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    Efficiency of Choroidal Thickness Monitoring to Prevent Topiramate Induced Acute Angle Closure Glaucoma
    (Modestum Ltd, 2015) Kara, Selcuk; Ozcimen, Muammer; Aydin, Hacer Doganay; Sakarya, Yasar; Gencer, Baran; Tufan, H. Ali; Arikan, Sedat
    The aim of this study is to investigate early findings of the choroidal effusion induced by topiramate use which is thought to be responsible for bilateral acute angle closure glaucoma. Enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT) recordings of 34 patients who has been used topiramate for the prophylaxis of migraines, before and after 2 weeks of drug use were retrospectively investigated. Alterations in subfoveal choroidal layer thicknesses and peripapillary retinal nerve fiber layer (RNFL) thickness were measured manually by two masked observers. The mean measurements of subfoveal choroidal layer thickness were 315.67 +/- 80.98 mu m before use of the drug and 314.89 +/- 76.40 mu m in 2nd week of drug use. However, this slight decrease was not statistically significant. The mean peripapillary RNFL thickness was 104.47 +/- 10.48 mu m before use of the drug, and significant thinning was found only in the temporal quadrant during follow-up after use of the drug (p=0.008). No subclinical subfoveal choroidal effusions were encountered using EDI SD-OCT in patients after 2 weeks of topiramate use. Further studies are needed to find out the cause of bilateral ciliochoroidal effusion related with topiramate use.
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    Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome
    (Consel Brasil Oftalmologia, 2014) Kara, Selcuk; Ozcimen, Muammer; Bekci, Taha Tahir; Sakarya, Yasar; Gencer, Baran; Tufan, Hasan Ali; Arikan, Sedat
    Purpose: To compare the subfoveal choroidal thickness (SFCT) of patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) and normal controls via enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this retrospective, case-control study, 49 eyes from 49 patients that had undergone polysomnography were included. SFCT of the horizontal and vertical line scans were manually measured for all eyes based on EDI-OCT images. Two separate analyses were performed according to different apnea/hypopnea index (AHI) groupings. Initial testing was conducted using non-OSAHS, mild OSAHS (5 <= AHI<15), moderate OSAHS (15 <= AHI<30), and severe OSAHS (AHI >= 30) patient groupings, while secondary testing used non-OSAHS, mild OSAHS (5 <= AHI<15), and moderate/severe OSAHS (AHI >= 15) patient groupings. Results: The mean SFCT was 314.5 mu m in the non-OSAHS patients (n=14), 324.5 mu m in the mild OSAHS patients (n=15), 269.3 mu m in the moderate OSAHS patients (n=11), and 264.3 mu m in the severe OSAHS patients (n=9). SFCT between the four groups revealed no significant differences despite a trend towards slight thinning in the severe group (P=0.08). When the moderate and severe groups were merged and compared with the mild OASHS and non-OSAHS groups, SFCT of the moderate/severe group was found to be significantly thinner than that of the mild group (P=0.016). A negative significant correlation was found between SFCT and AHI in OSAHS patients (r=0.368, P=0.033). Conclusions: In patients with moderate/severe OSAHS, EDI-OCT revealed a thinned SFCT. Other accompanying systemic or ocular diseases may induce perfusion and oxygenation deficiency in eyes of OSAHS patients. Further studies are required in order to determine the exact relationships between ocular pathologies and clinical grades of OSAHS.