OBJECTIVES: The aim of the study was comparison of wet-type age-related macular degeneration in phakic and pseu-dophakic patients in terms of anatomical and functional success based on the real-life data of Türkiye.
METHODS: The multicenter retrospective real-life study data of the. retinal study group were used in this study. Among 867 eyes of 867 patients were included in the study. Patients were divided into two groups according to the status of the lens; phakic group and pseudophakic group. The follow-up period of the two groups, the number of injections at the 1st, 2nd, and 3rd years, and changes in the central macular thickness (CMT, µ) and visual acuity (VA, logMAR) of the patients at the beginning, 6th, 12th, 24th, and 36th months were examined.
RESULTS: In our study, the number of injections in the 1st, 2nd, and 3rd years, respectively, was 4.2±2.0, 1.8±1.9, and 1.0±1.7 in the phakic group, and 3.9±2.0, 1.7±1.9, and 0.8±1.4 in the pseudophakic group. When the two groups were compared in terms of the number of injections, there was a statistically significant difference in the 1st year, but there was no signifi-cant difference in the 2nd and 3rd years (p=0.001, p=0.350, and p=0.288, respectively). There was no statistically significant difference between the groups in terms of CMT in the baseline, 6th, 12th, 24th, and 36th months (p=0.991, p=0.327, p=0.652, p=0.599, and p=0.873, respectively). Although there was no difference in VA between groups at the beginning (p=0.052), the phakic group showed statistically better VA in controls at 3rd, 6th, 12th, 24th, and 36th months (p=0.001, p=0.001, p=0.000, p=0.000, and p=0.003, respectively).
DISCUSSION AND CONCLUSION: Differences in the number of injections and visual results between phakic and pseudophakic patients in wet type AMD may necessitate the creation of different treatment and follow-up protocols.

OBJECTIVES: The objective of the study is to evaluate anatomical and functional results such as best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) in patients who received intravitreal dexametha-sone (DEX) implant for diabetic macular edema (DME), and to compare the efficacy according to patients’ lens status and concurrent phacoemulsification surgery.
METHODS: A total of 70 eyes of 55 patients with DME who received intravitreal DEX implantation were included in this retrospective study. Patients who received intravitreal DEX implantation were divided into three groups phaco-DEX (group 1), pseudophakic (group 2), and phakic (group 3). The BCVA, CMT, and IOP changes were compared between the three groups.
RESULTS: One month after the intravitreal DEX implant, BCVA improved in all three groups. (p=0.001, p=0.01, and p=0.009, respectively). There was a decrease in CMT at the end of 1st and 4th months in all three groups compared to the preoperative measurements (p=0.005, p<0.001, p<0.001 respectively). While IOP was increased in group 2 and group 3, no IOP increase was observed in group 1. (p=0.41, p=0.01, and p=0.01, respectively).
DISCUSSION AND CONCLUSION: Combining intravitreal DEX implantation with phacoemulsification surgery seems to be an effective and reliable method in patients with DME accompanied by cataract. The IOP elevation in follow-up visits of phakic and pseu-dophakic patients after intravitreal DEX implantation was not observed in the Phaco-DEX group.

OBJECTIVES: The objectiove of the study is to evaluate and compare the outcomes of pars plana vitrectomy (PPV) and PPV combined with scleral buckle (SB) in vitrectomised cases with recurrent retinal detachment (RD) and to analyze the effects of adding SB to the procedure.
METHODS: Patients with recurrent RD due to grade C proliferative vitreoretinopathy (PVR) were included in this ret-rospective comparative case series. Patients who underwent re-PPV with or without SB were included and two groups (re-PPV; re-PPV+SB) were compared in terms of anatomical and functional success.
RESULTS: Sixty-five cases were included in the study: 32 underwent re-PPV and 33 underwent re-PPV+SB procedures. Reattachment was achieved in 59.4% of the re-PPV group versus 81.8% of the re-PPV+SB group (p=0.047). Although preoperative BCVA was worse in the re-PPV+SB group (p=0.005), postoperative BCVA at the last visit was similar in both groups (p=0.065).
DISCUSSION AND CONCLUSION: In the treatment of recurrent RD with grade C PVR, combining the SB procedure with PPV contributes to anatomical and functional outcomes.

OBJECTIVES: To study the prevalence of fundus lesions in anaemics and define the hematological risk factors for retinopa-thy using the receiver operating characteristic curve analysis.
METHODS: For this retrospective study, patients ≥18 years and diagnosed with anemia with dilated fundus examination by a retina specialist from May 2019–April 2020 were included. Anemic retinopathy (AR) was present if hemorrhages in different layers of the retina, Roth’s spots, exudates, cotton wool spots, retinal edema, and optic disc changes were noted. Patients with secondary anemia were excluded. Two groups were identified: Group 1: Patients with AR; Group 2: Patients with no AR with normal fundus. Demographic features, fundus findings, and hematological parameters were noted.
RESULTS: 38 (30%) eyes of 23 patients had AR; 90 (70%) eyes of 47 patients had no AR. The mean age in Group 1 and Group 2 was 54.7±18.9 and 58.6±15.3 years, respectively. Low hemoglobin (Hb) [mean = 7.82±1.64 gm/dl, p=<0.001] and hematocrit [mean = 26.93±5.22 %, p=0.002] values were noted in the AR group. AUC values for Hb (0.737) and hemat-ocrit (0.719) were higher for the AR group. Hb < 8.95g/dl could predict AR with 85.8% sensitivity and 68.9% specificity, and hematocrit < 30.5% could predict AR with 80% sensitivity and 53.2% specificity. On regression analysis, Hb (p<0.001) and hematocrit (p=0.000) were associated with AR.
DISCUSSION AND CONCLUSION: Retinopathy is frequently seen in severe anemic patients. It is recommended that patients having low anemia should undergo a retinal examination.

OBJECTIVES: The purpose was to study the association between ocular dominance, refractive status, and biometric pa-rameters.
METHODS: Ocular dominance was assessed on consenting participants with non-pathological eyes using “hole-in-the-card test.” The participants were then examined for visual acuity, biometric measurements, and refraction. Data were analyzed using IBM SPSS software.
RESULTS: Among a total of 660 participants in our study, right eye dominance was found in 508 (76.97%) participants. We found that horizontal keratometry readings (K1) were greater in the dominant eye compared to the non-dominant eye, showing a statistically significant difference in emmetropes (p<0.001) and hyperopes (p<0.001). The axial length was found to be longer but not significantly greater in dominant eye among while it was significant among myopes (p<0.001) and hyperopes (p<0.001). In myopic anisometropes, the axial length was significantly longer and more myopic in the dominant eye (24.0±0.7 mm) than non-dominant eye (23.9±0.4 mm) while the non-dominant eye was more hyperopic in anisometropic hyperopes.
DISCUSSION AND CONCLUSION: Right eye was dominant in majority of participants. The dominant eye was more myopic and had greater axial length in anisometropes. The dominant eye was more astigmatic than the non-dominant eye. Visual acuity was not affected by ocular dominance. The mean difference in biometric measurements was significantly greater in hyperopic eyes. The assessment of ocular dominance could improve patient satisfaction in refractive surgeries and monovision treatments. Treatment protocols could be fine-tuned based on ocular dominance. Normative data in various biometric measurements could take into consideration laterality in terms of dominance.

OBJECTIVES: Benign essential blepharospasm (BEB) is a focal dystonia characterized by involuntary contractions of the orbicularis oculi and periocular muscles. We aimed to investigate the effects of muscle receptor levels on the etiopatho-genesis of blepharospasm by evaluating the orbicularis oculi estrogen receptor (ER) and androgen receptor (AR) levels.
METHODS: Four blepharospasm patients (2 females and 2 males) who underwent upper lid blepharoplasty and/or orbicu-laris myomectomy and 4 healthy cases (2 females, 2 males) that had upper lid blepharoplasty were included. The pretarsal, preseptal, and orbital parts of the orbicularis muscles of the patients who underwent orbicularis myomectomy and the waste muscle tissue materials taken from the preseptal orbicularis muscles of the patients who had only upper blepharo-plasty were analyzed. Immunohistochemical staining was performed with estrogen alpha and androgen.
RESULTS: In healthy men, the orbicularis oculi muscle was stained with ER at a moderate intensity and with AR at a high intensity. In men with blepharospasm, the orbicularis oculi were not stained with ER at all, but at a high intensity with AR. In healthy women, the orbicularis oculi were stained with ER and AR at a high intensity (>50%). In women with ble-pharospasm, the staining intensities of both receptors were moderate.
DISCUSSION AND CONCLUSION: We determined a decrease in ER and AR in females and almost the absence of ER in males with BEB. This decrease in ER may be associated with a functional abnormality in mitochondria and the decrease in hormonal receptors may be associated with sarcopenia in orbicularis oculi muscle fibers.

OBJECTIVES: We aimed to evaluate the change in eyelid and ocular surface parameters that were measured using a digital measurement program, the change in the visual field (VF), and the correlation between ocular surface area (OSA) and VF parameters in patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis.
METHODS: Patients who underwent upper eyelid blepharoplasty for involutional dermatochalasis between August 2015 and August 2019 were included in the study. The difference between preoperative and postoperative 3rd month values of manually measured margin reflex distance 1 (MRD1), digitally measured eyelid and ocular surface parameters (MRD1, MRD 2 [MRD2], upper eyelid crease height [ECH], pretarsal show height [PTH], eyebrow line-height [EBH] and OSA), and VF parameters were evaluated. The correlation between preoperative and postoperative values of manually and digi-tally measured MRD1 and also preoperative and postoperative values of OSA and VF parameters were analyzed.
RESULTS: Thirty-six eyes from 36 patients were included in this study and the mean age of patients was 57.93±7.64 years. There were statistically significant changes between preoperative and postoperative values in means of the manually measured MRD1 and the digitally measured MRD1, PTH, OSA, and ECH (p<0.001). However, the postoperative changes in the mean MRD2 and EBH were not statistically significant (p=0.664 and p=0.983). There were moderate positive cor-relations between pre- and post-operative OSA values and pre- and postoperative values of manual and digital MRD1. A statistically significant agreement was observed between the change in OSA and the change in all VF parameters (Bland–Altman analysis test).
DISCUSSION AND CONCLUSION: Digital measurements can be used to evaluate the changes in eyelid and ocular surface parameters in pa-tients who underwent upper eyelid blepharoplasty surgery. OSA provides fast results in accordance with linear measure-ments and is compatible with the change in the VF.

We present the long-term results of the implantation of a capsular tension ring (CTR) and Ahmed capsular tension segments (CTS) together for the management of mikrospherophakia in a 35-year-old female patient. The patient had uncontrolled secondary angle-closure glaucoma, despite previous laser peripheral iridotomy, and visual impairment due to lenticular myopia. Clear lens extraction was performed under general anesthesia. The capsular bag was stabilized with a classical CTR and two Ahmed CTSs sutured to the sclera. A single-piece hydrophobic acrylic intraocular lens (32.0 D for the right and 30.0 D for the left eye) was implanted in the capsular bag. The anterior chamber depth was stable, and intraocular pressure (IOP) was 10–12 mmHg in both eyes in the early post-operative period. The bag complex gradually moved forward, IOP gradually increased, and the left eye underwent trabeculectomy surgery in the 4th year of follow-up.

Optical coherence tomography-angiography (OCTA) is a fast, reliable, and non-invasive technique for the diagnosis and follow-up of patients with commotio retinae (CR). Severity of the damage to the retinal and choroidal microvasculature in OCTA imaging and the visual prognosis are directly related to the severity of trauma. There are a few published reports on OCTA in CR that shows alterations of the retinal or superficial choroidal vessels and choriocapillary plexus. OCTA imaging seems to be predictive for visual prognosis. Herein, we present a 6-year-old boy, who had blunt trauma to the right eye with a stick during outdoor playing with visual acuity reduction to 0.1 following resolution of the Berlin’s edema. In our case, OCTA revealed damage to the outer layers of the retinae and choriocapillaris and resulting in permanent vision loss. OCTA is a non-invasive, rapid, and safe imaging technique that qualitatively and quantitatively analyzes blood flow from the superficial capillary plexus to the choriocapillaris, which can be predictive in the visual prognosis.

A 28-year-old young Caucasian female patient without a history of trauma or vascular disease presented with blurred vision and paracentral scotoma in her left eye. Fundus examination showed a small foveal hemorrhage in the superficial retinal layers. Initial visual acuity was 20/50 in the LE. After 2 weeks, visual acuity increased to 20/20, and hemorrhage was resolved in optical coherence tomography angiography (OCT-A) spontaneously. No vascular lesion was seen in any layer of the retina in OCT-A analysis.

Insects are a class of living creatures within the arthropods. Bite is a wound produced by the mouth parts of an insect. Although insect bite reactions are commonly seen in clinical practice, especially in dermatology clinics, injuries from insect bites are less commonly encountered in ophthalmology clinics. Herein, we report a 28-year-old male presenting with a rapidly growing mass on his right upper eyelid following a suspected insect bite.

To report a patient with bilateral sequential non-arteritic anterior ischemic optic neuropathy (NA-AION) following severe COVID-19 infection. A 50-year-old male patient reported a 1-week history of painless vision loss in the right eye in ad-diton to complaining of blurred vision in the left eye 4 weeks earlier. He had tested COVID-19 positive 4 weeks before the onset of symptoms in his left eye. Further investigations revealed that the most possible cause of vision loss was NA-AION associated with COVID-19. COVID-19 infection may be responsible for NA-AION. Therefore, ophthalmologists should keep this infection in mind when systemic investigation for the underlying etiology of NA-AION.