Objectives: The purpose of the study was to evaluate the effect of different treatment modalities on refractive outcomes in patients treated with severe retinopathy of prematurity (ROP). Methods: The records of children who were treated for severe ROP in our clinic between January 2015 and August 2018 were retrospectively reviewed. The children who were treated were analyzed in three subgroups as intravitreal bevacizumab (IVB), laser photocoagulation (LPC), and IVB + LPC. Spherical equivalent (SEQ), spherical and cylindrical power measurements of the cases were recorded in diopters (D). SE =-0.25D was accepted as myopia and SE of more than 1 D between two eyes was accepted as anisometropia. Results: A total of 160 eyes of 80 participants were eligible for inclusion: 38 eyes in the IVB group, 24 eyes in the LPC group, 16 eyes in the IVB + LPC group, 44 eyes in the spontaneously regressed group, and 38 eyes in the full-term children. Although the mean spherical power and SEQ in the IVB group were lower than in the LPC group (p=0.019 and 0.013, respectively), there was no significant difference between the IVB group and the IVB + LPC group (p=0.541 and 0.804, respectively). In terms of mean cylindrical power and prevalence of myopia and anisometropia, there was no significant difference between the treatment groups (p>0.05). Conclusion: Although spherical power and SEQ can change according to the ROP treatment management, there is no difference in terms of the cylindrical power, prevalence of myopia, and anisometropia. The most important risk factor for myopia and anisometropia in premature children may be ROP severity and retinal immaturity.

Aims. To compare anatomical and functional success rates in patients with primary acquired nasolacrimal duct obstruction undergoing external dacryocystorhinostomy (EX-DCR) either with adjunctive 5-fluorouracil (5-FU) or silicone tube intubation. Methods. In this retrospective comparative study, 37 eyes in 32 patients who underwent EX-DCR with adjunctive 5-FU (5-FU group) and 43 eyes in 40 patients who underwent EX-DCR with silicone intubation (controls) between 2018 and 2019 were included. Results. The mean age of patients in 5-FU and control groups was 59.8 ± 9.4 and 57.0 ± 15.3 years, respectively. The mean follow-up was 18.70 ± 3.47 months in the 5-FU group and 21.38 ± 7.76 months in the control group. Anatomical success was determined based on patency rates at the time of irrigation and recurrence, while subjective symptoms (improvement in tearing) were used to evaluate the functional success. Lacrimal patency rates in 5-FU and control groups were 83.3% and 86.0%, respectively, while recurrence was observed in 16.2% of 5-FU and 14.0% of control subjects. The two groups were comparable in terms of patency and recurrence rates ( ) as well as rates of epiphora ( ). Conclusion. Both EX-DCR procedures were effective in the management of nasolacrimal duct obstruction. Our results suggest that EX-DCR augmented with 5-FU may represent a more feasible and cost-effective therapeutic option as compared to silicone tube placement in these patients.

Objectives: The purpose of the study was to determine the differences of optical coherence tomography angiography (OCTA) measurements between the patients with neovascular age-related macular degeneration (AMD) and non-neovascular early AMD. Methods: This retrospectively designed study included patients with neovascular AMD (N-AMD group) and non-neovascular early AMD (NN-AMD group). The patients had a completed ocular examination including best-corrected visual acuity (BCVA, in decimal), intraocular pressure (IOP, mmHg), and OCTA measurements such as choroidal blood flow (au) and retinal vessel density (VD, %). Results: The N-AMD group (1.46 +/- 0.28 au) showed a lower mean choroidal flow measurement than the NN-AMD group (1.73 +/- 0.32 au), (p<0.001). The patients in the N-AMD group had reduced VD measurements in all superficial and deep retinal layers compared with the NN-AMD group. However, significant differences in VD measurements were observed only in total superficial parafovea and in the superior and inferior quadrants of superficial parafovea while comparing the N-AMD and NN-AMD groups (p<0.05 for all). Almost all deep retinal VD measurements (p<0.05 for them) were significantly different in the N-AMD group except the overall and foveal zones (p=0.144 and p=0.433, respectively). Conclusion: Retinal VD is reduced in patients with N-AMD when compared to NN-AMD. This outcome offered a retinal vessel contribution to AMD pathogenesis.

Purpose: To investigate longitudinal changes in retinal neurovascular components over a 3-year period using optical coherence tomography (OCT) and OCT angiography (OCTA) in pediatric and adolescent individuals diagnosed with type 1 diabetes mellitus (DM) but without signs of diabetic retinopathy (DR). Methods: Individuals with type 1 DM and no clinical signs of DR were evaluated between May and September 2022. Quantitative evaluation was performed on neurovascular components of the retina in both the macular and peripapillary regions. Data from the previous 3 years (Group 1) were compared with current data (Group 2). Relationships between pubertal stage, duration of diabetes, and glycosylated hemoglobin (HbA _1c ) levels were examined. Results: The study included 92 eyes from 46 participants diagnosed with type 1 DM. Group 2 had significantly lower vessel densities in the foveal and parafoveal superficial capillary plexus and deep capillary plexus than Group 1. However, central foveal thickness (CFT), inner retinal thickness, peripapillary retinal nerve fiber layer thickness, and nasal inferior disc-vessel density were significantly higher in Group 2. A significant relationship was found between pubertal stage and vessel densities in both the superficial capillary plexus and optic disc regions. HbA _1c levels and diabetes duration correlated with the foveal avascular zone area and superficial capillary plexus/deep capillary plexus-vessel densities. Conclusions: Initially, the peripapillary microvascular structure is more affected than the macula in type 1 DM. However, after 3 years, microvascular macular decline becomes more prominent. Additionally, foveal retinal thickness and peripapillary retinal nerve fiber layer thickness were significantly increased.

Drug-induced ocular surface disorders (DIOSDs) are a significant yet frequently underrecognized cause of ocular morbidity, affecting millions of patients worldwide. The ocular surface—comprising the cornea, conjunctiva, and tear film—is susceptible to damage from both topical and systemic pharmacological agents through mechanisms including direct epithelial cytotoxicity, tear film disruption, inflammatory pathway activation, and corneal neurotrophic injury. Benzalkonium chloride (BAK), the most widely used ophthalmic preservative, remains the principal causative agent in topical medication-related disease, with up to 50% of long-term users developing signs of ocular surface dysfunction. Systemic agents such as isotretinoin and dupilumab are increasingly recognized as important causes of meibomian gland dysfunction and conjunctivitis, respectively. Severe drug reactions including Stevens-Johnson syndrome may result in permanent vision-threatening sequelae. Diagnosis requires high clinical suspicion and thorough medication history, while management centers on eliminating or modifying the offending agent, transitioning to preservative-free formulations, and providing targeted ocular surface therapy. A multidisciplinary approach and patient education are essential for optimal outcomes. İlaca bağlı oküler yüzey bozuklukları, dünya genelinde milyonlarca hastanın etkilendiği, klinik pratikte sıklıkla göz ardı edilen önemli bir morbidite kaynağıdır. Kornea, konjonktiva ve göz yaşı filminden oluşan oküler yüzey; topikal ve sistemik farmakolojik ajanlara bağlı olarak epitelyal sitotoksisite, göz yaşı filmi bozulması, inflamatuar yolakların aktivasyonu ve kornea nörotrofik hasarı gibi çeşitli mekanizmalarla zarar görebilmektedir. En yaygın kullanılan oftalmik koruyucu olan benzalkonyum klorür (BAK), topikal ilaçlara bağlı oküler yüzey hastalığının başlıca nedeni olmaya devam etmekte; uzun süreli kullanıcıların %50'sine kadarında oküler yüzey disfonksiyonu bulguları gelişmektedir. İzotretinoin ve dupilumab gibi sistemik ajanlar, sırasıyla meibomian bezi disfonksiyonu ve konjonktivit nedenleri arasında giderek daha fazla tanınmaktadır. Stevens-Johnson sendromu gibi ağır ilaç reaksiyonları kalıcı ve görmeyi tehdit eden sekellerle sonuçlanabilir. Tanı, yüksek klinik şüphe ve kapsamlı ilaç hikayesi gerektirmektedir; tedavi ise suçlu ajanın değiştirilmesi veya kesilmesi, koruyucusuz formülasyonlara geçiş ve hedefe yönelik oküler yüzey tedavisi üzerine yoğunlaşmaktadır. En iyi sonuçlar için multidisipliner yaklaşım ve hasta eğitimi çok önemlidir.