Ebru Nevin Cetin

Objective: To investigate whether residual optical coherence tomography (OCT) findings in the neurosensory retina and quantitative choroidal parameters are associated with best-corrected visual acuity (BCVA) after center-involved diabetic macular edema (DME) has resolved following anti–vascular endothelial growth factor (anti-VEGF) treatment. Methods: Medical records of 44 patients comprising 49 treated eyes were reviewed retrospectively. All eyes had received at least 3 initial intravitreal anti-VEGF injections before the postresolution assessment. Central 1 mm spectral-domain OCT B-scans were examined for disorganization of the retinal inner layers (DRIL), ellipsoid zone (EZ) disruption, and external limiting membrane (ELM) disruption. Enhanced-depth imaging OCT was used to measure subfoveal choroidal thickness (SFCT) and calculate the choroidal vascularity index (CVI) after Otsu-based binarization of a manually selected subfoveal choroidal area. Generalized estimating equation (GEE) models were used to account for inter-eye correlation. Results: Mean (SD) BCVA was 0.48 (0.45) logMAR. Mean (SD) SFCT and CVI were 241 (60) μm and 0.65 (0.08), respectively. BCVA was poorer in eyes with DRIL (P = .008), ELM disruption (P < .001), and EZ disruption (P = .001). DRIL was also associated with a higher frequency of ELM and EZ disruption (P < .001 and P = .001, respectively). Hard exudates were not significantly associated with BCVA after GEE analysis (P = .055). Choroidal thickness and CVI did not differ significantly across retinal biomarker subgroups. CVI showed a modest inverse association with age (r = −0.324, P = .023) but was not significantly associated with BCVA. Conclusion: In eyes evaluated after resolution of center-involved DME, poorer BCVA was associated with persistent inner and outer retinal microstructural abnormalities, particularly DRIL and ELM/EZ disruption. In contrast, posttreatment SFCT and CVI were not significantly associated with BCVA or retinal biomarker status.

X-linked retinoschisis is an inherited retinal disease caused by mutations in the RS1 gene; however, a genotype-phenotype correlation regarding the mutation type or location within the RS1 gene and...

In this study, we aimed to describe the demographic and clinical findings of children with uveitis at a tertiary pediatric rheumatology and ophthalmology center. A retrospective cross-sectional study was conducted with 46 patients who were diagnosed with uveitis before the age of 16 years and were followed regularly for at least 6 months between January 2013 and June 2019. Demographic data, uveitis characteristics, underlying diseases, systemic treatment modalities, drug side effects, complications, and surgical intervention were evaluated. Eighty-three eyes of 46 patients were included in the study. The mean age at diagnosis of uveitis was 9.2±4.5 (1.6-15.6) years, and the mean uveitis follow-up period was 54±41 (6-191) months. Twenty-one patients (45.7%) had uveitis associated with rheumatologic diseases. Juvenile idiopathic arthritis was the most common disease (23.9%). Visual acuity was categorized as moderately impaired in 6 eyes (7.2%), severely impaired in 4 eyes (4.8%), and blindness in 1 eye (1.2%). Methotrexate (87%) was the most frequently used systemic immunosuppressive agent in treatment. Adalimumab (73.9%) was added to treatment in resistant cases. Thirtyfive patients (76.1%) had complications in at least 1 eye secondary to uveitis or uveitis treatment. Posterior synechiae (11 eyes, 13.2%) was the most common complication during treatment. In order to preserve visual acuity, pediatric uveitis should be recognized early and especially persistent/chronic cases should be started on effective systemic treatment immediately.

Objective To assess the course of neurodegeneration based on retinal layer thickness and integrity analysis in diabetic patients without retinopathy and to evaluate its association with inner retinal reflectivity. Methods This retrospective case–control study included 80 eyes of 80 patients with DM without retinopathy and 40 eyes of 40 healthy subjects with a follow-up of ≥1 year. SD-OCT was used for assessment of retinal reflectivity and macular layer thicknesses. Optical intensity ratios (OIRs) were defined as the mean OCT reflectivity of ganglion cell and inner nuclear layer to the mean reflectivity of RPE. Results After Bonferroni correction, thinning in pericentral, superior and nasal sectors in total retina, superior ganglion cell, pericentral and nasal inner plexiform, and superior inner retinal layers, as well as thickening in inferior and pericentral outer plexiform layer remained significant in the study group (p < 0.0125). Ganglion cell layer OIR significantly correlated with the changes in superior retina (r = 0.278, p = 0.013), central inner retina (r = 0.247, p = 0.027), and pericentral retinal thickness (r = 0.240, p = 0.032), and no eyes had disruption of retinal layers in the study group initially or finally. Conclusion Ganglion cell layer reflectivity significantly correlated with the amount of pericentral retinal thinning during the time course in the diabetic group, which was more prominent in the inner retinal layers.

Purpose: To firstly present management of toxic anterior segment syndrome (TASS) and possible postoperative endophthalmitis (POE) after implantation of a new hydrophilic-acrylic posterior chamber (PC) phakic intraocular lens (pIOL) in a case with undeclared history of COVID-19.Methods: A 21-year-old male without known disease represented severe anterior chamber inflammation (hypopyon), poor vision and corneal edema without vitreous involvement (TASS) at 24-hours after PC-pIOL implantation for unilateral high myopia (amblyopic).Results: Preoperative best-corrected visual acuity (BCVA) was 0.2 OS (-13 diopters). At 56-hours, vitreous was involved with visual loss indicating POE. The patient confessed that he had COVID-19 1-month ago. COVID-19 immunoglobulin M/G tests were positive, while other markers were negative. Intracameral/intravitreal antibiotics were applied. BCVA was 0.15 without hypopyon at 24-hours. Cultures were negative. Final BCVA was 0.6 with normal examination.Conclusion: TASS/POE etiology could not be demonstrated in this case, whereas COVID-19-related proinflammatory systemic background could have effect on triggering/aggravating this scenario.].

Purpose: To evaluate the corneal and anterior chamber morphology in phakic eyes with noninfectious intraocular inflammation. Methods: This study included 59 eyes with active uveitis, 62 with inactive uveitis, and 95 healthy eyes. Corneal endothelial cell density, hexagonal cell ratio, coefficient of variation (CV), corneal thickness and volume, maximum keratometry, and anterior chamber volume and depth (ACD) measurements were performed using a specular microscope and Pentacam HR. Results: The mean duration of uveitis was 24.6 +/- 40.5 (0-180) months. The mean number of uveitis attacks was 2.8 +/- 3.0 (1-20). Coefficient of variation was significantly higher in the active uveitis group compared with inactive uveitis group (p=0.017, Post Hoc Tukey). Anterior segment parameters other than coefficient of variation were not significantly different between active/inactive uveitis and control groups (p>0.05). Multiple linear regression analysis showed that coefficient of variation was greater in active uveitis compared with inactive uveitis after adjusting for the duration of uveitis, type of uveitis, having a rheumatologic disease, and having immunosuppressive treatment (p=0.003). The duration of uveitis and number of attacks were not significantly correlated with ocular parameters (p>0.05, Spearman's correlation). The difference in parameters was not significant based on uveitis type (p>0.05). Conclusions: Coefficient of variation was higher in eyes with active uveitis than that in eyes with inactive uveitis, whereas corneal endothelial cell density and anterior chamber morphology did not significantly differ between active/inactive uveitis and control groups.

The aim of the study was to investigate iris alterations in diabetic retinopathy (DR). Sixty-nine eyes of 69 patients were recruited and three groups of patients were examined: proliferative DR (n = 25), non-proliferative DR (n = 21) and healthy controls (n = 23). Macular optical coherence tomography (OCT), anterior segment iris OCT, and slit lamp digital camera photographs were taken. The thicknesses of the iris at a distance of 1 mm, 2 mm, and 3 mm from pupil margin were measured via iris OCT. Iris crypt count, furrow extent, color tone and collarette/diameter ratio were measured by means of anterior segment photography. Visual acuity, refractive error, intraocular pressure, and numbers of intravitreal injections were also recorded. The iris thickness measurements at 1 mm from pupil margin were significantly correlated with the macular thickness measurements (r = 0.32, p = 0.016). In the proliferative DR group, total number of injections were significantly correlated with the iris thickness measurements at 1 mm (r = 0.25, p = 0.04). The iris thickness measurements at distances 1 mm, 2 mm, and 3 mm from the pupil margin were similar in all of the groups (p > 0.05). Iris thickness did not correlate with age, intra-ocular pressure and collarette iris ratio in all the participants (p > 0.05). Iris thickness is similar in diabetic patients and healthy controls. Meanwhile, iris thickness near the pupillary margin is positively correlated with macular thickness.

To investigate corneal topographic alterations in patients with uveitis and isolated systemic inflammatory disease (SID).This retrospective cross-sectional study included 44 patients with uveitis w...

To investigate the association of retinal biomarkers with the choroidal parameters in retinitis pigmentosa (RP).