2019 Issue 1 at a Glance:
This issue of our journal comprises 6 original research articles, 1 review, and 4 case reports selected from among the studies conducted by ophthalmologists both nationally and internationally to protect and improve human health.
Yaşar et al. present an epidemiological study investigating the relationship between pseudoexfoliation syndrome (PES) and antidepressant drug use. Their survey of systemic diseases and medication use conducted among 2017 individuals revealed that antidepressant drug use was more common in the PES group. The authors pointed to the common role of oxidative damage and inflammation caused by free radicals in the pathogenesis of both PES and depression, and suggested that inflammation induced by the accumulation of pseudoexfoliative material in the brain could trigger depression, thus resulting in higher rates of antidepressant drug use in PES patients (see pages 1-5).
In a study by Mayalı et al. evaluating the effect of body position on intraocular pressure (IOP), no statistically significant differences were detected in IOP values measured in 52 patients in sitting, standing, and supine positions using the Icare PRO tonometer. Age and gender also had no effect on IOP measured in the different body positions. Based on these results, the authors concluded that the Icare PRO could be used reliably to monitor IOP during clinical follow-up of patients with limited mobility, such as those who are bedridden (see pages 6-9).
The most common form of uveitis, or intraocular inflammation, is anterior uveitis. HLA-B27-associated uveitis is the most common etiology of anterior uveitis overall and especially presentations with hypopyon. In spite of ongoing research, the pathogenesis of HLA-B27-associated uveitis is not fully understood. Patients with HLA-B27-associated uveitis show variation in their clinical features, response to treatment, and systemic comorbidities. In their study investigating the demographic, etiologic, and clinical characteristics of HLA-B27-associated uveitis, İnanç et al. report that this type of uveitis is characterized by sudden-onset anterior segment inflammation with unilateral or alternating bilateral involvement and limited duration. They also report that uveitis may be associated with certain systemic diseases, especially ankylosing spondylitis, and visual prognosis is good despite complications (see pages 10-14).
Sül et al. investigated first-year outcomes in patients with active neovascular age-related macular degeneration (nAMD) who did and did not have cataract surgery while under intravitreal ranibizumab (IVR) therapy. The authors report that cataract surgery resulted in significant visual gains in patients receiving anti-VEGF therapy without adversely affecting AMD progression. They concluded that anti-VEGF therapy combined with cataract surgery could be considered a safe and effective treatment method in patients with active nAMD (see pages 15-19).
Smoking is a known risk factor for the development of certain ocular pathologies, including AMD, ischemic optic neuropathy, hypertensive retinopathy, cataract, glaucoma, and thyroid orbitopathy. In a study by Kuddusi Teberik, spectral domain optical coherence tomography (SD-OCT) was used to compare macular, choroidal, and retinal nerve fiber layer (RNFL) thicknesses in smokers and healthy non-smokers. Their analysis showed that RNFL thickness is reduced in chronic smokers, while macular and choroidal thickness were not affected (see pages 20-24).
Eye and vision screening is included within the responsibilities of infant/child follow-up in the preventive medicine services provided by family physicians in Turkey. Gürsel Özkurt et al. evaluated family physicians’ approach to eye and vision screening in the province of Diyarbakır by conducting a 16-question survey with 100 family physicians working in the urban center and surrounding districts. While 88% of the physicians who participated in the survey stated that they knew the red reflection screening test, only 16% conducted it regularly and 36% said they did red reflex examination only if a problem was suspected. It was also determined that many of the physicians did not know the proper timing of treatment and did not refer patients to an ophthalmologist in a timely manner if they did detect a problem, and some centers were not equipped with basic instruments such as an ophthalmoscope. The authors concluded by emphasizing the significant lack of information on this public health issue and reported that it would be useful to conduct educational seminars on the subject (see pages 25-29).
The review by Gülkaş and Şahin entitled “Current Therapeutic Approaches to Chronic Central Serous Chorioretinopathy” examines available treatment options when CSCR, which is characterized by serous neurosensorial retinal detachment and typically has good prognosis, deviates from its usual clinical course and becomes chronic. The authors provide valuable information about this issue, for which various therapies have been tried in recent years, including verteporfin-photodynamic therapy (PDT) with different parameters (standard protocol, half-dose, half-fluence PDT), anti-vascular endothelial growth factors, glucocorticoid antagonists, mineralocorticoid receptor antagonists, and subthreshold micropulse laser (see pages 30-39).
In the first case report of the issue, Doğanay et al. present two patients with CSCR accompanying Behçet’s disease. They suspected systemic steroid use as the main culprit behind this association and emphasized the need to consider CSCR in patients who report a decline in vision while under steroid therapy (see pages 40-43).
In another interesting case report in this issue, Sanches et al. describe a case of Staphylococcus epidermidis endophthalmitis presenting as panuveitis following an unrecognized ocular trauma. Based on this case, the authors point out the need to properly evaluate posttraumatic patients with unremarkable findings and obtain a comprehensive history due to the possibility of hidden adverse effects (see pages 44-46).
Çınar et al. report a patient who developed periorbital emphysema after endoscopic nasal polyp surgery. Their report brings attention to the fact that although this complication is rare, it may require urgent intervention due to the possibility of increased IOP and disrupted circulation due to pressure exerted on the globe by the trapped subcutaneous air (see pages 47-50).
Kumar et al. describe the recent case of a 24-year-old patient on active military duty who was being treated for dengue hemorrhagic fever and presented with severe visual impairment in his right eye. Examination revealed sub-ILM hemorrhage in his right (dominant) eye. Dengue fever is an acute viral (Flavivirus) infection transmitted by mosquito bite, and infected patients can have diffuse ocular findings as well as rare cases of premacular hemorrhage. Considering the potential risks of steroid therapy and vitrectomy, and because time was of the essence to the patient due to his profession, he was treated with pneumatic tamponade with prone positioning. The authors report that this novel treatment may be a useful method to be considered for patients who are not eligible for active surgical treatment (see pages 51-54).
