Fatma Selin Kaya

This study evaluated the association between admission Aggregate Index of Systemic Inflammation (AISI) and complicated clinical course in surgically managed patients with sinusitis-related subperiosteal orbital abscess (SPOA). Thirty-four patients with sinusitis-related SPOA who underwent surgical drainage in addition to systemic antibiotic therapy between June 2020 and January 2026 were retrospectively reviewed. A complicated clinical course was defined as the occurrence or persistence of an intracranial complication and/or requirement for repeat surgical intervention after initial drainage during the same hospitalization. AISI, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, C-reactive protein, white blood cell count, and absolute neutrophil count were evaluated. A complicated clinical course occurred in 8 patients (23.5%); 5 developed intracranial complications, 5 required repeat surgical intervention, and 2 met both criteria. AISI was significantly higher in the complicated group than in the uncomplicated group (median: 3869 versus 1364; P =0.021), whereas other inflammatory markers did not differ significantly. AISI showed the highest numerical area under the receiver operating characteristic curve among the evaluated markers (AUC: 0.774; 95% CI, 0.596–0.953). A cutoff value of ∼1800 yielded 87.5% sensitivity and 69.2% specificity, although superiority over other markers was not statistically significant on DeLong testing. Admission AISI may serve as an adjunctive, hypothesis-generating marker for early risk stratification in surgically managed sinusitis-related SPOA.

: Purpose: Evaluation of patients with acute dacryocystitis according to their demographic characteristics and seasonal distribution and to report our results of external dacryocystorhinostomy (EX-DCR) applied to these patients. Method: A retrospective study was conducted on 44 patients who underwent EX-DCR after antibiotic therapy due to acute dacryocystitis between September 2021 and November 2024. Patients who had previously undergone EX-DCR, had a history of facial trauma, and were under the age of 18 were not included in the study. Results: 33 (75%) of 44 patients were females. The age range of the patients was minimum 18 and maximum 85 years, the average age was 55.8 ± 17.1 years. Laterality ratio was 20 (45.5%) in the right eye and 24 (54.5%) in the left eye. 8 (18.2%) of the patients had their dacryocystitis attack in October, and 7 (15.9%) in July. No complaints of epiphora were observed in 39 (88.6%) of the patients to whom we performed EX-DCR surgery. Conclusion: Acute dacryocystitis predominantly affects female patients, with seasonal variation suggesting a possible link to environmental factors. (EX-DCR) with bicanalicular silicone tube intubation demonstrated a high success rate in resolving symptoms in patients with nasolacrimal duct obstruction.

Purpose: To report a rare case of vision loss from Erdheim-Chester Disease (ECD) and long term, follow up, management and results. Case Report: A 62-year-old woman presented with bilateral exophthalmos and deterioration in visual acuity of both eyes. Magnetic resonance imaging studies revealed bilateral intraconal orbital tumors. She was diagnosed optic neuropathy in both eyes. The patient was treated with pegylated interferon and systemic pulse steroid. However, recurrences were common. Subsequently, the patient underwent regular corticosteroid injection directly into the retro-orbital region of both eyes monthly, which led to intermittent improvement of vision. At the 8th month of visual impairment, Vemurafenib was initiated. Results: The visual acuity and visual field scores were stable for 6 years during the follow-up. No major complication was observed. Conclusion: Combined vemurafenib and perioculer steroid injection is a well tolerated therapy with less systemic adverse effects which may benefit patients with orbital involvement of ECD. Key words: Erdheim–Chester disease; compressive optic neuropathy; vemurafenib; Optical coherence tomography; Optical coherence tomography angiography. Received: 14 March 2024 Accepted after revision: 28 August 2024 Accepted Manuscript online: 29 August 2024 © . Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

A 58 year-old male patient presented with fluctuating vision in right eye. Dilated fundus examination on presentation showed wavy choroidal folds and cotton wool spots in the posterior pole of right eye.

Purpose In order to analyze the data and retinal microvasculature for non-arteritic anterior ischemic optic neuropathy (NAION), patients were referred to have carotid Doppler ultrasound (CDU) from 2016 to 2020. Methods In this case–control observational study, 30 NAION patients were evaluated with CDU. Twenty-two NAION patients (at least 3 months after the onset of symptoms) and 9 normal subjects underwent a complete ophthalmic examination including optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A). NAION eyes and fellow eyes were further divided into two groups based on the presence of carotid stenosis (CS). NAION patients with CS were termed “CS-NAION”; and those without CS were termed “NCS-NAION.” Measurements of radial peripapillary capillary vessel density (RPC VD), ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) thicknesses were compared among groups. Results Fourteen of 30 NAION patients referred to have carotid Doppler were positive for CS with each one of such referrals having less than 50% stenosis. RNLF, GCC and RPC VDs were reduced in NAION patients’ eyes, when compared to controls and the fellow eyes. RPC VD was significantly lower in the temporal-superior (P = 0.037) and the superior-temporal (P = 0.012) sectors of the NCS-NAION patients than in the CS-NAION patients. No significant differences were found between CS-fellow eyes and NCS-fellow eyes in terms of RPC VDs, RNLF or GCC. Conclusion Results of the study highlight the effect of the carotid artery stenosis on ocular perfusion pressure in the pathogenesis of NAION. More extensive studies are necessary.

Purpose The objective of this study was to investigate the optic nerve’s elastic properties and optic nerve sheath diameter (ONSD) using shear-wave elastography (SWE) in patients with idiopathic intracranial hypertension (IIH) compared to healthy individuals. Methods The study included 22 IIH patients and 15 healthy subjects. SWEs were performed on the optic nerve and ONSD, and optic nerve stiffness were measured. Results The patients with IIH demonstrated higher stiffness of the optic nerve compared with that of healthy volunteers (P < 0.001). The optic nerve sheath diameter of the optic nerve in the IIH group was significantly larger than that in the control group (P < 0.001). There was no correlation between the disease duration and SWE values in the Spearman correlation test. Conclusion These findings suggest that ONSD can be used as a follow-up method in the treatment of IIH. However, there was not any correlation between the disease duration and SWE-based stiffness measurement of the optic nerve.

Purpose: To analyze the data and retinal microvasculature for nonarteritic anterior ischemic optic neuropathy (NAİON) patients referred to have carotid Doppler ultrasound from 2016 to 2020. Methods: In this case-control observational study, 30 NAİON patients evaulated with carotid doppler sonography. 22 NAION patients (at least 3 months after onset of symptoms) and 9 normal subjects underwent a complete ophthalmic examination including optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A). NAİON eyes and fellow eyes were further divided into the groups according to presence of carotid stenosis (CS). NAION patients with CS were termed "CS-NAION"; those without were termed "NCS-NAION". Measurements of radial peripapillary capillary vessel density (RPC VD) and ganglion cell complex (GCC), disk retinal nerve fiber layer (RNFL) thickness were compared among groups. Results: Fourteen of 30 NAİON patients referred for carotid Doppler were positive for CS with all of such referrals having less than 50% stenosis. RNLF, GCC and RPC VDs were reduced in NAION eyes, when compared to controls and the fellow eyes. RPC VD was significantly lower in the temporal-superior (P=0.037) and the superior-temporal (P=0.012) sectors of the NCS-NAION patients than in the CS-NAION patients. No significant differences were found between CS-fellow eyes and NCS-fellow eyes in terms of RPC VDs, RNLF or GCC. Conclusion: Results of the study highlight the effect of carotid artery stenosis on ocular perfusion pressure in the pathogenesis of NAİON. More extensive studies are necessary.