcı olabilir.

The aim of this study is to evaluate the retinal and choroidal structures in r- and nr-axSpA patients using spectral domain optical coherence tomography (SD-OCT) and to compare changes with healthy controls. In this cross-sectional study, 70 axSpA patients (50 radiographic- and 20 nr-axSpA) and 50 healthy control subjects were included. Choroidal thickness (ChT), macular thickness, retinal nerve fiber layer (RNFL), and the ganglion cell complex (GCC) were measured by SD-OCT. For ChT values, seven lines at nasal and temporal were drawn at 500-μm intervals, centering the subfoveal sclerochoroidal junction. Analysis of the data was performed with the SPSS program. Mann–Whitney U test was performed for comparison of non-normally distributed continuous data; Student’s t test was used for normal distributed data. No significant difference was observed between 70 (66% male; mean age 39.7 ± 10.4 years) axSpA patients (50 radiographic and 20 nr-axSpA) and 50 (mean age 41.2 ± 6.2 years) healthy control subjects (p 0.417). R-axSpA and nr-axSpA groups and control group were similar in terms of spherical equivalent, intraocular pressure, axial length, and body mass index (p 0.574, p 0.874, p 0.918, p 0.344, respectively). While mean macular and GCC thicknesses were significantly lower in the patient group than in the healthy group, there was no significant difference between the two groups in terms of RNFL thickness. The present study showed that there was no significant relationship between markers and scores indicating disease activity and ChT, MT, RNFL, and GCC thicknesses. However, an increase in choroidal thickness and involvement of the retinal layers has also been demonstrated in patients with spondyloarthritis. In addition, the relationship between disease activity and retinal layer involvement is remarkable in the r-axSpA group.

We investigated the acute subclinical choroidal and retinal changes caused by Coronavirus Disease 2019 (COVID-19) in patients with and without pulmonary involvement, using spectral domain optic coherence tomography.This prospective case-control study included COVID-19 patients: 50 with pulmonary involvement and 118 with non-pulmonary involvement. All patients were examined 1 month after recovering from COVID-19. The changes were followed using optic coherence tomography parameters such as choroidal and macular thickness and retinal nerve fibre layer and ganglion cell complex measurements.All choroidal thicknesses in the pulmonary involvement group were lower than in the non-pulmonary involvement group and the subfoveal choroidal thickness differed significantly (p=0.036). Although there were no significant differences between the central and average macular thicknesses in the two groups, they were slightly thicker in the pulmonary involvement group (p=0.152 and p=0.180, respectively). A significant decrease was detected in the pulmonary involvement group in all ganglion cell complex segments, except for the outer nasal inferior segment (p0.05). In addition, a thinning tendency was observed in all retinal nerve fibre layer quadrants in the pulmonary involvement group compared to the non-pulmonary involvement group.In COVID-19 patients with pulmonary involvement, subclinical choroidal and retinal changes may occur due to hypoxia and ischemia in the acute period. These patients may be predisposed to ischemic retinal and optic nerve diseases in the future. Therefore, COVID-19 patients with pulmonary involvement should be followed for ophthalmological diseases.

Purpose To detect the changes that can be determined with optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in young and short-term smokers. Method In this cross-sectional, observational, and comparative study, 45 "healthy" smokers and 45 healthy non-smoker control participants were included. Those with a smoking history between 1 year to 5 years and an average of 10–30 cigarettes per day were included in the study. OCT and OCTA measurements were made at least 60 min after smoking and at least 8 h after caffeine-containing beverages in order to end the effect of nicotine on systemic and retinal blood flow in the smoking group. Results The mean smoking period was 2.2 ± 0.13 years. Mean macular thickness(MMT), retinal nerve fiber layer(RNFL), and choroidal thickness(Cht) were significantly lower in the smoker group, while ganglion cell-inner plexiform layer(GC-IPL) thickness was higher. Vessel density(VD) values were similar between groups, while perfusion density(PD) values were significantly higher in the smoker group. There were significant correlations between MMT and outer VD, outer PD, foveal avascular zone(FAZ) perimeter and circularity index. FAZ area and central VD and PD were inversely correlated. Also, FAZ circularity index and subfoveal, nasal, and temporal ChTs were positively correlated. Conclusion Despite the short-term smoking, ischemic effects were observed in retinochoroidal and vascular structures.

BACKGROUND: The aim of study was to evaluate the retinal layers and macular capillary network with OCTA in acromegaly patients, to compare with healthy population. METHODS: In this prospective, observational, and comparative study, 40 acromegaly patients and 40 healthy control participants were included. Serum IGF-1 levels and disease duration of all patients were noted. Macular layers and angiography scanning was performed with a Zeiss Cirrus 5000 OCTA system. Macular thickness, RNFL, and GC-IPL values were obtained. For central vessel and perfusion density, central 6 mm was obtained and was evaluated by dividing into three groups (inner, outer, full). FAZ parameters were evaluated dividing into three groups (area, perimeter, circularity index). Analysis of the data was performed with the SPSS for Windows. RESULTS: There was no significant difference between the patient group and the control group in terms of age, gender, best corrected visual acuity (BCVA), spherical equivalent (SE), intraocular pressure (IOP), and axial length (AL). The mean follow-up period after diagnosis was 11.0 ± 5.5 years. Central and mean macular thicknesses were also significantly higher in the acromegaly group (p

AIM: To compare the efficacy of bevacizumab, ranibizumab, and aflibercept in pseudophakic cystoid macular edema (CME) patients with Irvine-Gass syndrome (IGS). METHODS: This study is designed as retrospective consecutive case series. Those who developed postoperative pseudophakic CME that refractory to topical treatment and were treated with anti-vascular endothelial growth factor (VEGF) agents included in the study. Optical coherence tomography (OCT) examination including central macular thickness (CMT), total macular volume (TMV), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) and choroidal thickness (ChT) measurements at the baseline, 1(st), 3(rd) and 6(th) month controls were performed. RESULTS: Fifty-nine eyes of 59 patients with CME and other healthy eyes of the patients (Control group) were evaluated. There were 22 eyes of 22 patients in the bevacizumab group (group 1), 19 eyes of 19 patients in the ranibizumab group (group 2), and 18 eyes of 18 patients in the aflibercept group (group 3). There was no difference in terms of age, gender, axial length, IOP, and spherical equivalent values. The baseline subfoveal and mean ChT were higher in the IGS group. The difference between the baseline and sixth month values of subfoveal and mean ChT were compared in the CME groups, thinning was observed in all three groups. GCL was thinner in the patient group at the 6th month of treatment. The resolution time of CME was observed faster in group 1. CONCLUSION: All three anti-VEGF agents seem to be effective in CME but bevacizumab appears to be slightly more cost-effective than the other two alternatives.

Purpose To investigate anterior segment parameters (ASPs) and dry eye disease (DED), including the status of the meibomian glands, in patients with acromegaly. Methods In this cross-sectional, comparative study, 36 acromegaly patients and 40 healthy sex- and age-matched controls were included. Participants received a comprehensive ophthalmological examination, including intraocular pressure measurements with Goldmann applanation tonometry (IOPGAT) and central corneal thickness corrected intraocular pressure (IOPCCT) measurements, and were evaluated for ASPs and DED. For ASPs, white-to-white (WTW), apical (ACT) and thinnest corneal thickness (TCT), corneal volume (CV), keratometry readings (K1, K2, and Kmean), anterior chamber depth (ACD) and volume (ACV), and iridocorneal angle (ICA) were obtained via Sirius topography. DED was assessed with Schirmer's test, tear breakup time (TBUT), and Ocular Surface Disease Index (OSDI) scores. Meibography scores (MSs) were obtained with the Sirius topography device. Results Patients had higher mean IOPGAT (P = .006), IOPCCT (P = .01), ACT (P = .024), and TCT (P = .005) but narrower ICA (P = .014) than controls. Although Schirmer's test did not differ between the groups (P = .442), patients had higher OSDI (P Conclusion Patients with acromegaly have greater IOP, greater corneal thickness, but narrower ICA than healthy individuals, as well as DED with increased MSs, which suggests meibomian gland dysfunction.

Background: It has been approximately 70 years since the discovery of the Zika virus (ZIKV). It had been established that the virus causes mild infections and is confined to Africa and Asia; however, major changes in the clinical and epidemiologic patterns of ZIKV infection have occurred in recent years. The virus has attracted intense interest because of the possible association of several autoimmune and neurodevelopmental disorders. Methods: We present a summary of the articles that attempt to explain the ZIKV unknowns and strengthen the association with some disorders that are thought to be related to ZIKV, by describing the discovery milestones from the initial identification of the virus to the present day. Results: New evidence strengthens the association between ZIKV infections and Guillain–Barre syndrome (GBS), microcephaly and various neurodevelopmental and ophthalmologic disorders as a result of numerous new clinical and experimental studies. Conclusions: The World Health Organization declared the end of the “Public Health Emergency of International Concern” in December 2016, but ZIKV and associated consequences remain a significant enduring public health challenge.

To investigate the long-term effect of HIV infection on the ganglion cell–inner plexiform layer and retinal capillary network. This prospective, cross-sectional case-control study included 45 HIV-infected patients and 45 healthy individuals. Optical coherence tomography angiography (OCTA) was used for the assessment of macular, peripapillary retinal nerve fiber layer (RNFL) thicknesses, ganglion cell–inner plexiform layer, vessel density, perfusion density, and foveal avascular zone. The mean disease duration was 7.3 ± 1.9 years (range, 5–12 years) in the HIV group. The mean CD4 count (nadir) for all the patients was 147.09 ± 122 cells/mm3 and the mean RNA was 173.6 ± 913.8 copies/ml. No statistically significant difference was determined between the groups in respect of the average and foveal MT (p = 0.05). A significant difference was found between the two groups in respect of the mean VD and PD parameters (p < 0.05). Peripapillary PD was significantly decreased in the HIV group. There was a significant difference between the average and superior and inferior half-region of GC-IPL values. Using Pearson’s correlation analysis, no significant correlation was determined between the duration of HIV infection and mean GC-IPL, MT and VD, and PD values (r − 0.223, p 0.141; r − 0.223, p 0.141; r − 0.169, p 0.268; r − 0.105, p 0.491; r − 0.095, p 0.535 respectively). The results of this study provide evidence of microvascular and neuroretinal loss in individuals with well-suppressed HIV infection, compared with healthy control subjects. OCTA is an important test for the screening of retinal microvascular changes over time in HIV-infected cases.

Background Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that mainly affects axial skeleton. Ocular inflammation is one of the most common extra-articular manifestations of axSpA, mainly form of acute anterior uveitis (AAU). However posterior segment of the eye was rarely evaluated. The inaccessibility of posterior structures like choroid and retina to direct examination led clinicians to use non-invasive imaging technics. Optical coherence tomography (OCT) is an imaging technology providing, high-resolution, and non-invasive cross-sectional view of microscopic, anterior and posterior ocular structures. Objectives To evaluate the retina and choroidal vascular structures in axSpA patients by using the advantage of OCT and to compare the changes (if any) with healthy control subjects. Methods In total 70 (66% male; mean age 39.7 ± 10.4 years) axSpA patients (50 radiographic- and 20 nr-axSpA) and 50 (mean age 41.2 ± 6.2 years) healthy control subjects were included in the analysis. All patients underwent a detailed ophtalmalogic examination by the same opthtalmologist. All individuals with significant refractive errors (>3 diopters of spherical equivalent refraction) and intraocular pressure ≥21 mmHg were excluded from the analysis. Choroidal thicknes (ChT), macula, and the ganglion cell complex (GCC) were measured by spectral domain optic coherence tomography (SD-OCT) by the same experienced operator. Results Mean (± SD) BASDAI score was 3.6 ± 2.5, BASFI score was 3.4 ± 2.9, aSDAS-CRP was 2.6 ± 1.3 in axSpA patients and 14% of them has a history of aAU and 61% ever treated with TNFi agents. There was no significant difference between groups regarding refractive error (P=0.640), intraocular pressure (P=0.815) and BMI (P=0.124) that could affect the OCT measurements. ChT (P Conclusion Our results showed that beside anterior segment inflammation, posterior segment of the eye could be affected in both r- and nr-axSpA patients. Retina and choroidal vascular network forms the posterior segment of the eye. The thinning of GCC which form the inner neural layer of the retina is a good indicative of micro-neurotoxicity in axSpA. Elevation of the ChT may be an important indicator of inflammation. Acknowledgement None Disclosure of interests Berkay akmaz: None declared, Fahrettin akay: None declared, Dilek Solmaz: None declared, onay Gercik: None declared, Gokhan Kabadayi: None declared, Idil Kurut: None declared, Servet akar Grant/research support from: MSD, abbvie, Roche, UCB, Novartis, Pfizer, amgen, Consultant for: MSD, abbvie, Roche, UCB, Novartis, Pfizer, amgen, Speakers bureau: Pfizer

Aim: To evaluate whether anterior segment parameters (ASPs) differ between patients with Graves’s ophthalmopathy (GO) and healthy individuals. Materials and Methods: In a case-control study, 62 patients with GO and 45 healthy sex- and age-matched individuals were compared for ASPs obtained from Scheimpflug camera imaging (Sirius, Florence, Italy). The ASPs were anterior chamber depth (ACD), anterior chamber volume (ACV), iridocorneal angle (ICA), corneal volume, corneal curvatures (K1, K2, and Kmean), and white-to-white, apical, and thinnest corneal thickness. Results: Mean white-to-white corneal distance, corneal volume, ACD, ACV, ICA, K1, K2, and Kmean were similar between patients and controls (p = 0.815, p = 0.285, p = 0.522, p = 0.102, p = 0.275, p = 0.114, p = 0.566, p = 0.137, p = 0.405, and p = 0.447, respectively). There was a negative correlation between mean Hertel measurement and mean ACD (r = - 0.284, p = 0.003), ACV (r = - 0.283, p = 0.003), and ICA (r = - 0.295, p = 0.002). Conclusion: The ASPs were not associated with significant alterations between patients with GO and controls.

Background:Systemic sclerosis (SSc) is characterized by fibrosis of the skin, internal organs and vasculopathy. Invivo, the retina provides a unique opportunity to assess the microcirculation in the eye. Previous studies have been evaluated the changes in the retinal and choroid layer and showed thinning of the choroid layer and reduced retinal microvascular density.Objectives:To analysis the retinal and optic disc capillary network in patients with SSc without clinical signs of retinal involvement by using optical coherence tomography angiography (OCTA).Methods:In total 40 SSc patients who classified according to the ACR/EULAR criteria and 40 healthy control subjects were included in the analysis. All patients underwent a detailed ophthalmologic examination by the same ophthalmologist. After pupil dilatation, macular angiography was performed with 6x6 mm area scanning using standardized system and images of the retinal capillary plexus were analyzed by Cirrus OCTA software. Mean macular thickness, retinal nerve fiber layer (RNFL) and the Ganglion cell inner plexiform layer (GC-IPL), vessel density (VD), perfusion density (PD), optic disc PD, reflux index and foveal avascular zone (FAZ) parameters were measured by the same experienced operator.Results:There was no significant difference between SSc and controls in terms of age, sex, spherical equivalent (SE), intra ocular pressure (IOP), and axial length (AL). Central and mean macular thickness, nasal and inferior RNFL thicknesses were significantly thinner in SSc patients (Table). Additionally GC complex thicknesses were significantly thinner in all quadrants compared to controls.Central vessel density (CVD) and central perfusion density (CPD) values were found significantly decreased in all regions in patients with SSc. Optic disc perfusion density values were also decreased in SSc group. An inverse correlation was found between central macular thickness, FAZ area and perimeter values (rho:-0.300, p:0.007; rho:-0.276, p:0.013, respectively).There was no relationship between the disease duration and the OCTA measures.Conclusion:Vascular and perfusion density were found decreased in patient with SSC at the results of OCTA measures. These findings may help to understand vasculopathy in the pathogenesis of the disease and OCTA may be a new method providing objective and non-invasive information about capillary network in SSc.TableDemographic and ocular parameters of study populationParametersSSc(n = 40)Control(n = 40)pAge, years; mean (SD)47.2 (8.6)47.5 (8.1)0.631Male sex, n (%)24(60)16 (40)0.087Disease duration, months; mean (SD)81.3 (38.0)N/A-Foveal MT(µ)246.3 ± 19.4252.6 ± 15,30.033Average MT(µ)280.8 ± 12,4286.5± 8.70.008Vessel density (mm-1), 6 mm total area; mean (SD)17.60 ± 1.3118.66 ± 0.640.006Perfusion density, 6 mm total area; mean (SD)43.25 ± 3.3245.94 ± 1.520.002Circularity index; mean (SD)0.72 ±0.090.73 ± 0.060.049RNFL nasal (µ); mean (SD)74.37±12.3674.05±8.480.011RNFL inferior (µ); mean (SD)122.62±17.87127.40±12.630.023Inferior nasal GCC(µ); mean (SD)85.72 ± 8.5385.82 ± 4.840.001Inferior temporal GCC(µ); mean (SD)82.70 ± 8.6284.95 ± 4.150.001Superior nasal GCC(µ); mean (SD)86.35 ± 7.7386.8 ± 5.700.012Superior temporal GCC(µ); mean (SD)47.2 (8.6)47.5 (8.1)0.631MT: Maculer thickness; RNFL: Retinal nerve fiber layer; GCC: Ganglion cell complexDisclosure of Interests:None declared

Amaç:Crohn hastalığı (CD) ve ülseratif kolit (ÜK) bir grup inflamatuar barsakhastalığıdır (IBD) .IBD'de oftalmik bozukluklar ortaya çıkabilir. En sıkgörülen bulgular episklerit ve üveittir. Çalışmanın amacı IBD'deki koroidal vemaküla kalınlığını (MT ve CT) değerlendirmek ve bunu hastalık aktivitesi ilekontrol etmektir.Yöntem:IBD grubu 50 hastanın 50 sağ gözünü içeriyorken, kontrol grubu ise 50 sağlıklıgönüllünün herhangi bir gözünden oluşmuştu. Tüm katılımcılar spectral domainoptical coherence tomography (SD-OCT) ile test edildi. CT değerleri yedi farklınoktada elde edildi.Bulgular:IBD'nin ortalama süresi 3.9 ± 1.5 yıl idi. Foveal maküler kalınlık; çalışmagrubunda 258.1 ± 14.2 µm, kontrol grubunda 262.7 ± 20.9 µm idi. Gruplararasında anlamlı fark yoktu (P = 0,19). Subfoveal, temporal 500 µm, 1000 µm ve1500 µm CT ölçümleri, çalışma grubunda sırasıyla istatistiksel olarak anlamlıydı(p, Objective: Crohn’s disease (CD)and ulcerative colitis (UC) are a group of inflammatory bowel disease (IBD).Ophthalmic disorders might occur in IBD. The most common findings areepiscleritis and uveitis.Then purpose of the study was to evaulate thechoroidal and macular thickness (MT and CT) in the IBD and to check it with the diseaseactivity.Methods:IBD group was including 50 patients and the control group consisted of 50healty volunteers. All participants weretested with spectral domain optical coherence tomography (SD-OCT). The CTvalues were obtained at seven different points.Results:Mean duration of the IBD was 3.9±1.5 years. Foveal macular thickness was 258.1 ± 14.2 µm in study group and262.7 ± 20.9 µm in the control group. There was not significant differencebetween groups(P=0,19). Subfoveal, temporal 500 µm, 1000 µm, and 1500 µm CTmeasurements were respectively statistically significant in the study group(p

Objective To evaluate the changes in anterior segment parameters after neodymium-yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy in 1-piece and 3-piece IOLs. Methods In an institution, 65 eyes of 65 consecutive pseudophakic patients with posterior capsule opacification underwent Nd:YAG laser capsulotomy. The patients were divided into two groups according to the IOL type. Group-1 consisted of 35 subjects with 1-piece IOL and Group-2 consisted of 30 subjects with 3-piece IOL. Anterior segment parameters were measured with the Sirius rotating camera before, one week and one month after Nd:YAG laser capsulotomy. Results Mean age was 72.3±5.2 years in 1-piece IOL and 72.3±6.8 years in 3-piece IOL. There were no statistically significant differences before capsulotomy for IOP, axial length, spherical equivalent, anterior chamber depth, central corneal thickness, anterior chamber angle and anterior chamber volume between two IOL groups. BCVA improved after capsulotomy in both groups (p=0.001). Both IOL groups had statistically significant myopic shift compared with the baseline values (P= 0.03 and P=0.01 resp.). Both IOL groups had statistically significant decrease in ACD, from baseline to the 1st week and 1st month (p=0.04 and 0.03 resp.). Conclusion To achieve the highest percentage of refractive and anterior segment stability surgeons may prefer to implant the 1-piece IOL design.

Purpose To assess choroidal thickness changes in young adults with systemic arterial hypertension. Methods This prospective study comprised 80 hypertensive patients and 80 healthy control subjects. Choroidal thickness was measured with spectral-domain optical coherence tomography (SD-OCT) (RS-3000, Nidek). Choroidal thickness was obtained at the subfovea, 500 µm, 1000 µm, and 1500 µm nasal to the fovea (N500, N1000, N1500) and 500 µm, 1000 µm, and 1500 µm temporal to the fovea (T500, T1000, T1500). Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured with a mercury sphygmomanometer. Only the right eye values were used for statistical comparisons between the groups. Results Mean age was 23.8 ± 2.8 years in hypertensive subjects and 23.5 ± 2.1 years in the control group (p = 0.945). All choroidal thickness measurements (mean choroidal thickness, subfoveal choroidal thickness, all nasal and all temporal choroidal thicknesses) were significantly lower in hypertensive subjects (p500, T500, T1000, T1500; p = 0.001 for N1000; and p = 0.012 for N1500). The correlations between choroidal thickness measurements and blood pressure (SBP, DBP, MAP) were insignificant (p>0.05 for all correlations). Choroidal thickness measurements were also insignificantly correlated with disease duration (p>0.05 for all correlations). Conclusions The results of this study demonstrated that choroidal thickness decreases in patients with systemic arterial hypertension. This may be caused by arteriolar sclerosis and vascular contraction caused by high intravascular pressure in the choroid.

Objectives To report the clinical features of ocular injuries associated with explosive military ammunition in insurgent attacks in Turkey. Methods The medical records of 48 casualties who were treated for ocular injuries sustained in insurgent attacks at the Combat Region Hospitals in Turkey were retrospectively reviewed. The reviewed data included initial visual acuity, type of explosive military ammunition (ie, improvised explosive device, mine, hand grenade and rocket-propelled grenade), type of globe injury (open-globe vs closed-globe injury), traumatised globe zones, the presence/absence of an intraocular foreign body, medical interventions, status during the explosion and injuries to other parts of the body. The visual acuity differences between different explosive materials and between ‘on-foot’ and ‘inside-vehicle’ casualties were investigated. Results A total of 83 injured eyes were analysed. The mean patient age was 24.5±6.6 years. The mean initial logarithm of the minimum angle of resolution visual acuity was 0.60±0.63. The injuries were due to improvised explosive devices in 28 cases (58.3%), land mines in 16 cases (33.3%), and hand grenades and rocket-propelled grenades in 2 cases each (4.2%). Forty-seven eyes (56.6%) had open-globe injuries. The most frequently involved zones were zone 1 (50.0%) in closed-globe injuries and all zones (31.9%) in open-globe injuries. Intraocular foreign bodies were present in 45/47 (95.7%) eyes with open-globe injuries. Twelve (14.4%) eyes with no light perception were enucleated, and two (2.4%) eviscerated. The difference in the visual acuities between the on-foot and inside-vehicle casualties and between the injuries that were caused by the different types of explosive ammunitions was also insignificant (p=0.271 and 0.394, respectively). Conclusions The clinical results for eye injuries caused by explosive military ammunition sustained during insurgent attacks in Turkey are disappointing irrespective of the explosive material. The use of protective eyeglasses might improve the outcomes and should be encouraged.

Radiation retinopathy remains a devastating cause of visual morbidity in patients undergoing radiation for globe, orbit, and head and neck malignancies. A 65-year-old female was admitted with the complaint of low vision in the right eye for two months. Best corrected visual acuity was 20/32 in the right eye and 20/25 in the left eye. Slit lamp examination was normal in both eyes. Fundoscopic examination revealed perifoveolar hard exudates, paramacular microhemorrhages, telangiectasias, and macular degeneration in both eyes. Fundus florescein angiography showed enlargement of the foveal avascular zone, perifoveal capillary telangiectasia, and widespread venous beading bilaterally. Optical coherence tomography revealed bilateral cystoid macular edema. The prediagnosis of diabetic retinopathy was not confirmed because of the absence of diabetes mellitus after endocrinologic evaluation. Detailed medical history explored external beam radiotherapy to the head and neck region for nasopharyngeal cancer 10 years ago. The ultimate diagnosis was radiation retinopathy.

To explore choroidal thickness (ChT) and retinal thickness (RT) changes in patients with type 1 diabetes mellitus (DM).Sixty patients with Type 1 DM and 60 age- and sex-matched healthy controls were included in this prospective case-control clinical study. All patients underwent a complete ophthalmological examination. ChT of each participant was measured at the fovea and horizontal nasal and temporal quadrants at 500-µm intervals to 1500 µm from the foveola using spectral-domain optical coherence tomography (SD-OCT). Age, gender, disease duration, serum glycosylated hemoglobin (HbA1c), fasting glucose level, axial length (AL) and refractive error were noted and analyzed.Mean disease duration, mean HbA1c and mean fasting blood glucose in diabetic patients were 6.1±2.8 years, (8.9±0.9)% and 287.5±69.1 mg/dl, respectively. Age, gender, AL, spherical equivalent differences between the patients and subjects were insignificant (p0.05). Subfoveal ChT, nasal quadrant ChT measurements, temporal 1500 µm and mean nasal ChT were significantly lower in diabetic patients (p0.05 for all). Temporal 500 µm and 1000 µm ChT measurements, mean temporal ChT, average ChT, central macular thickness and average macular thickness did not differ significantly between the groups (p0.05 for all).This study showed that there is choroidal thinning in young Type 1 diabetic patients with early period of disease duration without diabetic retinopathy nor any other systemic diseases. Choroidal changes in type 1 DM seem to begin at nasal and distal temporal retina. These results need to be verified by larger and longitudinal studies.

Bu calismada santral seroz koryoretinopati (SSR)’li olgularda dogal seyir sonuclarinin ve predispozan faktorlerin bildirilmesi amaclanmistir. Primer SSR tanisi konulan ve 6 aylik takip boyunca herhangi bir tedavi almayan 34 olgu calismaya dahil edildi. Hastalarin kayitlari retrospektif olarak incelendi. Tum hastalarin Snellen eseline gore duzeltilmis en iyi gorme keskinlikleri, on segment biomikroskopisi ve fundus muayeneleri, optik koherens tomografi ve fundus floresan anjiyografi tetkikleri kaydedildi. Kayitlar SPSS 14,0 programi kullanilarak istatistiksel olarak degerlendirildi. Hastalarin yas ortalamasi 33,17±6,13, cinsiyetleri ise 26 erkek ve 8 bayandi. Olgularin %58,8’inde A tipi kisilik mevcuttu. Hastalik baslamadan once ciddi stres bozuklugu yasayan hastalarin orani ise %82,4(28)’ dur. Olgularin mesleklere gore dagilimi ise %35,3 askeri personel, %20,6 polis, %2,9 doktor, %11,8 esnaf, %23,5 isci, %5,9 ev hanimi olarak bulunmustur. Ilk basvuruda yapilan muayenede SSR gelisen gozdeki Snellen eseline gore en iyi duzeltilmis gorme keskinligi ortalama 0,59±2,04’dur. Hastaligin gozlere gore dagilim orani ise; %73,6 sag goz, %23,5 sol goz ve %2,9 her iki goz olarak ortaya cikmistir. Hastaligin alti aylik takipten sonra kroniklesme orani %14,7’dir. Kroniklesmeyen olgularin ortalama iyilesme sureleri 1,90±0,63 aydir. SSR’de stres en onemli predispozan faktordur. Strese bagli ortaya cikan bazi biyokimyasal degisiklikler koroid damarlarinda permeabilite degisikligi yapmaktadir. Hastaligin dogal seyrinde buyuk bir kismi spontan olarak iyilesmektedir. Kronik ve tekrarlayan olgularda tedavide bu patofizyolojik mekanizma dusunulerek ileri calismalarin yapilmasi gerekmektedir. Predisposing factors in central serous chorioretinopathy and the natural progress of the illness To report the results of the natural progress and predisposing factors of the patients with central serous chorioretinopathy (CSR). The study comprised 34 patients diagnosed with primary central serous retinopathy and having no medication in preceding 6 months follow-up. Reports of the patients were examined retrospectively. The best corrected visual acuity (BCVA) with Snellen chart, results of anterior slit lamp microscopy and fundus examination as well as optical coherence tomography and fundus fluorescein angiography were evaluated. Statistical evaluation was performed with the SPSS program (SPSS 14.0 demo, SPSS inc., Chicago, Illinois). Mean age of the patients was 33.17±6.13 years with 26 men and 8 women. A type personality was exist in 58.8% of total patients. The ratio of the patients having critical stress disorder before the illness had started was 82.4%. Distribution of the patients according to their occupations were found as: 35.3% military personnel, 20.6% policeman, 11.8% trade, 23.5% worker and 5.9% housewife. On the first examination, mean BCVA of the eyes with CSR was 0.59±2.04. The distribution ratio of the pathology according to the eyes were: 73.6% right eye, 23.5% left eye and 2.9% bilateral. The ratio of chronicity of the illness after 6 months follow-up period was 14.7%. Mean recovery time of the patients with no chronicity was 1.90±0.63 months. The most important predisposing factor in CSR is stress. Some biochemical changes due to stress leads to change the permeability of choroid capillaries. Most of the patients are recovering in the natural progression of the illness. Considering this physiopathological mechanism, further studies are necessary for the treatment of chronic and recurrent patients. J. Exp. Clin. Med., 2012; 29:272-275

A 21-year-old Caucasian man presented with a complaint of nyctalopia. Visual acuity in both eyes was 20/20 and anterior segment biomicroscopy results were unremarkable. Fundoscopy revealed peripheral avascular zones, minimal peripheral retinal exudation from the retinal vessels, peripheral retinal telangiectasias and anastomosis in both eyes, and retinal vascular dragging toward the temporal periphery in both eyes. Full field electroretinography showed that rod responses were almost absent and that cone responses were reduced. Macular optical coherence tomography showed normal structure in both eyes. Vascular changes were attributed to a subclinical form of familial exudative vitreoretinopathy. This was an interesting case due to the association of familial exudative vitreoretinopathy with rod-cone dystrophy.

To investigate the effect of monofocal spheric acrylic intraocular lenses (IOL) on the visual field (VF) parameters.Thirty-six healthy pseudophakics (group 1) and 42 age-matched healthy volunteers (group 2) who had visual acuity ofor = 9/10 Snellen lines underwent central 24-2 threshold VF testing by Humphrey 750i VF analyzer. Subjects of group 1 had undergone VF testing 2 months after cataract surgery. The VFs were divided into three concentric zones for analysis. Age, visual acuity, pupillary size, foveal threshold, mean (MD) and pattern standard deviation (PSD) values, and mean decibel (dB) thresholds. MD and PSD of the three concentric zones were compared between the groups.There was no significant difference between the groups in regards to age, gender, pupillary size, visual acuity, and mean foveal threshold. Mean MD was -2.4 +/- 2.5 decibel (dB) in the pseudophakics and -1.06 +/- 1.9 dB in the controls (p = 0.01; t = -2.63). Mean PSD values of group 1 and 2 were 2.5 +/- 1.5 dB and 2.06 +/- 1.3 dB, respectively (p = 0.145; t = -1.47). There were statistically significant differences between mean MD values of three concentric zones of both groups (p0.003, for all). The reduction of VF sensitivity through peripheral retina was more pronounced in the pseudophakics.Even monofocal spheric acrylic IOLs have relatively insignificant effect on visual acuity, and foveal threshold may influence global indices such as MD on VF testing. Possible causes of reduction in VF sensitivity should be clarified by further studies in pseudophakics.

Purpose To assess retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), and macular thickness changes in young adults with systemic arterial hypertension. Methods This study included 80 young patients (age 23.8 ± 2.8 years) with systemic hypertension (sHT) without any known systemic or ocular disease and 80 age-matched (23.5 ± 2.1 years) healthy controls. Retinal nerve fiber layer thickness, macular thickness, and GCC thickness were measured with spectral-domain optical coherence tomography. Results Mean disease duration was 3.45 ± 1.48 years (range 2-10). Differences in intraocular pressure, body mass index, axial length, and spherical equivalent between the groups were insignificant (p>0.05). The differences in RNFL thickness did not differ between the groups. Patients with sHT had significantly lower central macular thickness (p = 0.037), inner superior macular thickness (p = 0.045), and outer temporal superior and outer temporal inferior GCC (p0.05). Systolic and diastolic blood pressure were significantly correlated with inner temporal superior and inner temporal inferior GCC thickness in a negative manner (pConclusions Ganglion cell complex thickness decrease is possibly a better retinal marker for hypertensive changes with respect to RNFL and macular thickness.

Purpose: This study explores retinal structural changes in type 1 diabetes without clinically diagnosed diabetic retinopathy (DR). Methods: Peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, and macular thickness (MT) were measured in 90 type 1 diabetic patients by using spectral domain optical coherence tomography. The values were compared with 100 sex- and age-matched healthy controls. The independent t test was used to assess differences in the mean age, mean diabetic and ocular parameters, and the thickness values between the diabetic and control groups. Multiple linear regression analysis was performed to investigate the correlation between the thickness values and diabetic and ocular parameters. Results: Whole-RNFL, the superior and inferior quadrants, and the superior half of the peripapillary RNFL thicknesses were significantly thinner in diabetic patients compared with controls (p < 0.05). GCC thicknesses in the average macular, outer temporal superior and outer temporal inferior sectors were significantly thinner in diabetic patients (p < 0.05). Central and average MTs were similar in both groups (p > 0.05). There were significant negative correlations of the duration of type 1 diabetes with the inner nasal MT, inner temporal superior GCC thickness, inner nasal inferior GCC thickness, and outer nasal superior GCC thickness (p < 0.05). Similarly, there were significant negative correlations of the level of HbA1c with the whole-RNFL thickness, superior-half-RNFL thickness, and superior-quadrant-RNFL thickness (p < 0.05). Conclusions: Type 1 diabetic patients without clinically diagnosed DR had neurodegeneration in the inner retinal layers compared with healthy controls.

Purpose: The aim of this study was to evaluate choroidal thickness changes during acute attacks of familial Mediterranean fever (FMF). Methods: Fifty patients with FMF and 50 healthy controls were included. Choroidal thickness of each participant was measured at the foveola and horizontal nasal and temporal quadrants at 500-µm intervals to 1,500 µm from the foveola using spectral-domain optical coherence tomography. White blood cell count, erythrocyte sedimentation rate (ESR) and serum levels of fibrinogen and C-reactive protein (CRP) were evaluated. The clinical findings (peritonitis, arthritis and pleuritis) were noted. Results: Choroidal thickness was significantly thicker at all measurement points in FMF patients compared to healthy controls during an acute attack (p < 0.05). There were positive correlations between the choroidal thickness and ESR, fibrinogen and, particularly, CRP levels. Clinical findings did not change the choroidal thickness significantly (p > 0.05). Conclusions: Increased choroidal thickness in the acute phase of FMF is possibly related to the inflammatory edematous changes in the choroid.

To report a case of gunpowder injury to left eye with both superficial and deep seated corneal-conjonctival multiple gunpowder particles. A 30-year-old noncommicent officer injured by the explosion of a heavy machine gun loaded with a big caliber bullet during the battle training. He suffered from the multiple particles of nonactivated gunpowder to his face and left eye. His visions were 20/20 in the right eye and 20/32 in the left eye with Snellen visual acuity chart. Multiple gunpowder particles and tattooing of skin were seen in the left periorbital region. Slit lamp examination revealed mild subconjunctival hemorrhage, mild conjunctival chemosis, multiple black sphere shaped gunpowder particles embedded in the lid margins, conjunctiva and corneal epithelium of left eye. At the central cornea there was a closed perforation and a paracentral crystalline lens perforation. The slit lamp examination also revealed an intralenticular foreign body. Multiple subconjunctival and superficial corneal gunpowder particles were removed using a 28-gauge needle. Deep stromal particles were left in their place, as there was a high risk of corneal perforation. There was no cataract formation in the lens. At the end of the sixth month, a few subconjunctival particles, a few deep stromal particles and an intralenticular particle in the left eye remained without any inflammatory reaction and cataract formation. Barut ile olusan kornea ve lens yaralanmasi Multipl barut tanecikleri ile sol gozden derin ve yuzeyel yerlesimli korneal-konjonktival yaralanma vakasi rapor edildi. 30 yasindaki bir astsubay egitim sirasinda ucaksavar mermisinin patlamasi sonucu yaralanmistir. Sol gozu ve yuzunde aktive olmamis barut parcalari bulunmaktaydi. Gorme duzeyleri Snellen eseline gore sag gozde 20/20 sol gozde 20/32 duzeyindeydi. Sol periorbital bolgede multipl barut parcalari ve tatuaj izlenmekteydi. Yarik lamba ile yapilan muayenede hafif subkonjonktival hemoraji, kemosiz, kapak kenarlarina, kornea ve konjonktivaya yapisik kure sekilli multipl siyah barut parcalari izlenmekteydi. Santral korneada kapali perforasyon ve parasantral lens perforasyonu izlenmekteydi. Lens icerisinde yabanci cisim mevcuttu. Multipl subkonjonktival ve yuzeyel barut parcalari 28 gauge igne ile temizlendi. Korneal perforasyon nedeni ile derinde yerlesik olan partikuller cikarilmadi. Lenste katarakt olusumu izlenmedi. Alti aylik takibin sonunda intralentikuler, subkonjonktival ve korneal barut parcalarinin herhangi bir inflamatuar reaksiyona sebebiyeti ve katarakt olusturdugu gozlenmemistir. J. Exp. Clin. Med., 2012; 29:249-251

BACKGROUND AND OBJECTIVE: To identify long-term changes in choroidal thickness after solar retinopathy. PATIENTS AND METHODS: The study included 25 eyes of 25 men with acute solar retinopathy. Ocular examination, best corrected visual acuity (BCVA), and retinal and choroidal thickness measurements obtained using spectral-domain optical coherence tomography were evaluated. RESULTS: The mean follow-up was 6.1 ± 0.4 months. The initial BCVA decreased in the affected eyes ( P < .001). The mean BCVA (logMAR) improved significantly from 0.16 ± 0.06 to 0.03 ± 0.05 at 6 months ( P < .001). There were no significant differences in the initial retinal and choroidal thicknesses between the affected and other eyes, while there was a significant decrease in the mean macular thickness and mean macular volume at 1 month and the mean choroidal thickness increased ( P < .001). CONCLUSION: Significant retinal and choroidal thickness changes occurred after solar retinopathy. The changes in choroidal thickness suggest that the effects of solar retinopathy might not be limited to the retina. [ Ophthalmic Surg Lasers Imaging Retina. 2015;46:738–742.]

Purpose: The aim of this study was to explore the effect of age on the success of transcanalicular diode laser-assisted dacryocystorhinostomy (TCDCR). Methods: Seventy patients (70 eyes) who underwent transcanalicular diode laser-assisted dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction as a primary surgery were included in this retrospective, nonrandomized study. The patients were divided into two groups according to age. Mean ages were 21.3 ± 3.3 in group 1 and 60.3 ± 7.3 in group 2. The records of the 3-, 6-, and 12-month follow-up examinations were evaluated, and the anatomical and functional outcomes were noted. Functional success was defined as the absence of epiphora as indicated by the patient. Anatomical success was determined as patency of the neo-ostium with irrigation. Results: At the 3-month follow-up, 67% cases in group 1 showed anatomical success and 52% showed functional success; in group 2, the rates were 100% and 92%, respectively. Functional and anatomical success rates were the same for both the 6- and 12-month visits; 46% in group 1 and 76% in group 2. The results in group 2 were significantly better at all three follow-up visits (p

Morning Glory Sendromunda (MGS) optik koherens tomografinin ( OKT) klinik önemini değerlendirmek. Mayıs 2013 ile haziran 2014 tarihleri arasında MGS tanısı konan iki hastanın iki gözü retrospektif olarak incelendi. Hastaların tam oftalmolojik ve sistemik muayenesinin ardından, horizontal ve vertikal B mod OKT görüntüleri elde edildi. Sistemik muayenede birinci olguda biküspit aorta ve kardiyak aritmi saptandı. İkinci olguda sistemik patoloji saptanmadı. Etkilenen 2 gözde de görme keskinliği 0.1 ve altında ölçüldü. Peripapiller ve maküler bölgenin OKT görüntülerinde tüm gözlerde genişlemiş optik disk, iç retina katlarında skizis benzeri boşluklar içeren nörosensöryel retina dekolmanı izlendi. Oküler ve sistemik morbiditenin azaltılması için MGS'nin erken teşhisi ve uzun dönem takipleri önemlidir. Oküler komplikasyonların tanı ve takibi için OKT faydalı bir araç olabilir, To assess the clinical importance of optical coherence tomography (OCT) in morning glory syndrome (MGS). Two eyes of two patients who diagnosed of MGS between May 2013 and June 2014 were evaluated retrospectively. After the complete ophthalmological and systemic examination of the patients, horizontal and vertical B mod OCT images were obtained. In the systemic examination, bicuspid aortic valve and cardiac arrhythmia were detected in the first case. No systemic disease were detected in the second case. Visual acuity was measured

To investigate the effect of pseudophakia on visual electrophysiology.Right eyes of 60 pseudophakic (study group) age- and sex-matched 60 phakic (control group) volunteers were included. Subjects without any ocular and systemic disease, who had visual acuity of more than 9/10 underwent full-field electroretinogram (ERG), pattern electroretinogram (PERG), pattern visual evoked potentials (PVEP) and electro-oculogram (EOG) recordings.The P100 latency to 1º-check was significantly shorter in both pseudophakic groups (study group: 102.98 ± 6.11, control group: 107.06 ± 10.70, p=0.012). The P100 amplitude to 15'-check was significantly higher in the pseudophakic groups (study group: 13.96 ± 7.01, control group: 11.60 ± 4.69, p: 0.033). Regarding ERG, b-wave implicit time in rod response and a-wave implicit time in standard combined response (SCR) were significantly shorter in the pseudophakic group (p=0.017, and less than 0.001, respectively). B-wave amplitude in rod response and a-wave amplitude in SCR were significantly higher in the study group (p less than 0.001 for both). The P1 and N1 amplitude and implicit time differences in 30-Hz flicker response were not significant (p more than 0.05). Conversely, P3/P4 implicit times in oscillatory potentials (OPs) were delayed in the pseudophakic group (p=0.001, and 0.002, respectively). The P1 amplitude increase in OPs in the study group was significant (p less than 0.001). The N95 latency in PERG was significantly delayed (p=0.002) and P50 amplitude was increased (p=0.002) in the pseudophakics. Arden ratio in EOG was similar in both groups (p=0.961).Pseudophakia seems to influence ocular electrophysiological tests. Possible causes of these influences in the patients with pseudophakia should be clarified by further studies.

Purpose: To investigate the effect of air flight on intraocular pressure (IOP). Methods: Baseline IOP of 25 healthy volunteers was measured at a ground level of 1760 feet above sea level (ASL) using Tono-Pen XL™. Measurements were repeated after reaching an altitude of 19,000 feet and then on the second hour during a routine flight. Cabin pressure was kept around 8000 feet. IOP measurement was repeated after landing (3.5 hr after taking off). Change in the IOP was evaluated. Results: Mean ± SD IOP was 14.2 ± 2.7 mmHg at ground level and was 14.0 ± 2.2 mmHg after gaining maximum altitude (p = 0.78). Mean IOP dropped to 12.3 ± 2.5 mmHg on the second hour of flight and 12.0 ± 1.7 mmHg after landing. Decrease in IOP on the second hour (13.4%, p = 0.005) and after landing (15.7%, p = 0.001) were significant. Conclusion: IOP significantly decreased on the second hour measurements during a routine flight, and this change was sustained after landing.

porters of this assumption are the positive correlations between the choroidal thickness and the indicators of inflammation such as erythrocyte sedimentation rate, fibrinogen and C-reactive protein levels. These findings suggest that an increase in the severity of the inflammatory reaction causes an increase in the choroidal thickness in patients with FMF. Additionally, some clinical studies also demonstrated vascular capillary enlargement, tortuosity and extravasation in nail folds of patients with FMF [3, 4] . Another important point is that not all inflammatory conditions of choroid have funduscopic findings, even Vogt-Koyanagi-Harada disease [5, 6] . Kaya et al. [1] hypothesized that the cause of increase in choroidal thickness may be the Dear Editor We read Kaya et al.’s comments [1] on our article entitled ‘Choroidal Thickness Changes in the Acute Attack Period in Patients with Familial Mediterranean Fever’ [2] with great interest. Kaya et al. [1] assert that there is no evidence of inflammation in the choroid during the acute phase of familial Mediterranean fever (FMF). The authors claim that if an inflammation was present, a uveitic presentation like VogtKoyanagi-Harada disease would be seen in the patients. We think it is probable that the systemic inflammatory and vasculopathic nature of FMF causes increased vascular permeability, exudation and enlargement of the choroidal vessels during the acute attacks, which give rise to an increase in choroidal thickness. The strongest supReceived: December 15, 2015 Accepted: December 30, 2015 Published online: February 2, 2016