Objectives: This study aimed to investigate the relationship between nasal septal deviation and paranasal abnormalities in the etiology of primary acquired nasolacrimal duct obstruction (PANDO). Methods: A total of 37 (8 men, 29 women) patients (48 eyes with PANDO) between the ages 20 and 77 years (mean age, 52.8 ± 13.1 years) were included in the study. In the axial sections of paranasal sinus computed tomography, the transverse diameters at the most upper part and the most distal part of the nasolacrimal canal were separately measured. In addition, the relationships between PANDO and nasal septal deviation, inferior turbinate hypertrophy, agger nasi cells, paradoxical middle turbinate, concha bullosa, and the angle between the bony inferior turbinate and medial wall of the maxillary sinus were investigated. Results: A statistically significant relationship was found between PANDO and the axial location of septal deviation classification, axial angle of septal deviation classification, paradoxical middle turbinate, angle between the bony inferior turbinate and medial wall of the maxillary sinus and inferior meatus measure. Conclusion: The authors concluded that the location and angle of the nasal septal deviation in the axial plane, width of the angle between the bony inferior turbinate and medial wall of the maxillary sinus, inferior meatus measure, and paradoxical middle turbinate may be effective factors in the etiology of PANDO.

Purpose: To compare the morphological features of the bony nasolacrimal canal (NLC) in Caucasian adults with and without primary acquired nasolacrimal duct obstruction (PANDO).Methods: The study included one eye each from 38 patients with PANDO and 38 age- and gender-matched controls without PANDO, all of whom underwent multidetector computed tomography. In tomographic images, length, and orientation angles of the NLC, transverse canal diameters at the duct entrance and lower end, and minimum (narrowest) transverse and anterior-posterior canal diameters were measured. Results: The two groups were similar for NLC length and angulations. The transverse entrance diameter was significantly narrower in the PANDO group (mean, 4.6 mm vs. 5.1 mm) (p = 0.09). The narrowest site was most frequently in the middle duct or slightly above the middle in both groups (p > 0.05). The minimum canal diameters were significantly smaller in the PANDO group (p = 0.010 and p = 0.003). When gender subgroups were compared, the significant differences continued for the transverse entrance and minimum diameters in females with PANDO (p = 0.006) and for the minimum anterior-posterior diameter in males with PANDO (p = 0.02). Conclusion: Narrowness of the bony NLC may play a role in the etiopathogenesis of PANDO in adult Caucasians.

Objectives: This study was designed to investigate the long-term effects of intravitreal anti-vascular endothelial growth factor (VEGF) injections on ocular surface and anterior segment parameters. A comparison was performed of the treated eye and the fellow healthy eye. Methods: The study group included patients who had received at least 3 intravitreal injections of anti-VEGF agents (bevacizumab, ranibizumab, or aflibercept) for retinal vascular disorders. All of the subjects were treated in only 1 eye. A complete ophthalmological examination, including evaluation of tear break-up time (TBUT), the Schirmer 1 test, the Oxford Grading Scale, and the Ocular Surface Disease Index (OSDI) questionnaire, corneal topography, and specular microscopy were performed in both eyes 1 month after the last injection. Results: In this study, 49 eyes of 49 patients who underwent regular intravitreal injection in 1 eye were enrolled. The mean age was 63.85±9.8 years (range: 29-86 years). A mean of 4.06±1.7 (range: 3-11) injections were administered. There was no significant difference in the intraocular pressure, TBUT, Schirmer 1, fluorescein staining, or specular microscopy parameters (p>0.05). The mean non-invasive TBUT first and average values; the central, thinnest, and apex corneal thickness measurements; the anterior chamber depth, irido-corneal angle, corneal volume, and keratometry values were similar in each individual (p>0.05 for all parameters). The mean OSDI score was 27.5±17.6 for the injected eyes and 15.9±12.9 for the non-injected eyes (p<0.0001). Conclusion: Intravitreal anti-VEGF injections had no effect on ocular surface, corneal endothe-lium, and anterior segment parameters.

Purpose The aim of this study was to detect early retinal vascular changes with optical coherence tomography angiography (OCTA) in type 1 diabetes mellitus (T1DM) patients without diabetic retinopathy and to evaluate the correlation of the results with carotid intima-media thickness (IMT). Design This is a case–control and cross-sectional study. Methods This study included 38 adult patients with T1DM, and 38 age and gender-matched healthy controls. Retinal and optic disc (OD) measurements were taken using OCTA. The carotid artery IMT of each patient was measured using Doppler ultrasonography. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density, foveal avascular zone (FAZ), non-flow area (NFA) and foveal density (FD) were analysed in the fovea centred 6 × 6 mm macular area. The superficial capillary plexus and DCP were also scanned centred on the peripapillary region. The correlations between OCTA measurements and carotid IMT, duration of DM and haemoglobin A1c levels in patients with T1DM were evaluated. Results The mean values for carotid IMT were significantly higher in diabetic patients than in controls ( p < 0.001). The mean values for vessel density SCP, DCP and OD were significantly lower in the diabetic group ( p < 0.05). There were correlations between the carotid IMT and duration of T1DM and the evaluated parameters of OCTA. Conclusion Microvascular changes in the SCP and DCP in patients with T1DM without DR offer important data. OCTA can be used to detect early microvascular changes in patients with T1DM without DR. In addition, a relationship was found between SCP vascular dropout and carotid IMT.

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