ISSN 2757-8135 | E-ISSN 2757-9816
Volume: 2  Issue: 2 - June 2022

Page I

2.Results of wavefront excimer laser correction of refractive errors in adult amblyopic patients
Almila Sarıgül Sezenöz, Leyla Asena, Sezin Akca Bayar, Gülşah Gökgöz, Dilek Dursun Altınörs
doi: 10.14744/eer.2022.17363  Pages 47 - 53
PURPOSE: The objective of the study was to evaluate the refractive outcome in corrected distance visual acuity (CDVA) of adult amblyopic eyes after Wavefront Excimer Laser Correction (WELC) surgery and determine the pre-operative factors that affect the possible visual improvement.
METHODS: Sixty-two patients (>21 years) with refractive anisometropic, ametropic amblyopia who underwent WELC surgery between 2014 and 2021 in our clinic were enrolled. Patients with an ocular pathology causing a decrease in vision, abnormal corneal topography, abnormal slit lamp, and fundus examinations were excluded from the study. Medical records of the pre-operative and post-operative 6th month–1 year were retrospectively reviewed for CDVA values, refractive status under cycloplegia, manifest refraction values, the binocular sensory status, and the near stereoacuity measurements. The statistical analyses were held by IBM® SPSS® Statistics 19.0 (SPSS Inc., Chicago IL, USA).
RESULTS: Sixty-two eyes of 62 patients were included in the study. Correlation analysis revealed that pre-operative logMAR CDVA (r=0.495, p=0.04) and pre-operative astigmatism values (r=0.563, p=0.03) had a statistically significant correlation with increase in visual acuity. It was observed that more significant increase in CDVA was obtained in the high astigmatism (≥3D) group (p=0.045). No statistically significant correlations were detected between post-operative increase in CDVA and age (r=–0.08, p=0.78) and type of refractive error (r=–0.19, p=0.50). There was a significant improvement in near stereoacuity measurements postoperatively (p<0.05).
CONCLUSION: Improvement in CDVA and binocular function was observed in all adult amblyopic eyes after WELC. In adult amblyopic patients, WELC surgery of refractive errors can be an alternative treatment technique.

3.Evaluation of the factors affecting visual outcome after successful pars plana vitrectomy surgery for rhegmatogenous retinal detachment
Emin Utku Altındal, Ahmet Burak Bilgin
doi: 10.14744/eer.2022.80664  Pages 54 - 61
PURPOSE: The objective of the study was to evaluate the factors affecting visual prognosis and to analyze optical coherence tomography findings after successful pars plana vitrectomy (PPV) surgery for rhegmatogenous retinal detachment (RRD).
METHODS: Forty-one eyes of 41 patients who underwent PPV for RRD for the 1st time between December 2010 and July 2013 were included in the study with a retrospective design. Patients were divided into two groups according to visual acuity: Group 1 consisted of 24 patients with improved final best corrected visual acuity (BCVA) after post-operative 6th month; Group 2 consisted of a total of 17 patients: 14 patients with stable final BCVA and 3 patients with deteriorated final BCVA after the post-operative 6th month. Correlation between preoperative and postoperative variables was assessed.
RESULTS: The mean follow-up period was 16.93±7.5 (range, 7–36) months. While 26 (63.4%) patients had macula-off RRD, 15 (36.6%) patients had macula-on RRD. Pre-operative BCVA (p<0.001) and post-operative BCVA (p=0.002) was significantly better in eyes with macula-on RRD. Pre-operative and post-operative BCVA were found to have positive correlation (p<0.001, r=0.58). The number of eyes with intact photoreceptor inner segment/outer segment (IS/OS) junction, disrupted IS/OS junc-tion, foveal epiretinal membrane (ERM), and parafoveal ERM was 8 (33.3%), 2 (8.3%), 1 (4.2%), and 13 (54.2%) in Group 1, while it was 2 (11.8%), 3 (17.6%), 2 (11.8%), and 10 (58.8%) in Group 2, respectively.
CONCLUSION: Pre-operative BCVA and absence of macular detachment are important prognostic factors in patients with RRD.

4.Effects of Subthreshold Yellow Pattern Laser Treatment in Diabetic Macular Edema: Optical Coherence Tomography Angiography Study
Irmak Karaca, Filiz Afrashi, Serhad Nalçacı, Jale Menteş, Cezmi Akkin
doi: 10.14744/eer.2022.29292  Pages 62 - 68
PURPOSE: To assess the effects of subthreshold yellow pattern laser (SYPL) treatment in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA).
METHODS: Thirty eyes of 30 diabetic patients diagnosed as naïve DME (central subfield thickness (CST) <400μm) between October 2018 and January 2020 at Ege University, Department of Ophthalmology were prospectively included in the study. Fovea sparing SYPL were performed to the macula. Comprehensive eye examination along with OCTA were performed at baseline, 1st month, and 3rd month of follow-up. Data during the follow-up were compared with the baseline.
RESULTS: The mean age of the patients (15 male, 15 female) was 63.7±6.7 (48-74) years. The mean diabetes duration was 17.9±5.4 (13-27) years; mean HbA1c was 6.6±0.5 (5.7-7.7) g/dL. Best-corrected visual acuity (BCVA) did not show significant change during the follow-up (p=0.698). CST measurements were 323.7±40.1 (262-393) μm, 316.8±40.9 (268-377) μm and 318.1±39.9 (226-396) μm at baseline, 1st, and 3rd month, respectively (p=0.591). On OCTA, mean vessel density (VD) in superficial capillary plexus (SCP) were 44.7±4.6 (37.4-52.3), 45.6±4.7 (38.6-54.9) and 44.6±3.9 (37.5-49.8); while mean VD in deep capillary plexus (DCP) were 43.1±4.8 (36.3-52.7), 45.3±4.8 (38.9-54.2) and 42.7±3.3 (37.4-49.3) at baseline, 1st, and 3rd month, respectively (p=0.383 and p=0.291). Foveal avascular zone (FAZ) area did not change significantly during the follow-up (p=0.998).
CONCLUSION: SYPL treatment in DME appears to be safe with no statistically significant difference in macular capillary perfusion, as well as no change in BCVA and CST during the 3 months of follow-up.

5.Comparison of intravitreal bevacizumab responses in different morphologies of macular edema due to branch retinal vein occlusion: Short-term results
Esra Vural, Leyla Hazar, Ender Sırakaya
doi: 10.14744/eer.2022.22931  Pages 69 - 74
PURPOSE: The purpose of the study was to compare the results of intravitreal bevacizumab in patients with macular edema (ME) due to branch retinal vein occlusion (BRVO) according to different ME morphologies.
METHODS: In this retrospective study, 24, 13, and 22 patients with ME type due BRVO were included in the serous reti-nal detachment group, cystoid ME group, and diffuse ME group, respectively. The best-corrected visual acuity (BCVA) was evaluated with an ETDRS chart, and central macular thickness (CMT) was evaluated by spectral domain optical coherence tomography at the 1st, 2nd, and 3rd months.
RESULTS: The mean ages of the patients were 64.25±7.80, 64.84±7.96, and 61.81±6.67 years in the serous, cystoid, and diffuse groups, respectively (p=0.414). While no significant difference was observed in the serous group in terms of BCVA and CMT at the 1st month after injection compared with that in the cystoid group (p=0.201 and p=0.986), BCVA and CMT values at the 2nd and 3rd months were statistically different (p=0.021, p=0.003, p=0.015, and p=0.006, respectively). When the serous group and the diffuse group were compared, only a significant difference was found in CMT at the 2nd month (p=0.016).
CONCLUSION: Intravitreal bevacizumab treatment was more effective in terms of anatomical and visual results in the serous group compared with that in the cystoid group; however, at the end of the 3rd month, it showed similar results with the diffuse group.

6.Comparison of intraocular lens power calculation formulas in patients with cataract and maculopathy
Mehmet Esat Teker, Cumali Değirmenci, Filiz Afrashi, Sait Eğrilmez
doi: 10.14744/eer.2022.49469  Pages 75 - 79
PURPOSE: The purpose of the study was to compare the effect of biometric formulas used in calculating intraocular lens (IOL) power on target refraction when planning cataract surgery in patients with diabetic macular edema (DME), age-related macular degeneration (AMD), or epiretinal membrane (ERM).
METHODS: The study was carried out in the Ege University Medicine Faculty Department of Ophthalmology after obtaining local ethics committee approval. Sixty-two eyes with cataracts and ERM, AMD, or DME that increased retinal thickness were included in the study group. Fifty-four eyes with cataracts and no retinal pathology were included in the control group. Lens power calculations based on measurements obtained with optical and ultrasound biometers were made using the SRK-T, Holladay 2, Hoffer Q, Haigis, and Barrett Universal 2 formulas and the results were compared.
RESULTS: In the study group, 31 eyes (50%) had DME, 16 (26%) had AMD, and 15 (24%) had ERM. The mean of arithmetic de-viations from target refraction was lowest with the Barrett Universal 2 formula (p>0.05). When the Haigis formula was used, there was a significant deviation in both the study and control groups, while only the control group showed a significant deviation with the Hoffer Q formula (p<0.05). There was no significant difference between the groups in terms of absolute deviations (p>0.05).
CONCLUSION: In cataract patients with maculopathy and increased retinal thickness, the likelihood of inaccurate IOL power calculation was lowest with the Barrett Universal 2 and highest with the Haigis formula. These results should be further examined in larger patient series.

7.Ocular prophylaxis in the newborn
Mahmut Celik, Özge Altun Köroğlu
doi: 10.14744/eer.2022.40085  Pages 80 - 83
In the first 4 weeks of life, an ocular infection is seen in 1–12% of newborns and this clinical situation is called “ophthalmia neonatorum.” The etiology includes bacterial, viral, and chemical causes. Unfortunately, severe conjunctivitis progressing to corneal ulceration and blindness may develop in the newborns due to inadequate ocular prophylaxis. The development of these cases can be prevented by screening the mothers during pregnancy and giving treatment if necessary and/or provid-ing the newborns with appropriate ocular prophylaxis.

8.Bilateral sclerochoroidal calcification in a case with asymptomatic primary hyperparathyroidism
Ferdane Ataş, Ali Osman Saatci
doi: 10.14744/eer.2022.35744  Pages 84 - 87
Sclerochoroidal calcification is an uncommon degenerative ocular disease that is characterized with calcium deposits at the level of choroid and sclera. This condition could be related to calcium pyrophosphate metabolism disorders such as primary hyperparathyroidism. We presented a case who received the diagnosis of the primary hyperparathyroidism after the detec-tion of asymptomatic fundus lesions on a routine eye examination.

9.Isolated primary orbital hydatid cyst: Two cases
Melis Palamar, Derya Dirim Erdoğan, Taner Akalın, Oğuz Reşat Sipahi
doi: 10.14744/eer.2022.55264  Pages 88 - 92
Hydatid cyst is a rare parasitic disease caused by Echinococcus granulosus or Echinococcus alveolaris tapeworm. The most common sites that are affected are liver, lung, and central nervous system. Other rarely affected sites are orbit and bone. Herein, two cases of isolated primary orbital hydatid cysts that were surgically managed are presented.

10.Scleral buckle infection with Aspergillus and pyogenic granuloma: A case report
Hazan Gül Kahraman, Şeyda Uğurlu
doi: 10.14744/eer.2022.70299  Pages 93 - 96
Scleral buckle infection after detachment surgery is a rare condition and it can occur even years after. We report two cases with scleral buckle infection who had undergone detachment surgery 11 and 12 years ago. The first patient was admitted to clinic with pain and discharge. Intense purulent discharge, conjunctival hyperemia, chemosis, and a large mass extending to the corneal surface were seen on her anterior segment examination. The second case had reconstruction surgery with oral mucosal greft for sponge exposure 4 years ago and she had purulent discharge, conjunctival chemosis and sponge were exposed on her anterior segment examination. During the surgery of both cases, yellowish-white multiple foci seen on buckle material which gave an impression of a fungal infection. We performed removal of the mass and scleral buckle in the first case, and removal of the scleral buckle, covering of thinned sclera with oral mucosal greft, and tarsorrhaphy in the second case. After Aspergillus grown on the culture media, lavage with voriconazole and voriconazole eye drop treatments completed and there was no recurrence in terms of detachment and infection.