Hasan Öncül

Background/aim: Bevacizumab biosimilars are increasingly used as alternatives to reference bevacizumab in ophthalmic practice, but comparative real-world evidence in treatment-naïve neovascular age-related macular degeneration (nAMD) remains limited. In this study, the short-term anatomical, functional, and documented safety outcomes associated with bevacizumab, bevacizumab-bvzr (Zirabev), and bevacizumab-awwb (Mvasi) were evaluated in treatment-naïve patients with nAMD in a multicentre real-world setting. Materials and methods: This multicentre retrospective cohort included 250 treatment-naïve eyes with nAMD from 16 centres in Türkiye that completed a 3-month loading regimen with the same bevacizumab agent. Central macular thickness (CMT) was the prespecified primary longitudinal outcome; best-corrected visual acuity (BCVA) was secondary, while intraretinal fluid (IRF) and subretinal fluid (SRF) were repeated binary outcomes. CMT and BCVA were analysed using longitudinal linear mixed-effects models, whereas IRF and SRF were analysed using binomial generalised linear mixed-effects models with a logit link. Documented adverse events were assessed descriptively. Results: In the primary longitudinal CMT analysis, time (p < 0.001) and the agent-by-time interaction (p = 0.016) were significant, whereas the overall agent effect was not (p = 0.932). At the third follow-up, adjusted mean CMT was 295.1 (95% CI, 276.5–313.6), 302.4 (277.1–327.8), and 306.2 (281.7–330.7) μm for bevacizumab, bevacizumab-bvzr, and bevacizumab-awwb, respectively. For BCVA, time (p < 0.001), agent (p = 0.042), and the agent-by-time interaction (p = 0.031) were significant; corresponding adjusted mean BCVA values were 0.721 (95% CI, 0.632–0.810), 0.605 (0.483–0.726), and 0.897 (0.779–1.016) logMAR. IRF decreased over time (p = 0.001), without significant agent or interaction effects. Time-averaged adjusted SRF probability was lower with bevacizumab-bvzr than with bevacizumab and bevacizumab-awwb. No systemic adverse events were documented; ocular adverse-event observations were infrequent. Conclusion: Short-term anatomical and visual outcomes changed during the three-injection loading phase, with adjusted longitudinal trajectories differing for CMT and BCVA. These findings represent exploratory observational associations and do not demonstrate superiority or equivalence among the agents.

Background/Objectives: To evaluate longitudinal structural and vascular changes in the posterior segment following gonioscopy-assisted transluminal trabeculotomy (GATT) in primary open-angle glaucoma (POAG). Methods: This retrospective observational study included 36 eyes of 36 patients with POAG. Examinations were performed at baseline, at 1 week, and at 1, 3, and 6 months. Optical coherence tomography assessed macular layers and peripapillary retinal nerve fiber layer (RNFL) thickness. Enhanced depth imaging-OCT assessed choroidal thickness (CT). Optical coherence tomography angiography (OCTA) provided superficial and deep macular and peripapillary vessel density (VD). Longitudinal changes in visual acuity (VA), intraocular pressure (IOP), retinal and choroidal structure and microvasculature were evaluated. Results: Mean IOP decreased from 19.0 ± 8.3 mmHg to 15.0 ± 3.4 mmHg at 6 months (−20%; p = 0.002). VA showed a significant overall time effect (p = 0.005), characterized by a transient decline at week 1 and subsequent recovery, with no significant difference between baseline and month 6. RNFL thickness varied numerically across visits, without a significant overall time effect (p = 0.504). CT decreased at week 1 and approached baseline values by months 3–6, without a significant overall longitudinal change. No OCTA-derived microvascular parameter remained statistically significant after correction for multiple comparisons. No significant associations were found between IOP reduction and CT or RNFL changes, or between CT and OCTA parameters. Conclusions: GATT was associated with moderate IOP reduction, while no statistically significant short-term changes were detected in posterior segment structural and OCTA-derived microvascular parameters during the six-month follow-up.

Background/Objectives: Age-related macular degeneration (AMD) is a leading cause of irreversible visual impairment, and AREDS2-based nutritional supplementation is recommended for clinically eligible patients to reduce the risk of disease progression. However, successful implementation depends on regular supplement use and sustained adherence. This study investigated demographic, socioeconomic, clinical, and physician-related factors associated with regular AREDS2 supplement use and evaluated medication adherence, physician counseling, and patient-reported barriers among clinically eligible patients with AMD. Methods: In this single-center cross-sectional study, 389 patients with intermediate AMD or advanced AMD in one eye who fulfilled the indications for AREDS2 supplementation were enrolled. Participants reporting occasional supplement use were excluded. A structured interviewer-administered questionnaire was used to collect demographic, socioeconomic, and clinical data, together with information on physician recommendation, medication adherence, patient knowledge, and perceived barriers to supplementation. Factors associated with regular AREDS2 supplement use were evaluated using univariable and multivariable logistic regression analyses, whereas adherence patterns and patient-reported barriers were analyzed descriptively. Results: Of the 389 participants, 273 (70.2%) reported regular AREDS2 supplement use, whereas 116 (29.8%) were non-users. Multivariable analysis showed that younger age, educational attainment, and physician recommendation were independently associated with regular supplement use (adjusted OR for physician recommendation, 5.38; 95% CI, 2.68–10.81; p < 0.001). Among regular users, 53.5% met the study-defined criteria for good medication adherence. The most frequently reported barriers among non-users were financial burden, limited supplement availability, polypharmacy, and insufficient knowledge regarding AREDS2 supplementation. Conclusions: Regular AREDS2 supplement use among clinically eligible patients with AMD was associated with demographic, educational, and physician-related factors, whereas long-term adherence remained suboptimal despite substantial uptake. These findings emphasize the importance of effective physician counseling, structured patient education, and interventions addressing socioeconomic barriers to improve the real-world implementation of evidence-based nutritional supplementation in AMD.

Age-related macular degeneration (AMD) is a leading cause of irreversible visual impairment and is driven by complex genetic, inflammatory, and vascular mechanisms. ABO and Rh blood group antigens, which are expressed on vascular endothelium and involved in immune and hemostatic pathways, have been implicated in various systemic diseases; however, their potential association with AMD phenotypic variation remains unclear. In this cross-sectional study, 488 patients with clinically confirmed AMD from a tertiary referral center were included. AMD was classified as neovascular AMD (wet AMD) or nonneovascular AMD (dry AMD) based on multimodal imaging and standardized diagnostic criteria. ABO and Rh blood group data were obtained from medical records, and individuals with major known AMD risk factors, including smoking, alcohol consumption, and obesity, were excluded to reduce confounding. Associations between AMD subtypes and ABO blood groups and Rh factor were evaluated using the Pearson chi-square test, and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The mean age of participants was 66.9 ± 4.7 years, and 273 patients (55.9%) had neovascular AMD. A statistically significant association was observed between ABO blood group distribution and AMD subtypes (χ² = 8.31, p = 0.040). A higher proportion of patients with neovascular AMD had blood group A, whereas blood group B was relatively more common among patients with nonneovascular AMD. However, individual pairwise crude odds ratio analyses did not demonstrate statistically significant associations for specific ABO blood groups. No association was observed for Rh status. These findings suggest a possible modest association between overall ABO blood group distribution and AMD phenotype; however, the clinical significance of this relationship remains uncertain, particularly in the absence of multivariable adjustment. Larger multicenter studies with comprehensive multivariable analyses are warranted.

To evaluate real-world injection burden, treatment switching patterns, and visual outcomes in patients with diabetic macular edema (DME) receiving intravit

Amaç: Hipotiroidi ve hipertiroidi olgularında korneaların topografik ölçümleri, aberometri ve dansitometrik değerlerini sağlıklı bireylerle karşılaştırmalı olarak incelemek.Gereç ve Yöntem: Bu kesitsel karşılaştırmalı çalışmaya 20 hipotiroidi hastası (grup I), 20 hipertiroidi hastası (grup II) ve yaşları eşleştirilmiş 20 kontrol (grup III) dahil edildi. Pentacam yüksek çözünürlüklü görüntüleme sistemi, kornea topografik ölçümlerini, aberrometriyi ve dansitometriyi belirlemek için kullanıldı.Bulgular: Ortalama yaş grub I, II ve III sırasıyla 42,11±12,84(21-65), 44,52±10,11(20-66), 44,04±8,06 (20-65) yıldı (p =0,091), gruplar arasında anlamlı fark yoktu, 0-2 mm ve 2-6 mm dansitometri değerleri açısından gruplar arasında istatistiksel olarak anlamlı fark bulunamadı (p>0,05). 6-10 mm kornea bölgesinde ön, orta stroma, arka ve total olmak üzere tüm katlarda hipertiroidili grupta kontrol grubuna göre anlamlı düzeyde yüksekti (sırasıyla p=0,002, p=0,001, p=0,002 ve p=0,001). 10-12 mm periferik kornea bölgesinde tüm katlardaki kornea dansitometri değerleri hipertiroidi grubunda hem kontrol grubuna hem de hipotiroidi grubuna göre anlamlı olarak yüksekti (tüm değerler için p

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in individuals over the age of 50. This study aims to evaluate the

We aimed to examine the effect of strabismus surgery on quality of life levels in children and adolescents. The Health-Related Quality of Life Inventory version 4.0 (HRQOL 4.0), consisting of 23 questions and 4 subscales (physical functioning, emotional functioning, social functioning, and school problems), was administered to the children and adolescents who underwent strabismus surgery and their parents between December 2024 and June 2025, at preoperative and postoperative 1st and 3rd months. The postoperative deviation angle of the cases was 10 Prism Diopter (PD) or less. Strabismus surgery was performed by an Ophthalmologist, and the scales were evaluated by a Child and Adolescent Psychiatrist. 27 cases were included in our study. 17 (62.9%) of the cases were girls and 10 (37.1%) were boys. The average age was 9.0 ± 3.9 (7–17) . In child and adolescents, the change in the physical functionality parameters of the cases was not statistically significant (p >0.05), but the change in the parameters of emotional functionality, social functionality and school-related problems between the preoperative, postoperative 1st month and postoperative 3rd month was statistically significant (p < 0.05). In the parents’ proxy opinion of the child, the change in physical functionality, emotional functionality, social functionality parameters between preoperative, postoperative 1st month and postoperative 3rd month was statistically significant (p < 0.05), but in the parameters of school-related problems, preoperative, postoperative 1st month and postoperative 3rd month were statistically significant. The change between was not statistically significant(p >0.05) (Table 2). Successful surgery for strabismus results in measurable improvement in the quality of life in children and adolescents and in the parents proxy opinion of the child’s quality of life.

Diabetic papillopathy is a rare ocular finding in patients with diabetes mellitus. Optic disc edema accompanying minimal visual changes caused by diabetic papillopathy distinguishes it from other optic neuropathies. The pathophysiology of diabetic papillopathy is still not clearly understood. Patients with diabetic papillopathy tend to be asymptomatic, but they may present to the clinic with mild blurred vision. Diagnosis can be made by excluding other possible causes of optic disc swelling. Diabetic papillopathy is essentially a diagnosis of exclusion. For this reason, the differential diagnoses in these patients need to be well known. There are no proven treatment options for diabetic papillopathy. However, since these patients often recover on their own, following the patients without treatment seems to be a reasonable approach for now. Papillophlebitis is a rare condition look like as incomplete central retinal vein occlusion due to optic disc edema and hemorrhages at the disc edge. It typically occurs in young, healthy women with acute, painless unilateral vision loss or blurred vision, optic disc edema, and retinal vein engorgement. Diagnosis is made by excluding other possible causes. There is no evidence-based, accepted treatment method for papillophlebitis.

Purpose: To evaluate the relationship between subfoveal choroidal thickness and plasma asymmetrical dimethylarginine level and the severity of diabetic retinopathy in patients with type 2 diabetes mellitus. Methods: A total of 68 cases, including 15 patients without diabetic retinopathy, 17 patients with nonproliferative diabetic retinopathy, 16 patients with type 2 diabetes mellitus and proliferative diabetic retinopathy, and 20 healthy patients (control group), were enrolled in this study. Subfoveal choroidal thickness was measured manually using the enhanced depth imaging optical coherence tomography scanning program, and plasma asymmetrical dimethylarginine level was measured using a commercial micro enzyme-linked immunosorbent assay kit. Results: The subfoveal choroidal thickness values and plasma asymmetrical dimethylarginine levels were significantly different between the four groups (p<0.001 and p<0.001). The subfoveal choroidal thickness values were significantly lower in the proliferative diabetic retinopathy group than in the other three groups (no diabetic retinopathy, nonproliferative diabetic retinopathy, and control groups; p<0.001, p=0.045, and p<0.001, respectively). The plasma asymmetrical dimethylarginine levels were significantly higher in the proliferative diabetic retinopathy group than in the other three groups (p<0.001, p<0.04, and p<0.001, respectively). In addition, a significant negative correlation was also found between plasma asymmetrical dimethylarginine level and subfoveal choroidal thickness (p<0.001, r=-0.479). Conclusion: Asymmetrical dimethylarginine is an important marker of endothelial dysfunction and endogenous endothelial nitric oxide synthase inhibitor. The severity of diabetic retinopathy was related to increased plasma asymmetrical dimethylarginine level and reduced subfoveal choroidal thickness in type 2 diabetic patients with diabetic retinopathy.