Psödoeksfoliasyon Glokomu: Klinik Görünüm ve Tedavi Seçenekleri

To evaluate the association of Graves’ Ophthalmopathy (GO) with the meibomian glands and investigate the relation of ocular surface changes with meibomian gland parameters in patients with GO.This ...

This study aimed to evaluate subclinical retinal microvascular changes with OCTA in juvenile systemic lupus erythematosus (JSLE) patients without ocular involvement.Ten eyes of 10 JSLE and 13 eyes ...

To describe the clinical features and microstructural characteristics assessed by in vivo confocal microscopy (IVCM) in patients with adenoviral epidemic keratoconjunctivitis (EKC). The study included 20 eyes of 12 patients who presented to the Kocaeli University Medical Faculty, Department of Ophthalmology with complaints of watering, crusting, and stinging, were clinically diagnosed EKC, and were examined by slit-lamp biomicroscopy and IVCM during the prodromal phase and the punctate keratitis, deep epithelial keratitis, and subepithelial infiltration stages of EKC. While biomicroscopic examination findings were normal during the prodromal period of EKC, IVCM showed an increase in Langerhans cell numbers in the subbasal plexus. After onset of clinical EKC, the punctate epithelial keratitis stage was characterized by findings of hyperreflective cell clusters in the basal epithelium layer, increased accumulation of Langerhans cells in Bowman’s layer, and hyperreflectivity in the anterior stromal layers. In the deep epithelial keratitis stage, the basal epithelial cells displayed peripheral hyperreflectivity and the hyperreflectivity of the anterior stromal surface increased and became more rounded. In the subepithelial keratitis stage, these findings persisted in addition to increased anterior stromal surface hyperreflectivity and focal round plaques. This study shows that the inflammatory process in the cornea starts in the prodromal period of EKC. Massive inflammation of the epithelium and stroma was observed in the active phase and focal changes were observed on the anterior stromal surface starting in the subepithelial infiltration period.

Aim: Nivolumab is an immune checkpoint inhibitor that has recently been widely used for metastatic malignant melanoma. We report a case who developed multiple different ocular immune-related side effects (iRAEs) related to nivolumab. Case Presentation: A 60-year-old man on nivolumab treatment for metastatic malignant melanoma developed a decrease in vision in both eyes several days after the third infusion. The initial best-corrected visual acuity (BCVA) was counting fingers in both eyes. Slit-lamp examination revealed no abnormal findings in the anterior segment of both eyes. Posterior segment evaluation showed serous retinal detachment, including the whole macula and inferior retina in both eyes, and optical coherence tomography (OCT) confirmed the diagnosis. On en face OCT analysis, hyperautoflorescent dots were noticed on the whole macular region but more intense at the inferior quadrant corresponding to serous retinal detachment. On Fluorescein Angiography (FA), no abnormality was observed. Oral corticosteroid treatment was administered. Subretinal fluid resolved one week after treatment in the right eye and two weeks after treatment in the left eye. BCVA was 20/20 in both eyes at first month of treatment. After that, oral corticosteroid treatment was tapered and stopped at the end of the second month. The patient was followed monthly. Two months after the treatment patient presented with an anterior uveitis episode with mild vision loss. Slit-lamp examination revealed 3+ cells in the anterior chamber and posterior synechia in both eyes. Posterior segment examination was normal. The patient was treated with topical corticosteroid and cycloplegic for two months. Hyperautoflorescent dots formed with serous detachment disappeared six months after the onset of serous detachment, and they did not occur during anterior uveitis episodes. Conclusions: This is the first clinical report of nivolumab-associated ocular iRAEs presenting with recurrent episodes presenting with serous retinal detachment and anterior uveitis. En face OCT imaging may help diagnose and show the activity of the posterior segment manifestation. When managed properly and observed closely following general and ocular conditions, it is possible to held iRAEs and overcome them by oral and/or topical corticosteroid therapy without interrupting the nivolumab.

Purpose: This prospective clinical case series aimed to evaluate the effect of suprachoroidal implantation of mesenchymal stem cells (MSCs) in the form of spheroids as a stem cell therapy for retinitis pigmentosa (RP) patients with relatively good visual acuity. Methods: Fifteen eyes of 15 patients with RP who received suprachoroidal implantation of MSCs in the form of spheroids were included. Best-corrected visual acuity (BCVA), 10–2 and 30–2 visual field examination and multifocal electroretinography (mfERG) recordings were recorded at baseline, postoperative 1st, 3rd and 6th months during follow-up. Results: Baseline median BCVA of RP patients was 1.30 (1.00–2.00) logMAR. BCVA has improved to 1.00 (0.50–1.30), 0.80 (0.40–1.30) and 0.80 (0.40–1.30) at the postoperative 1st, 3rd and 6th months, respectively. The improvements from baseline to the 3rd and 6th months were statistically significant (p = 0.03 and p < 0.001, respectively). In the 30–2 VF test, median MD was significantly improved at the 6th month compared to baseline (p = 0.030). In the 10–2 VF test, the median MD value was significantly different at the 6th month compared to the baseline (p = 0.043). The PSD value of the 10–2 VF test was significantly different at the 6th month compared to the 3rd month (p = 0.043). The amplitudes of P1 waves in < 2°, 5°–10° and 10°–15° rings improved significantly at the postoperative 6th month (p = 0.014, p = 0.018 and p = 0.017, respectively). There was also a statistically significant improvement in implicit times of P1 waves in 10°–15° ring at the postoperative 6th month (p = 0.004). Conclusion: Suprachoroidal implantation of MSCs in the form of spheroids as a stem cell therapy for RP patients with relatively good visual acuity has an improving effect on BCVA, VF and mfERG recordings during the 6-month follow-up period. Spheroidal MSCs with enhanced effects may be more successful in preventing apoptosis and improving retinal tissue healing in RP patients.