ISSN: 2459 - 1777 | E-ISSN 2587-0394
Volume : 7 Issue : 2 Year : 2022
Beyoglu Eye Journal - Beyoglu Eye J: 7 (2)
Volume: 7  Issue: 2 - 2022

Page 76
Abstract | Full Text PDF

2.The Effects of Lidocaine, Fentanyl, and Remifentanil on Hemodynamics and Intraocular Eye Pressure After Tracheal Intubation: A Randomized Clinical Trial
Ali Caner Sayar, Özlem Deligöz, Ferhunde Dilek Subaşı, Serhat İmamoğlu, Osman Ekinci
PMCID: PMC9169139  doi: 10.14744/bej.2022.79037  Pages 77 - 82
INTRODUCTION: An increased reflex in sympathetic and sympathoadrenal activity caused by tracheal intubation causes an increase in arterial blood pressure, and increased venous pressure causes an increase in intraocular pressure (IOP). The aim of the current study was to compare the effects of lidocaine, fentanyl, and remifentanil to determine which agent was most effective in the prevention of elevated IOP.
METHODS: The patients were separated into 3 groups (lidocaine, fentanyl, and remifentanil). Heart rate and mean arterial pressure (MAP) were measured and recorded 2 min after the administration of the drugs and at 1, 5, and 10 min after intubation. IOP was measured and recorded in each eye separately by an ophthalmologist preoperatively, at 2 min after drug administration and at 1, 5, and 10 min after intubation.
RESULTS: MAP was found to be high (122.750±17.068) in the lidocaine group at 1 min after intubation. In all 3 groups, the right and left eye IOP values were found to be higher at 1 min after intubation than at 2 min after drug administration. Only the difference in the lidocaine group was statistically significant (p=0.003). In all 3 groups, the right and left eye IOP values at 5 min after intubation were statistically significantly lower than the values at 1 min after intubation (Group 1: p=0.001, Group 2: p=0.000, and Group 3: p=0.000).
DISCUSSION AND CONCLUSION: From the results of this study, it was concluded that remifentanil and fentanyl were more effective drugs than lidocaine in the prevention of increased IOP and hemodynamic response to intubation, and there was no significant difference between these two drugs.

3.Evaluation of Retinal Vessel Density and Foveal Avascular Zone in Unilateral Exudative Choroidal Neovascularization by Optical Coherence Tomography Angiography
Gamze Dereli Can, Öner Gelişken
PMCID: PMC9169141  doi: 10.14744/bej.2022.61587  Pages 83 - 88
INTRODUCTION: To evaluate treatment-naïve patients with neovascular-exudative age-related macular degeneration (eARMD) in one eye and early-/intermediate-stage nonexudative ARMD (neARMD) in the fellow eye by optical coherence tomog-raphy-angiography (OCTA).
METHODS: A total of 70 eyes of 35 patients (17 females) with first diagnosis of eARMD in one eye and early/interme-diate-stage neARMD in the fellow eye were included in this study. The eARMD diagnosis was confirmed by fluorescein angiography. Each subject underwent OCTA imaging by RTVue XR Avanti OCT device. Capillary vessel density (VD) of superficial (SCP) and deep (DCP) retinal capillary plexuses and foveal avascular zone (FAZ) parameters were measured.
RESULTS: The mean age was 72.0±8.9 years (range 59–87). The mean visual acuity was 0.7±0.5 logMar for the eARMD eyes and 0.4±0.3 logMar for the fellow eyes (p=0.012). Nineteen patients (54.3%) had occult choroidal neovascularization (CNV), and 16 patients (45.7%) had classical CNV. The mean FAZ area was measured 0.30 ± 0.11 mm2 in the eARMD eyes and 0.27±0.11 mm2 in the fellow eyes (p=0.387). The FAZ circularity index measurement was 1.15±0.03 in eARMD eyes and 1.11±0.05 in the fellow eyes (p=0.014). There was no statistically significant difference in any measure of the macular SCP and DCP’s VD between eARMD eyes and their fellow eyes.
DISCUSSION AND CONCLUSION: Potential retinal vascular alterations will be important in ARMD pathogenesis.

4.The Effect of ChromaGen Contact Lenses on Corneal Clarity: A Corneal Densitometry
Çağrı İlhan, Mehmet Ali Şekeroğlu, Sibel Doguizi, Pelin Yilmazbas
PMCID: PMC9169144  doi: 10.14744/bej.2022.20082  Pages 89 - 94
INTRODUCTION: The purpose of this study is to investigate the effect of ChromaGen contact lens (CCL) on corneal clarity, expressed through the measurement of corneal densitometry (CD) values.
METHODS: This study included 22 eyes of 22 patients with congenital red-green color vision deficiency who were admitted to our clinic for the CCL trial. After a detailed ophthalmological examination and CD measurement with Pentacam HR (Oculus Optikgerate GmbH, Wetzlar, Germany), the most appropriate CCLs were defined through pseudoisochromatic plates and inserted for 2 h. The CD measurement was repeated after the removal of the CCL. Comparison was made of CD values before and after the insertion of the most appropriate CCL. The after-CCL/before-CCL ratio was calculated, and the effect of CCL type on this ratio was investigated.
RESULTS: The after-CCL values were higher in the anterior, central, posterior, and total thickness of the 0–2 mm concen-tric zone (p=0.044, p=0.040, p=0.021, and p=0.032, respectively) when compared to the before-CCL values. There was no statistically significant difference between before-CCL and after-CCL values in any layer of the 2–6, 6–10, and 10–12 mm concentric zones (p>0.05, for all). After-CCL/before-CCL ratios were similar in the Magenta2 (M2), Magenta3 (M3), and Violet3 (V3) types of CCLs (p>0.017).
DISCUSSION AND CONCLUSION: Usage for 2 h of CCL was observed to increase CD values in all layers of the 0–2 mm concentric zone irrespective of the type of CCL. Further studies with longer follow-up are required to determine the long-term effects and detect differing effects of CCL with different base curves.

5.Posterior Pole Asymmetry Analysis in the Children with Anisometropia
Sezin Akça Bayar, Almila Sarıgül Sezenöz, Sibel Oto
PMCID: PMC9169140  doi: 10.14744/bej.2022.48344  Pages 95 - 102
INTRODUCTION: The objectives of the study were to investigate the inter and intraocular differences in posterior pole asym-metry analysis (PPAA) with optical coherence tomography (OCT) in anisometropia, to examine the relationship between the presence of anisometropia and amblyopia and retinal thickness.
METHODS: Patients between ages of 5 and 16 years with anisometropia who applied to our clinic were included in the study. Macular retinal thickness measurements were evaluated by PPAA using the posterior pole algorithm of the spectral domain-OCT device. Asymmetry was analyzed both as the difference between the right and left eyes and the difference between the superior, inferior, and mean retinal thicknesses of 64 separate quadrants in the same eye. Hemispheric and right-left eye asymmetry differences analyses were performed.
RESULTS: 118 patients were included in the study(65 females and 53 males). Group 1 consisted of anisometropic patients (n=46), Group 2 consisted of anisometropic amblyopia patients (n=40), and Group 3 consisted of control group (n=32). The mean age of the patients was 9.72±5.6 years. The mean spherical equivalent difference between the two eyes of the patients was 1.7±0.6 D. When anisometropic eyes were compared with normal eyes, there was no significant difference between mean superior, inferior and total retinal thickness, and right-left eye asymmetry values (for all, p>0.05). In the asymmetry evaluation performed by counting the black boxes in the PPAA, a significant difference was found in the right-left asymmetry evaluation in anisometropic amblyopic eyes, in some quadrants and in the right-left asymmetry analysis (p<0.05).
DISCUSSION AND CONCLUSION: While no difference was found between anisometropic and normal eyes in the PPAA, there was differences in some quadrants in the anisometropic amblyopic group compared to the control group suggesting that there is an in-volvement in the peripheral quadrants of the macula, especially in treatment resistant amblyopic patients.

6.Choroidal Neovascularization Associated with Best Vitelliform Macular Dystrophy
Seda Karaca Adıyeke, Gamze Türe
PMCID: PMC9169145  doi: 10.14744/bej.2022.54376  Pages 103 - 108
INTRODUCTION: Objectives: The aim of the study was to evaluate the clinical and optical coherence tomography (OCT) findings of pa-tients with choroidal neovascularization (CNV) due to best vitelliform macular dystrophy (BVMD).
METHODS: Six eyes that were diagnosed with CNV associated with BVMD were evaluated retrospectively. A standard ophthalmologic examination, a fundus fluorescein angiography (FA), and the OCT findings of the patients were examined. Anatomical and functional changes seen after treatment were evaluated.
RESULTS: One (16%) of the cases was female and five (83%) were male. The mean age was calculated as 36.3±24.9 years (range 11–73 years). The mean follow-up period of the cases after detecting CNV was determined as 26 months (range 6–168 months). Best corrected visual acuities were 0.65±0.39 logMAR (1.0–0.2 logMAR) when CNV was detected and 0.42±0.25 logMAR (limits 0.7–0.2 logMAR) at the end of the follow-up. Photodynamic therapy was applied to one (17%) of the cases, and intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment was applied to the others (83%). The mean number of intravitreal injections was found to be 3±1.37 (range 2–4).
In all cases, intraretinal fluid (IRF), subretinal fluid (SRF), external limiting membrane, and irregularities in inner retinal layers were observed in the initial OCT examinations. In all cases, it was observed that the IRF regressed with treatment and SRF continued in five eyes. Hypertrophic outer retinal scarring developed in all cases.
DISCUSSION AND CONCLUSION: In cases with CNV due to BVMD, regression in CNV activity was achieved with intravitreal anti-VEGF injec-tion treatment. The IRF is a marker that can be used both in the diagnosis and treatment monitoring of CNV associated with BVMD.

7.The Effect of Lower Eyelid Malposition Repair on Palpebral Fissure Size Changes
Şenay Aşık Nacaroğlu, Gamze Ozturk Karabulut, Kubra Serefoglu Cabuk, Korhan Fazıl, Muhittin Taskapili
PMCID: PMC9169142  doi: 10.14744/bej.2022.75537  Pages 109 - 114
INTRODUCTION: The aim of the study was to evaluate the effect of changes in the horizontal and vertical palpebral fissure dimensions on surgical success performed due to entropion and ectropion of the lower eyelid.
METHODS: The present research was conducted as a retrospective and interventional case series who had undergone in-volutional lower eyelid malposition repair with a lateral tarsal strip (LTS) alone, LTS with a medial spindle, and LTS with the advancement of the lower eyelid retractors. The subjects’ medical records, including demographic and clinic characteris-tics, pre-operative assessment of horizontal eyelid laxity, and surgical outcomes, were reviewed. The distance between the pupillary light reflex and the lower-eyelid margin marginal reflex distance 2 (MRD-2) and the horizontal palpebral aperture (HPA) width were measured using the Image J program in the pre-operative and post-operative 6-month follow-up. The correlation between surgical success, changes in pre-operative and post-operative MRD-2, and HPA width was assessed by the Spearman rank correlation test.
RESULTS: A total of 66 eyelids of 48 patients were included in the study. This cohort comprised of 41 males (86.4%) and 7 females (13.6%), 18 of whom underwent bilateral surgery. The pre-operative mean MRD-2 was 7.13 ± 1.98 mm, and the post-operative 6-month mean MRD-2 was 6.21±1.19 mm (p<0.01). The mean post-operative HPA width was statistically significantly higher in comparison with the mean pre-operative HPA width (27.35±2.41, 26.89±2.39, p=0.02, respectively). There was no correlation between success rate and changes in horizontal and vertical palpebral fissure dimensions.
DISCUSSION AND CONCLUSION: LTS surgery is a method that turns the shortened HPA width to normal and enables the successful correc-tion of the lower eyelid malpositions.

8.Choroidal Thickness in Emmetropia: An Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography-Based Study
Selim Cevher, Mehmet Barış Üçer, Tayfun Şahin
PMCID: PMC9169138  doi: 10.14744/bej.2022.89266  Pages 115 - 120
INTRODUCTION: To investigate and determine the choroidal thickness (CT) in healthy emmetropic Turkish subjects aged between 20 and 40 years using Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography (EDI-OCT).
METHODS: This study included 194 eyes of 194 healthy emmetropic subjects. All participants underwent a detailed oph-thalmologic examination. Axial length (AL) was measured with optical biometry. CT measurements were performed at subfoveal, 1.0 mm temporal, and 1.0 mm nasal using the EDI-OCT. Central macular thickness (CMT) measurements were also performed at the same time. Participants were divided into two groups; Group 1 (age between 20 and 30 years) and Group 2 (age between 31 and 40 years). CT and CMT were compared among two groups.
RESULTS: The mean age of all the subjects was 26.61±6.08 years, the mean AL was 23.44±0.72 mm, and the mean spherical equivalent was −0.11±0.28 Diopter. The mean subfoveal, nasal, and temporal CT was 389.27±86.61 μm, 354.54±86.86 μm, and 368.25±78.69 μm, respectively. Subfoveal and nasal CT of female participants were found thinner than male par-ticipants (p=0.013 and p=0.008, respectively). CT and CMT were found similar between Group 1 and Group 2.
DISCUSSION AND CONCLUSION: This study showed that mean subfoveal CT and CMT was 389.27±86.61μm and 268.17±18.76 μm, respec-tively, among healthy emmetropic Turkish subjects. Females had thinner CT in subfoveal and nasal quadrants. In addition, age did not affect CT between 20 and 40 years.

9.Comparison of Long-Term Visual and Refractive Results of Transepithelial and Mechanical Photorefractive Keratectomy
Basak Saracoglu Yilmaz, Alper Agca, Muhittin Taskapili
PMCID: PMC9169146  doi: 10.14744/bej.2022.06978  Pages 121 - 125
INTRODUCTION: The aim of the study was to present and compare 2 years results of mechanical photorefractive keratectomy (M-PRK) and transepithelial photorefractive keratectomy (T-PRK) for myopia.
METHODS: One hundred and nine eyes of 55 patients were included in this retrospective study. The mean age of the pa-tients was 26.9±5.2 years. Forty-four eyes (40.4%) had M-PRK and 65 eyes (59.6%) had T-PRK. Follow-up time was 2 years. Refractive errors (RE), uncorrected visual acuity (UCVA), and high-order corneal aberrations were compared.
RESULTS: The mean RE was −2.33±0.88 D and the mean UCVA was 0.24±0.17 logMAR at baseline for M-PRK patients. At month 24, those measurements were changed to −0.27±0.32 D and 0.99±0.04 logMAR. The mean RE was 2.19±0.73 D and the mean UCVA was 0.23 ± 0.15 logMAR at baseline for T-PRK patients. At month 24, those measurements were changed to −0.14±0.32 D and 0.99±0.01 logMAR. The mean REs significantly decreased and the mean UCVA significantly increased after both type of surgeries (all p<0.001). In M-PRK group, 4 mm zone total corneal aberration and 6 mm total-coma-spherical corneal aberrations were statistically significantly increased in post-operative term. In T-PRK group, only 6 mm total-spherical corneal aberrations were statistically significantly increased in post-operative term. There was no serious complication during surgeries or follow-up time.
DISCUSSION AND CONCLUSION: M-PRK and T-PRK were a safe and effective in the treatment of myopia in 2 years term. Some high-order aberrations may be increase after those treatments.

10.Evaluation of Systemic Endothelial Dysfunction in Retinal Vein Occlusions
Erdinc Bozkurt, Türkhun Çetin, Ibrahim Rencüzoğulları
PMCID: PMC9169147  doi: 10.14744/bej.2022.44265  Pages 126 - 133
INTRODUCTION: Our aim in this study was to evaluate the systemic endothelial dysfunction status and carotid intima-media thickness (CIMT) in patients with retinal vein occlusion (RVO).
METHODS: Seventy-six patients who presented to the clinic with the diagnosis of RVO and 76 age- and gender-matched healthy individuals without a RVO history were included in the study. The patients’ best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measures, and diabetes, hypertension, hyperlipidemia, carotid artery disease, body mass index, and smoking histories were recorded. The endothelial function levels of the patients, pulse wave velocity (PWV), flow-mediated dilation (FMD), and CIMT were measured. Endothelial dysfunction was detected by applying the FMD technique to the brachial artery. CIMT was evaluated by B-mode ultrasonography. Serum hematological parameters were evaluated.
RESULTS: BCVA (logMAR) was 1.39±1.30 in patients with RVO and 0.028±1.22 in the control group (p<0.001). CMT was 588.76±104.02 µm in patients with RVO and 265.20±45.11 µm in the control group (p=0.001). Hypertension, diabetes, and hyperlipidemia were found to be significantly higher in patients with RVO (p-value 0.001, 0.002, and 0.001, respec-tively). There was a significant difference between the groups in terms of FMD, PWV, and CIMT (all of them, p<0.001).
DISCUSSION AND CONCLUSION: The deterioration of FMD and PWV, which are indicators of endothelial dysfunction in patients with RVO, suggests that systemic endothelial dysfunction may play a role in the pathogenesis of RVO. Comprehensive studies with more patient participation are needed.

11.Assessment of the Quality and Reliability of YouTube Videos on Fuchs Endothelial Corneal Dystrophy
Ruveyde Bolac, Yücel Öztürk, Elvin Yildiz
PMCID: PMC9169149  doi: 10.14744/bej.2022.90277  Pages 134 - 139
INTRODUCTION: The aim of the study was to assess the quality and reliability of videos on Fuchs endothelial corneal dystro-phy (FECD) on YouTube.
METHODS: A search of YouTube was performed for the term “FECD” without any changes to the website’s standard search preferences. The first 100 videos were recorded. A total of 71 videos were evaluated regarding the DISCERN score (min–max: 16–75), Journal of the American Medical Association (JAMA) score (min–max: 0–4), and Global Quality Scale (GQS) score (min–max: 0–5).
RESULTS: The mean DISCERN score was 40.1±15.6 (moderate), the mean JAMA score was 2.01±0.7 (poor), the mean GQS score was 2.5±1.3 (moderate), and the mean video power index score was 106.8±135.7. Twenty-three of the videos (32.4%) were uploaded by physicians, 25 (35.2%) by universities/private hospitals, and 21 (29.6%) by health channels. Thir-ty-six videos (50.7%) contained information about the disease, 24 (33.8%) discussed surgical techniques, and 11 (15.5%) were about patient experience.
DISCUSSION AND CONCLUSION: YouTube provides only moderate-quality health information on FECD. Physicians and professional organiza-tions should be aware of and embrace this evolving technology to raise awareness about FECD.

12.Is COVID-19 Infection a Trigger for Herpetic Stromal Keratitis?
Burçin Kepez Yıldız, Derya Özkan, Adem Tellioğlu, Ahmet Demirok
PMCID: PMC9169143  doi: 10.14744/bej.2022.81994  Pages 140 - 142
In June 2020, a 28-year-old female patient was admitted to our clinic with reduced vision in the left eye. She had systemic COVID-19 infection in May 2020 and during her treatment course, her visual complaints had begun approximately 1 week after the beginning of the COVID-19. Previously, the patient had bilateral femtosecond assisted – Laser in situ Keratomile-usis in our clinic in 2018. There was no previous history of herpetic eye involvement. In her examination, the uncorrected visual acuity was 20/20 in the right and 20/32 in her left eye. Slit-lamp examination revealed interlamellar infiltration at the flap interface in the left eye. Considering herpetic activation, ganciclovir ointment 5 × 1, valacyclovir tablet 2 × 1, and prednisolone acetate 1.0% eye drops 5 times a day and artificial tear 5 × 1 were started. Two weeks later, the infiltration completely resolved and the uncorrected visual acuity increased to 20/20.

13.Chickenpox Associated Retinitis and Occlusive Vasculitis in a Vaccinated Child: A Case Report and Literature Review
Gökçen Özcan, Emine Temel, Nilufer Yalçındağ, Erdal Ince, Pınar Bingöl Kızıltunç, Elif Ince, Huban Atilla
PMCID: PMC9169136  doi: 10.14744/bej.2022.50490  Pages 143 - 149
Either retinitis and occlusive vasculitis are rare but vision threatening ocular complications of chickenpox in children. In this case report a 13-year-old girl who developed chickenpox 2 days before complaining with visual loss in her right eye is present-ed. She was vaccinated one dose of varicella zoster virus (VZV) vaccine when she was 12 months old. Best corrected visual acuity was counting fingers at 1.5 m in right eye. A subtle anterior segment inflammation and mild vitritis were observed. Fun-doscopic examination of right eye showed ischemia in paracentral macula and white foci of retinitis along the superotemporal branch of retinal vessels. She was hospitalized and intravenous acyclovir treatment at 3 × 10 mg/kg daily dose was started. Serum IgM and IgG for VZV were positive. Aqueous humor PCR test was also reported positive for VZV DNA. Oral meth-ylprednisolone was added at a dose of 64 mg/day at the 3rd day acyclovir treatment. Macular edema developed at 4th week of treatment and bevacizumab was administered intravitreally. After 3 injections retinal edema subsided completely. At 6-month follow-up retinal ischemia in superotemporal periphery was observed and photocoagulation was added to treatment.

14.Isolated Bilateral Macular Edema due to Le Fort Type 1 and Mandibular Fracture: A Case Report
Kürşad Ramazan Zor, Erkut Küçük, Çiğdem Samur Salbaş, Gamze Yıldırım Biçer
PMCID: PMC9169137  doi: 10.14744/bej.2022.86548  Pages 150 - 153
We report the diagnosis and follow-up process of a case who had bilateral macular edema after blunt facial trauma. A 36-year-old male patient with Le Fort type 1 and mandibular fracture without direct ocular trauma referred to the oph-thalmology clinic. Visual acuity was 0.1 in both eyes according to Snellen chart. Ocular examination was normal except bilateral macular edema. The patient did not have any prior systemic or neurological diseases. The patient did not have cotton-wool spots, retinal hemorrhage, or Purtscher flecken in the fundus examination. He used topical 0.1% nepafenac solution for 1 month. Visual acuity returned to normal after complete resolution of the macular edema at 1 month and did not recur in the follow-up. We think that this case may be an isolated macular edema due to facial trauma or an atypi-cal presentation of Purtscher retinopathy. Although facial fractures and trauma may cause Purtscher retinopathy with involvement of different retinal structures, the findings in this case suggest that isolated involvement of macula can also occur in these injuries.

15.The Association Between Electronic Learning and Myopia Progression Among School-Age Children During the Coronavirus Disease 2019
Ali Nouraeinejad
PMCID: PMC9169148  doi: 10.14744/bej.2022.08216  Pages 154 - 155
Abstract | Full Text PDF

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