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    Anterior segment parameters and corneal specular microscopy findings in rheumatoid arthritis
    (2019) Tasli, Nurdan Gamze; Aktas, Nurdagül; Karakurt, Yucel; Ucak, Turgay; Agcayazi, Sumeyye Burcu; Icel, Erel; Yilmaz, Hayati
    Aim: To compare the anterior segment parameters and specular microscopy findings between patients with Rheumatoid arthritis (RA) and healthy controls. Material and Methods: In this prospective study, 55 patients diagnosed with RA and age and matched 55 control subjects without any systemic diseases were enrolled. Central corneal thickness (CCT), corneal endothelial cell density (cells/mm2) (ECD), percentage of hexagonal cells of corneal endothelial cells ( HEX), and cell size variability (CV%) of endothelial cells were measured using noncontact specular microscopy (CEM-530 Specular Mıcroscope, NIDEK ). Anterior chamber depth (ACD), Axial Length (AL), white to white limbus length and keratometry were measured using an ocular biometry system. In all patients of RA group, disease activity severity was assessed with The Disease Activity Score in 28 joints diseases activity score (DAS28 rate). Results: There were statistically significant differences between RA patients and control subjects regarding ACD (3.06±0.43 vs 3.24±0.31; p: 0.001), white to white limbus length (11.63±0.45 vs 11.76±0.38; p: 0.02), CV% (35.49±5.96 vs 32.02±5.22, p: 0.001) and hexagonality (67.31±4.66 vs 71.35±11.02; p: 0.001). In correlation analysis, there was a negative correlation between disease periods and both ACD and CCT; while there was a negative correlation with the number of cells and endothelial cell density and DAS 28 score. Conclusion: Although there was not a significant difference regarding endothelial cell density values in RA group compared with healthy controls; there was a negative correlation between the disease activity and endothelial cell density. Moreover, CV% was significantly higher and hexagonality % was significantly lower in RA group; indicating the endothelial damage and increase in the expected compensatory response. Further, larger studies are warranted to define the exact pathological mechanisms and clinical outcomes of this corneal endothelial damage in RA patients.
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    Evaluation of the effect of chronic smoking habit on corneal endothelial cells, central corneal thickness and dry eye tests
    (2019) Karakurt, Yucel; Sunar, Mukadder; Tasli, Nurdan Gamze; Ucak, Turgay; Agcayazi, Sumeyye Burcu; Ugurlu, Adem; Icel, Erel
    Aim: The aim of our study was to evaluate the effects of chronic smoking habit on corneal endothelial cells, central corneal thickness, and dry eye tests. Material and Methods: A total of 160 eyes of 160 chronic smokers and 160 eyes of 160 control cases were included in the study. The smokers were grouped into 4 groups according to pack-year smoking as follows: 0-10, 10-20, 20-30, >30. Endothelial cell density (CD), average cell size (AVG), percentage of hexagonal cell (HEX), and coefficient of variation (CV), central corneal thickness (CCT) were measured using a specular microscope. The Tear Break-Up Time (TUBT) and Schirmer tests were performed. Results: In Group 1 and Group 2, there was no significant difference between the smoker and the control groups in terms of CD, AVG, HEX and CV. In Group 3 and Group 4, there was a significant decrease in CD and HEX values, while there was a significant increase in AVG and CV values. CCT values were not significantly different in the Groups 1,2 and 3, whereas there was a significant decrease in the Group 4. TBUT and Schirmer tests were significantly decreased in all groups. Conclusion: It was found that as the number of pack-year increased, CD and HEX values decreased and AVG and CV values increased. Dry eye tests were affected in a shorter period of time, while CCT was affected in a longer period of time than the time required for CD, HEX, AVG and CV parameters to be affected.
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    The findings of corneal specular microscopy in patients with keratoconus
    (2019) Tasli, Nurdan Gamze; Ucak, Turgay; Karakurt, Yucel; Icel, Erel; Ugurlu, Adem; Agcayazi, Sumeyye Burcu
    Aim: The aim of this study was to determine the correlation of corneal endothelial cell density, coefficient of variation and hexagonal cell ratio with the stages of keratoconus and corneal thickness. Material and Methods: The study included 102 eyes from 51 patients. The corneal topography was performed using the Sirius corneal topographic device and the examination of the endothelium was performed using Nidek CEM-530. The patients were divided into groups in accordance with keratometry values (group 1: K2<45 D, group 2: K2 45-52 D, group 3: K2> 52 D) and thinnest cornea thickness (group 1:> 450 µm, group 2: 400-450 µm, group 3: <400 µm). Specular microscopic findings were compared according to the severity of keratoconus and corneal thickness. Results: Of the patients, 29 (50%) were male and 22 (50%) were female. The mean age was 29.8 ± 7.7 (15-45) years. Endothelial cell count and hexagonal cell ratio were significantly lower in severe keratoconus compared to mild and moderate keratoconus and the coefficient of variation was higher in severe keratoconus compared to the other groups (p <0.001). When the patients were compared according to the pachymetry value at the thinnest point of the cornea, the endothelial cell number and the hexagonal cell ratio were found to be lower in the group with pachymetry less than 400 µm (p <0.001). The coefficient of variation was higher in the same group compared to the others (p <0.001). Conclusion: It was revealed that endothelial cell density, hexagonal cell ratio decreased and the coefficient of variation increased with the progression of keratoconus. Specular microscopic examinations in patients with keratoconus provide important data in addition to topography