Esteemed Colleagues,
In the second issue of 2023, the Turkish Journal of Ophthalmology features six original studies, one review, and three case reports.
In their study titled “The Effect of Mask Use on the Ocular Surface During the COVID-19 Pandemic”, Dikmetaş et al. evaluated the relationship between the clinical signs and symptoms of dry eye and the duration of mask use in healthy individuals using regular face masks. The study included 35 patients with no additional ophthalmologic pathology who were divided into two groups, those with ≤6 hours/day of mask use (group 1) and >6 hours/day of mask use (group 2), and compared in terms of Ocular Surface Disease Index (OSDI) score, ocular surface staining with fluorescein, and tear break-up time (TBUT). OSDI values were similar in the two groups, while TBUT was less than 10 seconds in 50% of the eyes in group 1 and 65% of the eyes in group 2. In addition, evaluation of corneal staining according to Oxford staging showed that staining was more severe in patients who wore masks for >6 hours/day. The authors emphasized that prolonged mask use leads to adverse ocular surface changes.
In their study titled “Clinical Approach to Ocular Cicatricial Pemphigoid”, Çiftçi et al. retrospectively evaluated the medical records of 11 patients diagnosed with ocular cicatricial pemphigoid (OCP). Conjunctival involvement was detected in all eyes included in the study, and eyelid involvement was detected in 14 eyes (63.63%). Eighteen eyes (81.81%) had corneal involvement, most commonly persistent corneal epithelial defect (n=8). According to the Tauber staging system, 7 (31.81%) eyes were stage 2, 8 (36.36%) were stage 3, and 7 (31.81%) were stage 4. Of the 9 patients who underwent biopsy, 6 (66.66%) were histopathologically diagnosed with OCP. Systemic involvement was observed in 5 (45.45%) of the 11 patients, with oral mucosal involvement being the most frequent (18.18%).
In a study by Malkoç Şen and Serbest Ceylanoğlu titled “Factors Affecting the Incidence of Ptosis After Trabeculectomy”, 312 patients (339 eyes) who underwent trabeculectomy surgery with mitomycin C were evaluated retrospectively and ptosis was detected in 35 (10.3%) of the 339 eyes. Of these, 30 eyes (8.8%) of 30 patients had transient ptosis and 5 eyes (1.5%) of 4 patients had permanent ptosis. Preoperative duration of antiglaucoma drug use, antiglaucoma drugs used, time between trabeculectomy and needling, and ocular massage did not differ significantly between the groups, whereas rates of needling and eye itching due to antiglaucoma drug-related allergy were significantly higher in patients with ptosis.
In a study by Erdem et al. titled “An Association Between the Intestinal Permeability Biomarker Zonulin and the Development of Diabetic Retinopathy in Type II Diabetes Mellitus”, blood zonulin levels were examined in 33 patients with type II diabetes with no diabetic retinopathy (DR), 28 patients with nonproliferative DR, 28 patients with proliferative DR, and 32 healthy individuals. Zonulin levels were significantly higher in the proliferative DR group compared to the other three groups, as well as in the non-DR and nonproliferative DR groups compared to the control group. The authors stated that high zonulin levels may have an important role in the development of DR, especially in the transition to the proliferative stage.
In their study titled “Choroidal Vascularity Index and Choroidal Thickness Changes Following Renal Transplantation”, Aksoy et al. investigated changes in choroidal vascularity index (CVI), subfoveal choroidal thickness (SFCT), glomerular filtration rate (GFR), intraocular pressure (IOP), and mean arterial pressure (MAP) in 49 patients who underwent kidney transplantation. While there was a significant difference in GFR and SFCT measurements before and after renal transplantation (p<0.001), there were no differences in CVI (p=0.09), MAP (p=0.14) and IOP (p=0.84) measurements.
In a cross-sectional study titled “Audiometric Evaluation of the Relationship between Sensorineural Hearing Loss and Chronic Glaucoma”, Gülyeşil et al. aimed to evaluate sensorineural hearing function in chronic glaucoma patients and compare the results with healthy individuals. The ocular findings and audiometry results of 24 primary open-angle glaucoma (POAG) patients (group 1, 24 ears), 22 patients with pseudoexfoliative glaucoma (PEG) (group 2, 22 ears), and 21 healthy individuals (group 3, 21 ears) followed for more than 5 years were compared. Group 1 had significantly higher hearing thresholds at 500 and 1,000 Hz compared to group 3, while hearing thresholds at all tested frequencies were higher in group 2 compared to group 3. The authors emphasized the possible coexistence of hearing problems in patients with chronic glaucoma and pointed out the importance of performing routine ocular and otolaryngological examinations in older adults.
The review by Atan et al. titled “The Effect of Blindness on Biological Rhythms and the Consequences of Circadian Rhythm Disorder” examines the circadian rhythm disorders caused by blindness and emphasized the need to evaluate sleep problems and plan treatment approaches accordingly in visually impaired individuals.
The case report titled “Coincident Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy in COVID-19” by Yılmaz Çebi et al. describes the clinical course of a 29-year-old woman with both acute macular neuroretinopathy and paracentral acute middle maculopathy after COVID-19 infection.
A case series by Yalçınbayır et al. titled “Different Cases, Different Manifestations of Post-COVID-19 Retinal Artery Occlusion: A Case Series” is significant in terms of showing that occlusion of the retinal arterial system can occur at different levels following COVID-19 infection. The first case was central retinal artery occlusion (CRAO) with sudden loss of vision, the second was inflammatory peripheral retinal artery occlusion, vasculitis, and uveitis that did not affect vision, and the third was CRAO with progression from orbital cellulitis to orbital apex syndrome.
The other case series in this issue is by Gülpınar İkiz et al., titled “Flap-Related Complications Following Temporal Inverted Internal Limiting Membrane Flap for Macular Hole Repair”. Their study evaluated three patients with flap-related complications after vitrectomy and temporal inverted flap surgery for the repair of macular holes. The first patient exhibited the “flap closure pattern” followed by delayed spontaneous closure of the macular hole, the second patient developed flap contracture and a nasally located epiretinal membrane after early postoperative closure of the macular hole, and in the third patient, early postoperative flap dislocation was observed.
We hope that the articles selected for this issue will provide you interesting and enjoyable reading.
Respectfully on behalf of the Editorial Board,
Hakan Özdemir, MD
