Turkish Journal of Ophthalmology最新文献

Objectives: To compare white-to-white (WTW) measurements obtained by Pentacam and MS-39 and to assess their relationship with visual and refractive status.

Materials and methods: This prospective cross-sectional study included 126 participants (one eye per participant). Visual acuity was measured with and without correction using a Snellen chart and converted to logarithm of the minimum angle of resolution (logMAR). Refractive status was determined by manifest refraction, and the spherical equivalent was calculated. WTW measurements were determined using Pentacam and MS-39. For paired comparisons, Wilcoxon signed-rank test was used. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to assess agreement between the two devices. Spearman test was used to evaluate the correlation with visual and refractive variables.

Results: The mean age of the participants was 27.21±5.64 years. Mean uncorrected distance and corrected visual acuities were 1.11±0.45 logMAR and 0.05±0.20 logMAR, respectively. The mean spherical equivalent was -4.02±2.03 diopters. The mean WTW distance was 11.82±0.41 mm with Pentacam and 11.83±0.43 mm with MS-39. No statistically significant paired difference was found between the devices (W=3839.5, p=0.584). A Bland-Altman mean bias of -0.009 mm suggested a small systematic difference between the two devices. Intraclass correlation showed good agreement (ICC=0.847, 95% confidence interval: 0.789-0.890; p<0.001). While there was no significant correlation with corrected distance visual acuity, both WTW measures had weak but significant correlations with uncorrected distance visual acuity and spherical equivalent.

Conclusion: Pentacam and MS-39 produce comparable results overall and show strong agreement for WTW measurements. While the inter-device difference was unaffected by visual and refractive state, WTW showed minor correlations with unaided visual acuity and refractive error.

Objectives: To translate the Adult Strabismus Quality of Life Questionnaire (AS-20) into Turkish and evaluate its reliability and validity in Turkish adult patients with strabismus.

Materials and methods: Adult patients diagnosed as having strabismus and followed at the pediatric ophthalmology and strabismus unit of a tertiary university hospital were consecutively recruited. Patients with previous strabismus surgery, cognitive impairment, or insufficient Turkish language proficiency were excluded. A group of 15 participants completed the questionnaire a second time after a 2-week interval to evaluate test-retest reliability.

Results: A total of 111 adult patients (63.1% female) were included in the analysis. The mean age was 32.0±14.5 years, and exotropia was the most common deviation pattern (85.1%). Diplopia was present in 7.2% of participants. The Turkish AS-20 demonstrated good internal consistency, with a total Cronbach's alpha of 0.874. The psychosocial subscale showed a Cronbach's alpha of 0.862, and the functional subscale demonstrated a Cronbach's alpha of 0.822, indicating good reliability. Test-retest reliability analysis demonstrated excellent temporal stability for the psychosocial subscale, the functional subscale, and the total score (p<0.001).

Conclusion: The Turkish version of the AS-20 is a reliable and valid instrument for assessing strabismus-specific quality of life, demonstrating good internal consistency, high temporal stability, and applicability in both clinical practice and research settings.

Objectives: To evaluate the histological subtypes, surgical margin status, and high-risk features of periocular basal cell carcinomas (BCC) excised over a one-year period at a secondary referral centre in England.

Materials and methods: This retrospective audit included 100 consecutive periocular BCC excisions performed at James Paget University Hospital between August 2024 and August 2025. Demographic, clinical, and histopathological data were extracted from operative records and histopathology reports. Surgical margins were classified as complete (≥0.4 mm), close (0.1-0.3 mm), or incomplete (tumour present at the inked margin or <0.1 mm). Fisher's exact test was used to evaluate the association between infiltrative histological subtype and the presence of perineural invasion.

Results: Of the 100 patients included (58% male, 42% female; mean age 75.7 years), nodular BCC was the most common histological subtype (83%), followed by infiltrative (14%), superficial (2%), and basosquamous (1%) variants. Complete excision was achieved in 83% of cases, while close and incomplete margins were observed in 8% and 9% of excisions, respectively. Perineural invasion was identified in 2% of tumours, both of which demonstrated infiltrative histology. The infiltrative subtype showed a statistically significant association with perineural invasion (p=0.007). The majority of BCCs were located in the medial canthus (56%), an anatomically complex region associated with increased surgical difficulty and a higher risk of incomplete excision.

Conclusion: High rates of complete excision were achieved in this cohort of periocular BCCs. Infiltrative histological subtype was associated with an increased risk of perineural invasion and incomplete excision, particularly when located in the medial canthus. These findings support a risk-adapted surgical strategy as well as consideration of Mohs micrographic surgery for aggressive tumour subtypes and anatomically complex periocular locations.

Objectives: In this study, we aimed to characterize the clinical presentation patterns, complications, and visual prognosis of Fuchs' uveitis syndrome (FUS) patients at a tertiary center in Türkiye.

Materials and methods: Sixty-one FUS patients (64 eyes) were enrolled in this retrospective study. Detailed ophthalmic and systemic history was obtained from patients at the initial examination. Visual acuity measurement (decimal values, converted to logarithm of the minimum angle of resolution [logMAR]), slit lamp examination, dilated fundus examination, intraocular pressure measurement with Goldmann applanation tonometry were performed at each visit.

Results: Keratic precipitates (KP) were present in 57 eyes (89.06%) at initial examination. Diffuse small stellate greyish KPs were observed in 50 eyes (78.13%). Thirty eyes (46.88%) presented with heterochromia. Twenty-seven eyes (42.19%) had vitreous debris/fibrillary appearance or condensation. The most common complication was cataract (79.69%), of which the most common type was posterior subcapsular cataract. At presentation, anterior chamber cells were seen in 32 eyes (50%). The mean visual acuity was 0.28±0.56 logMAR at the first examination and 0.25±0.48 logMAR at the final examination (p=0.542).

Conclusion: According to our findings, unilateral uveitis accompanied by low-grade anterior chamber inflammation, diffuse small stellate KPs, and diffuse stromal iris atrophy, with or without vitreous debris, remains the most characteristic clinical presentation among patients with FUS. Iris findings such as heterochromia and iris nodules are less frequently observed in Turkish patients, likely due to ethnic variations.

Objectives: To assess the short-term effects of a standardized dose of caffeine on selected ocular parameters in young adults and to examine its possible influence on visual performance during screen-based activities.

Materials and methods: This prospective experimental study included 52 healthy university students aged 18-30 years. Participants consumed a standardized dose of 240 mg of caffeine in the form of black coffee. Ocular parameters including intraocular pressure (IOP), pupil diameter, contrast sensitivity, near point of accommodation, accommodative facility, vergence facility, visual reaction time, stereopsis, and ocular motility were assessed before and 30 minutes after caffeine intake. Pre- and post-intervention measurements were compared using paired t-tests, with p<0.05 considered statistically significant.

Results: Significant improvements were observed in accommodative facility (right eye [OD]: p=0.04; left eye [OS]: p<0.001; both eyes [OU]: p=0.0003), vergence facility (p=0.01), and contrast sensitivity in OU (OD and OS: p<0.001). The near point of accommodation decreased significantly, indicating improved accommodative ability (OD: p=0.02; OS: p=0.009; OU: p<0.001). Visual reaction time improved in most participants, although the change was not statistically significant (p=0.08). Pupil diameter increased significantly (p<0.001). IOP showed a small but statistically significant increase (p<0.001), remaining within normal physiological limits. Changes in stereopsis were not statistically significant (p=0.06). Minor changes were also observed in saccadic and pursuit eye movements.

Conclusion: A single dose of caffeine led to measurable short-term improvements in visual performance, particularly in accommodation and contrast sensitivity, along with a modest improvement in reaction time. Small increases in pupil diameter and IOP were also observed. These findings suggest that moderate caffeine intake may offer some benefit during visually demanding tasks. However, caution may be needed for individuals at risk of ocular hypertension. Larger, placebo-controlled, and multicenter studies are recommended to confirm these findings and to evaluate long-term effects.