2022 Issue 6 at a Glance:
Esteemed colleagues,
In its sixth issue of 2022, the Turkish Journal of Ophthalmology features eight original studies, a review, and three case reports.
A clinical study by Altan-Yaycıoğlu et al. reports the ocular complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) procedures. Early diagnosis and treatment are essential for graft-versus-host disease after allo-HSCT, which is an increasingly frequent procedure with expanding indications as well as improved success, and ophthalmologists will be an indispensable stakeholder in this process.
A study by Doğan et al. entitled “The Effect of Prolactinoma on Tear Film Functions” provides a look at benign pituitary tumors, especially prolactinomas, which cause a typical visual field loss in the form of bitemporal hemianopsia, from the point of view of another undesired outcome: dry eye.
A study by Akça Bayar et al. examining the effects of intracameral drugs and dyes on corneal endothelial apoptosis by in vivo and in vitro analyses in experimental animals is an important reference. The study showed that intracameral adrenaline, trypan blue, and lidocaine injections caused histopathological toxicity in the corneal endothelium. Therefore, caution seems warranted in the use of the intracameral drug administration route, which has been recommended as an alternative to the application of drugs to the ocular surface and has become popular in “dropless cataract surgery.”
Prolonged contact lens use is a well-known risk factor for dry eye. However, Şimşek et al. observed a significant increase in ocular surface disease index and dendritic cell density using silicone-hydrogel contact lenses for period as short as 1 month. Fortunately, these latest-generation contact lenses did not cause significant changes in corneal sensitivity, tear secretion, meniscus volume, or subbasal corneal nerve density, reflectivity, and tortuosity in the short term.
In their study of 120 diabetic patients without retinopathy or reduced visual acuity, Shah et al. showed that contrast sensitivity decreased with longer duration of diabetes and increased glycosylated hemoglobin level. The study demonstrated that contrast sensitivity testing is a much better indicator of metabolic control than retinal imaging or visual acuity testing and suggests that contrast sensitivity testing should also be added to the follow-up criteria for type 2 diabetes patients with disease duration longer than 5 years and HbA1c levels above 8%.
Ataş et al. investigated bacillary layer detachment (BLD), a common tomographic finding, in 58 eyes of 29 patients diagnosed with acute Vogt-Koyanagi-Harada disease. They reported that BLD was more common in severely affected eyes but because it resolved rapidly with treatment, its presence did not affect long-term visual function.
Acute retinal necrosis is an ophthalmological emergency that requires immediate treatment after diagnosis. Delayed diagnosis and especially the administration of corticosteroids before starting antiviral therapy allow retinal necrosis to spread. In their large series of 48 patients, Aksu-Ceylan et al. found that early diagnosis and early initiation of antiviral therapy were critical in terms of final vision.
The comprehensive vision screening with axial length, spherical equivalent, and corneal curvature parameters conducted in 1382 school children by Gopalakrishnan et al. is a strong study because normative data for Indian children in this age group have not been previously determined. The general distribution of ocular biometry parameters in children in India will be an important reference for studies on myopia and associated risk factors.
The review article for this issue, written by Mirzayev and Gündüz, comprehensively addresses the heading of “Hamartomas of the Retina and Optic Disc” with rich visual support including the modalities of ultrasound, fundus autofluorescence, optical coherence tomography, optical coherence tomography angiography, and fluorescein angiography. Although some do not require treatment, if complications such as vitreous hemorrhage, macular exudation, retinal detachment, macular hole, epiretinal membrane, and choroidal neovascularization occur, it seems prudent to follow-up the retinal and optic disc hamartomas that require treatment in light of this review.
Menteş and Değirmenci used multimodal imaging in their case report of a pediatric patient with pigmented paravenous retinochoroidal atrophy (PPRCA) and cystoid macular edema (CME). They reported that the occurrence of CME without ocular inflammation was an unusual finding for PPRCA and that chronic or latent inflammation may be involved in the etiology of PPRCA.
Dermatofibrosarcoma protuberance is a locally aggressive and infiltrative malignant tumor that occurs most commonly on the trunk and least commonly in the head and neck region and has a relatively high recurrence rate. Aslan Kaya et al. present the case of a 44-year-old woman with tearing of the right eye and swelling in the medial canthus for 15 years, and their comprehensive approach to diagnosis and treatment compensates for the lack of a review on this subject.
The scleral fixation sutures of posterior chamber intraocular lenses can create pseudoblebs with Seidel-positive cystic filtration. In their case report, Hoang and Clement describe filtering pseudoblebs secondary to persistent posterior chamber intraocular lens in a patient with Marfan syndrome and discuss the relationship between pseudoblebs and previous ocular surgeries. The filtration was stopped by patching with scleral grafts, constituting a successful treatment example.
As we say farewell to 2022 with articles featuring examples of comprehensive diagnosis and successful treatment, even in rare and challenging diseases, I wish for the new year to bring more health and peace.
Respectfully on behalf of the Editorial Board,
Sait Eğrilmez, MD