Aslıhan Yılmaz Çebi

Ficus carica (fig) has long been used in traditional medicine, but its effects on the eye remain largely undocumented in the scientific literature. This case series describes four patients who developed ocular surface reactions following exposure to raw fig milk. Two patients applied fig milk directly to their eyes for relief of ocular discomfort; one used it on the periocular area, and one was exposed accidentally while harvesting figs. All patients presented within 24 h of exposure and were examined with slit-lamp biomicroscopy and fluorescein staining. Findings included eyelid edema, conjunctival hyperemia, follicular conjunctivitis, and punctate epitheliopathy, with no significant corneal involvement. Treatment with topical corticosteroids (loteprednol for the ocular surface and hydrocortisone for periocular skin) and artificial tears led to full recovery within 2 weeks without complications. These cases underscore the potential ocular hazards of fig milk despite its traditional use, highlighting the need for public awareness and further clinical research into its safety and applications in ophthalmology.

To investigate the ophthalmic characteristics of patients with spinal muscular atrophy (SMA). Clinical and refractive features of genetically confirmed SMA patients were assessed retrospectively. Three groups were established based on disease type, excluding patients with concurrent eye disease or those with unreliable measurements due to systemic conditions. The study enrolled patients with SMA type 1 (n = 18), SMA type 2 (n = 16), and SMA type 3 (n = 14). Gender distribution showed nine males and nine females in type 1, ten males and six females in type 2, and ten males and four females in type 3, with no significant difference (p = 0.456). Average ages were 2.67 ± 1.03 for type 1, 6.69 ± 3.72 for type 2, and 11.21 ± 5.48 for type 3. SMA Type 1 exhibited a higher hyperopia frequency than the other groups (p = 0.009), while SMA type 2 had a higher myopia prevalence (p = 0.007). No significant differences were found in astigmatism distributions (p = 0.887 and p = 0.778). Best-corrected visual acuity was comparable between type 2 and type 3 (p = 0.304). One type 1 patient had esotropia, and one type 2 patient had exotropia. Three SMA type 1 patients had optic atrophy, and no patients exhibited associated retinal findings. Individuals with SMA may encounter refractive issues, strabismus, and optic atrophy. Patients' refractive conditions seem to differ based on the disease type, potentially linked to the illness's pathophysiology and age group. Comprehensive research with larger sample sizes and control groups is essential for a more profound understanding.

To retrospectively analyze long-term outcomes of pediatric pars planitis (PP). PP was defined as vitreal inflammation with snowbank or snowball formation in the absence of a related disease. Eighty-five eyes of 44 patients were included in this study. Demographic and clinical characteristics were obtained from medical records. Approximately 70% of the patients were males; the mean patient age was 10.4 ± 3.6 years at presentation, and the mean follow-up time was 42.8 ± 27.9 months. At presentation, the mean best corrected visual acuity (BCVA, logMAR) was 0.17 ± 0.27 in the right eyes and 0.27 ± 0.33 in the left eyes. Common symptoms included blurry vision (29 eyes, 65%), redness (17, 38%), pain (8, 18%), and floaters (5, 11%). Sight-threatening complications included optic disc edema/hyperemia (26, 30%), cataracts (16, 18%), macular edema (16, 18%), and glaucoma (15, 17%). All 38 patients who initially required systemic treatment received corticosteroids. During the follow-up, 24 patients were treated with azathioprine, 20 with methotrexate, 11 with cyclosporine, 20 with adalimumab, and 8 with infliximab. At the final examination, the mean BCVA of the right and left eyes improved significantly (0.08 ± 0.23 and 0.06 ± 0.17, p = 0.006 and p < 0.001, respectively). The severities of vitritis, anterior chamber inflammation, snowbank/snowball formation, and endotheliitis decreased (all p < 0.001). Thirty-one patients remained on systemic treatment, with only four patients still receiving corticosteroids. No life-threatening adverse effects were reported. Despite pediatric PP's mild course, severe vision-threatening complications can occur. Immunomodulatory or biologic agents are important for controlling inflammation and tapering corticosteroids. Further research could enhance understanding of optimal treatments.

Purpose: This study aimed to investigate the long-term effects of COVID-19 on corneal endothelial cell morphology in patients with ocular symptoms to assess possible corneal involvement in patients who recovered. Methods: The COVID-19 group included patients diagnosed and treated at Istanbul University Cerrahpasa Medical Faculty with confirmed SARS-CoV-2 infection and ocular irritation symptoms. The control group was comprised of age- and sex-matched individuals. The controls had no ocular pathologies. Noncontact specular microscopy (Konan Cell Check SL, Hyogo, Japan) was performed using the center method after 156 ± 16 days of COVID-19 diagnosis. Parameters such as endothelial cell density (ECD), hexagonality (HEX), coefficient of variation, and central corneal thickness were analyzed. Results: Specular microscopy results of 54 COVID-19 patients with ocular irritation symptoms and 72 controls were evaluated. Ocular symptoms in COVID-19 patients included conjunctival hyperemia, foreign body sensation, tearing, ocular secretion, and chemosis. Mean (±SD) ECD was 2770 ± 31 (cells/mm²) in the COVID-19 group and 2897 ± 26 in the control group, and mean (±SD) HEX was 46.52 ± 6.38 in the COVID-19 group and 58.22 ± 13.94 in the control group. COVID-19 patients exhibited significantly lower endothelial ECD and HEX levels than controls (P = 0.003 and P < 0.001, respectively). Coefficient of variation and central corneal thickness analyses did not reach statistical significance. Conclusions: COVID-19 can cause long-term alterations in the corneal endothelial cells, leading to decreased ECD and HEX. Future research should focus on the long-term implications of COVID-19 on the corneal health and visual outcomes.

Purpose: We aimed to analyze retinal microvascular parameters, measured by optical coherence tomography angiography in patients with internal carotid artery stenosis compared to healthy individuals. Materials and Methods: A total of 41 eyes from 30 patients who had varying degrees of carotid stenosis, and 42 eyes from 42 healthy controls, were enrolled in this study. Depending on the degree of stenosis evaluated by Doppler ultrasonographic imaging, the patient group was further subclassified into mild, moderate, and severe carotid artery stenosis. Superficial and deep capillary plexus vessel densities, radial peripapillary capillary vessel density, foveal avascular zone, and flow densities in the choriocapillaris and outer retina were evaluated by optical coherence tomography angiography. Results: The superficial and deep capillary plexus vessel densities were significantly reduced among the groups, only sparing the foveal region. The mean superficial plexus vessel density was 45.67 ± 4.65 and 50.09 ± 4.05 for the patient and control group, respectively (p = 0.000). The mean deep capillary plexus density was 46.33% ± 7.31% and 53.27% ± 6.31% for the patient and control group, respectively (p = 0.000). The mean superficial and deep capillary vessel densities in the foveal region did not show any statistical difference between the patient and control groups (p = 0.333 for the superficial and p = 0.195 for the deep plexus vessel density). Radial peripapillary capillary vessel density was decreased in the patient group (p = 0.004). The foveal avascular zone area was wider in the patient group but this difference did not show a significant difference (p = 0.385). Conclusions: Retinal microvascular changes are a prominent outcome of internal carotid disease, and even mild stenosis can lead to alterations in the retinal microvascular bed which could be detected by OCTA. By early detection of microvascular changes in the retina in this patient group, we might speculate the overall vascular condition.

COVID19’da Akut Maküler Nöroretinopati ve Parasantral Akut Orta Makülopati Birlikteliği

COVID19 Hastalığından Sonra Retinal Mikrovasküler Bozulmanın ve Klinik Birlikteliklerinin Optik Koherens Tomografi Anjiyografi ile Değerlendirilmesi

Purpose To compare macula vascular parameters in optical coherence tomography angiography (OCTA) of children with history of retinopathy of prematurity (ROP) who were treated with laser photocoagulation (LPC) or intravitreal Bevacizumab therapy. Methods Forty eyes of 28 ROP children treated with LPC and 36 eyes of 22 ROP children treated with intravitreal Bevacizumab and 40 eyes of 40 age-gender matched term children were included the study. Capillary plexus densities in macula, FAZ parameters, outer retina and choriocapillaris flow rates, and central foveal thickness were measured. Results Foveal superficial and deep capillary plexus densities were found significantly higher in LPC and intravitreal Bevacizumab injection (IBI) groups compared to control group. FAZ area was found significantly lower in LPC and IBI groups compared to control group (p ‹ 0.001). Higher foveal superficial capillary plexus density, higher central foveal thickness, and lower FAZ area were found to be associated with poorer visual acuity in correlation analysis (p ‹ 0.05). In IBI group, earlier anti-VEGF therapy was found to be associated with lower foveal superficial capillary plexus density. Conclusion Microvascular characteristics such as FAZ area and capillary plexus densities of macula are deteriorated in ROP. There is no significant difference between the treatment alternatives of ROP in terms of macular microvascular parameters.

The aim is to report a case of bilateral macular edema after COVID-19 pneumonia.A 66-year-old male patient with history of COVID-19 pneumonia presented to us with decreased vision. Examination show...