RESUMEN
PURPOSE: To determine the level of vascularization and peripheral vascular findings by fluorescence angiography in patients with aggressive retinopathy of prematurity or Type 1 retinopathy of prematurity treated with a single dose of anti-vascular endothelial growth factor. METHODS: Data of patients referred to the authors' clinic for fluorescence angiography examination between June 2016 and September 2021 were retrospectively analyzed. Patients who had their first fluorescence angiography examination at the age of 1 year or older were included in the study. RESULTS: A total of 486 eyes of 250 patients were included. Of these, 83 eyes (17.1%) had vascular termination in Zone II and 403 eyes (82.9%) in Zone III. In 62.7% of eyes, the distance from the vascular terminals to the temporal ora serrata was less than two disk diameters, and in 20.2%, it was more than two disk diameters. Abnormal vascular findings were noted, including circumferential vessels (41.2%), finger-like projection anomaly (36.2%), hyperfluorescence (16.9%), fine branching and blunt termination (15%), and arteriovenous shunt (9.9%). CONCLUSION: Fluorescence angiography performed late in the course of treatment can clearly define the vascular termini and detect abnormalities that cannot be detected by indirect ophthalmoscopy. Follow-up with fluorescence angiography can help prevent complications that can lead to vision loss.
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Inhibidores de la Angiogénesis , Angiografía con Fluoresceína , Inyecciones Intravítreas , Vasos Retinianos , Retinopatía de la Prematuridad , Factor A de Crecimiento Endotelial Vascular , Humanos , Retinopatía de la Prematuridad/tratamiento farmacológico , Retinopatía de la Prematuridad/diagnóstico , Angiografía con Fluoresceína/métodos , Estudios Retrospectivos , Femenino , Inhibidores de la Angiogénesis/uso terapéutico , Inhibidores de la Angiogénesis/administración & dosificación , Masculino , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Lactante , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patología , Recién Nacido , Preescolar , Edad Gestacional , Fondo de Ojo , Niño , Estudios de Seguimiento , Ranibizumab/administración & dosificación , Ranibizumab/uso terapéutico , Bevacizumab/uso terapéutico , Bevacizumab/administración & dosificaciónRESUMEN
AIM: : To evaluate any abnormalities on retinal examination and retinal microvascularity in patients recovered from COVID-19. MATERIALS AND METHODS: : Cross-sectional, case- control study. Patients between 18 and 65 years old with PCR-confirmed SARS-CoV-2 infection and age matched controls were included. Macular and retinal nerve fiber layer thickness, vessel density of the superficial (SCP) and the deep retinal capillary plexus (DCP) and the foveal avascular zone (FAZ) were measured and compared with controls. RESULTS: : This study included 200 eyes of 200 cases totally. Of them 105 cases were patients and 95 cases were controls. Retinal abnormalities were detected by indirect ophthalmoscopic examination in ten patients of 105 cases (10.5%). There was no statistically significant difference in the vessel density of the SCP and the DCP and the mean FAZ measurements. CONCLUSION: : There isn't any relevant difference between early post-COVID-19 patients and general population in terms of retinal microvascularity.
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COVID-19 , Fóvea Central , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Fóvea Central/irrigación sanguínea , Vasos Retinianos , Angiografía con Fluoresceína , Estudios Transversales , Agudeza Visual , Tomografía de Coherencia Óptica , SARS-CoV-2RESUMEN
PURPOSE: To define late-stage fluorescein angiography (FA) findings in patients who received anti-vascular endothelial growth factor (VEGF) agents (intravitreal bevacizumab or aflibercept) as a treatment for stage 3 retinopathy of prematurity (ROP) in zone II. We also compared the findings of untreated eyes. METHOD: Infants with a history of ROP who underwent fluorescein angiography were evaluated retrospectively. The patients were divided into 2 groups: those who received anti-VEGF treatment and those who regressed spontaneously without treatment. Vascular abnormalities, such as vascular leakage, shunts at the vascular-avascular junction, periarteriolar areas with hypoperfusion, fine branching and blunt termination of the vessels and, were recorded. RESULTS: Angiography evaluations revealed leakage in the eyes of 27.69% of the infants in the anti-VEGF-treated group and in 21.7% of the untreated group (p = .638). Among the abnormal vascular findings in the peripheral retina, the ratios of fine branching and blunt termination, numbers of shunts along the vascular-avascular junction, and sizes of periarteriolar areas of hypoperfusion were significantly larger in the untreated group than in the treated group (p < .05; p < .01). The gestational ages and birth weights were significantly lower (p ≤ .05) in infants with vascular findings in both groups. CONCLUSION: Vascular abnormalities in the peripheral retina are likely due to the ROP itself. Although these abnormalities were detected by FA imaging in both treated and untreated infants with ROP, they were significantly less frequent in patients treated with anti-VEGF, indicating that anti-VEGF treatments have a partially positive effect on the retinal vascularization process.
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Retinopatía de la Prematuridad , Inhibidores de la Angiogénesis/uso terapéutico , Bevacizumab/uso terapéutico , Factores de Crecimiento Endotelial/uso terapéutico , Angiografía con Fluoresceína/métodos , Edad Gestacional , Humanos , Lactante , Recién Nacido , Inyecciones Intravítreas , Retinopatía de la Prematuridad/diagnóstico , Retinopatía de la Prematuridad/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
PURPOSE: To evaluate the retinal nerve fiber layer (RNFL) thickness, the ganglion cell complex (GCC) and vessel density of the radial peripapillary capillary (RPC) plexus of eyes with regressed papilledema in idiopathic intracranial hypertension (IIH) patients using optical coherence tomography angiography (OCT-A) and comparing the results with healthy controls. MATERIALS AND METHODS: Fifty-one eyes of 31 patients diagnosed with IIH and 52 eyes of 52 healthy subjects were enrolled in this study. All patients underwent a complete ophthalmological examination and a 4.5 × 4.5 mm peripapillary OCT-A scanning. The quantitative results of the peripapillary RNFL and GCC thicknesses and vessel density of the RPC were analyzed. RESULTS: The vessel density in the inferior, superior nasal, and inferior nasal sectors of the patients with IIH significantly exceeded the vessel density of the healthy controls (P = 0.008, P = 0.008, and P = 0.000, respectively). The RNFL and GCC thickness measurements were comparable in both groups. CONCLUSIONS: Patients with IIH show vascular abnormalities in the inferior nasal region, which can be detected with OCT-A. As a noninvasive imaging modality, OCT-A could provide a new perspective for understanding the pathophysiology of IIH and could also be useful in the follow-up of these patients.
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Papiledema , Fotoquimioterapia , Seudotumor Cerebral , Humanos , Fibras Nerviosas , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes , Seudotumor Cerebral/complicaciones , Células Ganglionares de la Retina , Tomografía de Coherencia ÓpticaRESUMEN
BACKGROUND: The aim of this study was to demonstrate the presence of the virus in tear and conjunctival secretions of clinically-confirmed COVID-19 pneumonia patients. METHODS: This prospective study was conducted at Bakirkoy Dr. Sadi Konuk Training and Research Hospital (2020/190). Nasopharyngeal and ocular samples were obtained by swab technique and investigated by RT-PCR. RESULTS: A total of 83 patients were included. The mean age was 61.88 ± 16.04 years. 28.92% of the patients had mild, 65.06% moderate and 6.02% severe pneumonia radiologically. RT-PCR was positive in 31 (37.35%) patients in the first nasopharyngeal swabs and in 19 (22.89%) in the second swabs. 17 of 19 patients had positive both first and second nasopharyngeal swabs; only the second swabs of two patients were positive. The first conjunctival swabs RT-PCR were positive in 5 out of 83 clinically-confirmed patients or 33 laboratory-confirmed patients (rates: 6.02% and 15.15%). There were no positives detected in the second conjunctival swabs. CONCLUSIONS: SARS-CoV-2 can be detected in the conjunctival swabs of patients with COVID-19 pneumonia.
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COVID-19 , SARS-CoV-2 , Conjuntiva , Humanos , Persona de Mediana Edad , Estudios Prospectivos , ARN ViralRESUMEN
PURPOSE: To investigate the incidence and causes of amblyopia in congenital ptosis. METHODS: The frequency and causes of amblyopia were evaluated in 83 eyes of 72 patients with congenital ptosis. Patient ages ranged between 10 months and 70 years. Amblyopia was defined as best-corrected visual acuity of 0.7 or less. After a complete ophthalmologic examination, the amount of ptosis and levator function was determined and the following amblyogenic factors were identified: ametropia, anisometropia, and strabismus. In cases with no other reason for amblyopia, stimulus deprivation amblyopia due to ptosis was assumed. RESULTS: The amount of ptosis was mild in 5 (6%), moderate in 26 (31%), and severe in 52 (63%) of 83 eyes with congenital ptosis. Strabismus was present in 17 (20%) eyes. Visual acuity could not be determined in 10 of 83 eyes with ptosis in children younger than 4 years. The overall incidence of amblyopia in the remaining 73 eyes was 48%. Of those patients with amblyopia, 54% had refractive errors such as anisometropia or ametropia, 20% had strabismus with or without refractive errors, and 26% had amblyopia solely attributed to ptosis. When all eyes with ptosis were included, the rate of stimulus deprivation amblyopia was 12% and all of these eyes had severe ptosis. CONCLUSION: Early detection and treatment of amblyogenic factors such as refractive errors and strabismus is recommended and, when the pupillary axis is occluded with severe ptotic eyelids, surgery should be performed as soon as possible to prevent stimulus deprivation amblyopia.
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Anomalías Múltiples , Ambliopía/congénito , Blefaroptosis/congénito , Adolescente , Adulto , Anciano , Ambliopía/epidemiología , Ambliopía/fisiopatología , Blefaroplastia , Blefaroptosis/epidemiología , Blefaroptosis/cirugía , Niño , Preescolar , Diagnóstico Diferencial , Humanos , Incidencia , Lactante , Persona de Mediana Edad , Refracción Ocular , Turquía/epidemiología , Agudeza Visual , Adulto JovenRESUMEN
PURPOSE: To determine the astigmatism outcomes after cataract surgery performed using superonasal and superotemporal clear corneal incisions. SETTING: Department of Ophthalmology, Kartal Training and Research Hospital, Istanbul, Turkey. METHODS: This prospective study includes consecutive 45 eyes of 34 patients having phacoemulsification with implantation of foldable acrylic intraocular lens through a corneal tunnel incision between January and April 2004. The right eye always had a superotemporal incision while the left eye a superonasal incision. Astigmatism was measured by keratometry readings before surgery and 3rd, 15th, and 45th days postoperatively. The surgically induced astigmatism (SIA) was calculated by the vector analysis using the Holladay-Cravy-Koch method at 3rd day, 2nd and 6th weeks postoperatively. RESULTS: The mean preoperative astigmatism was 0.74 +/- 0.45 diopter (D) in the temporal incision group and 0.69 +/- 0.39 D in the nasal incision group. Fifty-eight percent of eyes had against-the-rule (ATR) astigmatism, 26% had with-the-rule (WTR) astigmatism, and 16% were astigmatically neutral. At 6 weeks, 46% of eyes had ATR astigmatism and 35% had WTR astigmatism. The mean total astigmatism was lower in the temporal incision group than in the nasal incision group at all successive examinations postoperatively. Although the total astigmatism decreased at 6 weeks in both groups, temporal incisions yielded less total and surgically induced astigmatism (P < .05). CONCLUSIONS: Cataract surgery using superotemporal incision induced significantly less SIA in the early postoperative period.