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    Correlation of Corneal Endothelial Cell Density with Corneal Tomographic Parameters in Eyes with Keratoconus
    (TURKISH OPHTHALMOLOGICAL SOC, 2017) Bozkurt, Banu; Yilmaz, Mevlut; Mesen, Ali; Kamis, Umit; Koktekir, Bengu Ekinci; Okudan, Suleyman
    Objectives: To examine changes in corneal endothelial cell density (ECD) in different stages of keratoconus and evaluate its correlation with corneal tomographic parameters. Materials and Methods: Two hundred six patients with keratoconus were enrolled in the study. Corneal topography was performed by Sirius (CSO, Italy), which has a rotating Scheimpflug camera and a Placido disc topographer. Automatic endothelial analysis was done with the non-contact endothelial microscope (20x probe) of Confoscan-4 (NIDEK, Japan). The eyes were classified into stages based on steepest keratometric value as follows: mild <45 D; moderate 45-52 D; severe >52 D and according to thinnest cornea thickness (TCT) as <400 mu m, 400-450 mu m, and >450 mu m. Tomographic and endothelial cell parameters were compared among the groups using Kruskal-Wallis test and the correlations between them were analyzed using Spearman correlation. Results: The study included 391 eyes of 100 male (24.29 +/- 7.7 years, range 11-47 years) and 106 female (26.26 +/- 7.5 years, range 13-45 years) patients (p=0.07). Mean ECD values were 2628 +/- 262 cells/mm(2), 2541.9 +/- 260.4 cells/mm(2), and 2414.6 +/- 384.3 cells/mm(2) in mild, moderate, and severe keratoconus, respectively (p<0.001) and 2592.3 +/- 277 cells/mm(2), 2502 +/- 307 cells/mm(2) and 2348 +/- 296 cells/mm(2) in corneas with TCT values >450 mu m, 400-450 mu m, and <400 mu m, respectively (p<0.001). ECD showed significant negative correlation with keratometric and elevation parameters and positive correlation with pachymetric parameters (p<0.05). Conclusion: As endothelial cell numbers seem to decrease with the progression of keratoconus, specular/confocal microscopy screening should be carried out, especially in eyes with advanced stages and corneas with TCT <400 mu m.
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    Spectral-Domain Optical Coherence Tomography Findings in Lipemia Retinalis
    (SLACK INC, 2016) Ozturk, Banu Turgut; Bozkurt, Banu; Mesen, Ali; Gonul, Saban; Ipekci, Suleyman Hilmi
    Severe hypertriglyceridemia can give rise to a fundus appearance with whitish-colored retinal vessels called lipemia retinalis. A 52-year-old man with hypertriglyceridemia presented with a best-corrected visual acuity of 20/20 in both eyes and creamy-white retinal vessels on fundus. Spectral- domain optical coherence tomography (SDOCT) revealed hyperreflective and engorged retinal vessels and white dots mainly accumulated in the inner nuclear and ganglion cell layer. Follow-up fundus examination after plasmapheresis sessions revealed normal retinal vessels. The hyperreflective appearance of the retinal vessels in OCT reversed rapidly 5 days after the treatment, whereas hyperreflective dots in retina disappeared slowly in 3 months. OCT is useful in demonstrating inner retinal changes associated with lipemia retinalis at histopathological level. The hyperreflective dots in inner retina associated with leakage from superficial retinal capillaries attested the correlation of their location with their origin.