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PRCIS: In recent years, ChatGPT has been widely used as a source of information. In our study, it was revealed that ChatGPT gives accurate information about glaucoma. PURPOSE: We examined the knowledge of ChatGPT about glaucoma. MATERIALS AND METHODS: Frequently asked questions about glaucoma found on websites of ophthalmology associations and hospitals, and social media applications were assessed. Evidence-Based Recommendations in the European Glaucoma Society Terminology and Guidelines for Glaucoma, Fifth Edition were evaluated. Using the ChatGPT-4, each question was asked twice on different computers to assess the reproducibility of answers. The answers provided were recorded and 2 specialist ophthalmologists evaluated them independently, assigning scores ranging from 1 to 4. RESULTS: The answers to all questions about glaucoma resulted in 88.7% completely correct, 7.5% correct but insufficient, and 3.8% misleading information and correct information. No question was answered completely incorrectly. While 85.8% of the general knowledge questions were answered correctly, 91.7%, 86.6%, and 91.7% of questions about diagnosis, treatment, and prevention were answered correctly, respectively. The number of questions prepared based on the European Glaucoma Society Terminology and Guidelines for Glaucoma was 16. The rate of completely correct answers to these questions was 75.0% (12). While 3 (18.8%) answers were correct but insufficient, 1 response (6.3%) contained false information and correct information. CONCLUSIONS: Our study revealed that ChatGPT answered 9 out of 10 questions about general information, diagnosis, treatment, and preventive and follow-up about glaucoma with acceptable and satisfactory accuracy rates. In addition, 3 of 4 answers given by ChatGPT were completely correct according to Terminology and Guidelines for Glaucoma.

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INTRODUCTION: This study aimed to compare the neuroaxonal damage of the optic nerve and retina in multiple sclerosis (MS) patients with and without overactive bladder (OAB). PATIENTS AND METHODS: We included patients with MS, divided into two groups, based on the severity of OAB symptoms, as evaluated by the OAB-V8 questionnaire. The groups were compared in terms of each dial of the Expanded Disability Status Scale (EDSS), best-corrected visual acuity, intraocular pressure, peripapillary retinal nerve fiber layer (pRNFL) thickness, macular thickness, and macular ganglion cell-inner plexiform layer (mGCIPL) thickness. RESULTS: The study involved a total of 120 eyes, 78 eyes from 43 female patients, and 42 from 22 male patients. There were 86 eyes (Group 1) with OAB-V8 score under 8 and there were 34 eyes (Group 2) with OAB-V8 score of 8 or over. EDSS median value was 1 (0-2) for Group 1 and 2 (0.8-3.3) for Group 2 (p = 0.004). A comparison of pRNFL thicknesses showed statistically significant lower average, superior, and inferior median values in Group 2. A comparison of mGCIPL thicknesses showed statistically significant lower values in Group 2 for superior, superonasal, inferotemporal, and superotemporal quadrants CONCLUSION: This study revealed, for MS patients without optic neuritis attacks, there was a higher incidence of OAB when the EDSS score was higher. There was a statistically significant relationship between the existence of OAB and thinning in both mGCIPL and pRNFL. The most relevant factor for OAB was found to be pRFNL inferior quadrant thinning.

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PURPOSE: To evaluate the efficacy of trephination and monocanalicular/bicanalicular silicone tube use depending on the number of affected canaliculi in patients with canalicular obstruction. METHODS: This retrospective study included 46 eyes of 36 patients who underwent trephination and silicone tube intubation performed by a single experienced oculoplastic surgeon due to canalicular obstruction between 2005 and 2020. Monocanalicular silicone tube was applied to patients with one canalicular obstruction, and bicanalicular silicone tube was applied to those with the upper and lower canalicular involvement of the same eye. Canalicular obstructions were divided into groups according to their localization as proximal, middle, and distal. The silicone tubes were kept in place for at least 5 months after the operation, and the follow-up duration of the patients was at least 12 months. RESULTS: Twenty (55.6%) patients were female and 16 (44.4%) were male. The mean age was 15.82 ± 7.02 years in the treatment success group and 28.87 ± 12.74 years in the treatment failure group (p = 0.001). While 67.6% of the eyes in the treatment success group had monocanalicular obstruction (monocanalicular silicone tube applied), 66.7% of those in the treatment failure group had bicanalicular obstruction (bicanalicular silicone tube applied) (p = 0.049). The most common distal obstruction was seen in the treatment success group, and the least distal obstruction and the most proximal obstruction were observed in the treatment failure group (p < 0.001). The mean duration silicone tube stay was 9.37 ± 1.96 months in the treatment success group and 7.25 ± 1.42 months in the treatment failure group (p = 0.003). CONCLUSION: We consider that trephination with the use of a monocanalicular or bicanalicular silicone tube depending on the number of affected canaliculi can be the first choice of treatment in canalicular obstruction due to its high success rate, especially in distal obstruction.

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BACKGROUND: Restless legs syndrome (RLS) is one of the most frequent comorbidities accompanying multiple sclerosis. Patients with multiple sclerosis (MS) show thinning in the retinal layers throughout the disease. The thinning is related to acute attacks and progression and atrophy of the brain. Optical coherence tomography (OCT) provides relevant information on the pathophysiology of MS. We aimed to evaluate OCT parameters in patients with MS to investigate any changes related to the coexistence of RLS. METHODS: We consecutively enrolled 75 adults with relapsing-remitting MS. Participants were assessed by using demographic and clinical parameters along with the excessive sleepiness in the daytime (ESS), fatigue severity scale (FSS), and RLS severity scale (IRLSSG). The thickness of the peripapillary retinal nerve fiber layer (pRNFL), macular thickness (MT), and macular ganglion cell - inner plexiform layer (MGCIPL) complex was measured with spectral-domain OCT. RESULTS: Of the 75 participants, 20 were found to have RLS, and 55 did not. Scores of ESS, FSS, and MS disability (EDSS) were worse in patients with RLS. There was no significant difference in retinal nerve fiber layer thickness except for the inferior quadrant(p = 0.029). The mean inferior pRNFL thickness was 104.5 ± 22.6 µm in the RLS (+) group and 114.2 ± 21.6 µm in the RLS (-) group. CONCLUSION: Patients with RLS had excessive daytime sleepiness, were more fatigued, had higher EDSS scores, and had a thinner retinal layer in the inferior quadrant. Overall, data from the study suggest a possible relationship between retinal volume changes in MS patients with RLS.

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PURPOSE: To evaluate the effect of monocanalicular silicone tube intubation outcomes as an initial surgical treatment in children older than 1 year old with primary nasolacrimal obstruction. METHODS: Probing or monocanalicular silicone tube intubation was performed as primary surgical treatment on 12-48 months old children with primary nasolacrimal obstruction. Probing was performed on 53 eyes of 43 patients and silicone tube intubation on 45 eyes of 39 patients. Treatment was considered successful after improvement in patient complaints, the presence of normal tear meniscus, and normal results of fluorescein disappearance time test. Retrospective treatment success was compared between two groups according to age groups. RESULTS: Treatment success was 79.1% in the probing group and 92.3% in the silicone tube intubation group. The success of the treatment was evaluated separately in the groups of 12 to <24 months, 24 to <36 months, and 36 to <48 months, and although the success level of the silicone tube intubation group was consistently found to be higher, the difference was not statistically significant. Treatment success decreased statistically significantly in the probing group with increased age of the patients, especially after 24 months. There was no such statistically significant decrease in the silicone tube intubation group. CONCLUSION: The choice of monocanalicular silicone tube intubation for primary surgical treatment in children with primary nasolacrimal obstruction provides success without the need for repetitive surgical interventions, especially in children older than 24 months.

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PURPOSE: To compare the inhibitory effects of dovitinib and bevacizumab for treatment of corneal neovascularization (CNV). METHODS: Thirty-nine adult female Sprague Dawley rats weighing 180 to 250 g were used. CNV was induced by silver nitrate in the right eye of each rat. After the chemical burn, the animals were randomized into 5 groups. Group 1 did not receive any chemical substance. Group 2 received dimethyl sulfoxide, group 3 received bevacizumab 5 mg/mL, group 4 received dovitinib 5 mg/mL, and group 5 received bevacizumab 5 mg/mL + dovitinib 5 mg/mL topically administered twice daily for 14 days. On the 14th day, slit-lamp examination was performed, and anterior segment photographs were taken. The corneal neovascular area was measured on photographs as the percentage of the cornea's total area using computer imaging analysis. The corneal sections were stained with hematoxylin and eosin for histopathological examination. RESULTS: A statistically significant decrease in the percentage of CNV was found in all treatment groups (group 3, group 4, and group 5) compared with the control group (group 1) (P < 0.01). A statistically significant difference in the percentage of CNV was found among group 3, group 4, and group 5 (P = 0.003). The percentage of CNV in group 4 was significantly higher than that in group 3 and group 5 (P1 = 0.004; P2 = 0.006). There was no statistically significant difference in the percentage of CNV between group 3 and group 5 (P = 0.228). CONCLUSIONS: Dovitinib is a newly developed multitargeted tyrosine kinase inhibitor. Topical administration of dovitinib effectively inhibited CNV, but this effect of dovitinib was found less than topical bevacizumab.

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OBJECTIVES: To evaluate corneal biomechanics before and after collagen crosslinking (CXL) in patients with progressive keratoconus. MATERIALS AND METHODS: In this prospective study, CXL was performed under topical anesthesia after removal of the epithelium (epi-off technique) by applying ultraviolet A (UVA) light at a wavelength of 365 nm and power of 3 mW/cm2 or 5.4 joule/cm2. Isoosmolar 0.1% riboflavin solution was administered before and during UVA irradiation. In addition to ophthalmologic examination, ocular response analyzer measurements were performed pre- and postoperatively. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), Goldmann-correlated intraocular pressure (IOPg), and central corneal thickness (CCT) were recorded. RESULTS: The study included 35 eyes of 30 patients with progressive keratoconus. The mean age was 28.2±6.5 years and postoperative follow-up time was 20.2±14.7 months (range: 6-74 months). The mean CH was 8.60±1.23 mmHg preoperatively, 8.96±2.05 mmHg in the early postoperative period (1-6 months), (p=0.28) and 8.96±1.28 mmHg in the late postoperative period (10-29 months) (p=0.48). Mean CRF was 7.13±1.50 mmHg preoperatively, 8.48±2.16 mmHg in the early postoperative period (p=0.009), and 7.71±1.29 mmHg in the late postoperative period (p=0.40). Mean IOPcc was 12.78±2.34 mmHg preoperatively, 15.38±4.21 mmHg in the early postoperative period (p=0.12) and 13.68±3.61 mmHg in the late postoperative period (p=0.48). Mean IOPg was 9.56±2.73 mmHg preoperatively, 13.01±4.45 mmHg in the early postoperative period (p=0.046), and 10.86±3.47 mmHg in the late postoperative period (p=0.44). Mean CCT was 484.43±41.26 µm preoperatively, 474.16±64.74 µm in the early postoperative period (p=0.70), and 470.38±33.64 µm in late postoperative period (p=0.71). CONCLUSION: CXL is a treatment modality believed to affect corneal biomechanics in keratoconus, but the results of larger patient series with longer follow-up periods may enable a better evaluation.

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OBJECTIVES: To show the importance of frozen section-controlled excision to avoid the re-recurrence of recurrent basal cell carcinoma (BCC) of the eyelids. MATERIALS AND METHODS: Thirty-five cases who underwent eyelid tumor excision in different centers and were admitted to our clinic with recurrent eyelid tumors. Recurrent tumors were resected by excision 1-2 mm from the tumor's visible margin and sent to pathology for frozen section examination. Eyelid reconstructions with flap and graft were performed after confirming that the surgical margins were negative. RESULTS: Twenty-one (60%) of our patients were male and 14 (40%) were female. Median age of our group was 63.4±14.2 years. Excision and sending the excised material for frozen section control was performed once for 11 patients, twice for 12 patients, 3 times for 8 patients and 4 times for 4 patients to confirm that the surgical margins were clean. All pathology samples were reported as BCC. All patients had eyelid reconstruction with flap and graft. Recurrence was detected in 2 patients (5.7%) during 1 to 8 years (mean 4.3 years) of follow-up and those patients were reoperated; no recurrence was detected in the remaining 33 patients (94.3%). CONCLUSION: Frozen section control can provide low re-recurrence rate in patients with recurrent BCC of the eyelids.

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Dengue fever is a flavivirus infection transmitted through infected mosquitoes, and is endemic in Southeast Asia, Central and South America, the Pacific, Africa and the Eastern Mediterranean region. A 41-year-old male patient had visual impairment after travelling to Thailand, which is one of the endemic areas. Cotton wool spots were observed on fundus examination. Fundus fluorescein angiography showed minimal vascular leakage from areas near the cotton wool spots and dot hemorrhages in the macula. Dengue fever should be considered in patients with visual complaints who traveled to endemic areas of dengue fever.

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Pseudoxanthoma elasticum (PXE) is a genetic multisystemic disorder affecting the skin, eyes and cardiovascular system. Basic fundoscopic findings in PXE result from Bruch's membrane involvement. The most important fundoscopic findings are angioid streaks. Other significant ocular findings are peau d'orange appearance, optic disc drusen, pattern dystrophy-like macular appearance, comet lesions, and choroidal neovascularization. Comet lesions are a pathognomonic ocular finding for PXE. The presence of both angioid streaks in the fundus and typical skin lesions should alert clinicians to PXE. Herein, we present two PXE cases with comet lesions.