To investigate the effect of menstrual cycle-related hormonal fluctuations on retinal and choroidal microvasculature using swept-source optical coherence tomography angiography (SS-OCTA). In this prospective study, a cohort of 31 healthy women with regular menstrual cycles was enrolled. SS-OCTA imaging was performed during three standardized menstrual phases: early follicular (day 3), ovulatory (day 14), and mid-luteal (day 21). Macular and peripapillary regions were evaluated using 3 × 3 mm and 4.5 × 4.5 mm scan protocols, respectively. Vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) was automatically quantified using the device’s software. Choroidal thickness (CT) was manually measured in all quadrants, and the foveal avascular zone (FAZ) area was manually delineated by two independent graders. To control for diurnal variation, all measurements were conducted between 11:00 a.m. and 12:00 p.m. A statistically significant decrease in macular CT was observed across the menstrual phases (p = 0.002), along with significant variations in peripapillary CT in the temporal and inferior quadrants (p = 0.004 for both). VD in the peripapillary region showed significant differences in the superior quadrant of the SCP (p = 0.040), the inferior quadrant of the DCP (p = 0.008), and in the temporal and inferior quadrants of the CC (p = 0.011 and p = 0.007, respectively). In the macula, CC-VD in the inferior quadrant differed significantly (p = 0.030). FAZ area remained stable throughout the cycle. Post-hoc analysis revealed significant differences between the early follicular, ovulatory, and mid-luteal phases. Hormonal fluctuations throughout the menstrual cycle appear to influence both retinal and choroidal microvasculature, particularly in the choriocapillaris and peripapillary regions. These findings underscore the importance of considering menstrual phase when interpreting OCTA measurements in women of reproductive age, to improve diagnostic accuracy and consistency in clinical and research settings.

To evaluate the efficacy and safety of intravitreal injections of 4 mg (high dose) of aflibercept in treatment-naive patients with neovascular AMD(nAMD) with treat and extend(TREX) dosing regimens, and to determine the frequency of injections. In this interventional, retrospective study a total of 15 eyes of 14 patients (eight female and 9 male) with nAMD were included. All patients were examined and OCT imaging was performed at the time of initial presentation, on the day of each injection and at subsequent follow-up visits. Each eye received intravitreal injections of 4 mg/0.1 mL aflibercept at the dose of every 4 weeks for three months (loading phase) after that 4 mg high dose of aflibercept was applied as the TREX regime. The eyes with a minimum follow-up time of 12 months are included. The mean age of the patients was 74.9 ± 7.3(61–85) years and the mean follow-up time was 20.33 ± 8.7(12–34) months. Total number of injections were 9.3 ± 3.0 (5–14) during the follow-up period. A statistically significant increase was found in terms of best-corrected visual acuity and central macular thickness between mean baseline values and at 1, 3, 6, 12 months, and the final examination(p < 0.05 for each comparison). No complication was observed during follow-up. High-dose Aflibercept of 4 mg/0.1 mL application with the TREX regimen was found to be efficient and safe. High-dose may also help to reduce the frequency of injections and visits in the follow-up period in eyes with nAMD. Prospective studies with large series are warranted.

Objectives:The objcetive is to compare the anatomic and functional outcomes of vitrectomy between internal limiting membrane (ILM) peeling and non-ILM peeling in diabetic tractional retinal detachment (TRD).Methods: Twenty-three eyes with diabetic TRD with ILM peeling were compared with twenty-four eyes with non-ILM peeling.Best-corrected visual acuity (BCVA) was recorded at baseline and 3, 6, 9, 12 months, and end of follow-up.The mean retinal thickness across nine different regions that defined in the Early Treatment Diabetic Retinopathy Study (ETDRS) were obtained.The ETDRS grid was used to determine the extent of macular involvement.Results: In the 1st month postoperatively, the mean BCVA of eyes with ILM peeling (1.08±0.63LogMAR) was significantly better than eyes with ILM non-peeling (1.69±0.75LogMAR, p=0.003).There was also a significant difference at 9 and 12 months between groups in BCVA, in favor of ILM peeling (p=0.012 and p=0.047, respectively).Seven patients (29.2%) developed epiretinal membrane (ERM), and one patient (4.1%) had ERM with the lamellar macular hole in the ILM nonpeeling group, while only one patient developed ERM in ILM peeling group during the follow-up.Conclusion: ILM removal may be considered in diabetic TRD surgery, as it can provide rapid visual recovery.Moreover, post-operative ERM formation was less frequent in ILM peeled eyes within 1 year after surgery.

PurposeWe aimed to describe single layered free ILM graft technique (FIGT) and present results of this technique in the primary surgery of large macular holes (MHs).MethodsIn this retrospective study, we identified MHs with a minimum hole diameter >400 mu m that underwent FIGT by a single surgeon. Nineteen eyes were found to have an associated epiretinal membrane (ERM) and four eyes demonstrated a patchy ILM staining intraoperatively. A single layered FIGT was performed first by peeling the ILM around the hole and then creating a free ILM flap and transplanting it to cover the hole. All cases were evaluated for anatomical closure and visual improvement.ResultsTwenty-three eyes of 22 patients (mean age 68.7 +/- 7.4 years) were included in the study. The mean follow-up was 9.6 +/- 4.9 months. Flap closure was observed in two eyes (8.6%) at week 1, while all eyes (100%) showed a complete closure at month 1. Mean preoperative visual acuity of 1.42 +/- 0.66 LogMAR increased to 1.11 +/- 0.51, 0.99 +/- 0.34, 0.92 +/- 0.38, 0.74 +/- 0.37, 0.52 +/- 0.28, 0.64 +/- 0.39 respectively at week 1, month 1, month 3, month 6, year 1 and final follow-up postoperatively (p < .05 for all). In none of the eyes ERM recurred, nor flap contraction developed.ConclusionThe study showed encouraging results using free ILM graft in the primary surgery of large MHs. This technique might be considered in large MHs that are associated with ERM or demonstrate patchy ILM staining. Further studies are needed to prove the effectiveness also in the long-term.

INTRODUCTION: The global COVID-19 pandemic has led to significant changes in emergent and elective treatment approaches in medical field, including ophthalmology. The aim of our study is to evaluate the indications, anatomical, and visual results of vitreoretinal surgery (VR) procedures performed during the pandemic and quarantine period. METHODS: VR procedures applied in the treatment of various retinal diseases in a tertiary eye hospital between March 11th and May 31st, 2020, during the COVID-19 pandemic and quarantine period were retrospectively reviewed. Indications of the applications, anatomical and visual results, and surgical complications were evaluated. RESULTS: In this period, 197 (59%) of 335 patients who underwent VR procedure were male, 138 (41%) were female. VR procedure was performed frequently in rhegmatogenous retinal detachment (48.6%) cases, followed by diabetic tractional retinal detachment (14.0%), complicated vitreous hemorrhage (11%), silicone oil extraction due to silicon-related complications (10%), endophthalmitis (7.5%), vitreoretinal pathologies secondary to trauma (5.8%), nucleus drop (2.1%), and intraocular lens drop (1.5%) cases. The pre-operative mean best corrected visual acuity of cases increased from 0.021+-0.167 to 0.258+-0.213 (p=0.042) logMAR. Local anesthesia was applied to 255 (76.1%) and general anesthesia to 80 (23.9%) of the patients who underwent VR in guideline adhered operating rooms. About 95% (n=318) of the patients were anatomically successful and the retina was reattached. Intraocular pressure fluctuations were the most common complication in patients. Elevated intraocular pressure was observed in 9.8% of the patients who underwent treatment for RRD, and hypotonia was found in 9.3% of the patients who underwent silicone oil extraction. DISCUSSION AND CONCLUSION: The visual and anatomical success and complication rates of VR procedures during the COVID-19 period are similar to pre-pandemic period. If appropriate protection, ventilation, and operating room conditions are provided, the risk of contamination for healthcare workers and patients can be minimized and VR interventions may be safely applied.

Background: In young adults with rhegmatogenous retinal detachment, pneumatic retinopexy can be a cost-effective and minimally invasive highly effective method in suitable cases. Objectives: To evaluate the role of pneumatic retinopexy in the treatment of young adults with rhegmatogenous retinal detachment (RRD) and the factors that may affect the success of pneumatic retinopexy. Design: Retrospective study. Methods: The study included 67 eyes of 67 patients aged between 21 and 40 who underwent pneumatic retinopexy (PR) between January 2015 and June 2021 for primary RRD. We retrospectively analyzed the prognostic factors that may affect the success of PR, such as preoperative age, best corrected visual acuity, tear site, lens condition, and axial length. Results: PR was successful in 61.2% of the patients, whereas 38.8% required secondary surgery. Between the group that had a single surgery (Group 1) and the group that required secondary surgery (Group 2) the tear location, axial length, and volumes of gases used were statistically different ( p = 0.04, p < 0.001, and p = 0.02, respectively). There was a significant difference in visual acuity before and after surgery in the group that was successful with a single surgery (Friedman χ 2 = 40.051, p < 0.001). There was no significant difference between the two groups in terms of intraocular pressure ( p > 0.05), and glaucoma was not observed in the postoperative period. Conclusion: Since it is a minimally invasive and cost-effective method that provides rapid visual rehabilitation, it can be considered as first-line therapy in young adults who are suitable for PR.

Objectives:The aim of the study was to investigate the effect of panretinal photocoagulation (PRP) on aqueous flare and intraocular pressure (IOP) in the early period.Methods:Eighty-eight eyes of 44 patients were included in the study. The patients underwent a full ophthalmologic examination including the best corrected visual acuity, IOP measured by Goldmann applanation tonometry, biomicroscopy, and dilated fundus examination before PRP. Aqueous flare values were measured by the laser flare meter. Aqueous flare and IOP values were repeated in both eyes at the 1st and 24th h after PRP. The eyes of the patients who underwent PRP were included in the study as the study group, and the other eyes as the control group.Results:In eyes treated with PRP, 1st h (19.44 pc/ms) and 24th h (18.53 pc/ms) aqueous flare values were statistically higher than before PRP (16.66 pc/ms) (p<0.05). In the study eyes which were similar to the control eyes before PRP, the aqueous flare was higher at the 1st and 24th h after PRP compared to control eyes (p<0.05). The mean IOP at the 1st h (18.69 mmHg) after PRP in study eyes was higher than both pre-PRP (16.25 mmHg) and post-PRP 24th h (16.12 mmHg) IOP values (p<0.001). At the same time, the IOP value at the 1st h after PRP was higher than the control eyes (p=0.001). No correlation was observed between aqueous flare and IOP values.Conclusion:An increase in aqueous flare and IOP values was observed after PRP. Besides, the increase in both values starts even in the 1st h, and the values at 1st h are the highest values. At the 24th h, while IOP values return to baseline, aqueous flare values are still high. In patients who may develop severe intraocular inflammation or cannot tolerate increased IOP (such as previous uveitis, neovascular glaucoma, or severe glaucoma), control should be performed at the 1st h after PRP to prevent irreversible complications. Furthermore, the progression that may develop in diabetic retinopathy due to increased inflammation should also be kept in mind.

Introduction Alexandrite laser is generally used for hair removal and treatment of hyperpigmented skin lesions. It is important to use protective equipment during treatment. In previous cases, complications such as conjunctival hyperemia, anterior uveitis, and choroidal neovascularization were reported. We report a case who developed chorioretinal anastomosis secondary to inadvertent alexandrite laser exposure. Case description A 44 year-old woman presented with decrease of vision in the left eye. She had an history of alexandrite laser treatment for facial hair removal two weeks ago. Fundus examination of the left eye revealed an elevated yellowish lesion in the temporal macula and retina pigment epithelium (RPE) atrophy was observed in the inferotemporal perifoveal region. Optical coherence tomography (OCT) of the left eye revealed the disorganization of inner and outer retinal layers, a rupture in the Bruch membrane, and an absence of RPE. Fluorescein angiography images showed early hyperfluoresence inferior to the fovea. OCT angiography revealed an abnormal vascular network between deep retina layers and choroid. B-scan with flow overlay demonstrated the blood flow in the abnormal vascular network which is suggestive of chorioretinal anastomosis. The patient was followed monthly for choroidal neovascularization development. Six months after laser exposure the best corrected visual acuity was partially improved in the left eye and fundus examination showed pigmentary changes. Conclusion Chorioretinal anastomosis may rarely develop secondary to inadvertent alexandrite laser treatment. It is important to use protective equipment during treatment to prevent ophthalmological complications.

Bietti crystalline dystrophy is a rare hereditary autosomal recessive disease that causes photoreceptor loss secondary to degeneration of retinal pigment epithelium due to intracellular retinal pigment epithelial crystalline deposits and abnormal lipid metabolism. We aimed to present a case of choroidal neovascular membrane secondary to Bietti crystalline dystrophy diagnosed with multimodal imaging and treated with an intravitreal injection of aflibercept. A single dose of aflibercept injection might be effective due to its higher affinity for vascular endothelial growth factor (VEGF) in comparison with other anti-VEGFs. It might be a treatment alternative that can be considered in the choroidal neovascular membrane due to uncommon etiologies.

Objectives:The objectives of the study were to evaluate the vascular and stromal structure of the choroid in patients with inactive thyroid associated orbitopathy (TAO) by measuring choroidal vascularity index (CVI) and choroidal thickness (CT) using enhanced depth imaging (EDI) optical coherence tomography (OCT).Methods:The choroidal image was taken with EDI mode spectral domain (SD)-OCT. All scans were taken between 9.30 am and 11.30 am to avoid the diurnal variation of CT and CVI. To calculate CVI, macular SD-OCT scans were binarized using the publicly available software ImageJ and luminal area and total choroidal area (TCA) were measured. CVI was calculated as the proportion of LA to TCA. Furthermore, the relation between CVI and axial length, gender, and age was evaluated.Results:This study included 78 individuals with a mean age of 51.4±7.3 years. Group 1 consisted of 44 patients with inactive stage TAO, and Group 2 consisted of 34 healthy controls. Subfoveal CT was 338.92±73.93 µm in Group 1 and 303.97±40.35 µm in Group 2 (p=0.174). The CVI significantly differed between the two groups, which was higher in group 1 (p=0.000).Conclusion:Although CT was not different between groups, CVI which is the indicator of the vascular status of the choroid, was higher in patients with TAO in the inactive stage compared with healthy control subjects.

Purpose: To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change. Setting: Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. Design: Retrospective. Methods: Eyes that were not suitable for corneal refractive surgery, had high myopia between −6.00 diopters (D) and −20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded. Results: 36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% (P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye. Conclusions: Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.

Choroidal vascular tumors; it may present as circumscribed and diffuse choroidal hemangiomas and rarely choroidal hemangiopericytoma and phacomatosis pigmentovascularis. Choroidal hemangiomas are benign vascular hamartomatous tumors that occur in two forms: circumscribed and diffuse. The circumscribed form is typically an isolated finding without systemic associations, while the diffuse form generally occurs in association with Sturge–Weber syndrome. Circumscribed choroidal hemangiomas are generally seen as well-circumscribed, round or oval, elevating dome-shaped orange or red masses located posterior to the equator in the fundus, whereas diffuse choroidal hemangiomas have a diffuse red-orange color appearance (tomatoketchup). Although the diagnosis of choroidal hemangioma is better investigated by means of multimodal imaging, indocyanine green angiography and ultrasonography are the most important tests in the differential diagnosis. For circumscribed choroidal hemangiomas with exudative retinal detachment or cystoid macular edema, a variety of treatment modalities are available. Symptomatic patients can be treated with oral propranolol, photodynamic therapy, transpupillary thermotherapy, plaque radiotherapy, external radiotherapy or intravitreal anti-vascular endothelial growth factors.In this review, the pathogenesis, clinical features and treatment methods in choroidal vascular tumors will be discussed.

Purpose The assessment of retinal and choroidal changes in eyes with unilateral Fuchs uveitis syndrome (FUS) with the fellow eye and healthy control group. Methods Thirty-nine unilateral FUS patients and 42 healthy control subjects were enrolled. Spectralis domain optical coherence tomography (SD-OCT, Spectralis; Heidelberg Engineering GmbH, Heidelberg, Germany) was used to evaluate retinal and choroidal structures. Retinal and choroidal thicknesses were recorded from OCT images. Choroidal images were binarized to calculate choroidal vascularity index (CVI) with ImageJ 1.52 s (National Institutes of Health, Bethesda, MD, USA) program. Results CVI was found to be significantly lower in the FUS group compared to the fellow eyes and healthy control groups ( p = 0.039 and p = 0.046, respectively). There was no significant difference in central choroidal thickness in the FUS group compared to the fellow eyes and control groups ( p = 0.552 and p = 0.321, respectively). There was no statistically significant difference between the 3 groups in terms of macular thickness in all quadrants ( p > 0.05 for all quadrants). Conclusions Affected eyes tend to decrease in CVI, while there is no difference in retinal and central choroidal thicknesses in patients with FUS compared to eyes of other unaffected eyes and healthy individuals. It may be because the chronic inflammation associated with the disease affects the vascular structure of the choroid.

BACKGROUND:To investigate the longitudinal retinal vascular and structural alterations by using OCTA following successful repair of retinal detachment (RD) by using silicone oil (SO) endotamponade. METHODS:A prospective cohort study was performed on 24 eyes of 24 subjects; 17 of them with macula-off and seven with macula-on RD. At least four OCTA scans were generated for each study eye; two before and two after SO removal (SOR). At each session, retinal thickness (RT), vascular density (VD) in the superficial (SCP) and deep capillary plexuses (DCP) and foveal avascular zone(FAZ) size were measured within the fovea, parafovea and whole macular image. The changes in repeated measures of the same parameters especially before and after SOR were performed and compared within macula-on and macula-off groups and between fellow eyes. RESULTS:"In the macula-off eyes, RT measurements within the whole macula, fovea and parafovea reduced as compared with their fellow eyes(p < 0.0001, p = 0.001 and p < 0.0001, respectively) and did not improve after SOR. Additionally, all of the whole macular, foveal, and parafoveal VD measurements at SCP and foveal VD at DCP were less than their fellow eyes after SOR (p = 0.026, p = 0.023 p = 0.026, and p = 0.002, respectively). In macula-on eyes, RT measurements decreased within the parafovea and whole macular area before SOR (p = 0.018 and p = 0.011, respectively) but improved after SOR. Also, VD measurements did not change during follow-up and were not statistically different than their fellow eyes (p > 0.05). FAZ enlargement was found in eyes with macular-off RD after SOR, whereas it was not observed with macular-on RD (p = 0.038and p = 0.237, respectively). CONCLUSIONS:Treatment of macula-off RD with SO tamponade has been associated with vascular retinal abnormalities which did not improve following SOR. On the contrary, successful treatment of RD with SO tamponade in macula-on eyes VD measurements of SCP and DCP were not statistically different than their fellow eyes.

Précis: The choroidal vascularity index (CVI) is a new marker for the choroid. The decrease in CVI following latanoprost use can provide a better understanding of the pathogenesis of the posterior segment side effects of latanoprost such as cystoid macular edema and central serous choroidopathy. Purpose: The purpose of this paper is to evaluate the changes in the CVI, total choroidal area (TCA), stromal area (SA), luminal area (LA), and choroidal thickness (CT) following latanoprost therapy in patients with primary open angle glaucoma and ocular hypertension. Materials and Methods: Patients with newly diagnosed primary open angle glaucoma or ocular hypertension who had never received antiglaucoma therapy were included. Each patient received latanoprost 0.005% once daily. Enhanced depth imaging mode of spectral-domain optical coherence tomography scans was taken before the start of latanoprost therapy and in the first and third months. Subfoveal CT, CVI, TCA, LA, and SA for the submacular area, and 4 quadrants of the peripapillary area were calculated from the scans. Results: A total of 36 eyes of 18 patients were analyzed. Subfoveal CT increased significantly (P=0.007). Mean TCA (P=0.008) and SA (P<0.001) in the first and third months were higher than baseline in the submacular regions. Mean CVI was lower in the first and third months (P<0.001). There was an increase in the mean TCA and SA in the peripapillary temporal (P=0.001 and 0.028) and inferior (P=0.002 and <0.001) quadrants and a decrease in mean CVI in the temporal (P=0.027) and inferior (P=0.003) peripapillary quadrants. A negative correlation was found between the rate of decrease in intraocular pressure and the macular region CVI. Conclusions: Following latanoprost use for several months, the CVI was significantly decreased in newly treated patients with glaucoma or ocular hypertension, among other changes to the choroid. These findings may contribute to a better understanding of the effects of prostaglandins on the posterior segment of the eye.

Abstract BackgroundTo analyze the anatomical and functional outcomes of ILM peeling and to compare those with patients who did not perform ILM peeling in tractional retinal detachment with diabetic retinopathy.MethodsThe study was designed retrospectively. It was planned to include all consecutive eyes with TRD that had macular involvement and successful repair using 23-gauge(G) pars plana vitrectomy (PPV) between 2019 and 2021 and were followed in the retina for at least 12 months. A total of 163 eyes were evaluated. Forty-seven eyes with TRD (24 without ILM peeling and the rest with ILM peeling applied) were eligible to be part of the study.ResultsIn the first month of the postoperative period, the mean BCVA(LogMAR) of eyes with ILM peeling (1.08±0.63) were significantly better than eyes with ILM non-peeling (1.69±0.75, p=0.003). Similarly, there was a statistically significant result at 9- and 12-months p=0.012 p=0.047, respectively. The mean preoperative CMT was 494.96±90.67 while 362± 85.77 in postoperative 1 month and 300.74± 86.23 in 12 months in study group.(for each, p=0.000) Although the mean CMT was thinner in the ILM peeling group than in the ILM non-peeling group during the follow-up, this difference was not statistically significant(p>0.05).ConclusionsEpiretinal membrane formation and macular edema were observed less frequently in the ILM peeling group during the 30-month follow-up. In addition, rapid improvement was achieved in terms of visual acuity in the eyes with ILM peeling.

Purpose To evaluate the microvascular changes in the macular and peripapillary area after intravitreal dexamethasone implant in diabetic macular edema (DME) Material and Methods We included 31 eyes of 31 patients treated with a single dose dexamethasone implant for DME. All subjects underwent swept-source optical coherence tomography (OCT) and OCT angiography imaging before (T0), and one month (T1), two months (T2), and four months (T4) after dexamethasone injection. The foveal avascular zone (FAZ) area of superficial and deep capillary plexus (SCP and DCP) was calculated by delineating the FAZ border using the measurement tool of the device. The vessel density (VD) of SCP and DCP and choriocapillaris (CC) in the macular and peripapillary area were automatically calculated. Results There was an insignificant reduction in FAZ area measurements of SCP after dexamethasone injection in DME patients (p = 0.846). The FAZ area of DCP were significantly smaller compared to T0 measurements at T1, T2, and T4 (p = 0.013, p = 0.031, and p = 0.029, respectively). The mean average parafoveal VD measurements were significantly decreased after dexamethasone injection in SCP and DCP (p = 0.004, p = 0.005). The peripapillary VD in retinal capillary plexuses and choriocapillaris showed no significant difference after dexamethasone injection. Conclusion Intravitreal dexamethasone leads to a significant FAZ area decrease in DCP with a reduction in parafoveal VD measurements. In addition, no significant VD changes were observed in the peripapillary area after dexamethasone. These findings indicate that dexamethasone may improve macular ischemia with no significant effects on peripapillary microvasculature in DME patients.

Purpose: To evaluate the influence of trifocal and monofocal intraocular lens implantation on the optical coherence tomography-signal strength index values obtained during macular and peripapillary scanning. Method: Study group included 60 eyes of 60 patients with intraocular lens (Acriva BB UD 613 monofocal in 30 eyes and Acriva Trinova UD trifocal in 30 eyes) implantation after uneventful phacoemulsification. Thirty eyes of 30 healthy subjects without any intraocular surgery were selected as the control group. Eyes with best corrected visual acuity less than 20/20 due to any media opacity, high refractive errors excluded. Macular and retinal nerve fiber layer scans were generated by optical coherence tomography after pupillary dilation. Intergroup comparisons of signal strength index values of the macular and peripapillary scans were performed between eyes implanted with two different intraocular lenses and control group. Results: The mean signal strength index of the peripapillary and macular scans obtained in the eyes implanted with both monofocal and trifocal intraocular lenses were statistically less than the control group (p < 0.05, for all). SSI's of macular and peripapillary scans recorded from the eyes implanted with either monofocal or trifocal intraocular lenses were not statistically different from each other (p = 0.957 and p = 0.877, respectively). Conclusion: In the present study despite different intraocular lenses properties, the image quality values were not found to be lower in eyes with trifocal sinusoidal intraocular lenses implantation compared to monofocal intraocular lenses during macular and peripapillary optical coherence tomography scans.

Purpose: To compare the lens autofluorescence (AF) levels among patients with end-stage renal failure and undergoing hemodialysis secondary to hypertension, patients with well-controlled hypertension, and healthy controls. Method: This study was a prospective, cross-sectional, comparative study conducted between February and April 2018. Two groups of patients and a group of healthy individuals were included in the study. The first group of patients included individuals with a renal insufficiency due to essential hypertension who underwent regular hemodialysis treatment (dialysis group). The second group included patients with well-controlled essential hypertension (hypertension group). Lens autofluorescence was measured via a scanning confocal lens fluorescence biomicroscope optical system for all participants. The measurement of fluorescence ratio is given as a numerical data. The AF results were compared in all groups. Results: The study included 87 individuals. There were 29 individuals (33.3 %) in the dialysis group, 30 (34.5 %) in the hypertension group, and 28 (32.2 %) in the healthy group. The mean fluorescence ratio(FR) was 0.20 +/- 0.06, 0.20 +/- 0.04, and 0.17 +/- 0.04 in the dialysis, hypertension, and healthy groups respectively. There was a significant difference in the mean FR measurements between the three groups (p = .004). As a result of a binary comparison, mean FR values for patients in the dialysis group were higher (0.20 +/- 0.06) than for healthy individuals (0.17 +/- 0.04), which was statistically significant (p = .025). Mean FR measurements of hypertensive patients were higher (0.20 +/- 0.04) than healthy individuals (0.17 +/- 0.04), which was also statistically significant (p = .02). However, there was no statistically significant difference among the mean FR measurements between the hypertension and dialysis groups (p = .63). Conclusion: We demonstrated that lens autofluorescence increased in patients with renal failure undergoing hemodialysis and those with well-controlled hypertension. The mean lens autofluorescence levels were significantly higher in both patient groups than the healthy control group.