No abstract

Purpose Our study evaluated macular and optic disc vascular density (VD) changes in patients diagnosed with keratoconus, as compared with gender and age-matched healthy controls, in relation to the keratoconus stage. Methods This comparative cross-sectional study included adult patients who received a diagnosis of keratoconus at the Cornea Clinic. All scans consisted of two 4.5 mm × 4.5 mm images of the optic disc area and 6 × 6 mm images of the macular area using optical coherence tomography angiography. Results The study included 67 patients (26 women (38.8%) and 41 men (61.2%)) and 74 controls (31 women (41.9%) and 43 men (58.1%)). The mean ages of the keratoconus group and the control group were 30.0 ± 8.0 and 31.1 ± 7.5, respectively. Macular VD (whole, superficial, and deep) and peripapillary VD (whole) values were decreased statistically significant compared with the control group ( p < 0.01 and p = 0.015, respectively). The keratoconus stage was negatively correlated with both the macular VD ( p = 0.048, r = −0.314) and whole-peripapillary VD values ( p = 0.03, r = −0.34). Conclusion Keratoconus might affect the posterior and anterior segments due to similar etiologies, including diminished collagen quality. Therefore, examination of the posterior segment should be performed thoroughly in keratoconus patients.

The first use of ultrasound biomicroscopy (UBM), which is an important method for monitoring and evaluating the anterior segment and the anterior chamber angle in ophthalmology, was made by Pavlin et al. (1) in the early 1990s. Sound energy is used in the high-frequency spectrum in UBM. With this spectrum, tissue penetration occurs to a depth of about 5 mm, which is more or less on the surface. UBM is a tool that enables the identification of not only anterior segment structures but also pathologies located in posterior segment structures such as the peripheral retina and ciliary body. It is an important imaging modality in the treatment of vitreoretinal diseases by cross-sectional imaging of the peripheral retina, pars plana, and vitreous base, which cannot be seen even via indirect ophthalmoscopy performed using a scleral buckling method.The most important advantage of UBM compared with anterior segment optical coherence tomography is that posterior chamber structures such as the ciliary body, lens zonules, and anterior choroid can also be displayed without dilating the pupils (2).In many vitreoretinal diseases, pars plana vitrectomy (PPV) is applied as the standard surgical approach. Many complications related to PPV may be encountered postoperatively. Some of these complications are related to the anterior segment.The aim of this study was to investigate by UBM postoperative changes in the morphology of the anterior segment in phakic patients in whom tamponade was not used during PPV. MethodsBetween March 2012 and October 2015, phakic patients for whom PPV was planned were included in the study prospectively. Patients on whom cataract surgery was performed along with PPV and/or gas or silicone oil was used as intraocular tamponade were excluded from the study, and 21 eyes of 21 patients were statistically included in the evaluation.The study was performed in accordance with the Helsinki Declaration. All patients who were included in the study were given information regarding the intervention and written informed consent was received. Approval of the local ethics committee was obtained for the execution of the work. Appraisement of Anterior Segment Changes caused by Vitrectomy without Internal Tamponade using Ultrasonic Biomicroscopy in Phakic EyesObjective: Our study aimed to investigate morphological changes using ultrasonic biomicroscopy (UBM) in the anterior segment after phakic pars plana vitrectomy (PPV) without tamponade.Methods: PPV surgery planned phakic patients were prospectively studied between October 2012 and March 2015. PPV patients who did not undergo cataract surgery and in whom intraocular tamponade was not used were included in the study. UBM measurements were taken a few days before and 10 days after the surgery. Through axial images of the anterior segment, the anterior chamber depth (ACD) and lens thickness (LT) were measured. Through the temporal quadrant over the radial cross-section images, the trabecular network-iris angle (TIA), ciliary body thickness (CBT), scleral thickness (ST),...

Amaç: Kliniğimizde psödoeksfoliyasyonlu olgulara uygulanan katarakt cerrahisi sonuçlarını ve ön kamara parametre değerlerini değerlendirmektir.

Bir hafta önce sağ gözünden fakoemülsifikasyon ve göz içi lens cerrahisi olan 85 yaşındaki erkek hasta, tarafımıza 1. hafta kontrolü için başvurdu. Hasta ameliyatın 1. gününden itibaren görmesinin yavaşça azaldığını ifade etti. Ön segment muayenesinde sağ gözde kornea ödemi, Descemet membranında kırışıklık, ön kamarada fibrin reaksiyon ve psödofakik izlendi. Sol göz fakik idi. Görme keskinliği (GK) sağda 3 metreden parmak sayma (mps), solda 0,1 seviyesinde, göz içi basıncı (GİB) sağ ve solda 14 mmHg olarak izlendi. Fundus muayenesinde sağ retina net olarak değerlendirilemedi. Ultrasonografi'de sağ retina yatışık izlendi. Sol göz fundus muayenesi doğal gözlendi. Hastanın postoperatif 1. gün kontrolünde kaydedilmiş notlarında sağ göz GK seviyesi 0,4, GİB 14 mmHg idi, ön segment muayesinde korneanın saydam ve ön kamaranın sakin olduğu izlendi. Postoperatif 1. haftada ön kamarada fibrin reaksiyon olması nedeniyle 25 μg/mL 0,1 cc doku plazminojen aktivatörü enjeksiyonu uygulandı. Enjeksiyondan 1 gün sonra fibrinin gerilemesine rağmen Descemet membran kırışıklığının ve kornea ödeminin aynı şekilde devam etmesi nedeniyle Descemet membran dekolmanı şüphesiyle ön segment optik koherans tomografi (OCT) çekildi. Çekilen OCT'de total Descemet membran dekolmanı izlendi. Descemet membran dekolmanını tedavi etmek amaçlı ön kamaraya sülfür hekzaflorür (SF6) enjeksiyonu uygulandı. SF6 enjeksiyonu sonrası ilk gün kornea ödeminin ve keratik strianın kaybolduğu, GK'nin 0,3 seviyesine çıktığı, GİB'nin 14 mmHg, korneanın saydam olduğu, ön kamarada gaz olduğu ve fibrinin tamamen gerilemiş olduğu gözlendi. Bu çalışmamızda postoperatif fibrin membrana eşlik eden total Descemet membran dekolmanı olan bir olguyu ve başarılı olan tedavimizi sunmayı amaçladık.