Publications by authors named "Mehmet Fuat Alakus"

19 Publications

  • Page 1 of 1

Can dynamic and static pupillary responses be used as an indicator of autonomic dysfunction in patients with obstructive sleep apnea syndrome?

Int Ophthalmol 2021 Mar 24. Epub 2021 Mar 24.

Department Ophthalmology, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey.

Purpose: We aimed to reveal whether static and dynamic pupillary responses can be used for the detection of autonomic nervous system (ANS) dysfunction in patients with obstructive sleep apnea syndrome (OSAS).

Methods: We included in this study patients with OSAS, who were divided into three groups according to the apnea-hypopnea index (AHI) (group 1, mild [n = 20]; group 2, moderate [n = 20]; and group 3, severe [n = 20]), and healthy controls (group 4, n = 20). Pupillary responses were measured using a pupillometry system.

Results: Static (mesopic PD, P = 0.0019; low photopic PD, P = 0.001) and dynamic pupil responses (resting diameter, P = 0.004; amplitude of pupil contraction, P < 0.001; duration of pupil contraction, P = 0.022; velocity of pupil contraction, P = 0.001; and velocity of pupil dilation, P = 0.012) were affected in patients with different OSAS severities. Also, AHI was negatively correlated with mesopic PD (P = 0.008), low photopic PD (P = 0.003), resting diameter (P = 0.001), amplitude of pupil contraction (P < 0.001), duration of pupil contraction (P = 0.011), velocity of pupil contraction (P < 0.001), and velocity of pupil dilation (P = 0.001).

Conclusion: We detected pupil responses innervated by the ANS were affected in the OSAS patients. This effect was more significant in the severe OSAS patients. Therefore, the pupillometry system can be an easily applicable, noninvasive method to detect ANS dysfunction in the OSA patients.
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http://dx.doi.org/10.1007/s10792-021-01814-0DOI Listing
March 2021

Investigation of corneal topographic and densitometric properties of Wilson's disease patients with or without a Kayser-Fleischer ring.

Eye Vis (Lond) 2021 Mar 11;8(1). Epub 2021 Mar 11.

Department of Internal Medicine, University of Health Sciences, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakır, Turkey.

Background: To investigate the topographic measurements and densitometry of corneas in Wilson's disease (WD) patients with or without a Kayser-Fleischer ring (KF-r) compared to healthy individuals.

Methods: This cross-sectional study included 20 WD patients without a KF-r (group I), 18 WD patients with a KF-r (group II), and 20 age-matched controls (group III). The Pentacam high resolution imaging system is used to determine corneal topographic measurements and densitometry.

Results: Mean age for groups I, II and III was 25.40 ± 6.43 years (14-36 years), 25.38 ± 6.96 years (16-39 years), 23.60 ± 6.56 years (17-35 years), respectively (P = 0.623). There was no significant difference between the groups in terms of the anterior corneal densitometry values (P > 0.05), while the 6-10 mm and 10-12 mm mid stroma and the 2-6 mm, 6-10 mm, and 10-12 mm posterior corneal densitometry values in group II were significantly higher than those in groups I and III (for all values, P <  0.05). However, the 10-12 mm posterior corneal densitometry values in group I were also significantly higher than those in group III (P = 0.038). The central corneal thickness (CCT), thinnest corneal thickness (tCT), and corneal volume (CV) values in groups I and II were significantly lower than those in group III (for CCT values, P = 0.011 and P = 0.009; for tCT values, P = 0.010 and P = 0.005; for CV values, P = 0.043 and P = 0.029).

Conclusion: In WD patients with a KF-r, corneal transparency decreased in the peripheral posterior and mid stromal corneal layers; for these patients, corneal transparency may be impaired not only in the peripheral cornea but also in the paracentral cornea.
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http://dx.doi.org/10.1186/s40662-021-00231-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948376PMC
March 2021

Evaluation of corneal safety in systemic lupus erythematosus patients undergoing long-term hydroxychloroquine treatment.

Cutan Ocul Toxicol 2021 Mar 23;40(1):21-25. Epub 2020 Dec 23.

Ophthalmology Clinic, Gazi Yaşargil Diyarbakir Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey.

Purpose: The aim of this study was to examine the effects of long-term use of hydroxychloroquine (HQ) on the pachymetric, aberrometric, and densitometric values of the cornea and corneal endothelium in lupus patients.

Method: Twenty-two eyes (study group) of 22 patients using HQ for treatment of lupus and 25 eyes (control group) of 25 healthy individuals were included in this prospective study. A specular microscopy was used to measure corneal endothelial cell density (ECD), percentage of hexagonal cells (HEX%), coefficient of variation of the cell size (CV). Then, a Pentacam® HR corneal tomography system was used to measure central corneal thickness (CCT), corneal aberrometry values in 6-mm pupil diameters and corneal densitometry values in 6-mm corneal zones (0-2 mm and 2-6 mm).

Results: While ECD was significantly lower in the study group than in the control group ( = 0.034), CCT was significantly higher in the study group ( = 0.032). The higher-order aberrations values and the anterior corneal densitometry values in the 0-2 mm and 2-6 mm corneal zones in the study group were found to be significantly higher than the control group ( = 0.021,  = 0.007 and  = 0.013).

Conclusion: Prolonged use of HQ may cause some changes in the cornea. In the follow-up of these cases, detailed examination of the cornea as well as the macula may be important for the protection of corneal health.
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http://dx.doi.org/10.1080/15569527.2020.1861003DOI Listing
March 2021

Corneal and lens densitometry with Pentacam HR in children with vernal keratoconjunctivitis.

Clin Exp Optom 2021 Mar;104(2):156-161

Department of Ophthalmology, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Clinical Relevance: Corneal and lens densitometry measurements provide clinically important information for the evaluation and monitoring of corneal and lens health in patients with vernal keratoconjunctivitis.

Background: To compare the corneal and lens densitometry values between paediatric patients with vernal keratoconjunctivitis (VKC) and healthy individuals.

Methods: This study included 72 eyes of 72 patients with VKC (25 with mild VKC [Group 1], 22 with moderate VKC [Group 2], and 25 with severe VKC [Group 3]), and 25 eyes of 25 healthy subjects (Group 4). Corneal and lens densitometry values were measured using Pentacam HR as follows: for corneal densitometry in two different corneal zones (0-2 and 2-6-mm) and four different corneal depths (at the total thickness, anterior, central, and posterior layers), and lens densitometry in three different lens zones (Zone 1: 2.0-mm, Zone 2: 4.0-mm, and Zone 3: 6.0-mm).

Results: In the 0-2-mm corneal zone for the total thickness and all three layers, corneal densitometry values in Group 3 were significantly higher than those in Groups 1, 2, and 4 (for all values p < 0.012). There was no significant difference in the mean corneal densitometry values between Groups 1 and 2 (for all values p > 0.05). In these groups, the mean corneal densitometry values were significantly higher than those in Group 4 for the anterior layer in the 0-2 and 2-6-mm corneal zones (for all values p < 0.012). The mean values for Zone 3 and average lens densitometry values in Groups 2 and 3 were significantly higher than those in Group 4 (p = 0.001 and p = 0.001, respectively).

Conclusion: The current study showed corneal clarity changes in patients with mild, moderate, and especially severe VKC. An increase in the lens densitometry values was also observed in patients with moderate and severe VKC than in healthy individuals.
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http://dx.doi.org/10.1111/cxo.13144DOI Listing
March 2021

Changes in choroidal thickness after vitamin D supplementation in patients with vitamin D deficiency.

Can J Ophthalmol 2020 12 18;55(6):486-491. Epub 2020 Aug 18.

Department of Internal Medicine, University of Health Scıences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Objective: To determine the relationship between vitamin D (vit D) deficiency and choroidal thickness and to investigate changes in choroidal thickness after vit D treatment.

Methods: Sixty-five patients diagnosed with vit D deficiency (group 1) and 60 healthy individuals with normal vit D levels (group 2) were included in the study. The choroidal thickness in the subfoveal, nasal, and temporal regions of the fovea were measured manually using enhanced depth imaging optical coherence tomography. The choroidal thickness in the patients in group 1 was re-evaluated after treatment with vit D.

Results: The groups were similar in terms of age and sex (p = 0.138 and p = 0.198, respectively). The subfoveal, temporal (500 and 1.500 µm), and nasal (500 and 1.500 µm) choroidal thickness values in group 1 were statistically significantly lower than those in group 2 (p < 0.001 for all). After vit D replacement therapy, there was a significant increase in the choroidal thicknesses compared with the pretreatment measurements (p < 0.001 for all). There was a positive correlation between vit D values and subfoveal, temporal (500 and 1.500 µm), and nasal (500 and 1.500 µm) choroidal thickness values (r = 0.558 and p < 0.001, r = 0.415 and p < 0.001, r = 0.352 and p < 0.001, r = 0.349 and p < 0.001, and r = 0.294 and p = 0.001, respectively).

Conclusion: The choroidal thickness decreased in patients with vit D deficiency. The choroidal thickness values increased after vit D replacement therapy. Serum vit D levels should be assessed in studies evaluating choroidal thickness.
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http://dx.doi.org/10.1016/j.jcjo.2020.06.014DOI Listing
December 2020

Central serous chorioretinopathy associated with high-dose follistatin-344: a retrospective case series.

Int Ophthalmol 2020 Nov 15;40(11):3155-3161. Epub 2020 Jul 15.

Department of Ophthalmology, University of Health Sciences, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Turkey.

Purpose: To present 11 bodybuilding athletes who developed central serous chorioretinopathy (CSCR) following high-dose subcutaneous follistatin-344, a peptide-based performance and image enhancing drug, injections to increase muscle mass.

Methods: This is a retrospective case series from one institution. Demographic and clinical data of 11 patients who were admitted to our clinic with decreased visual acuity after high-dose follistatin-344 injections and optical coherence tomography (OCT) findings consistent with CSCR were analyzed.

Results: All 11 patients were male, and the mean age was 36.8 ± 8.1 years. All patients had a history of injecting complete 1 mg vials of follistatin-344 subcutaneously in the abdomen. There was a history of a single previous high-dose follistatin-344 injection in eight patients and multiple previous injections in three patients. At the time of diagnosis, ten patients had unilateral CSCR findings and one had bilateral CSCR findings. In all eight patients with a history of only one injection, subretinal fluid completely disappeared after an average of 2.3 ± 0.7 months and symptoms regressed. Recurrent CSCR developed in three patients with a history of multiple follistatin-344 injections.

Conclusion: Follistatin-344 injection can be considered as a risk factor for CSCR. To take medical history from CSCR patients including follistatin-344 use may be important to reveal the CSCR etiology.
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http://dx.doi.org/10.1007/s10792-020-01501-6DOI Listing
November 2020

Evaluation of the subfoveal choroidal and outer retinal layer thickness in obese women.

Clin Exp Optom 2021 Mar;104(2):178-186

Obesity Clinic, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Clinical Relevance: Obesity has become one of the most important health problems of today with its increasing prevalence. With the development of retinal imaging systems, obesity has been observed to be associated with changes in outer retinal layers and choroid in women.

Background: The aim of this study was to examine retinal layer parameters and their relationship with body mass index in obese women.

Methods: The study included 197 eyes of 197 women, of whom 44 were normal-weight, 40 were overweight, 40 were class 1 obese, 38 were class 2 obese, and 35 were morbidly obese. The thickness of the choroid was measured manually using an enhanced-depth imaging optical coherence tomography scanning program.

Results: The mean choroidal thickness values in five locations were lower than those of normal-weight, overweight, class 1, and class 2 obese women, in morbidly obese women (p < 0.05 for all). Subfoveal outer retinal layer thickness and specific sublayer thickness of the photoreceptor layer values were significantly lower in morbidly obese women than in normal-weight women, but there were no statistically significant differences between the groups in retinal pigment epithelium thickness and Bruch's membrane thickness (p = 0.001, p < 0.001, p = 1.00, and p = 0.101, respectively). Furthermore, there were significant negative relationships between body mass index and subfoveal choroidal thickness, subfoveal outer retinal layer thickness, and specific sublayer thickness of the photoreceptor layer values (r = -0.327, p < 0.001; r = -0.259, p < 0.001; and r = -0.281, p < 0.001, respectively).

Conclusions: Morbid obesity was associated with a thinner choroid, subfoveal outer retinal layer, and specific sublayer thickness of the photoreceptor layer in women. Furthermore, retinal hypoxia associated with morbid obesity may be related to a decrease in photoreceptor layer thickness. Thinning of the outer retinal layer may also lead to atrophy of the cone sheath.
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http://dx.doi.org/10.1111/cxo.13108DOI Listing
March 2021

Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery?

Eur J Ophthalmol 2020 Nov 19;30(6):1228-1231. Epub 2019 Nov 19.

Department of Endocrinology and Metabolic Diseases, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey.

Purpose: The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction.

Method: The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth.

Results: The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group.

Conclusion: Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.
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http://dx.doi.org/10.1177/1120672119889522DOI Listing
November 2020

An Analysis of Morphometric Qualities of Bulbus Oculi in Cataract Patients: A Comparative Biometric Study.

Anat Rec (Hoboken) 2016 09 8;299(9):1308-12. Epub 2016 Jul 8.

Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

Cataract is considered to be the primary reason for curable blindness that is caused by progressive loss of lens transparency and affects millions of people around the world. This study aims to analyze the changes in morphometric qualities of bulbus oculi (BO) as well as its morphometric measurements such as anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), axial length (AL), etc. depending on age and gender in cataract patients through comparison with healthy eyes. 200 eyes with cataract were separately analyzed in five different categories of ages for males and females at the ages of 40-89. Biometric measurements of a total of 128 eyes (64 males and 64 females) were used as the control group. The study revealed a strong negative relation between age and ACD and a strong positive relation between age and LT in males and females for healthy eyes and eyes with cataract (P < 0.05). No significant relation was found for VL and AL in either gender (P > 0.05). A significant decrease was observed in ACD with aging while a positive correlation with age was detected in LT. We believe that the data obtained from this study will serve as a guide for BO interventions, diagnose and treatment stages and training of physician assistants. Anat Rec, 299:1308-1312, 2016. © 2016 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/ar.23395DOI Listing
September 2016

Bilateral total optic atrophy due to transdermal methanol intoxication.

Middle East Afr J Ophthalmol 2013 Jan-Mar;20(1):92-4

Department of Ophthalmology, Batman State Hospital, Batman, Turkey.

In this case report, we document a 54-year-old woman with total bilateral optic nerve atrophy after local application of methanol containing spirit. Almost all the reported cases of methanol intoxication in the literature are caused by oral ingestion. In this rare case, we present transdermal absorption of methanol that may cause irreversible blindness in addition to intracerebral lesions.
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http://dx.doi.org/10.4103/0974-9233.106406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617539PMC
January 2014

Single injection of triamcinolone versus three repeated injections of bevacizumab for treatment of diabetic macular edema.

Int Ophthalmol 2013 Aug 19;33(4):375-80. Epub 2013 Jan 19.

Department of Ophthalmology, Malatya State Hospital, Malatya, Turkey.

To compare the effect of a single intravitreal injection of triamcinolone acetonide versus three consecutive monthly intravitreal injections of bevacizumab for the treatment of diabetic macular edema (DME). Forty patients treated with a single intravitreal injection of 4 mg triamcinolone acetonide (triamcinolone group) were compared with 40 patients treated with three consecutive monthly intravitreal injections of 1.25 mg bevacizumab (bevacizumab group). The triamcinolone group showed a significant decrease in mean central retinal thickness (CRT) from 472.5 μm ± 120.35 to 374.0 μm ± 152.31 after 3 months (p < 0.001). The bevacizumab group also showed a significant reduction in CRT from 464.5 μm ± 115.3 to 370.0 μm ± 142.31 (p < 0.001). The triamcinolone group displayed an increase in best-corrected visual acuity (BCVA) following a single intravitreal triamcinolone acetonide injection from a mean of +0.70 ± 0.17 logMAR to a mean of +0.54 ± 0.38 logMAR after 3 months (p < 0.05). The bevacizumab group also showed an increase in BCVA following three injections of bevacizumab from a mean of +0.73 ± 0.28 logMAR to a mean of +0.57 ± 0.33 logMAR (p < 0.05). Statistical analysis showed no significant difference between both groups at 3 months. Our study showed that a single intravitreal injection of triamcinolone is as effective as three consecutive monthly intravitreal injections of bevacizumab for treatment of DME with regard to BCVA and CRT measured by optical coherence tomography. Despite the recent popularity of bevacizumab, three injections are no more effective than a single injection of triamcinolone for the treatment of DME.
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http://dx.doi.org/10.1007/s10792-012-9709-zDOI Listing
August 2013

Effect of refractive status on peripapillary retinal nerve fibre layer thickness: a study by RTVue spectral domain optical coherence tomography.

Br J Ophthalmol 2013 Jan 10;97(1):75-9. Epub 2012 Nov 10.

Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey.

Aim: To evaluate the influence of axial length on retinal nerve fibre layer (RNFL) thickness in myopic, hyperopic and emmetropic eyes by spectral domain optical coherence tomography (OCT).

Methods: Subjects were divided into three groups: myopic (n=35), emmetropic (n=30) and hyperopic eyes (n=33). RNFL thickness was obtained from all octametric section parameters by RTVue OCT. Axial length and spherical equivalent values were determined for all patients.

Results: RNFL thickness values, except for lower and upper nasal sectors, were thinner in the myopic eyes than in the hyperopic eyes. Average RNFL thickness and the RNFL thicknesses of the superotemporal, superonasal, inferotemporal and lower temporal sectors were significantly different between the myopic and emmetropic eyes, and average RNFL thickness and the RNFL thicknesses of the upper temporal and inferonasal sectors were significantly different between the hyperopic and emmetropic eyes. The average peripapillary RNFL thickness had a negative correlation with axial length (r=-0.741, p<0.001). However, after correction of the magnification effect, the significant differences disappeared.

Conclusions: We have shown that axial length/refractive status affected the peripapillary RNFL thickness profile measured by RTVue OCT. To make a correct diagnosis for glaucoma, either the axial length-induced magnification effect should corrected by ophthalmologists or the RTVue OCT database should be improved by taking axial length into account.
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http://dx.doi.org/10.1136/bjophthalmol-2012-301865DOI Listing
January 2013

Evaluation of retrobulbar blood flow by color doppler ultrasonography after intravitreal ranibizumab injection in patients with neovascular age-related macular degeneration.

J Clin Ultrasound 2013 Jan 11;41(1):32-7. Epub 2012 Oct 11.

Department of Ophthalmology, Dicle University, Diyarbakir, Turkey.

Purpose: This study aimed to evaluate the changes in retrobulbar blood flow by using color Doppler sonography in patients who had undergone intravitreal ranibizumab injection for neovascular age-related macular degeneration (AMD).

Methods: The study comprised 37 AMD patients who had undergone intravitreal 0.5 mg ranibizumab injection. The ophthalmic artery, central retinal artery, and short lateral posterior ciliary artery of both eyes of patients were evaluated by color Doppler sonography. Peak systolic velocity, end-diastolic velocity, and resistance index were calculated before injection, and after injection on day 7 and day 30. The pre- and postinjection values were compared using Wilcoxon signed rank test.

Results: In a comparison with the preinjection values of peak systolic velocity, end-diastolic velocity, and resistance index, the postinjection values at both day 7 and day 30 showed no statistically significant difference in ophthalmic artery, lateral posterior ciliary artery, and central retinal artery (p > 0.05). Similarly, for the same parameters, pre- and postinjection values in the uninjected fellow eye showed no statistically significant difference (P > 0.05).

Conclusions: Intravitreal ranibizumab injection for neovascular AMD does not cause a significant change in the retrobulbar blood flow in either the injected eye or the fellow eye.
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http://dx.doi.org/10.1002/jcu.21989DOI Listing
January 2013

Evaluation of peripapillary retinal nerve fiber layer thickness of myopic and hyperopic patients: a controlled study by Stratus optical coherence tomography.

Curr Eye Res 2013 Jan 22;38(1):102-7. Epub 2012 Aug 22.

Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey.

Purpose: To investigate the peripapillary retinal nerve fiber layer (RNFL) thickness of myopic and hyperopic eyes in comparison with emmetropic control eyes and to evaluate the correlation between the peripapillary RNFL thickness with axial length and spherical equivalent (SE).

Materials And Methods: One hundred fifty-four eyes of 154 subjects were evaluated in this study. Subjects were divided into three groups; myopic group (n = 58 patients), hyperopic group (n = 62 patients) and emmetropic group (control group, n = 34 subjects). The peripapillary RNFL thickness was measured using the Stratus optical coherence tomography (OCT).

Results: The mean peripapillary RNFL was thinner in the myopic group than in the control group (p < 0.05). The RNFLs were thinner in superior, inferior and temporal quadrants (all p < 0.05); whereas it was thicker in nasal quadrant (p < 0.05). The RNFL was thicker only in nasal quadrant (p < 0.05) in the hyperopic group compared with the controls. There were negative correlations between axial length and the mean peripapillary RNFL thickness in the myopic (r = -0.763 p < 0.001) and hyperopic groups (r = -0.266 p < 0.05). However, correction of magnification effect by applying Littmann formula eliminated the relationship between RNFL thickness and axial length/SE.

Conclusion: We have shown that peripapillary RNFL thickness profile differed with refractive status and axial length of the eye. In this regard, we would like to caution ophthalmologists when they measure the RNFL thickness in patients with myopic or hyperopic eyes to diagnose glaucoma. Ocular magnification effect should be taken into account by ophthalmologists or Stratus OCT manufacturers.
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http://dx.doi.org/10.3109/02713683.2012.715714DOI Listing
January 2013

Fixed combination brimonidine-timolol versus brimonidine for treatment of intraocular pressure elevation after neodymium:YAG laser posterior capsulotomy.

J Ocul Pharmacol Ther 2012 Dec 18;28(6):576-80. Epub 2012 Jul 18.

Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey.

Purpose: To evaluate the efficacy of fixed combination brimonidine-timolol (FCBT) in comparison with brimonidine tartrate 0.2% and control for the treatment of intraocular pressure (IOP) spikes after neodymium:YAG (Nd:YAG) laser posterior capsulotomy.

Methods: One hundred five eyes of 105 patients were enrolled in the study. Patients were randomized to 3 groups (each group, including 35 patients): the FCBT group that received 1 drop of FCBT, the brimonidine group that received 1 drop of brimonidine tartrate 0.2%, and the control group that received 1 drop of artificial tear, 1 h before the laser procedure. Postoperative IOP measurements were performed at 1st, 2nd, 3rd, 24th hours, and seventh day.

Results: The mean IOP changes from baseline were statistically different between the study groups at first, second, and third hours (all P<0.001). Pairwise comparisons showed that although the mean IOP changes of the treatment groups were similar at 1st and 24th hours and seventh day (all P>0.05), the IOP levels of the brimonidine group were less reduced from baseline than the FCBT group at second and third hours (P=0.01 and P=0.03, respectively). The differences among the study groups concerning the incidence of IOP elevations of ≥5 or ≥10 mmHg were statistically significant (P=0.007, P=0.04, respectively). However, the differences between the treatment groups were not statistically significant (both P>0.05).

Conclusion: This study has shown that preoperative instillation of 1-drop FCBT was safe and effective for preventing IOP spikes after Nd:YAG laser posterior capsulotomy. FCBT may be a better option than brimonidine tartrate 0.2%, which is one of the current standard prophylaxes for these spikes.
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http://dx.doi.org/10.1089/jop.2012.0092DOI Listing
December 2012

Peripapillary retinal nerve fiber layer thickness in hyperopic children.

Optom Vis Sci 2012 Jul;89(7):1009-13

Department of Ophthalmology, Batman State Hospital, Batman, Turkey.

Purpose: To evaluate the relationship between the spherical equivalent (SE)/axial length and peripapillary retinal nerve fiber layer (RNFL) thickness profile measured using Stratus optical coherence tomography (OCT) in hyperopic children.

Methods: One hundred and sixty-four children with hyperopia were analyzed in the study. Subjects were divided into three groups according to their SE values: +3.00 D ≥ SE ≥ +0.50 D were designated as the low hyperopia group, +6.00 D ≥ SE ≥ +3.25 D as moderate hyperopia group, and +9.50 D ≥ SE ≥ 6.25 D as high hyperopia group. RNFL thickness measurements were taken from the superior, inferior, nasal, and temporal quadrants in the peripapillary region by Stratus OCT. Axial length, visual acuity, and SE values were also determined for all patients.

Results: There were 62 patients in the low hyperopia group, 60 patients in the moderate hyperopia group, and 42 patients in the high hyperopia group. The groups were similar concerning age and gender. The moderate and high hyperopia groups had lower mean BCVAs than low hyperopic group (both p < 0.001). SE and axial length were significantly different among all three groups (all p < 0.001). There were significant differences between low and high hyperopia groups concerning the mean RNFL thickness and the RNFL thicknesses of inferior and nasal quadrants (p = 0.045, p = 0.008, p = 0.03, respectively). However, when magnification attributable to SE/axial length is taken into account, the RNFL thickness differences disappear.

Conclusions: We have demonstrated that when measured using the Stratus OCT, which does not take magnification into account, measurements erroneously indicate that children with high hyperopia had thicker RNFLs in inferior and nasal quadrants than children with low hyperopia. The current Stratus OCT normative database may be misleading for correct diagnosis of glaucoma in highly hyperopic children.
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http://dx.doi.org/10.1097/OPX.0b013e31825dcfe2DOI Listing
July 2012

Topical loteprednol etabonate 0.5 % for treatment of vernal keratoconjunctivitis: efficacy and safety.

Jpn J Ophthalmol 2012 Jul 25;56(4):312-8. Epub 2012 May 25.

Department of Ophthalmology, Batman State Hospital, Batman, Turkey.

Purpose: To evaluate the efficacy and safety of loteprednol etabonate (LE) 0.5 % in vernal keratoconjunctivitis (VKC) patients compared to prednisolone and fluorometholone.

Methods: The patients were randomized into three groups: the loteprednol group, prednisolone group and fluorometholone group. Medications were administered four times daily, for a total of 28 days. Before starting treatment and at each visit thereafter, the major symptoms and signs of VKC were recorded and graded as 0 (none), 1 (mild), 2 (moderate) or 3 (severe). Adverse event reports including elevation of intraocular pressure (IOP) were recorded.

Results: There were no significant differences among the groups concerning baseline mean scores of signs and symptoms, which gradually improved in all except for pannus formation in the fluorometholone group. However, all signs and symptoms (except for chemosis) were significantly less improved in the eyes of the fluorometholone group compared with the other groups at each control visit. There was significant IOP elevation after the day 3 visit in the prednisolone group only.

Conclusion: LE was as effective as prednisolone and more effective than fluorometholone, and it had no side effects during the short-term treatment of VKC patients.
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http://dx.doi.org/10.1007/s10384-012-0152-5DOI Listing
July 2012

Distribution of central corneal thickness and intraocular pressure in a large population of Turkish school children.

Ophthalmic Epidemiol 2012 Apr 24;19(2):83-8. Epub 2012 Feb 24.

Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.

Purpose: To determine the distribution of central corneal thickness (CCT) and intraocular pressure (IOP) in a population of Turkish school children and to evaluate the relationships between these values and both age and gender.

Methods: A total of 30,320 eyes from 15,160 healthy school children aged 5-18 years were examined. CCT and IOP were measured using an ultrasonic pachymeter and a non-contact tonometer, respectively. Measurements were compared with age, gender, and parental consanguinity of subjects.

Results: The mean age of the school children was 10.43 ± 2.54 years. For right eyes, mean CCT was 557.91 ± 34.26 µm and mean IOP was 14.15 ± 2.87 mmHg. Mean CCT was significantly thicker in males compared to females (P < 0.0001). Mean IOP was significantly higher in females compared to males (P < 0.0001). CCT in children aged 14 years and older was significantly thinner than that in the younger age groups (P < 0.0001). There was a significant difference among the age groups for IOP (P < 0.05). No significant differences were observed in CCT or IOP related to parental consanguinity (P = 0.538, P = 0.319, respectively).

Conclusion: Mean CCT in Turkish school children is of comparable thickness to that in Western school children. CCT reached adult values around 14 years of age in our children. Furthermore, males had thicker CCT than females. IOP was lower in males than females, and increased with age.
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http://dx.doi.org/10.3109/09286586.2011.649227DOI Listing
April 2012

Effects of photodynamic therapy with verteporfin for the treatment of chronic central serous chorioretinopathy: An uncontrolled, open-label, observational study.

Curr Ther Res Clin Exp 2010 Jun;71(3):173-85

Department of Family Medicine, Duzce University Faculty of Medicine, Duzce, Turkey.

Background: Central serous chorioretinopathy is an idiopathic disorder that leads to serous neurosensory retinal detachment. The disorder is usually self-limited and resolves spontaneously; however, sometimes neurosensory retinal detachment persists. This form of the disorder is called chronic central serous chorioretinopathy (CCSC).

Objective: The aim of this study was to assess the effects of photodynamic therapy (PDT) on visual acuity with full-dose verteporfin for CCSC.

Methods: The eyes of patients with CCSC were included in the study. Ophthalmic examination including best-corrected visual acuity (BCVA), fundus examination, fluorescein angiography, and optical coherence tomography was performed before treatment and at 1, 3, 6, 9, and 12 months. PDT with full-dose verteporfin (6 μ/m(2) of body surface area) was applied only to areas of active leakage. BCVA was converted to a log of the minimum angle of resolution (logMAR) equivalent for statistical analysis. Central foveal thickness and BCVA between baseline and follow-up were compared.

Results: Seventeen eyes of 16 patients (13 males, 3 females; mean [SD] age, 39.75 [7.51] years; mean duration of follow-up, 13.06 [1.82] months) were used in the study. The mean (SEM) logMAR BCVA was 0.26 (0.07) at baseline and 0.04 (0.02) at 12 months. Mean logMAR BCVA values at baseline (0.259) and after treatment (0.112, 0.053, 0.047, 0.041, and 0.041 at 1, 3, 6, 9, and 12 months, respectively) differed significantly (P = 0.006, P = 0.005, P = 0.005, P = 0.005, and P = 0.005). There was a significant difference in the mean central foveal thickness at the final visit (169 μm) compared with the baseline value (383 μm; P < 0.001). BCVA decreased in one eye (20/20 vs 20/25) and persisted during follow-up; in the other 16 eyes, BCVA either increased (n = 10) or remained stable (n = 6).

Conclusions: In this small, open-label study, patients with CCSC treated with a single course of PDT with full-dose verteporfin had significant improvement from baseline in BCVA and resolution of subretinal fluid accumulation and active leakage. Treatment was generally well tolerated, but one patient had worsening in BCVA.
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http://dx.doi.org/10.1016/j.curtheres.2010.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967338PMC
June 2010