Objectives: To evaluate the prevalence and clinical course of elevated intraocular pressure (EIP) and glaucoma in different types of uveitis. Materials and Methods: A retrospective chart review was performed for patients who were treated for any kind of uveitis at Ege University Ophthalmology Department between January 2003 and January 2023. Patients with transient/persistent increase in intraocular pressure (IOP), who were already under treatment with antiglaucoma medications at the initial examination, or who were diagnosed with glaucoma during follow-up were included. Demographic features, uveitis type, time between uveitis and glaucoma/EIP diagnoses, topical and systemic treatments for uveitis, and antiglaucoma medications and surgeries were recorded. Results: A total of 2176 patient files (1206 anterior uveitis [AU], 247 intermediate uveitis [IU], 165 posterior uveitis [PU], 558 panuveitis [PanU]) were reviewed and 594 eyes of 440 (20.2%) patients (205 female, 235 male) were included in the study (292 eyes with AU, 80 eyes with IU, 44 eyes with PU, and 178 eyes with PanU). Glaucoma was observed in 220 eyes (37.0%) and EIP in 374 eyes (63.0%). Glaucoma was present in 120 eyes with AU, 23 eyes with IU, 13 eyes with PU, and 64 eyes with PanU. IOP was controlled with medical treatment in 458 eyes (77.1%) while glaucoma surgery/laser was needed in 113 eyes (19.0%). No treatment was required for 23 eyes (3.9%). Conclusion: The prevalence rate of glaucoma/EIP was 20.2%. Glaucoma was most observed in eyes with AU (41.1%), while EIP was most common with IU (71.2%).

Amaç: Bu çalışmanın amacı Fuchs heterokromik iridosiklit (FHİ) tanılı gözler ile sağlıklı diğer gözlerin kornealarının ve kornea biyomekanik özelliklerinin karşılaştırılmasıdır. Gereç ve Yöntem: Fuchs heterokromik iridosiklit tanılı 14 göz (Grup 1) ve sağlıklı diğer gözler (Grup 2) çalışmaya dâhil edildi. Tüm hastalara detaylı bir oftalmolojik bakıyı takiben Ocular Response Analyzer korneal biyomekanik özellikler ve speküler mikroskobi ile santral korneal kalınlık (SKK), korneal endotelyal hücre dansitesi (KEHD) değerlendirildi. Bulgular: En iyi düzeltilmiş görme keskinliği ve intraoküler basınç istatistiksel olarak benzerdi (p değerleri sırasıyla 0,077 ve 0,557). Korneal biyomekanik parametreleri olan korneal histerezis, korneal resiztans faktör, IOPcc ve IOPg değerleri her iki grupta istatistiksel olarak benzerdi (p değerleri sırasıyla; 0,521, 0,817, 0,980 ve 0,980 idi). Ortalama santral korneal kalınlık Grup 1’de 555,57±42,95 (467-626) mikron ve Grup 2’de 556,5±37,04 (480-623) mikron olarak saptandı (p=0,959). Ortalama korneal endotel hücre dansitesi Grup 1’de 2313±420,22 (1271-2717) ve Grup 2’de 2404,42±326,75 (1566-2834) hücre/mm2 saptandı (p=0,626). Sonuç: Sağlıklı gözler ile Fuchs Heterokromik İridosiklit tanılı gözler karşılaştırıldığında kornea biyomekanik parametreleri ve korneal endotel hücre dansitesi arasında anlamlı fark saptanmamıştır. Bu sonuçlar literatürdeki birçok çalışma ile çelişmekte olup daha geniş vaka serileri ile yeni çalışmalara ihtiyaç vardır.

To evaluate macular capillary perfusion in patients with fuchs heterochromic iridocyclitis (FHI) by using optical coherence tomography angiography (OCTA). A total of 19 eyes of 19 patients with unilateral FHI underwent detailed eye examination. OCTA (RTVue-XR Avanti) images were obtained from both eyes. OCTA parameters, including foveal avascular zone, superficial capillary plexus and deep capillary plexus vessel densities, were compared between the involved and fellow control eyes. The median age of the patients (11 females, 8 males) was 42.0 ± 9.63 (range 24–57) years. DCP and SCP densities at the parafoveal and perifoveal area were significantly lower in the FHI eyes compared to the control eyes (44.80 ± 5.24% vs. 54.70 ± 3.76% and 43.30 ± 5.10% vs. 53.70 ± 2.73%, respectively; p < 0.05). The median FAZ was 0.29 ± 0.12 (0.11–0.42) mm2 in the FHI eyes and 0.26 ± 0.09 (0.10–0.40) mm2 in the control eyes. This difference did not reach statistical significance (p = 0.199). Macular capillary perfusion was significantly reduced in both SCP and DCP in the eyes with FHI. FHI, which is known to affect the choroid layer, could also compromise macular capillary perfusion of the retina.

Objectives:To analyze emergency and outpatient admissions by glaucoma patients during complete lockdown due to coronavirus disease 2019 (COVID-19) to assess the effect of pandemic-related complete lockdown on glaucoma patients.Materials and Methods:This retrospective chart review included all glaucoma patients who were either examined and/or underwent emergency surgery between March 11, 2020 and May 31, 2020, a period of complete COVID-19-related lockdown in Turkey. The data were compared with data from patients seen during the same time period in 2019. Visual acuity and intraocular pressure data from patients examined after the lifting of the lockdown were also evaluated.Results:According to Turkish Ministry of Health guidelines, only emergency examinations and surgeries could be performed during the 82 days of the COVID-19 lockdown. During this period, a total of 11 eyes of 10 patients were operated and 123 patients were examined in the outpatient clinic. During the same period in 2019, 122 surgeries were performed, 39 of which were emergencies. In the first 4 weeks after the lockdown ended, 163 patients were examined at the outpatient clinic and marked visual loss was detected in 10 eyes of 9 (5.5%) patients who did not attend follow-up visits due to the pandemic.Conclusion:During the lockdown, emergency surgeries related to glaucoma decreased by 71.7% and marked visual loss was detected in 5.5% of the patients examined after the lockdown. These findings suggest that some patients were unable to present to clinics despite needing emergency care.

To evaluate ocular surface changes and meibomian gland scores in patients with oligoarticular juvenile idiopathic arthritis. This prospective study was conducted at Ege University School of Medicine, Department of Ophthalmology. A total of 34 eyes of 17 patients with oligoarticular juvenile idiopathic arthritis and 30 right eyes of 30 age and gender-matched healthy subjects were included. Besides ophthalmic examination Schirmer 1 test, tear film break up time, Oxford staining scale and meibography were performed. There was no statistically significant differences between groups in terms of age, mean intraocular pressure, mean Schirmer 1 test value, tear film break up time and Oxford staining score. The median upper and lower eyelid meiboscore were 1 ± 0.60 (IQR = 1), and 0 ± 0.34 (IQR = 0) in Group 1, and they were 1 ± 0.56 (IQR = 0), 1 ± 0.12 (IQR = 1) in Group 2. Also, mean upper and lower meiboscores were statistically similar (p values 0.068 and 0.545, respectively). However, the median total meiboscore was 1 ± 0.42 (IQR = 1) in Group 1 and 1 ± 0.66 (IQR = 1) in Group 2. The difference was statistically significant (p = 0.041). Aqueous-deficient dry eye is a well-known condition in patients with rheumatologic diseases. However, evaporative dry eye and meibomian glands were not studied earlier. The current study demonstrated that total meiboscores of oligoarticular juvenile idiopathic arthritis patients are higher than normal subjects, which indicates a possible evaporative dry eye tendency in this entity.

To investigate the effects of 1% cyclopentolate hydrochloride and 1% tropicamide eye drops on aqueous flare measurements by using the laser flare meter. One hundred forty eight eyes of 83 patients with inactive uveitis were enrolled. The patients were randomly assigned to receive either 1% tropicamide (Group 1) or 1% cyclopentolate hydrochloride (Group 2) as the mydriatic agent. Best corrected visual acuity (BCVA), intraocular pressure (IOP), aqueous flare reaction levels measured by laser flare meter device (FM 600, Kowa, Kowa Company Ltd, Nagoya, Japan) before and post dilatation agents were evaluated. Group 1 consisted of 75 eyes and Group 2 consisted of 77 eyes. The mean age of Group 1 patients was 34.85 ± 12.60 (range, 12–64) years; the mean age of Group 2 was 36.92 ± 13.30 (range, 12–70) years (p > 0.05). The mean BCVAs of two groups were 0.16 ± 0.43 (range, 0.00–3.10) logMAR and 0.17 ± 0.42 (range, 0.00–3.10) logMAR, respectively. There were no statistically significant differences between Groups 1 and 2 regarding gender or clinical characteristics (p > 0.05). No significant differences were detected in pre- or post-dilatation values between two groups (p = 0.470, p = 0.998). As a result, anterior chamber flare values in uveitis patients do not differ significantly between 1% tropicamide and 1% cyclopentolate hydrochloride, and both agents can be safely used for dilatation during examination of patients with uveitis.

PURPOSE:Retinal vasculitis and vein occlusions are common causes of serious visual loss in Behçet's disease. We aimed to evaluate the optical coherence tomography angiography (OCTA) findings of Behcet uveitis (BU) patients.METHODS:We evaluated 32 eyes of 16 patients with BU and 30 eyes of 15 healthy controls. Superficial capillary plexus (SCP) and deeper capillary plexuses (DCP) were evaluated using OCTA RTVue XR AVANTI.RESULTS:On SCP, nonperfusion/hypoperfusion areas (NPA) were seen in 10 eyes, perifoveal capillary arcade disruption (PCAD) was seen in 10 eyes, capillary network disorganization (CND) was seen in 7 eyes and intraretinal cystoid spaces (ICS) were seen in 2 eyes. On DCP, NPA were seen in 13 eyes, PCAD was seen in 11 eyes, CND was seen in 7 eyes and ICS were seen in 4 eyes.CONCLUSION:We showed that DCP were affected more than SCP in these patients. In addition, capillary vessel density of BU group was significantly lower than control group.

To evaluate the clinical findings and possible risk factors of patients with aphakic glaucoma following congenital cataract surgery and identify the factors affecting response to glaucoma treatment.

Myhre syndrome is a rare autosomal dominant multisystemic disorder. Typical features of this disorder include distinctive facial appearance, deafness, intellectual disability, cardiovascular abnormalities, short stature, brachydactyly, and skeletal anomalies. Gain-of-function mutations in the SMAD4 gene are responsible for this syndrome. Herein, we present a 9.6-year-old Turkish girl with molecularly confirmed Myhre syndrome who had novel findings including bilateral Axenfield Rieger anomaly with secondary glaucoma and bilateral enlarged vestibular aqueducts.

PURPOSE:To investigate the effect of 1% tropicamide on anterior chamber aqueous flare (ACAF) measurements acquired with laser flare meter in patients with pseudoexfoliation.METHODS:Thirty-three eyes of 33 patients with pseudoexfoliation were enrolled. Patients with the history of other ocular diseases, intraocular surgeries, and the presence of severe posterior synechia were excluded. Besides routine ophthalmological examination, ACAF levels were measured by laser flare meter device (Kowa FM 600) before and after instillation of 1% tropicamide.RESULTS:The mean age of 33 patients was 67.3±7.1 (53-85) years. Patients had a mean best corrected visual acuity of 0.25±0.41 (1.80-0.00) logMAR, cup-to-disc ratio of 0.45±0.22 (0.2-1), and IOP of 15.33±2.82 (9-20) mmHg. Although the mean ACAF value increased from 14.68±8.40 (3.4-40.4) photon/ms predilation to 15.41±10.74 (3.8-46.8) photon/ms post-dilation, the difference was not statistically significant (p=0.835).CONCLUSIONS:ACAF values in patients with pseudoexfoliation did not significantly differ after instillation of 1% tropicamide.

To evaluate the effect of bimatoprost/timolol maleate fixed combination (BTFC), latanoprost/timolol maleate fixed combination (LTFC), and travoprost/timolol maleate fixed combination (TTFC) on 24-h intraocular pressure (IOP) in patients with open-angle glaucoma.

Behçet’s Disease (BD) is a chronic multisystem vasculitis with unknown etiology, which is characterized by the triad of recurrent oral ulcers, genital ulcers, and iritis. The eye is one of the most commonly affected organs and typical ocular involvement is panuveitis with hypopyon and retinal vasculitis. The diagnosis is based on clinical evaluation including biomicroscopic and funduscopic examination. This article aims to review the clinical findings, diagnosis, and classification of BD.

To evaluate the learning curve of non-penetrating glaucoma surgery (NPGS).

Purpose: To evaluate the ocular surface and meibography of patients with inactive Behcet's uveitis.Methods: Twenty-five right eyes of 25 patients with inactive Behcet's uveitis (Group 1) and 25 right eyes of 25 healthy individuals (Group 2) were enrolled. Detailed eye examination along with Schirmer 1 test, tear film break-up time (t-BUT), ocular surface staining with fluorescein and Oxford scoring, and ocular surface disease index (OSDI) score assessment were performed. Lower and upper eyelid Meibomian glands were examined with infrared filter of slit-lamp biomicroscope (SL-D701 with DC-4 digital camera and BG-5 background illuminator, TOPCON, Tokyo, Japan (from grade 0 (no dropout of Meibomian glands) to grade 3 (gland dropout >2/3 of the total Meibomian glands)).Results: The mean ages were 36.847.39 (range, 23-59) and 33.88 +/- 8.25 (range, 18-55) in Group 1 and Group 2, respectively (p =0.547). When compared with Group 2, in Group 1, best-corrected visual acuity (0.28 vs. 0.00 logMAR, p <0.001), Schirmer 1 test (18.68 vs. 23.69, p =0.017) and mean tear film break-up time (10.76 vs. 13.36, p =0.026) were significantly lower; Oxford scale and OSDI scores were higher (p =0.039 and p <0.001, respectively). No significant difference in lower, upper and total (upper + lower) meiboscores were detected in between groups (p =0.062, p =0.228 and p =0.152, respectively).Conclusion: Despite the tendency toward dry eye syndrome, Behcet's uveitis does not seem to be associated with quantitative Meibomian gland changes, which is demonstrated by gland drop-out with meibography.

To investigate the correlation of Scheimpflug camera system and two noncontact specular microscopes in terms of central corneal thickness (CCT) and corneal endothelial cell morphology measurements.

We present the three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) findings of schisis-like maculopathy associated with structural changes of the optic nerve (ON) head as well as the treatment outcomes of a case of advanced glaucoma. In addition to ophthalmological examination, B-scan and 3D-SD-OCT images of the ON head, peripapillary retina, and the macula were obtained. The B-scan images only detected typical retinoschisis findings. However, the 3D-SD-OCT images of the ON head revealed defects of various sizes, shapes, and depths at the outer wall of the prelaminar and laminar regions of the ON canal. The 3D images were able to establish that these defects were both adjacent to and interconnected with the retinal layers. The patient successfully received 3D-SD-OCT-guided thermal laser treatment that is used in congenital optic disc pits complicated with macular schisis. In brief, 3D-SD-OCT is very useful for demonstrating the ON head defects that can lead to schisis-like maculopathy in cases of advanced glaucoma.

Purpose To evaluate the efficacy and safety of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in eyes with refractory neovascular glaucoma. Methods A retrospective chart review of patients with medically uncontrolled neovascular glaucoma who had received 50-µL intracameral bevacizumab (1.25 mg) before undergoing Ex-PRESS mini glaucoma shunt implantation was performed. Success was defined as a postoperative intraocular pressure (IOP) between 5 and 21 mm Hg without (complete success) or with or without (qualified success) glaucoma medications and no additional glaucoma surgery, or loss of light perception. Results In total, 33 eyes of 33 patients (15 female, 18 male) were enrolled in the study. The mean age of the study population was 61.2 years (range 36-78). The mean IOP decreased from 41.0 mm Hg (range 24-72) to 17.6 mm Hg (range 8-28) over a mean follow-up of 20.9 months (range 6-60) (p<0.001; Wilcoxon signed-rank test). Complete and qualified success rates were 36.4% and 66.7%, respectively. The average number of antiglaucoma medications decreased from 3.5 (range 2-4) preoperatively to 1.8 (range 1-4) postoperatively (p<0.001; Wilcoxon signed rank test). In 81.8% of cases, the decrease in IOP was 30% or more postoperatively. Conclusions Ex-PRESS mini glaucoma shunt implantation with preoperative bevacizumab injection may be an effective alternative procedure for refractory neovascular glaucoma.