Early detection and prevention of glaucoma progression are critical. However, studies of early visual field (VF) changes, particularly those using the 24-2C VF test, are limited. Evaluation of additional points in 2C may help identify glaucoma at an early stage, enabling timely intervention. Pre-perimetric glaucoma (PPG) is characterised by structural damage without noticeable VF loss in standard tests. Assessments of changes in retinal nerve fibre layer (RNFL) and macular ganglion cell complex (mGCC) thickness are valuable, but exploring how these structural changes are related to functional deficits is crucial. This study focused on the average of the additional points in the 24-2C test to understand their correlation with structural measures in the PPG. This study included 59 patients with PPG and 36 healthy individuals. All the patients underwent peripapillary and macular optical coherence tomography (OCT) (Nidek RS-3000 Advance; Nidek, Japan). RNFL thickness was evaluated using peripapillary OCT, and mGCC thickness was evaluated using the macular OCT glaucoma module. The mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI), and average of additional points in the 2C (AAP-2C) were evaluated using the 24-2C SITA Faster VF Humphrey Field Analyser III Model 850 (HFAIII; Zeiss Meditec, Dublin, CA, USA). The relationship between structural and functional parameters was statistically evaluated. The PPG group showed significantly lower RNFL and mGCC thickness values than the healthy group. The MD, PSD, and VFI did not differ significantly between the groups. For AAP-2C, the PPG group showed significantly lower sensitivity than healthy individuals. A statistically significant positive correlation between was observed between AAP-2C and mGCC thickness (p = 0.003, r = 0.385). However, the RNFL and mGCC thickness values showed no statistically significant correlations with the MD, PSD, and VFI. Although no glaucomatous change was observed in the VF in patients with PPG, these patients showed reduced sensitivity of the additional points. The reduced sensitivity of the additional points in the 24-2C VF test may reflect early macular functional alterations that correlate with structural damage during the pre-perimetric period.

Glaucoma is a progressive neurodegenerative disease that can lead to blindness; furthermore, axial myopia is associated with retinal and optic nerve changes that mimic glaucoma. Diagnosing glaucoma in myopic eyes is challenging due to anatomical variations, emphasizing the need for precise OCT-based evaluations. To evaluate the retinal nerve fiber layer (RNFL) thickness and Bruch's Membrane Opening-Minimum Rim Width (BMO-MRW) parameters in myopic patients with and without glaucoma by using Spectralis® optical coherence tomography (OCT), in order to reveal the relationship between axial length (AL) and OCT parameters and also to determine the OCT parameters that should be considered when diagnosing glaucoma in myopic cases. This prospective and cross-sectional study included 95 eyes from 95 cases. There were a total of 54 patients over 40 years of age without any systemic disease or glaucoma, and 41 patients without any systemic disease but with mild or moderate glaucoma, according to the Hodapp staging system. Optical biometry using the Lenstar® 900 and Heidelberg Engineering Spectralis® OCT Glaucoma Module Premium Edition (GMPE) with an anatomic positioning system (APS) were performed on all patients, along with a full ophthalmological examination. The cases were divided into subgroups according to the AL results of optical biometry as short (<24 mm) and long (≥24 mm). The measurement results were recorded and compared statistically. A total of 54 healthy subjects consisting of 27 with short AL and 27 with long AL were included. In the glaucoma group, 20 out of 41 subjects had short AL, while 21 had long AL. Using measurements in GMPE mode with APS, no statistically significant difference was found between the eyes with the short and long AL in the healthy group, both in terms of global RNFL thickness and BMO-MRW analyses. In the glaucoma group, there was no statistically significant difference between eyes with short and long AL in terms of RNFL and MRW analyses. In the myopic group, the highest AUC value of the RNFL measurements in different circular scans of the GMPE module was found in the inferotemporal area. Using the GMPE software with the APS to measure RNFL thickness, in particular in the inferotemporal quadrant, together with the BMO-MRW, really helped to make a definite diagnosis of glaucoma in myopic patients. In conclusion, utilizing GMPE with APS in the diagnosis of glaucoma provides accurate outcomes in myopic cases. The RNFL thickness and BMO-MRW values of the inferotemporal quadrant are particularly valuable in diagnosing glaucoma in myopic patients.

This retrospective cross-sectional study examined differences in serum 25-hydroxyvitamin D (25-OH D), total IgE, eosinophil levels, and outdoor exposure time in relation to disease severity in children with Vernal Keratoconjunctivitis (VKC). It also assessed these parameters across VKC subtypes. The study included 40 VKC patients and 43 healthy controls. Ophthalmologic examinations, serum 25-OH D, total IgE, eosinophil levels, and outdoor exposure times were evaluated. Disease severity was graded using Bonini's system. Multinomial logistic regression was used for statistical analysis. VKC patients had significantly lower 25-OH D (16.70 ± 5.50 vs. 23.98 ± 7.83 ng/ml, p < 0.001), higher IgE (248.52 ± 161.16 vs. 34.86 ± 17.38 ng/ml, p < 0.001), elevated eosinophils (365.72 ± 182.43 vs. 152.06 ± 80.23 cells/ml, p < 0.001), and reduced outdoor time (136.50 ± 42.39 vs. 210.0 ± 44.40 minutes, p < 0.001) compared to controls. 25-OH D negatively correlated with IgE (r = -0.505, p < 0.001) and eosinophils (r = -0.643, p < 0.001). Elevated IgE was significantly linked to mild-to-moderate VKC severity (OR = 1.120, p = 0.001). VKC patients exhibited lower serum 25-OH D and reduced daytime outdoor exposure, likely due to photophobia, compared to controls. No significant association was found between vitamin D or outdoor time and VKC severity. High IgE and eosinophil levels support VKC's allergic origin. The inverse correlations between 25-OH D, IgE, and eosinophil may suggest an immunomodulatory role. Large-scale, prospective interventional studies are warranted to validate these findings and elucidate causal relationships.

The purpose of this study is to compare the ganglion cell layer changes following temporal inverted internal limiting membrane flap (i-ILMF) surgery for idiopathic macular hole (IMH). This retrospective study included 50 eyes that underwent vitrectomy with a 2.5-disc-diameter temporal inverted internal limiting membrane flap (i-ILMF) technique. Demographic, functional, and anatomical data were collected before and after the surgery. The best corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings such as ganglion cell layer -inner plexiform layer (GCL-IPL) thickness and hole related parameters/indexes were compared in the preoperative period and 6th month after surgery. The average age of the patients was 68.8 ± 10.31 years, and the average duration of visual loss was 10.95 ± 6.54 months. The average GCL-IPL thickness increased significantly from 57.98 ± 21.43 μm to 68.74 ± 13.62 μm at 6 months after surgery (p < 0.001). The nasal GCL-IPL thickness was significantly increased from 56.94 ± 24.18 μm to 73.10 ± 15.39 μm after 6 months after surgery (p < 0.001). The temporal i-ILMF technique not only leads to high anatomical success and visual improvement but also results in a significant increase in GCL-IPL thickness postoperatively, suggesting a unique structural response to this method.

Sixth nerve palsy (SNP) is a neuro-ophthalmologic disorder characterized by palsy of the lateral rectus (LR) muscle. This palsy leads to diplopia and head position owing to difficulties with lateral gaze in the affected eye. The medical management of SNP is determined by its underlying condition. Most individuals with SNP get spontaneous resolution within a period of six months, systemic treatment. However, a limited number of individuals may necessitate intervention owing to diplopia as their primary complaint. Especially in such cases, it is necessary to choose an appropriate surgical method by taking into account the amount of squint in order to minimize surgical complications such as anterior segment ischemia. The objective of this case presentation is to provide information on Superior rectus transposition (SRT) surgery, a viable technique for treating SNP. Additionally, this case seeks to review current treatment approaches by evaluating alternative trend surgical procedures.