Key words: Bevacizumab; Intravitreal injections; Laser therapy; Retinopathy of prematurity, Treatment outcomes

Purpose: To assess the effect of low, moderate, and high myopia on the thickness of the retinal nerve fiber layer (RNFL) and Ganglion cell complex (GCC) measured by Spectral Domain Optical Coherence Tomography (SD-OCT) in non-glaucomatous subjects. Methods: The subjects were divided into three groups: low (n = 81, 35.6%), moderate (n = 79, 34.8%), and highly myopic eyes (n = 67, 29.5%). The RNFL thickness profile, including the average, superior, nasal, inferior, and temporal quadrant and each of the eight directional thicknesses, was measured. GCC parameters, including the average, superior, and inferior values, the focal loss volume (FLV), and the global loss volume (GLV), were measured. The correlation between the OCT measurements and the axial length was evaluated. Results: The average, superior, inferior, and nasal RNFL thicknesses of low and moderate myopic eyes were found to be significantly higher than those of highly myopic eyes. The temporal RNFL thicknesses were not different among the three groups. The average, superior, and inferior ganglion cell complex values of low and moderate myopic eyes were significantly higher than those of highly myopic eyes. The FLV and GLV of low and moderate myopic eyes were significantly higher than those of highly myopic eyes (p = 0.001 for all). In the moderate and high myopia groups, the average RNFL thickness and GCC thickness were both negatively correlated with the axial length. Conclusion: Highly myopic subjects tend to have thinner RNFL and GCC thicknesses than subjects with low and moderate myopia.

Purpose: To compare tear film osmolarity (TFO) and other dry eye tests between diabetic children and normal healthy children. Materials and Methods: Twenty-six diabetic children (Group 1) and 20 healthy children without any ocular and/or systemic disorder (Group 2) were enrolled in the study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, TFO measurement (Tear Lab Osmolarity System, San Diago, CA, USA), corneal epithelial thickness (CET) measurement using the anterior segment optical coherence tomography (OCT) (RTVue CAM, Optovue Inc, CA, USA), tear film break-up time (TFBUT) test, Schirmer test, meibography, and conjunctival brush cytology were performed. The results were compared between the groups. Results: The mean TFO was significantly higher in Group 1 (328.8 ± 12.8) than Group 2 (313.6 ± 15.1) (p = 0.001). The mean Schirmer test score was significantly lower in Group 1 (16.7 ± 5.1) than Group 2 (23.6 ± 5.6) (p = 0.00). Cytologic analysis revealed grade 0 changes in 11 patients (42.3%), grade 1 changes in 13 patients (50%), and grade 2 changes in 2 patients (7.7%) in Group 1 whereas grade 0 changes in 18 patients (90%) and grade 1 changes in 2 patients (10%) were observed in Group 2 (p = 0.004). The TFO levels were significantly associated with HbA1c levels (r = 0.459, p = 0.018). Conclusion: The study revealed significantly higher TFO, lower Schirmer test scores and changes in conjunctival cytology in diabetic children. Altered ocular surface changes in diabetic children may be due to the result of increased TFO.

Background: Since its emergence in Wuhan, China, COVID-19 has disseminated across many other countries worldwide. In this report, we firstly presented a patient with mild COVID-19 disease who developed paracentral acute middle maculopathy (PAMM) due to CRAO. Case presentation: A 54-year-old male patient who reported a contact with a COVID-19 patient applied to the hospital and tested positive for SARS-CoV-2 by polimerase chain reaction testing. He had no significant past medical history. Chest computed tomography was not notable. He had a mild COVID-19 course during hospitalization. Two weeks following COVID-19 diagnosis, he reported profund vision loss (counting fingers) in his right eye where central retinal artery occlusion (CRAO) was detected on fundoscopic examination. Coagulation profile was within normal limits. Hypercoagulable work up was also not notable. Treatment was given for CRAO. Visual acuity was counting fingers at 30 cm. Five days following treatment. Optical coherence tomography analysis showed increased diffuse reflectance and thickening at the level of inner nuclear layer consistent with PAMM. Fluorescein angiography illustrated no perfusion defect. Conclusion: This is the first case that reports PAMM in the setting of CRAO following COVID-19 diagnosis. Viral induced microangiopathy may involve in the development of CRAO in our patient without a hypercoagulable state and additional risk factors. Physicians should be vigilant to seek for retinal evaluation in patients with significant visual loss even after a mild COVID-19 history.

To investigate the clinical outcomes of three surgical approaches for ectopia lentis in Marfan syndrome (MS) patients who had undergone crystalline lens removal with posterior chamber intraocular lens (IOL) implantation techniques comprising the intrascleral fixation of IOL, sutured scleral fixation of IOL, and IOL implantation with the use of a Cionni capsular tension ring (CTR). This is a retrospective comparative study, including 35 eyes of 21 patients who underwent the intrascleral fixation of IOL (group 1), scleral IOL fixation with the Z-suture (group 2), and IOL implantation with the use of a Cionni CTR (group 3) following crystalline lens removal. The surgical indications were as follows: no improvement in visual function after eyeglasses or contact lens application due to excessive irregular astigmatism and advanced crystalline lens decentration in which the edge of the crystalline lens came up to the optical axis, or dislocation of the crystalline lens resulting in aphakia and secondary glaucoma due to lens dislocation. The surgical outcomes and complications due to surgery were compared between the groups. The mean age of the patients in the study was 12.3 ± 8.7 years (5–32 years). There were 10 eyes in group 1, 13 eyes in group 2, and 12 eyes in group 3. Visual acuity improved significantly in each group after surgery. Ocular residual astigmatism did not differ significantly between the groups (p = 0.51). There were no significant differences between the three surgical approaches in the current study in terms of the postoperative results and complications.