Irem Onal

Purpose To evaluate the effect of topical insulin eye drops in promoting epithelial healing in patients with neurotrophic keratopathy (NK) and persistent epithelial defects (PED), and to assess their impact on corneal sensitivity as an indicator of neurotrophic function. Methods This retrospective study included 24 patients with PED unresponsive to standard medical and surgical treatment. Patients received topical insulin eye drops (1 IU/mL) every six hours for one month. Corneal sensitivity, measured with Cochet-Bonnet esthesiometer, and PED size were recorded at baseline, and at 1st, 2nd week and 1st month after treatment initiation. Results The most common underlying etiology was epithelial debridement during vitrectomy and NK due to herpes simplex virus (n=6, 25.0% each), followed by chemical injury (n=4, 16.6%). While the initial epithelial defect area was 16.23±11.23 mm², the defect area at 1 month after initiating insulin eye drops was 0.63±1.27 (p=0.0019). Corneal sensitivity values showed improvement in all quadrants one month post-treatment (central, p=0.002; superior, ppp=0.002; temporal, p=0.001). Following treatment, recurrence was noted in 2 cases, while 6 patients showed a partial response. In 3 of these partial responders, isolated hyperkeratinized epithelial islands were identified. The mean duration of insulin drop use was 45.6±15.3 days, and the mean time to complete epithelial defect closure was 22.7±12.8 days. A mean total follow-up duration was 172.0 ± 71.7 days. Conclusion Topical insulin promotes epithelial healing in PED and may improve functional corneal sensitivity, potentially reflecting enhanced corneal neurotrophic function. Its accessibility and favorable safety profile make it a promising therapeutic option.

Purpose To investigate the relationship between axial length (AL) and corneal sensitivity (CS) in healthy pediatric eyes and to establish preliminary corneal sensitivity reference values across different AL groups. Methods This prospective, cross-sectional study included 353 children aged 5–18 years. AL was categorized into four groups: ≤22 mm, 22.01–23.99 mm, 24.0–25.99 mm, and ≥ 26 mm. CS was assessed in five corneal quadrants (central, superior, inferior, nasal, temporal) using a Cochet–Bonnet esthesiometer. Subgroup analyses were performed according to age groups. Non-parametric statistical analyses were applied to compare sensitivity values among AL groups. Results CS differed significantly across AL groups in all measured quadrants (overall p-values: central p = 0.005; superior p = 0.009; inferior p < 0.001; nasal p < 0.001; temporal p < 0.001). In eyes with AL≥26 mm, corneal sensitivity was significantly reduced in all quadrants compared with the AL≤22 mm group (all p ≤ 0.002). However, not all pairwise comparisons reached statistical significance, particularly those involving the 22.01–23.99 mm and 24.0–25.99 mm groups. Spearman correlation demonstrated a weak negative association between AL and CS across all quadrants (r = − 0.125 to − 0.212, p = 0.019 to < 0.001). In the primary adjusted model including age, sex, and CCT, AL remained independently associated with lower corneal sensitivity across all corneal quadrants. Conclusion In pediatric eyes, CS differed across AL groups and was lower in eyes with AL≥26 mm. This association remained evident after adjustment for age, sex, and CCT; however, given the uneven distribution of age-stratified subgroups, these findings should be interpreted with caution. These results provide preliminary reference data for pediatric corneal sensitivity and suggest that axial elongation may be associated with alterations in corneal sensory function.

To compare visual, refractive, and anatomical outcomes of lens extraction with Cionni ring and in-the-bag intraocular lens (IOL) implantation and Yamane in

Purpose The aim was to evaluate the effects of anti-VEGF and dexamethasone (DEX) implants on choroidal vascular structures in eyes with branch retinal vein occlusion (BRVO). Methods Eyes with temporal BRVO, unaffected fellow eyes, and age- and gender-matched healthy control eyes were retrospectively analyzed. Swept-source optical coherence tomography (SS-OCT) images were collected initially and at the 12-month follow-up visit. Choroidal vascularity index (CVI), choroidal thickness (CT), and central macular thickness (CMT) were measured. Demographic characteristics, treatment modalities, and best-corrected visual acuity (BCVA) were recorded. Results The study involved 305 eyes: 104 with BRVO, 104 healthy fellow eyes, and 97 eyes from healthy controls. Initially, BRVO eyes had lower CVI than fellow eyes and controls (p = 0.032, p = 0.001, respectively). CT was lower in BRVO eyes compared to fellow eyes and controls. Among BRVO eyes, 50 received DEX implants, 54 received anti-VEGF treatment. Significant CVI decrease at 12 months was seen in the anti-VEGF group (p = 0.014), while it remained similar in the DEX implant group (p = 0.619). No difference was observed among anti-VEGF agents. Conclusion The study primarily showed how different treatment approaches affected choroidal parameteres in a condition largely triggered by hypoxia. It suggested the use of CVI as a prognostic indicator to monitor anti-VEGF drug treatment in BRVO patients.

Purpose: Investigation of the relationship between blepharitis-related symptom scores, tear film functions, and conjunctival microbiota in patients with ocular rosacea (OR) compared with healthy controls was aimed. Methods: Consecutive 33 eyes of 33 patients with OR who were admitted from the dermatology clinic and age-matched and gender-matched 30 healthy controls were included in the study. Tear breakup time (TBUT), Schirmer score, and blepharitis symptom score (BLISS) were recorded for each patient. For the bacteriological examination, bacterial culture was obtained by inoculating the samples on chocolate agar, blood agar, and fluid thioglycollate medium. The growth of different colonies of bacteria was identified using matrix-assisted laser desorption or ionization time-of-flight mass spectrometry. Results: Bacterial culture positivity was observed in 13 eyes (39.4%) in the patients with OR and 10 eyes (33.3%) in the controls (P=0.618). Patients with OR showed worse TBUT and Schirmer scores, and higher BLISSs (P=0.005, P=0.007, and P=0.001, respectively). Patients with OR with conjunctival culture-positive results showed higher BLISSs (8.0±4.7) compared with those with negative results (4.7±2.3; PMicrococcus luteus (18.2%) in patients with OR and Staphylococcus epidermidis (20.0%) in the controls. Conclusion: This pilot study showed that patients with OR had similar conjunctival culture positivity compared with healthy controls. However, the observation of different dominant bacterial species in conjunctival microbiota and the observation of worse BLISSs in patients with OR with positive culture might suggest a potential role of conjunctival microbiota in the pathogenesis of OR.