Şenol Sabancı

Many factors influence pupil diameter, including ocular surgery. The purpose of this study was to investigate the effects of strabismus surgery performed through a limbal incision on static and dynamic pupillometry. Static and dynamic pupillometry measurements were made and compared in 32 eyes of 32 patients who were scheduled to undergo horizontal muscle recession and resection through a limbal incision in one eye preoperatively and postoperatively on 10 day and at months 1 and 3. All postoperative scotopic pupil diameter measurements of the cases were found to be significantly higher than the preoperative scotopic pupil diameter (p = .0027). In the dynamic pupillometry analysis, a significant difference was found between preoperative and postoperative day 10 and month 1 pupil diameter values of the cases for the measurements taken at seconds 1 and 2 and (p¹=0.0033, p²=0.0039, and p⁵=0.0238). No significant difference was found between preoperative and postoperative values for dynamic pupillometry pupil dilation velocities at any evaluation point. We believe that after strabismus surgery, the balance between the parasympathetic and sympathetic nervous systems, which determine the pupil diameter, is disrupted to the detriment of the parasympathetic nervous system.

Retinitis pigmentosa (RP) is a group of inherited diseases in which abnormalities in the photoreceptor cells (rods and cones) of the retina cause progressive vision loss over time. Currently, there are nearly 100 genes reported to be associated with RP. Genetic testing has become indispensable in the diagnosis and management of RP due to the clinical variability of the disease, phenotypic similarity with many inherited retinal dystrophies, the approval of gene therapy for RPE65-related inherited retinal dystrophies, and ongoing studies for a number of genes. Genetic testing also provides the most accurate information on prognosis, screening for the patient's family and subsequent generations, and facilitates genetic counseling. Although RP is the most common cause of inherited retinal dystrophies, a clear treatment modality has yet to be defined. In this review, we will describe genetic diagnostic methods and different treatment protocols in retinitis pigmetosa with their advantages and disadvantages.

Background/Objectives: To investigate the effect of strabismus surgery on ocular surface parameters, meibomian glands, and conjunctival impression cytology. Methods: Preoperative and postoperative (10th day, first month, and third month) tear break-up time (TBUT) tests, Schirmer 1 tests, corneal staining scores (CSS), meibomian gland (MG) loss rates, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (IC) results of 30 patients who underwent strabismus surgery were compared. Results: Significant differences were found between preoperative TBUT test results and those evaluated on the postoperative 10th day and at the postoperative first month (p < 0.0001 for both). There were also significant differences between the preoperative and postoperative first- and third-month Schirmer 1 test results (p = 0.02 and p < 0.0001, respectively). Furthermore, mean OSDI scores significantly differed between preoperative and postoperative 10th-day measurements (p < 0.0001). The mean postoperative 10th-day CSS was found to be significantly higher than the preoperative mean CSS (p < 0.0001). The stages in preoperative conjunctival IC samples were found to be significantly lower than those evaluated at all postoperative times (p < 0.0001 for all). Significant differences were observed between the preoperative lower eyelid MG loss rate and all postoperative MG loss rates (p < 0.0001 for the 10th day and first month and p < 0.001 for the third month). Lastly, the preoperative upper eyelid MG loss rate significantly differed from all postoperative MG loss rates (p < 0.0001 for the 10th day, p < 0.003 for the first month, and p < 0.0001 for the third month). Conclusions: We observed changes indicative of dry eye in the mean OSDI score, TBUT, Schirmer 1 test, MG loss rates, and conjunctival IC findings up to the postoperative third month in patients who underwent strabismus surgery. Therefore, we believe that patients undergoing strabismus surgery should be followed up for ocular surface diseases, particularly dry eye.

Background/Objectives: To evaluate the meibomian gland (MG) morphology and ocular surface parameters of children with atopic dermatitis (AD) without ocular symptoms. Materials and Method: Forty-five eyes of 24 children with AD and 44 eyes of 27 healthy children were included in the study. Upper and lower eyelid meibography measurements were performed for all cases and the rate of MG loss and the amount of tortuosity were evaluated. A Schirmer 1 test, tear break-up time (TBUT) test, and corneal staining scoring (CSS) were applied to all cases. Results: MG loss in the upper eyelid was 15.51 ± 10.39% in the AD group, while it was 9.30 ± 5.30% in the control group (p = 0.002). MG loss in the lower eyelid was 15.79 ± 10.93% in the AD group, while it was 9.23 ± 6.90% in the control group (p = 0.002). The rate of tortuosity in 26–50% of the upper and lower eyelid MGs was significantly higher in the AD group than in the healthy control group (p = 0.002 and p = 0.007, respectively). The Schirmer 1 test values were 10.98 ± 3.89 in the AD group and 17.41 ± 3.73 in the healthy control group (p < 0.0001). The TBUT values were found to be 9.18 ± 1.99 in the AD group and 11.40 ± 1.82 in the healthy control group (p < 0.0001). The CSS result was found to be significantly higher in the AD group than in the control group (p = 0.001). Conclusions: Significant MG loss was detected in patients with AD without eye complaints, which may cause the early deterioration of ocular surface parameters. We believe that close follow-up examinations of children with AD in terms of ocular surface complications may be necessary.

Background: This study aims to evaluate the quantitative changes in retinal nerve fiber layer (RNFL) thickness and radial peripapillary capillary (RPC) vessel density in patients with chronic central serous chorioretinopathy (CSCR), specifically excluding the peripapillary region. Methods: A prospective case–control study was conducted at the Antalya Training and Research Hospital, Health Sciences University, involving 65 patients with chronic CSCR. Participants were categorized into two groups based on the presence or regression of subretinal fluid (SRF). A control group of age- and sex-matched healthy individuals was also included. Optical coherence tomography angiography (OCTA) was used to assess RNFL thickness and RPC vessel density. Statistical analyses were conducted using SPSS, with non-parametric tests employed for between-group comparisons. Results: Patients with persistent SRF exhibited significant increases in RNFL thickness in the inferior and nasal quadrants compared to healthy controls (p = 0.003 and p = 0.014, respectively). Additionally, RPC vessel density in the small vessel disc area (%) was significantly lower in the persistent SRF group compared to controls (p = 0.021). A significant negative correlation was found between nasal quadrant RNFL thickness and small vessel disc area (p = 0.014, r = −0.306). Conclusions: Chronic SRF in CSCR patients, even when not involving the peripapillary region, leads to significant structural changes in both the neural and vascular components of the retina. These findings suggest that SRF contributes to broader retinal alterations and supports the need for early detection and management of CSCR to prevent long-term visual impairment.

This study aims to evaluate the frequency of hemorrhagic complications and identify potential risk factors in premature infants treated with intravitreal bevacizumab for retinopathy of prematurity (ROP). By addressing these gaps, we aim to enhance clinical decision-making and optimize treatment protocols in this vulnerable population. Methods: This retrospective study analyzed data from 132 premature infants treated with intravitreal bevacizumab for ROP. Hemorrhagic complications were categorized as preretinal or intravitreal based on clinical examination findings: preretinal hemorrhages were defined as bleeding confined to the ROP ridge and not exceeding two optic disc diameters, while intravitreal hemorrhages were defined as bleeding extending beyond two optic disc diameters into the vitreous cavity. Demographic and clinical variables, including gestational age, birth weight, maternal age, NICU length of stay, and the timing of anti-VEGF administration, were collected. Patients with pre-existing hemorrhages prior to treatment were excluded. Statistical analyses included descriptive methods, univariate comparisons, and binary logistic regression to identify independent risk factors for hemorrhagic complications. Results: Hemorrhagic complications were observed in 23 (17.4%) of the patients, with 91.3% being preretinal hemorrhages and 8.7% intravitreal hemorrhages. NICU length of stay was significantly longer in patients with bleeding (62.23 ± 12.87 days) compared to those without bleeding (45.78 ± 16.74 days, p < 0.0001). Logistic regression identified prolonged NICU stay as an independent risk factor for hemorrhagic complications, with each additional day increasing the risk by 5.1% (p = 0.008, OR = 1.051). Gestational age, birth weight, maternal age, and timing of anti-VEGF administration were not significantly associated with bleeding risk. Conclusions: This study highlights the significant role of NICU length of stay in increasing the risk of hemorrhagic complications in premature infants treated with intravitreal bevacizumab. The findings underscore the importance of comprehensive risk assessments, including preretinal hemorrhages, in optimizing treatment protocols. Future multicenter, prospective studies are warranted to validate these findings and refine safety strategies for ROP management.

Background and Aims: This study aims to evaluate the quantitative changes in retinal nerve fiber layer (RNFL) thickness and radial peripapillary capillary (RPC) vessel density in patients with chronic central serous chorioretinopathy (CSCR), specifically excluding the peripapillary region. Methods: A prospective case-control study was conducted at the Antalya Training and Research Hospital, Health Sciences University, involving 65 patients with chronic CSCR. Participants were categorized into two groups based on the presence or regression of subretinal fluid (SRF). A control group of age- and sex-matched healthy individuals was also included. Optical coherence tomography angiography (OCTA) was used to assess RNFL thickness and RPC vessel density. Statistical analyses were conducted using SPSS, with non-parametric tests employed for between-group comparisons. Results: Patients with persistent SRF exhibited significant increases in RNFL thickness in the inferior and nasal quadrants compared to healthy controls (p = 0.003 and p = 0.014, respectively). Additionally, RPC vessel density in the small vessel disc area (%) was significantly lower in the persistent SRF group compared to controls (p = 0.021). A significant negative correlation was found between nasal quadrant RNFL thickness and small vessel disc area (p = 0.014, r = -0.306). Conclusions: Chronic SRF in CSCR patients, even when not involving the peripapillary region, leads to significant structural changes in both the neural and vascular components of the retina. These findings suggest that SRF contributes to broader retinal alterations and supports the need for early detection and management of CSCR to prevent long-term visual impairment.

PurposeTo compare the results of intravitreal bevacizumab (IVB) monotherapy and combined intravitreal bevacizumab and laser photocoagulation (LPC) therapies applied in the same session to patients with aggressive retinopathy of prematurity (A-ROP) in our clinic.MethodsThe study included 67 eyes of 37 patients diagnosed with A-ROP and treated. Forty-nine eyes treated with anti-vascular endothelial growth factor agent injection monotherapy for A-ROP treatment were included in the first group. The second group consisted of 18 eyes that received injection therapy and LPC treatment. The clinical findings of the two groups were investigated, and their treatment results were compared.ResultsRecurrence was observed in 19 of the 49 (38%) eyes in the first group, but there was no recurrence in any of the cases in the second group. While only IVB was applied to eight cases with recurrence, the combination of LPC and IVB treatment was applied to 11 cases. A second recurrence was detected in two of the eight cases that had received IVB monotherapy as a treatment for recurrence and in three of the 11 cases that had received LPC and IVB. The treatment outcomes of the two groups did not statistically significantly differ (P = 0.181).ConclusionWe consider that the combined simultaneous LPC and IVB treatment we applied in A-ROP cases is an effective approach, particularly for cases where there are concerns about the patient's ability to attend follow-up appointments.

Introduction: Dry eye is a prevalent public health issue among the geriatric population. When accompanied by blepharoptosis, it carries the potential for complications. Materials and Method: The study involved the evaluation of dry eye survey scores, dry eye tests, and the structure of meibomian glands by meibography in 25 cases of unilateral blepharoptosis. Comparisons were made between ptotic and non-ptotic eyes. In addition, measurements of levator function, palpebral fissure distance, and margin reflex distance were recorded for both ptotic and non-ptotic eyes, and the relationships between these parameters were analyzed. Results: No significant differences were found between the ptotic and non-ptotic eyes in terms of tear break-up time, Schirmer 1 test results, or meiboscores in cases of unilateral blepharoptosis. However, the non-ptotic upper eyelids showed a greater area of loss in the meibomian glands compared to the ptotic eyelids. Conclusion: In cases of unilateral blepharoptosis, while a reduction in dry eye parameters was observed bilaterally, an increase in the degree of ptosis was associated with a bilateral decrease in tear production. No significant difference was found between the ptotic and non-ptotic upper eyelids in terms of meiboscores. Blepharoptosis does not appear to cause significant alterations in the meibomian glands. Keywords: Blepharoptosis; Dry Eye; Meibomian Gland Dysfunction.