Publications by authors named "Ersin Oba"

15 Publications

  • Page 1 of 1

Retinal nerve fiber layer and ganglion cell complex thickness in patients with type 2 diabetes mellitus.

Indian J Ophthalmol 2014 Jun;62(6):719-20

Department of Ophthalmology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

Aim: The aim of the following study is to evaluate the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness in patients with type 2 diabetes mellitus (DM).

Materials And Methods: Average, inferior, and superior values of RNFL and GCC thickness were measured in 123 patients using spectral domain optical coherence tomography. The values of participants with DM were compared to controls. Diabetic patients were collected in Groups 1, 2 and 3. Group 1 = 33 participants who had no diabetic retinopathy (DR); Group 2 = 30 participants who had mild nonproliferative DR and Group 3 = 30 participants who had moderate non-proliferative DR. The 30 healthy participants collected in Group 4. Analysis of variance test and a multiple linear regression analysis were used for statistical analysis.

Results: The values of RNFL and GCC in the type 2 diabetes were thinner than controls, but this difference was not statistically significant.

Conclusions: This study showed that there is a nonsignificant loss of RNFL and GCC in patients with type 2 diabetes.
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http://dx.doi.org/10.4103/0301-4738.136234DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131327PMC
June 2014

Results of intravitreal triamcinolone acetonide in patients with macular edema secondary to branch retinal vein occlusion.

Int J Clin Pharm 2014 Apr 9;36(2):438-42. Epub 2014 Feb 9.

Department of Ophthalmology, Sisli Etfal Training and Research Hospital, Halaskargazi caddesi Etfal sokak, Etfal Hastanesi, 34400, Istanbul, Turkey,

Background: Macular edema is one of the most common causes of visual loss in patients with retinal vein oclusions. Intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factors are modalities of treatment for macular edema secondary to branch retinal vein occlusion (BRVO).

Objective: To present the results of intravitreal triamcinolone acetonide therapy in patients with macular edema secondary to BRVO.

Setting: A retrospective clinical interventional study included 32 patients with macular edema secondary to BRVO.

Method: The records of 32 eyes of 32 patients who received 4 mg/0.1 mL injection of intravitreal triamcinlone for macular edema secondary to BRVO were evaluated. Patients with visual acuity <0.40 logMAR (logarithm of the minimum angle of resolution), central macular thickness (CMT) >260 μm and no neovascularization at baseline were included. Patients with diabetes mellitus, a history of intravitreal anti vascular endothelial growth factor injection, grid laser photocoagulation and ischemic BRVO were excluded. The re-injections were performed in cases with increased CMT >100 μm or vision loss of five or more letters.

Results: The mean follow-up was 12 ± 1.9 months. The visual acuity increased from 0.58 ± 0.16 at baseline to 0.25 ± 0.11 logMAR (P < 0.001). The CMT decreased from 490 ± 107 μm at baseline to 266 ± 90 μm at 12 months (P < 0.001). Both cataract and glaucoma developed in 18.75 % patients.

Conclusion: Intravitreal triamcinolone, due to absence of systemic side effects, can be used with confidence for treatment macular edema secondary to BRVO. However the main disadvantages of intravitreal triamcinolone injection are elevation of intraocular pressure and formation of cataract.
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http://dx.doi.org/10.1007/s11096-014-9918-9DOI Listing
April 2014

Effect of Bevacizumab Injection before Vitrectomy on Intravitreal Hemorrhage in Pseudophakic Patients with Proliferative Diabetic Retinopathy.

Ophthalmol Eye Dis 2013 15;5:11-5. Epub 2013 Jul 15.

Sisli Etfal Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey.

We evaluated the effect of intravitreal bevacizumab (IVB) injection before pars plana vitrectomy (PPV) on intravitreal hemorrhage (VH) during and after vitrectomy for postoperative the first day and the first month in pseudophakic patients with proliferative diabetic retinopathy (PDR). This retrospective study was performed on 44 eyes of 44 patients who underwent vitrectomy for PDR. Patients were divided into PPV (n = 22 eyes) and PPV + IVB (n = 22 eyes) groups. Injection of bevacizumab (1.25 mg/0.05 mL) was performed 3 days before vitrectomy. Outcomes of visual acuity as well as intraoperative and postoperative VH were compared between the two groups. One month after surgery, visual acuity improved in PPV and PPV + IVB groups (P = 0.005, P = 0.006), respectively. There was no difference between the two groups in best corrected visual acuity at baseline and after vitrectomy (P = 0.71). Intraoperative bleeding into the vitreous was recorded in 14 (63.6%) cases in the PPV group and in 7 (31.8%) cases in the PPV + IVB group. The first month, intravitreal hemorrhage was recorded in six patients in the PPV group and in two patients in the PPV + IVB group (P = 0.03). The mean pre-postoperative central macular thickness was similar in both groups. Intravitreal injection of IVB before vitrectomy decreased the rate of VH at the time of surgery and at the first postoperative month in patients with PDR.
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http://dx.doi.org/10.4137/OED.S12352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726581PMC
August 2013

Comparison of the effects of intravitreal bevacizumab and triamcinolone acetonide in the treatment of macular edema secondary to central retinal vein occlusion.

Indian J Ophthalmol 2014 Mar;62(3):279-83

Department of Ophthalmology, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey.

Aim: To compare the effects of intravitrealbevacizumab (IVB) and intravitreal triamcinolone acetonide (IVT) in the treatment of macular edema (ME) secondary to central retinal vein occlusion (CRVO).

Materials And Methods: There were 20 patients treated with IVB (1.25 mg/0.05 mL) and 16 treated with IVT (4 mg/0.1 mL). The two groups were compared with regard to best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography (OCT), slit-lamp biomicroscopy and fundus fluorescein angiography results, intraocular pressure (IOP), numbers of injections, and adverse events.

Results: The mean follow-up times in the IVB and IVT groups were 17.45±8.1 months (range: 8-33 months) and 19.94±10.59 months (range: 6-40 months), respectively (P = 0.431). Visual acuity increased and CMT decreased significantly within both groups, but no differences were observed between the groups (P = 0.718). The percentages of patients with increased IOP and iatrogenic cataracts were significantly higher in the IVT group than in the IVB group.

Conclusions: Treatment with IVB and IVT both resulted in significant improvement in visual acuity and a decrease in CMT in patients with ME secondary to non-ischemic CRVO, with no difference between the two treatments. The incidence of adverse events, however, was significantly greater in the IVT group than in the IVB group. IVB may be preferred over IVT for the treatment of ME in patients with non-ischemic CRVO.
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http://dx.doi.org/10.4103/0301-4738.105769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061662PMC
March 2014

Central macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy.

BMC Ophthalmol 2013 Apr 9;13:11. Epub 2013 Apr 9.

Sisli Etfal Training and Research Hospital, Eye Clinic, Istanbul 34400, Turkey.

Background: An increase in macular thickness due to fluid accumulation in the macula in patients with diabetes mellitus. Optical coherence tomography (OCT) has been shown to be highly reproducible in measuring macular thickness in normal individuals and diabetic patients. OCT can detect subtle changes of macular thickness. The aim of this study is to compare central macular thickness (CMT) of diabetic patients with type 2 diabetes without clinical retinopathy and normal controls, in order to assess possible increased macular thickness associated with diabetes mellitus.

Methods: Optical coherence tomography (OCT) measurements were performed in 124 eyes of 62 subjects with diabetes mellitus without clinically retinopathy (study group: 39 female, 23 male, mean age: 55.06 ± 9.77 years) and in 120 eyes of 60 healthy subjects (control group: 35 female, 25 male, mean age: 55.78 ± 10.34 years). Blood biochemistry parameters were analyzed in all cases. The data for central macular thickness (at 1 mm) and the levels of the fasting plasma glucose and glycosylated hemoglobin (HbA1c) were compared in both groups.

Results: The mean central macular thickness was 232.12 ±24.41 μm in the study group and 227.19 ± 29.94 μm in the control group.The mean HbA1c level was 8.92 ± 2.58% in the study group and 5.07 ± 0.70% in the control group (p=0.001). No statistically significant relationship was found between CMT, HbA1c, and fasting plasma glucose level in either group (p=0.05).

Conclusions: Central macular thickness was not significantly thicker in patients with type 2 diabetes without clinical retinopathy than in healthy subjects.
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http://dx.doi.org/10.1186/1471-2415-13-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623885PMC
April 2013

Giant osteoid osteoma of the ethmoid bone with unusual large nidus.

J Neurosci Rural Pract 2012 Sep;3(3):383-5

Department of Neurosurgery, Clinic of Neurosurgery, ŞişliEtfal Education and Research Hospital, Istanbul, Turkey.

Osteoid osteoma (OO) is a benign bone neoplasm which is seen in the long bones of appendicular skeleton. It is rarely seen in the cranium. Ethmoid bone OO has been very rarely reported so far. We report another case of giant osteoid osteoma involving the ethmoid bone with intraorbital and intracranial extension in a 3O year old female patient. This case with unusual anatomical location was presented. It is first time reporting a giant osteoid osteoma of ethmoid bone with such a large nidus.
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http://dx.doi.org/10.4103/0976-3147.102637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505348PMC
September 2012

Effect of intracameral carbachol given during cataract surgery on macular thickness.

Int Ophthalmol 2012 Oct 11;32(5):413-6. Epub 2012 May 11.

Eye Clinic, Sisli Etfal Training and Research Hospital, Halaskargazi Cad. Etfal Sok. No: 10, Sisli, Istanbul, Turkey.

To evaluate the effect of intracameral carbachol on foveal thickness in patients who underwent uneventful cataract surgery. This retrospective study included two groups: the study group patients (group 1, n = 47 eyes) had uneventful cataract surgery and received only carbachol 0.01 % for miosis; the control group patients (group 2, n = 49 eyes) had uneventful cataract surgery without carbachol or any intracameral medication(s). The groups were compared for foveal thickness after cataract surgery. All phacoemulsification plus intraocular lens implantation surgeries were performed under local anesthesia via temporal clear corneal tunnel incisions. Mean values and standard deviations were calculated for preoperative and postoperative visual acuity (VA) and foveal thickness (FT) at 1 and 4 weeks. Optical coherence tomography was used for the FT measurements, with the MM6 map program. The patients in the study and control groups had a mean age of 57.78 ± 9.07 and 59.72 ± 8.96, respectively (p = 0.355). All eyes had a significant improvement in VA. In the study group, the mean FT at the visits before and 1 and 4 weeks after surgery was 216.87 ± 21.06, 228.81 ± 30.52, and 222.94 ± 29.91 μm, respectively. For the control group, the mean FT, before and 1 and 4 weeks after surgery, was 222.53 ± 17.66, 231.67 ± 23.08, and 225.41 ± 22.59 μm, respectively. Intracameral carbachol 0.01 % had no effect on foveal thickness in patients who underwent uneventful cataract surgery.
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http://dx.doi.org/10.1007/s10792-012-9579-4DOI Listing
October 2012

[Traumatic orbital emphysema: a case report].

Ulus Travma Acil Cerrahi Derg 2011 Nov;17(6):570-2

Department of Ophthalmology, Şişli Etfal Training and Research Hospital, İstanbul, Turkey.

A 30-year-old male presented with sudden diminution of vision, orbital pain, diplopia, and swelling of the eyelid of the right eye after blowing his nose within three days after a blunt ocular trauma. His best-corrected visual acuities were 6/10 in the right eye and 10/10 in the left eye. Anterior segment and fundus examination were normal bilaterally. Limitation of upward ocular motility was noticed in the right eye. Diplopia was detected in both upward and downward motilities. Intraocular pressures were 21 mmHg in OD and 16 mmHg in OS. Hertel exophthalmometry measurements were 21 mm for the right eye and 19 mm for the left eye. The direct computerized tomography image displayed the inferior orbital wall fracture and orbital emphysema in the right orbit. Prophylactic antibiotherapy was applied. The patient was advised not to blow his nose. He had no complaints on the third day after the trauma. Follow-up examinations showed no ophthalmological complications.
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http://dx.doi.org/10.5505/tjtes.2011.79069DOI Listing
November 2011

Comparison of fixed combinations of dorzolamide/timolol and brimonidine/timolol in patients with primary open-angle glaucoma.

Int Ophthalmol 2011 Dec 30;31(6):447-51. Epub 2011 Dec 30.

Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

To compare the short-term effectiveness and ocular side-effects of fixed combinations of dorzolamide/timolol (DTFC) and brimonidine/timolol (BTFC) in patients with primary open-angle glaucoma (POAG). Forty-two eyes of 42 patients newly diagnosed with primary open-angle glaucoma were assessed prospectively. One of the two eyes was chosen randomly and treated with DTFC (2 × 1) for 4 weeks. The treatment was then stopped to allow a 4-week wash-out period. Following the wash-out period, the same eye was treated with BTFC (2 × 1) for 4 weeks. Intraocular pressure (IOP) values were measured before and after each treatment at 0800, 1,200 and 1,600 h. Tear function test results and ocular side-effects were also recorded. The mean baseline IOP values for DTFC and BTFC were 24.1 ± 1.8 and 24.6 ± 2.4 mmHg, respectively. The mean IOP values after 4 weeks of treatment with DTFC or BTFC were 17.1 ± 2.9 and 16.9 ± 2.5 mmHg, respectively. Both medications reduced IOP values significantly (P = 0.0000). The effectiveness of both medications was similar (P = 0.7363). Both combinations significantly reduced the amount of tear secretion and tear break-up time (P = 0.0000). Eye burning was more common with DTFC than with BTFC (P = 0.0182). Other adverse effects were observed at similar rates for both combinations. This study demonstrated that the IOP-reducing effects of DTFC and BTFC in patients with POAG are similar. The side-effect profile of BTFC is similar to that of DTFC. Lower occurrence of a burning sensation may improve patient compliance in the BTFC group.
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http://dx.doi.org/10.1007/s10792-011-9495-zDOI Listing
December 2011

Foveal and parafoveal retinal thickness in healthy pregnant women in their last trimester.

Clin Ophthalmol 2011 23;5:1397-400. Epub 2011 Sep 23.

Eye Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

Purpose: The inspection of foveal and parafoveal thickness in healthy pregnant women in the last trimester.

Materials And Methods: This study included 40 healthy pregnant women in their last trimester (study group: 40 women, 80 eyes) and 37 nonpregnant women (control group: 37 women, 74 eyes). Visual acuity, intraocular pressure, slit lamp examination of anterior and posterior segments, and visual field examination with automated perimetry were performed in both groups. Foveal and parafoveal thickness in the four quadrants (upper, nasal, temporal, and inferior parafoveal) and peripapillary retinal nerve fiber layer were measured by optical coherence tomography. There were no systemic or ocular problems in either group. Findings were analyzed with statistical software. A P value <0.05 was considered statistically significant.

Results: Mean foveal and parafoveal thicknesses in the study group were: foveal 236.12 ± 27.28 μm, upper quadrant 321.31 ± 12.28 μm, temporal quadrant 307.0 ± 12.05 μm, inferior quadrant 317.0 ± 10.58 μm, and nasal quadrant 313.62 ± 14.51 μm. Mean foveal and parafoveal thicknesses in the control group were: foveal 224.62 ± 21.19 μm, upper quadrant 311.62 ± 12.71 μm, temporal quadrant 296.87 ± 13.78 μm, inferior quadrant 305.43 ± 13.25 μm, and nasal quadrant 304.93 ± 13.44 μm. Mean retinal nerve fiber layer thicknesses in the study and control group were 110 ± 12.4 μm and 108 ± 13.1 μm, respectively.

Conclusion: Mean retinal thickness in pregnant women was higher than control group in all measurements. Statistically significant difference in thickness was only found in upper, temporal, and inferior parafoveal areas.
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http://dx.doi.org/10.2147/OPTH.S23944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198413PMC
November 2011

Surgical results of large and giant pituitary adenomas with special consideration of ophthalmologic outcomes.

World Neurosurg 2011 Jul-Aug;76(1-2):141-8; discussion 63-6

Department of Neurosurgery, Sisli Research and Education Hospital, Baskent University Medical School, Istanbul, Turkey.

Objective: To analyze functioning and nonfunctioning pituitary adenomas (PAs)>3 cm, with special emphasis on preoperative and postoperative visual functions.

Methods: The cases consisted of 49 women and 54 men with mean age of 43.2 years (range 19-66 years). All cases had a macroadenoma >3 cm in diameter. The transsphenoidal approach was performed in 117 procedures, and the transcranial approach was performed in 8 procedures. Radical tumor excision was achieved in 50 of 103 patients. Postoperative evaluation was done in 88 patients. Preoperative and postoperative visual acuity, visual field, and ocular fundi and their relationship with the pattern and duration of the symptoms and the size of the tumor were evaluated.

Results: Normalization of visual acuity was obtained in 71.5% of patients, improvement occurred in 13.6%, symptoms persisted in 13.6%, and symptoms worsened in 1%. Postoperative improvement of visual field defects (VFDs) was observed in 74.1% of patients, and visual impairment score improved postoperatively in 92% of patients. Patients operated on <6 months before the onset of vision loss had better and more sustained visual improvement. One patient died, and 15.5% of patients experienced surgery-related complications.

Conclusions: This study shows that patients with severe visual impairment may have remarkable improvement if surgical decompression is done early. The transsphenoidal approach should be performed to correct the patient's visual impairment and to relieve the pressure on the optic apparatus caused by macroadenoma of any size.
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http://dx.doi.org/10.1016/j.wneu.2011.02.009DOI Listing
October 2011

Intravitreal bevacizumab for macular edema due to branch retinal vein occlusion: 12-month results.

Clin Ophthalmol 2011 3;5:745-9. Epub 2011 Jun 3.

Sisli Etfal Training and Research Hospital, Eye Clinic, Sisli, Istanbul, Turkey.

Purpose: To present the functional and anatomic changes after intravitreal bevacizumab in eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO).

Design: The study was a retrospective study.

Materials And Methods: The study included 31 patients with ME due to BRVO. We compared the examination findings of patients with ME before and after intravitreal bevacizumab therapy at 12 months. The study included patients who had macular edema secondary to BRVO treated with bevacizumab. The therapy was started in the first week after occlusion. The initial therapy was three intravitreal bevacizumab injections at monthly intervals with 1.25/0.05 mL bevacizumab. Patients with a baseline visual acuity less than 0.5 (logarithm of the minimum angle of resolution [logMAR] 0.30), central macular thickness (CMT) more than 290 μm, and no neovascularization were included. Patients with diabetes mellitus or a history of intravitreal triamcinolone or grid laser photocoagulation therapy or ischemic BRVO were excluded. The retreatment criteria were as follows: increased CMT more than 100 μm combined with a loss of visual acuity of five or more letters. The statistical analysis of this study was carried out by paired samples t-test (SPSS). A P value of less than 0.05 was considered to be statistically significant.

Results: This retrospective study included 33 eyes of 31 patients (20 women, 11 men; mean age was 55.30 ± 9.62 years (range 36-75 years). Patients received a mean of 5.3 injections during 12 months of follow-up. The best corrected visual acuity increased from 0.66 ± 0.20 (logMAR) at baseline to 0.22 ± 0.13 (logMAR) (t = 15.42; P < 0.001) at month 12. The CMT decreased from 494.15 ± 104.16 μm at baseline to 261.79 ± 45.36 μm at month 12 (- 232.36 ± 109.98 μm); P < 0.001). No bevacizumab-related systemic or ocular adverse effects following intravitreal drug injections were observed. The majority of patients required reinjection(s) treatment for ME (84.9%).

Conclusion: Intravitreal therapy using bevacizumab appears to be an effective primary treatment option for ME due to BRVO. No serious ophthalmologic or systemic side effects were observed for intravitreal bevacizumab therapy. The main disadvantage of bevacizumab therapy is the requirement of multiple injections in order to maintain visual and anatomic improvements.
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http://dx.doi.org/10.2147/OPTH.S19279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3130911PMC
July 2011

An immunohistochemical analysis of the neuroprotective effects of memantine, hyperbaric oxygen therapy, and brimonidine after acute ischemia reperfusion injury.

Mol Vis 2011 Apr 26;17:1024-33. Epub 2011 Apr 26.

Bakırköy Dr. Sadi Konuk Training and Research Hospital Clinics of Eye Diseases, Istanbul, Turkey.

Purpose: This study applies treatment methods to rat retinas subjected to acute ischemia reperfusion injury and compares the efficacy of memantine, hyperbaric oxygen (HBO) therapy, and brimonidine by histopathological examination.

Methods: Thirty adult Wistar albino rats were divided into five groups after retinal ischemia was induced by elevating the intraocular pressure to 120 mmHg. The groups were as follows: group 1: control; group 2: acute retinal ischemia (ARI) model but without treatment group; group 3: memantine (MEM) treatment group; group 4: HBO therapy group; and group 5: brimonidine treatment (BRI) group. In the control group, right eyes were cannulated with a 30-gauge needle and removed without causing any intraocular pressure change. The ARI group was an acute retinal ischemia model, but without treatment. In the MEM group, animals were given a unique dose of intravenous 25 mg/kg memantine by the tail vein route after inducing ARI. In the HBO group, at 2 h following ARI, HBO treatment was applied for nine days. In the BRI group, a 0.15% brimonidine tartrate eye drop treatment was applied twice a day (BID) for seven days before ARI. Twenty-one days after establishing ischemia reperfusion, the right eyes were enucleated after the cardiac gluteraldehyde perfusion method, and then submitted to histological evaluation.

Results: On average, the total retinal ganglion cell number was 239.93 ± 8.60 in the control group, 125.14 ± 7.18 in the ARI group, 215.89 ± 8.36 in the MEM group, 208.69 ± 2.05 in the HBO group, and 172.27 ± 8.16 in the BRI group. Mean apoptotic indexes in the groups were 1.1 ± 0.35%, 57.71 ± 0.58%, 23.57 ± 1.73%, 15.63 ± 0.58%, and 29.37 ± 2.55%, respectively.

Conclusions: The present study shows that memantine, HBO, and brimonidine therapies were effective in reducing the damage induced by acute ischemia reperfusion in the rat retina. Our study suggests that these treatments had beneficial effects due to neuroprotection, and therefore may be applied in clinical practice.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3084223PMC
April 2011

A case of Joubert syndrome with features of ocular neovascularization.

J Pediatr Ophthalmol Strabismus 2010 May 21;47 Online:e1-3. Epub 2010 May 21.

Sisli Etfal Education and Research Hospital, Eye Clinic, Istanbul, Turkey.

A 12-year-old boy with a diagnosis of Joubert syndrome with bilateral horizontal nystagmus was evaluated. Neovascularization over the iris and the pupillary border was observed on biomicroscopy. There was pigmentary retinal dystrophy in both eyes. Fundus fluorescein angiography revealed ischemic areas and fluorescein leakage due to retinal neovascularization in both eyes.
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http://dx.doi.org/10.3928/01913913-20100507-04DOI Listing
May 2010

Ophthalmoplegic migraine associated with recurrent isolated ptosis.

Ann Ophthalmol (Skokie) 2009 Fall-Winter;41(3-4):206-7

Sisli Etfal Education And Research Hospital, Eye Clinic, Istanbul, Turkey.

We report a rare case ofophthalmoplegic migraine associated with isolated, recurrent unilateral eyelid ptosis in a 10-year-old girl. Labrotory test, pediatric and pediatric neurological examinations and imaging were normal. Recurrent isolated ptosis is a very rare manifestation of ophthalmoplegic migraine. Its recognition saves patient from unnecessary tests and interventions.
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April 2010