Medical hypothesis discovery and innovation in ophthalmology

Editorial/No abstract

We aimed to describe the causes, characteristics, and rate of parental consanguineous marriage associated with patients with visual impairments in Turkey. This study involved 236 patients with visual impairments. The 10th revision of the International Classification of Diseases was used to categorize the causes of visual impairments (based on the main cause in both eyes). The mean age of the patients was 38.5 ± 24.2 years (range, 6–95 years), and most were in the 15–30-year age group (35.6%). There were more male patients (65%) than female patients. Blindness, severe visual impairment, and mild to moderate visual impairment were observed in 30 (12.7%), 84 (35.6%), and 122 (51.6%) patients, respectively. Choroidal and retinal diseases were identified as the main underlying cause of visual impairment (62.7%), followed by nystagmus (23.7%), optic tract and nerve diseases (11.0%), congenital cataracts (0.8%), and glaucoma (1.7%). Parental consanguinity was present for 26.3% of the patients, and it was significantly more common in the 15–30-year age group (50%) compared to the other age groups. In Turkey, the main cause of visual impairment was choroid and retinal diseases in all the age groups above 14 years, while nystagmus was the most common cause in the age group below 15 years. Parental consanguinity was significantly higher among the patients with macular dystrophy and those with retinitis pigmentosa than with retinopathy of prematurity, optic nerve diseases, age-related macular degeneration, and diabetic retinopathy. Genetic factors are known to be involved in the development of these diseases, indicating that the issue of consanguineous marriage remains a problem in Turkey. 

We describe a 66-year-old man who developed bilateral choroidal detachment that was induced by unilateral topical administration of a fixed combination of 1% brinzolamide and 0.5% timolol maleate the day after an uneventful phacoemulsification surgery and intraocular lens implantation involving his right eye. We believe that the reaction was an idiosyncratic reaction, most likely against brinzolamide. The condition improved rapidly after the cessation of the fixed combination of brinzolamide and timolol maleate and treatment with 1% topical prednisolone acetate every hour and 1% cyclopentolate twice a day bilaterally. Although there are several similar cases involving choroidal detachment after oral acetazolamide and topical dorzolamide treatment mentioned in the literature, the present case is the first case report involving bilateral choroidal detachment after topical treatment with brinzolamide. 

The porcine eye is often used as an ex vivo animal model in ophthalmological research. It is well suited for investigations concerning refractive surgery; however, corneal topography data are scarce. This study investigated the corneal topography and pachymetry of the porcine eye to provide further reproducible data. We evaluated freshly enucleated porcine eyes (n = 16) by performing computerized corneal topographies (Orbscan® IIz, Bausch and Lomb, Rochester, NY, USA). We assessed the steepest and flattest keratometric powers (K1 and K2, units in diopters (D)), astigmatism (D), white-to-white (WTW) diameter (mm), thinnest point pachymetry (µm), anterior and posterior best-fit sphere (BFS) (D), refractive power of the anterior and posterior curvatures, and total refractive power of the cornea (D). The mean keratometric powers were 39.6 ± 0.89 D (K1) and 38.5 ± 0.92 D (K2), and the mean astigmatism was 1.1 ± 0.78 D. The mean WTW diameter was 13.81 ± 0.83 mm, and the mean corneal thickness was 832.6 ± 40.18 µm. The BFSs were 38.14 ± 0.73 D (anterior) and 42.56 ± 1.15 D (posterior), and the mean refractive powers were 43.27 ± 1.08 D (anterior) and -5.15 ± 0.20 D (posterior); therefore, the mean of the total refractive power was 38.16 ± 1.00 D. The topography and pachymetry of the porcine cornea showed a specific configuration differing from the human cornea. When using animal ex vivo models such as porcine corneas for experimental corneal surgery, findings such as these should be considered.

Lung cancer is still diagnosed during the advanced stage of the disease and most patients do not have the opportunity for surgical treatment, despite the new diagnostic equipment that has been made available in recent years, such as the radial and linear endobronchial ultrasound (EBUS) and electromagnetic fiberoptic bronchoscopy. However, novel targeted therapies with second generation tyrosine kinase inhibitors and immunotherapy are available. In this commentary, we will focus on eye metastasis after initiation of tyrosine kinase inhibitors due to epidermal growth factor mutation of lung cancer adenocarcinoma. 

We aimed to compare the therapeutic effects of topical 1% sodium hyaluronate (Healon) or hydroxypropyl methylcellulose (HPMC) for the treatment of alkali-induced epithelial corneal defects. An alkali burn was produced in 30 corneas of 30 New Zealand White rabbits, using a 7.5-mm-diameter trephine. The rabbits were randomly divided into three groups. Four times a day, one group was treated with 1% sodium hyaluronate, one with HPMC, and one (the control group) with physiologic saline. During the treatment period, the size of the epithelial defect was observed every day, up to day 17, using a slit-lamp biomicroscope (with fluorescein). Sodium hyaluronate significantly accelerated the wound healing process compared with saline and increased the healing rate to an even greater extent compared with HPMC. Sodium hyaluronate, but not HPMC, is an effective wound-healing adjuvant for alkali-induced corneal epithelial defects.