Op Dr Burcu Usta Uslu

03/12/2025

02/12/2025

Apixaban, paclitaxel, ibrutinib, and sildenafil use is associated with elevated rates of maculopathy, with incidence estimates up to 15.7% and dose-dependent risk for some agents.

https://ja.ma/4patfjc

25/11/2025

Perimetey Strategy Name Description Use / Comments

Full Threshold :Measures the exact light sensitivity (threshold) at each point by repeatedly testing brighter/dimmer lights. Most accurate but very slow. Often used for baseline or research.
Fast Threshold :Tests fewer levels to estimate threshold more quickly. Reasonable accuracy, shorter test time.
SITA Standard (Humphrey) “Swedish Interactive Threshold Algorithm” :— adapts to patient’s responses for faster testing without losing accuracy. Standard for glaucoma testing; good balance.
SITA Fast :Faster version of SITA Standard; slightly less precise. Useful for follow-up tests.
SITA Faster / Supra-threshold / Screening Quick screening; checks only if sensitivity is within normal range, not exact threshold. Screening only, not for diagnosis or follow-up.

2. Threshold

Definition

The threshold is the lowest light intensity (in decibels, dB) that the patient can detect at each specific location in the visual field.

Higher number (e.g. 30 dB) → normal sensitivity (can see dimmer lights).

Lower number (e.g. 10 dB or 0 dB) → poor sensitivity or defect (only sees very bright lights or none).

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Normal vs. Abnormal

Threshold value (dB) Interpretation

30–35 dB Normal sensitivity (young, healthy eye)
25–29 dB Mild reduction
15–24 dB Moderate reduction

24/11/2025

Mean Deviation (MD)

What it means:

MD shows overall (global) loss of sensitivity in the tested eye, compared with a normal age-matched population.

It’s the average difference in light sensitivity (in decibels, dB) between the patient’s results and normal values.

Normal range:

Normal: between 0 and −2 dB

Mild loss: −2 to −6 dB

Moderate loss: −6 to −12 dB

Severe loss: worse than −12 dB

).

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2. Pattern Deviation (PD)

What it means:

PD corrects for general depression (for example from cataract, small pupil, or overall blur) and highlights localized defects that are not due to uniform light reduction.

It’s very helpful to find typical glaucomatous scotomas (arcuate, nasal step, etc.).

Normal range:

Normal: PD close to 0 dB and few (if any) abnormal probability symbols (black squares).

Mild localized defect: PD around 2–4 dB

Moderate defect: PD around 4–8 dB

Severe localized defect: PD > 8–10 dB

24/11/2025

Photochromic vs Fixed Tint | Solid vs Gradient – Which is Better in Retinitis Pigmentosa? 🌟

When managing low vision in RP, tinted lenses are more than just cosmetic — they are functional tools. But the type of tint matters.

👓 Photochromic vs Fixed Tint

Photochromic: Convenient, darkens outdoors.
➡️ Limitation: May not activate fully indoors or in cars.

Fixed Tint: Consistent spectral filtering (amber, brown, FL-41).
➡️ Preferred for RP when photophobia & contrast loss are major complaints.

🌓 Solid vs Gradient Tint

Solid Tint: Uniform shade across the lens.
✅ Best for RP — gives consistent glare reduction and reduces scatter across the whole field.

Gradient Tint: Darker at top, lighter at bottom.
➡️ Useful for specific tasks (e.g., overhead glare while keeping near vision brighter), but less effective for global photophobia in RPClinical takeaway:

For most RP patients → Solid Fixed Tint (amber, brown, or blue-blocking) works best.

Reserve Photochromic or Gradient only when lifestyle or task-specific needs justify them.

👉 Tint prescribing is not “one-size-fits-all.” Always trial multiple options and choose based on patient comfort, functional goals, and real-world tasks.

20/11/2025

Revisiting Anterior Corneal Transplantation

Surgeons share their evolving approaches to DALK, SALK, Bowman’s layer grafts and emerging techniques that preserve host tissue and reduce rejection.

Albert Y. Cheung, MD, a corneal specialist at Virginia Eye Consultants in Norfolk, Virginia, says he is a big proponent of DALK. “Compared to penetrating keratoplasty, it offers so many advantages. The biggest one is that you maintain the endothelial layer, which is often the most consequential in terms of rejection risk. Preserving this layer helps prolong the longevity of the graft. Endothelial rejection is typically the most severe and hardest to reverse. It’s also the most common reason for graft failure. So especially in younger patients—where you’re hoping to get more than the average 10 years out of a graft—DALK can offer a better long-term outcome.”

Read more: https://www.reviewofophthalmology.com/article/revisiting-anterior-corneal-transplantation

14/11/2025

13/11/2025

Topical losartan is a promising, minimally invasive option for corneal haze/scarring with a practical regimen (0.8 mg/mL QID–6x/day), but epithelium status and dose-dependent toxicity are critical. While awaiting stronger clinical trial data, expect months-long treatment and careful monitoring.

The feature "Treating Corneal Fibrosis with Losartan" in our latest issue describes what physicians should know before prescribing this topical pharmaceutical for off-label management of corneal haze and scarring. Read now: www.reviewofophthalmology.com/article/treating-corneal-fibrosis-with-losartan

11/11/2025

Ophthalmologists weigh in on evolving diagnostic tools, emerging therapies, and practical approaches for managing today’s most challenging ocular-surface cases.

11/11/2025