2023 Issue 1 at a Glance:
Esteemed Colleagues,
The two major earthquakes that occurred on Monday, February 6 were a shocking tragedy. Tens of thousands of lives were lost, including many of our valued colleagues. Our wounds are deep. We wish God’s mercy to everyone who perished in the earthquake, offer condolences to their families, and hope for a speedy recovery to all those injured.
The first issue of the Turkish Journal of Ophthalmology in 2023 features seven original studies, a review, and three case reports. In a retrospective study titled “Evaluation of Behavioral Characteristics in Response to Visual Stimuli in Infants with Cerebral Visual Impairment,” Altınbay and Taşkın examined the behavioral characteristics in response to visual stimuli and the frequency of these characteristics in infants with cerebral visual impairment. They observed difficulty with distance vision in 84%, visual latency in 72%, need for movement in 69%, absence of visually guided reach in 69%, difficulty with visual complexity in 66%, difficulty with visual novelty in 50%, aimless gaze in 50%, and atypical visual reflexes in 47% of the patients. Although no fixation was detected in 25% of the patients, it was emphasized that favorable responses to visual rehabilitation could be obtained due to brain plasticity, and it is important to determine these infants’ behavioral characteristics in response visual stimuli in order not to miss this critical period. (see pages 1-7).
In their study titled “Improvement of Prostaglandin-Associated Periorbitopathy after Discontinuing Treatment,” Abalo-Lojo et al. examined the clinical course of glaucoma patients with prostaglandinassociated periorbitopathy after discontinuation of the prostaglandin analogue eye drops. In all of the patients included in the study, significant differences between the treated eye and fellow eye were observed in the periocular region, especially deepening of the upper eyelid sulcus and eyelid fat pad reduction, and improvement in these findings were noted one year after discontinuation of the drug. (see pages 8-12).
In a study by Özcan et al. titled “Efficacy of Optic Nerve Sheath Fenestration in Patients with Increased Intracranial Pressure,” medical records pertaining to 24 eyes of 17 patients who developed increased intracranial pressure due to idiopathic intracranial hypertension, cerebral venous sinus thrombosis, or intracranial cyst and underwent optic nerve sheath fenestration (ONSF) were examined, and improvement in best corrected visual acuity was observed in 20 (83.3%) of the eyes at 3 months after treatment compared to pre-treatment values. Improvement in visual field mean deviation was observed in 10 eyes (90.9%), while optic disc edema regressed in all eyes. The authors concluded that ONSF had beneficial effects on visual functions in patients with progressive vision loss due to increased intracranial pressure. (see pages 13-17).
Şekeroğlu et al. examined the static and dynamic pupillometry characteristics of patients with Duane syndrome (DS) and compared them with healthy eyes in their study titled “Is the Pupil Involved in Duane Syndrome? Static and Dynamic Pupillometry Characteristics.” The study included patients with unilateral isolated DS who had never undergone eye surgery, and no significant differences in any of the static and dynamic pupillometry parameters were found in comparison with the control group. Based on these results, the authors stated that the pupil was not affected in DS but emphasized that larger studies including DS patients with different ages and DS types may reveal different findings. (see pages 18-22).
Özdemir Yalçınsoy et al. retrospectively evaluated 14 patients with sympathetic ophthalmitis in terms of best corrected visual acuity, detailed ophthalmologic examination, optical coherence tomography (OCT), enhanced depth imaging-OCT, and fundus fluorescein angiography findings and treatment approaches in their study titled “Sympathetic Ophthalmia: Demographic Characteristics, Clinical Findings, and Treatment Results.” The mean follow-up time was 55.1±48.7 months, and it was determined that 10 patients (71%) had a history of ocular trauma while 4 patients (29%) had a history of ocular surgery. The patients were found to have optic disc edema (36%) and exudative retinal detachment (36%), and treatment included high-dose systemic corticosteroids in 8 patients (57%), azathioprine in 7 patients (50%), azathioprine and cyclosporine in 7 patients (50%), and tumor necrosis factor inhibitors in 3 patients (21%). Recurrence was reported in 4 patients (29%) during follow-up in this study, which will be very useful for physicians interested in the subject. (see pages 23-29).
In a retrospective cohort study titled “Ranibizumab or Aflibercept Monotherapies in Treatment-Naive Eyes with Diabetic Macular Edema: A Head-to-Head Comparison in Real-Life Experience” by Kaya et al., eyes with diabetic macular edema were evaluated in two groups, those who received ranibizumab (308 eyes) and those who received aflibercept (204 eyes) monotherapy using a pro re nata protocol. Although the functional and anatomical prognosis tended to be slightly better in the aflibercept arm, there was no statistically significant difference in visual outcomes at 12-month follow-up. (see pages 30-36).
In their study titled “Artifact-Removed Quantitative Analysis of Choriocapillaris Flow Voids,” Ersöz et al. investigated choriocapillaris flow voids (CFVs) with a new OCT angiography (OCTA) image processing strategy that can remove artifacts caused by vitreous opacities, sub-retinal pigment epithelium fluid and deposits, and subretinal fluid by thresholding en-face OCT images of the outer retina. The CFV number, mean area, and maximum area and percentage of nonperfused choriocapillaris area obtained using the proposed strategy were analyzed comparatively. The authors emphasized that this new artifact removal strategy, which they described for the first time in the literature, can be used for the evaluation of CFVs in eyes with subretinal fluid, drusen, drusen-like deposits, and pigment epithelial detachment. (see pages 37-43).
Özdek et al. present a review titled “Avascular Peripheral Retina in Infants,” in which they emphasize that an avascular peripheral retina in infants is a sign common to many pediatric retinal vascular diseases and is difficult to diagnosis. Key features of each disease included in the differential diagnosis, from retinopathy of prematurity to familial exudative vitreoretinopathy, Coats disease, incontinentia pigmenti, Norrie disease, persistent fetal vasculature syndrome, and other rare hematologic conditions and telomere disorders, are covered in detail in this review, which includes contributions from numerous physicians from both Türkiye and abroad who are experts on the topic. (see pages 44-57).
The first case in the case reports section is presented by Güven et al. and titled “Evaluation of the Long-Term Clinical Results of 3 Patients Implanted with the Argus II Retinal Prosthesis.” The study looks at the long-term clinical results of 3 patients with end-stage retinitis pigmentosa whose level of vision was light perception and projection and who were implanted with the Argus II retinal prosthesis. (see pages 58-66).
In their case report titled “Double Flip Technique for Graft Transfer in Autograft Pterygium Surgery,” Öztürk and Gündüz present the clinical results of two patients in whom they used a new autograft transfer technique to facilitate autograft suturing and correct graft orientation in pterygium surgery. The authors concluded that the new technique they describe contributed to easy autograft transfer and proper orientation. (see pages 67-69).
A case report titled “Sphenoid Bone Dysplasia: A Rare Cause of Compressive Optic Neuropathy Mimicking Glaucoma” by Kıyat et al. describes a 45-year-old female patient with optic disc pitting mimicking glaucoma in one eye due to sphenoid dysplasia compressing the optic nerve and emphasizes the importance of including compressive etiologies that cause optic disc pitting in the differential diagnosis of glaucoma. (see pages 70-73).
We hope that the articles selected for this issue offer you interesting and enjoyable reading.
Respectfully on behalf of the Editorial Board,
Hakan Özdemir, MD