Publications by authors named "Melike Balikoglu-Yilmaz"

20 Publications

  • Page 1 of 1

Rapid response to systemic steroid in macular alexandrite laser exposure: Multimodal imaging.

Eur J Ophthalmol 2020 May 18:1120672120924346. Epub 2020 May 18.

Department of Ophthalmology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Purpose: To report the management of accidental macular photocoagulation during a 750-nm Alexandrite laser hair removal procedure.

Methods: Single case report with images.

Results: A 23-year-old girl presented with an immediate visual field defect in her right eye after direct inadvertent exposure to a single discharge from a 750-nm Alexandrite laser used for laser hair removal. Baseline Snellen visual acuity was 20/20 in the involved right eye but the patient reported a subjective visual field defect. She was treated with oral methylprednisolone that was started at a dose of 1 mg/kg/day and then gradually reduced. Six months after the initial exposure, the final visual acuity was 20/20 and there was a significant improvement in the macular lesion. However, the subjective visual field defect continued. She underwent multimodal retinal imaging with optical coherence tomography, fundus fluorescence angiography, and optical coherence tomography angiography in addition to a visual field test and microperimety.

Conclusion: The present case documents a gradual visual and anatomical improvement following macular photic damage after accidental occupational exposure to a 750-nm Alexandrite laser. The treatment should be arranged according to the localization of the laser damage. Optical coherence tomography angiography also has the potential to help noninvasively detect choriocapillaris damage.
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http://dx.doi.org/10.1177/1120672120924346DOI Listing
May 2020

Analysis of central macular thickness and choroidal thickness changes in patients with cardiovascular risk factors.

Eye (Lond) 2020 11 28;34(11):2068-2075. Epub 2020 Jan 28.

Cardiology Clinic, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.

Objectives: The aim of this study was to evaluate central macular thickness (CMT) and choroidal thickness (CT) in the eyes of patients with cardiovascular risk factors (CVRF).

Methods: A cross-sectional, prospective observational study of 92 patients with CVRF and 21 healthy individuals was conducted. Patients were divided into four groups according to the SCORE system. CMT was evaluated via spectral-domain-optical coherence tomography (SD-OCT). CT at five defined points (subfoveal) [SF] and nasal 500 μm [N0.5] and 1500 μm [N1.5] and 500 μm [T0.5] and temporal 1500 μm [T1.5] from the center of the fovea were measured via enhanced depth imaging (EDI)-OCT.

Results: Mean SFCT at right eyes (RE) and left eyes (LE) were 311.21 ± 77.7 μm and 303.5 ± 49.6 μm, respectively, in patients with mild CVRF (Group 1); 266.5 ± 63.2 μm and 267.0 ± 62.6 μm, respectively, in patients with moderate CVRF (Group 2); 264.7 ± 57.5 μm and 272.3 ± 64.6 μm, respectively, in patients with high CVRF (Group 3); 272.3 ± 64.6 μm and 271.2 ± 63.4 μm, respectively, in patients with very high-risk CVRF (with coronary arterial disease (CAD) (Group 4); and 352.0 ± 74.4 μm and 363.1 ± 89.0 μm, respectively, in the control group. CT (at both eyes) was significantly lower at the subfoveal location in all study groups (P < 0.05), but at nasal and at temporal quadrants of group 3 and group 4 (P < 0.05). No significant difference in CMT was detected between the study and control groups.

Conclusions: This study demonstrated that CVRF might result in a remarkably thinner CT. Furthermore, subretinal drusenoid deposits were detected at a higher rate in the patients with CVRF than controls, and that rate increased in accordance with the severity of CAD. In the future, changes in CT may be used as a promising novel biomarker as part of the SCORE system prior to the development of CAD.
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http://dx.doi.org/10.1038/s41433-020-0775-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784908PMC
November 2020

Central Serous Chorioretinopathy: A Complication Associated with Behçet’s Disease Treatment

Turk J Ophthalmol 2019 02;49(1):40-43

Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey

Central serous chorioretinopathy (CSCR) is characterized by a well-defined serous choroidal detachment of the retinal pigment epithelium with one or more focal lesions of the neurosensory retina. Risk factors for CSCR are psychosocial stress, increased endogenous catecholamine, and increased endogenous cortisol. Systemic steroids can cause ocular side effects such as cataract development, increased intraocular pressure, and less frequently the development of CSCR, which can resolve spontaneously with close follow-up and simple treatment modification. CSCR should be considered in patients who complain of worsening vision under steroid treatment for pathologies requiring steroid therapy. In this study we present two patients, one man and one woman, who developed acute CSCR while under systemic steroid treatment for Behçet’s disease.
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http://dx.doi.org/10.4274/tjo.galenos.2018.83479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416479PMC
February 2019

Corneal Biomechanical Properties and Central Corneal Thickness in Pediatric Noninfectious Uveitis: A Controlled Study.

Eye Contact Lens 2018 Nov;44 Suppl 2:S60-S64

Department of Ophthalmology (E.S., P.O.), Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ankara, Turkey; and Department of Ophthalmology (M.B.-Y.), Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey.

Objective: To compare the corneal biomechanics, intraocular pressure (IOP), and central corneal thickness (CCT) of 37 patients with pediatric noninfectious uveitis with 36 healthy children.

Methods: Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated and corneal-compensated IOP (IOPg and IOPcc, respectively), and CCT were measured.

Results: The mean CRF was significantly lower in the pediatric uveitic eyes than controls (9.7±1.9 vs. 10.8±1.5 mm Hg, P=0.009), whereas there was no significant difference for mean CH, IOPg, IOPcc, and CCT between the two groups (10.1±1.9 vs. 10.8±1.7, 12.9±3.3 vs. 13.9±3.1, 13.8±2.8 vs. 13.6±3.2 mm Hg, and 550.7±49.5 vs. 555.1±33.5 μm, respectively, all P>0.05). The CCT values correlated with CH and CRF, with a Pearson correlation of 0.511 and 0.670 (P=0.013 and P<0.001, respectively), whereas disease duration did not correlate with any corneal biomechanics or CCT in pediatric uveitic eyes (all P>0.05).

Conclusions: Pediatric noninfectious uveitic eyes have lower CRF than controls but the CH, IOPg, IOPcc, and CCT values are similar.
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http://dx.doi.org/10.1097/ICL.0000000000000465DOI Listing
November 2018

A Rare Patient With Orbital Apex Syndrome, Anterior Uveitis, and Necrotizing Scleritis Due to Herpes Zoster Ophthalmicus.

J Craniofac Surg 2016 Nov;27(8):e750-e752

*Department of Ophthalmology, Faculty of Medicine†Eye Clinic, Ataturk Training and Research Hospital, Izmir Katip Celebi University‡Department of Ophthalmology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

The purpose of this study was to describe a patient of orbital apex syndrome, anterior uveitis, secondary glaucoma, corneal dellen, and necrotizing scleritis following an attack of herpes zoster ophthalmicus, and the placement of a pericardial patch graft. A 64-year-old male patient with blepharoptosis of his right eye and multiple vesicles on the forehead, nose and cheeks, limitation on all gazes, blepharoptosis, and exophthalmia was eventually diagnosed with ophthalmic zona with orbital apex syndrome. After the treatment with systemic antiviral and steroid, there was complete recovery of the unilateral vesicular eruption, ophthalmoplegia, and ptosis at the third month follow-up. However, anterior uveitis, necrotizing scleritis, secondary glaucoma, and corneal dellen developed during follow-up. At the ninth month, pericardial patch graft (Tutoplast) was placed due to progression of the scleral thinning. Graft vascularization was completed. Careful and long-term follow-up of patients with ophthalmic zona is required for possible ophthalmic complications of varicella zoster virus infections. A pericardial patch graft might be placed due to the development of necrotizing scleritis.
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http://dx.doi.org/10.1097/SCS.0000000000003098DOI Listing
November 2016

Choroidal and central foveal thickness in patients with scleroderma and its systemic associations.

Clin Exp Optom 2017 Nov 18;100(6):656-662. Epub 2016 Nov 18.

Department of Rheumatology, Izmir Katip Celebi University, Faculty of Medicine, Izmir, Turkey.

Background: The aim was to investigate the morphological changes in the fovea and choroid in patients with scleroderma and its systemic associations.

Methods: Thirty-four scleroderma patients and 31 healthy controls were enrolled. Choroidal thickness (CT) at five defined points (subfoveal [sfCT] and 1.0 [N1.0] and 3.0 µm nasal [N3.0] and 1.0 [T1.0] and 3.0 µm temporal [T3.0] from the centre of the fovea) and central foveal thickness were measured.

Results: The mean central foveal thickness (right eye 229.3 ± 28.6 versus 232.6 ± 29.7 and left eye 219.8 ± 21.4 versus 223.3 ± 21.9 µm) and sfCT (right eye 326.4 ± 56.5 versus 327.3 ± 62.1 and left eye 316.7 ± 53.4 versus 317.6 ± 51.6 µm) values were not different in patients with scleroderma compared with the controls (p > 0.05). The mean CT at N1.0, N3.0, T1.0 and T3.0 did not differ among these groups in both eyes (p > 0.05). There was no difference in the mean central foveal thickness and CT of both eyes in diffuse and limited scleroderma (p > 0.05). A negative correlation was found between anti-nuclear antibody positivity and CT at T3 and N3 (respectively, r = -0.439 and r = -0.383, p < 0.05).

Conclusion: Choroidal thickness at five points and central foveal thickness in both eyes did not significantly differ in scleroderma patients compared with healthy controls. Choroidal thickness at the T3 and N3 points showed a negative correlation with anti-nuclear antibody positivity.
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http://dx.doi.org/10.1111/cxo.12498DOI Listing
November 2017

Canaliculitis Awareness.

Turk J Ophthalmol 2016 Jan 5;46(1):25-29. Epub 2016 Jan 5.

Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.

Objectives: To evaluate the demographic characteristics, treatment, and results of patients with canaliculitis.

Materials And Methods: Medical records including the demographic characteristics, clinical findings, and treatment outcomes of patients diagnosed and treated for canaliculitis between September 2009 and March 2014 were analyzed retrospectively.

Results: The median age of the 7 canaliculitis patients consisting of 4 women and 3 men was 49 (range 8-58) years. All patients had unilateral canaliculitis (on the right side in 2 and left side in 5 patients) and the inferior canaliculus was involved more frequently (71.4%). Epiphora, chronic conjunctivitis, a palpable and thickened canaliculus, and yellow discharge from the punctum were present in all cases. Actinomyces spp. was the most frequently cultured microorganism (75%). Dacryolith was observed in 6 patients. Canaliculotomy and dacryolith removal with canalicular curettage were performed, followed by medical treatment (topical penicillin 100,000 U/ml and oral ampicillin/sulbactam) for 10 days. Patients were followed up for a mean duration of 17.0±15.2 (range 3-46) months. Signs and symptoms resolved completely within a month. Epiphora recurred in the 36th month in a single patient and was treated with daily canalicular irrigation with antibiotics and there were no further symptoms during 10 months of follow-up after the recurrence.

Conclusion: Canaliculitis is often overlooked and can be misdiagnosed. Every patient with chronic conjunctivitis and lacrimal infection should be examined carefully for canaliculitis.
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http://dx.doi.org/10.4274/tjo.68916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5076306PMC
January 2016

Bacteriological profile in conjunctival, lacrimal sac, and nasal specimens and conjunctival normalization time following external, endoscopic, and transcanalicular multidiode laser dacryocystorhinostomy.

Arq Bras Oftalmol 2016 May-Jun;79(3):163-70

Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey.

Purpose: To compare the conjunctival, lacrimal sac, and nasal flora cultures and conjunctival normalization time following external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) dacryocystorhinostomy (DCR) and to evaluate the relationship between culture positivity and surgical success. We further performed antibiotic sensitivity analyses for lacrimal sac culture samples.

Methods: A total of 90 patients with primary acquired nasolacrimal duct obstruction were recruited and divided into EX-DCR (n=32), EN-DCR (n=28), and TC-DCR (n=30) groups. Conjunctival, nasal, and lacrimal sac cultures and antibiograms were analyzed.

Results: In all three groups, coagulase-negative Staphylococcus (CNS) was predominantly isolated preoperatively from the conjunctiva, nose, and lacrimal sac and postoperatively from the conjunctiva. Preoperative and postoperative conjunctival culture positivity rates were similar between all the groups (p>0.05). A statistically significant difference in the growth rate of culture in the lacrimal sac was observed between the three groups (p=0.001). CNS and Staphylococcus aureus cultures were predominantly sensitive to linezolid, teicoplanin, tigecycline, vancomycin, and mupirocin. Conjunctival normalization times were similar between the three groups (p>0.05). Anatomical and functional success rates were not found to be significantly correlated with preoperative conjunctival and lacrimal sac culture positivity (p>0.05).

Conclusions: Similar rates of preoperative and 1-week postoperative conjunctival culture positivity were observed in all the groups; a significantly lower bacterial growth rate was observed in postoperative conjunctival cultures. CNS was the most commonly isolated organism. Bacterial growth rates in the lacrimal sac samples were significantly higher in the EN-DCR group. Bacterial growth rates obtained preoperatively from the conjunctival and lacrimal sac culture samples were not correlated with DCR success.
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http://dx.doi.org/10.5935/0004-2749.20160049DOI Listing
April 2017

Are There Any Changes in Corneal Biomechanics and Central Corneal Thickness in Fuchs' Uveitis?

Ocul Immunol Inflamm 2016 Oct 23;24(5):561-7. Epub 2015 Sep 23.

a Ulucanlar Eye Education and Research Hospital , Ankara , Turkey .

Purpose: To compare corneal biomechanics, intraocular pressure (IOP) and central corneal thickness (CCT) of 38 patients with unilateral Fuchs' uveitis (FU) with 42 healthy controls.

Methods: Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated and corneal-compensated IOP (IOPg and IOPcc, respectively) and CCT were measured.

Results: The mean CH, CRF, and IOPg of the involved FU eyes were significantly lower (9.5 ± 1.6, 9.0 ± 1.9 and 13.1 ± 4.3 mmHg) than contralateral eyes (10.1 ± 1.7, 9.9 ± 1.7 and 14.6 ± 3.4 mmHg), and controls (10.5 ± 1.5, 10.3 ± 1.5 and 14.8 ± 2.5 mmHg), respectively. There was no significant difference for mean IOPcc between involved FU or contralateral eyes and controls (14.8 ± 4.1, 15.5 ± 3.4 and 15.0 ± 2.7 mmHg). The CCT values correlated with CH and CRF in the involved and contralateral eyes.

Conclusions: Involved FU eyes had lower CH, CRF, and IOPg than contralateral eyes and controls, with no difference regarding IOPcc.
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http://dx.doi.org/10.3109/09273948.2015.1037459DOI Listing
October 2016

Comparing acromegalic patients to healthy controls with respect to intraocular pressure, central corneal thickness, and optic disc topography findings.

Indian J Ophthalmol 2014 Aug;62(8):841-5

Department of Glaucoma, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.

Aims: The aim was to compare the intraocular pressure (IOP), central corneal thickness (CCT), and optic disc topography findings of biochemically controlled acromegalic patients and the control group and to evaluate the effect of the duration of acromegaly and serum growth hormone and insulin-like growth factor-1 (IGF-1) levels on these ocular parameters.

Materials And Methods: IOP measurement with Goldmann applanation tonometry, CCT measurement with ultrasonic pachymetry, and topographic analysis with Heidelberg retinal tomograph III were performed on 35 biochemically controlled acromegalic patients and 36 age- and gender-matched controls.

Results: Mean IOP and CCT were 14.7 ± 2.9 mmHg and 559.5 ± 44.9 μm in the acromegaly patients and 13.0 ± 1.6 mmHg and 547.1 ± 26.7 μm in controls (P = 0.006 and P = 0.15, respectively). A significant moderate correlation was found between the duration of acromegaly and CCT (r = 0.391) and IOP (r = 0.367). Mean retinal nerve fiber layer (RNFL) thickness was significantly lower in the acromegalic patients (0.25 ± 0.05 mm) as compared to controls (0.31 ± 0.09 mm) (P = 0.01). A significant moderate correlation was detected between IGF-1 level and disc area (r = 0.362), cup area (r = 0.389) and cup volume (r = 0.491).

Conclusion: Biochemically controlled acromegalic patients showed significantly higher CCT and IOP levels and lower RNFL thickness compared to healthy controls and the duration of disease was correlated with CCT and IOP levels.
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http://dx.doi.org/10.4103/0301-4738.141035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185160PMC
August 2014

Surgical outcomes and incidence of retinal redetachment in cases with complicated retinal detachment after silicone oil removal: univariate and multiple risk factors analysis.

Retina 2014 Oct;34(10):1926-38

*Department of Ophthalmology, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey; †Department of Ophthalmology, Dr. Behcet Uz Children Disease and Surgery Training and Research Hospital, Izmir, Turkey; ‡Department of Biostatistics and Medical Informatics, Ege University Faculty of Medicine, Izmir, Turkey.

Purpose: To analyze the surgical outcomes and retinal redetachment frequency after silicone oil (SO) removal for complex retinal detachment.

Methods: This institutional-based study included 894 consecutive patients who underwent pars plana vitrectomy with SO endotamponade for complicated retinal detachment. The effects of preoperative best-corrected visual acuity, vitreous base shaving, intraoperative scleral buckling, retinectomy, SO viscosity, duration of SO, and vitreous hemorrhage at the first postoperative week on the risk of redetachment were investigated.

Results: During a mean follow-up of 39.9 months, anatomical success was not achieved in 118 patients (13.2%) after SO removal. On multivariate analysis, risk factors for recurrent retinal detachment included giant retinal tear (adjusted odds ratio [aOR], 12.39; P < 0.001), high myopia (aOR, 2.70; P = 0.011), surgeries without scleral buckling (aOR, 1.97; P = 0.039), inadequate vitreous base shaving (aOR, 117.62; P < 0.001), and vitreous hemorrhage at the first postoperative week (aOR, 12.13; P < 0.001).

Conclusion: Retinal detachment etiology, inadequate vitreous base shaving, lack of intraoperative scleral buckling, and vitreous hemorrhage at the first postoperative week after SO removal were significant risk factors for retinal redetachment after SO removal, but preoperative visual acuity, SO viscosity, and duration of SO had no significant effect on redetachment.
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http://dx.doi.org/10.1097/IAE.0000000000000204DOI Listing
October 2014

Comparison of scanning electron microscopy findings regarding biofilm colonization with microbiological results in nasolacrimal stents for external, endoscopic and transcanalicular dacryocystorhinostomy.

Int J Ophthalmol 2014 18;7(3):534-40. Epub 2014 Jun 18.

Department of Biostatistics and Medical Informatics, Ege University, Faculty of Medicine, Izmir 35100, Turkey.

Aim: To compare bacterial biofilm colonization in lacrimal stents following external dacryocystorhinostomy (EX-DCR), endoscopic dacryocystorhinostomy (EN-DCR), and transcanalicular dacryocystorhinostomy (TC-DCR) with multidiode laser.

Methods: This prospective study included 30 consecutive patients with nasolacrimal duct obstruction who underwent EXT-, EN-, or TC-DCR. Thirty removed lacrimal stent fragments and conjunctival samples were cultured. The lacrimal stent biofilms were examined by scanning electron microscopy (SEM).

Results: Eleven (36.7%) of the 30 lacrimal stent cultures were positive for aerobic bacteria (most commonly Staphylococcus epidermidis and Pseudomonas aeruginosa). However anaerobic bacteria and fungi were not identified in the lacrimal stent cultures. Twenty-seven (90%) patients had biofilm-positive lacrimal stents. The conjunctival culture positivity after the DCR, biofilm positivity on stents, the grade of biofilm colonization, and the presence of mucus and coccoid and rod-shaped organisms did not significantly differ between any of the groups (P>0.05). However, a significant difference was found when the SEM results were compared to the results of the lacrimal stent and conjunctival cultures (P<0.001).

Conclusion: Type of dacryocystorhinostomy (DCR) surgery did not affect the biofilm colonization of the lacrimal stents. SEM also appears to be more precise than microbiological culture for evaluating the presence of biofilms on lacrimal stents.
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http://dx.doi.org/10.3980/j.issn.2222-3959.2014.03.27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4067673PMC
June 2014

Prospective comparison of 3 dacryocystorhinostomy surgeries: external versus endoscopic versus transcanalicular multidiode laser.

Ophthalmic Plast Reconstr Surg 2015 Jan-Feb;31(1):13-8

Departments of *Ophthalmology and †Otorhinolaryngology, Bagcilar Education and Research Hospital, Istanbul; and §Department of Statistics, Yasar University, Faculty of Science and Letter, Izmir, Turkey.

Purpose: To analyze the clinical outcomes of external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) with dacryocystorhinostomy (DCR).

Methods: Ninety-two patients with primary acquired nasolacrimal duct obstruction were enrolled (divided into EX-DCR [n = 33], EN-DCR [n = 30], and TC-DCR groups [n = 29]) in this prospective study. Primary outcome measures were the anatomical and functional success of operations at the last control examination. Secondary outcome measures were the ostium size, surgical time, and complications.

Results: The difference in mean surgical time among the 3 groups was statistically significant (p < 0.0001). External DCR required the longest surgical time (46.6 ± 15.3 minutes), while TC-DCR was the shortest (20.3 ± 7.7 minutes). There were no significant differences between the groups regarding anatomical (81.8%, 75.9%, and 76.7% in EX-, EN-, and TC-DCR groups, respectively; p = 0.824) and functional success rates (81.8%, 72.4%, and 73.3% in EX-, EN-, and TC-DCR groups, respectively; p = 0.626). Final ostium size was the largest with EX-DCR (33.7 ± 17.4 mm) and smallest with EN-DCR (19.0 ± 8.9 mm; p = 0.001). The complication rate was similar in all groups. The most common complications were the formation of granulation tissue (16.3%) and intranasal synechiae (9.8%), all of which led to surgical failure and were more frequent in the EN- and TC-DCR groups.

Conclusions: External DCR, EN-DCR, and TC-DCR had similar success and complication rates in patients with primary acquired nasolacrimal duct obstruction. External DCR resulted in the largest ostium size. Transcanalicular DCR appeared to be effective with the shortest surgical time.
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http://dx.doi.org/10.1097/IOP.0000000000000159DOI Listing
June 2015

Corneal biomechanical properties measured by the ocular response analyzer in acromegalic patients.

Graefes Arch Clin Exp Ophthalmol 2014 Aug 13;252(8):1283-8. Epub 2014 May 13.

Ulucanlar Eye Education and Research Hospital, Altındag, Ankara, Turkey,

Purpose: To investigate the effect of acromegaly on corneal biomechanical parameters.

Methods: This cross-sectional, comparative clinical study included 34 acromegalic patients and 30 age-matched and sex-matched healthy controls. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated and corneal-compensated intraocular pressure (IOPg and IOPcc, respectively) were measured using the Ocular Response Analyzer. Central corneal thickness (CCT) was determined with the ultrasonic pachymeter.

Results: The mean duration of disease for the acromegalic patients was 5.3 years. There was no significant difference between the groups regarding mean CH, CRF, IOPg and IOPcc values. The respective mean values in patients with acromegaly and controls were 10.3 ± 2.2 and 9.5 ± 1.5 mmHg (p = 0.13) for CH; 10.5 ± 2.4 and 9.7 ± 1.7 mmHg (p = 0.16) for CRF, 16.1 ± 3.6 and 15.5 ± 2.9 mmHg (p = 0.49) for IOPg, 16.8 ± 3.4 and 17.0 ± 2.8 mmHg (p = 0.82) for IOPcc, and 544.8 ± 32.2 and 530.7 ± 22.9 μm (p = 0.05) for CCT. A significant moderate correlation was detected between the duration of acromegaly and IOPg OD (r = 0.430, p = 0.01). There was no significant correlation between other ocular parameters and levels of GH and IGF-1 at the time of diagnosis, the status of control, adenoma type, radiotherapy treatment, and drug usage.

Conclusions: In acromegalic patients, the duration of disease was correlated with IOPg OD level. Corneal biomechanical parameters and CCT values were not significantly different than those in age-matched and sex-matched healthy individuals.
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http://dx.doi.org/10.1007/s00417-014-2653-zDOI Listing
August 2014

Thirteen-year vitreoretinal surgical outcomes of 5,097 cases from a tertiary referral center in Turkey.

Ophthalmologica 2013 25;230(4):186-94. Epub 2013 Sep 25.

Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.

A 13-year retrospective chart review of 5,097 consecutive cases that underwent pars plana vitrectomy (PPV) in a tertiary referral center in Turkey was performed. Age at onset, sex, laterality, associated systemic disease, pre- and postoperative visual acuities (VA), indications, type of surgery and outcomes of surgery were analyzed. The most common indications for vitreoretinal surgery (VRS) were rhegmatogenous retinal detachment (n = 1,802, 35.4%) and proliferative diabetic retinopathy (n = 1,505, 29.5%). The most common vitreoretinal technique combinations performed were PPV with encircling endolaser (EL) and phacoemulsification with intraocular lens implantation (33.0%), PPV with encircling EL (30.4%), and only PPV (7.0%). A statistically significant increase in the mean VA was noted at the first- (1.16 ± 0.44 logarithm of the minimum angle of resolution, logMAR) and sixth-month (1.06 ± 0.61 logMAR) visits when compared to the preoperative VA (1.77 ± 0.58 logMAR; p < 0.001). Comparisons in the top surgical indications, techniques and outcomes for vitrectomy between the countries could be important for the development of subspecialization in VRS.
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http://dx.doi.org/10.1159/000354062DOI Listing
July 2014

Optic disc pit with sectorial retinitis pigmentosa.

Case Rep Ophthalmol Med 2013 23;2013:156023. Epub 2013 May 23.

Department of Ophthalmology, Bagcilar Education and Research Hospital, 34200 Istanbul, Turkey.

Sectorial retinitis pigmentosa (RP) and optic disc pit (ODP) are rare clinical conditions. We present a 40-year-old woman with a history of mild night blindness and decreased vision in the right eye for about 5 years. Fundus examination revealed retinal pigmentary changes in the superior and inferotemporal sectors covering the macula and reduced arterial calibre and ODP at the temporal edge of the optic disc. In addition, fundus autofluorescence, spectral-domain optical coherence tomography, fluorescein angiography, and multifocal electroretinogram scans confirmed these clinical findings. Visual acuity was decreased due to an atrophic-appearing foveal lesion. No intervention was suggested because of the poor visual potential. To the best of our knowledge, the present study is the first to describe coexistent optic disc pit and sectorial RP in the superior and inferotemporal sectors covering the macula in the same eye with figures.
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http://dx.doi.org/10.1155/2013/156023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677001PMC
June 2013

Comparison of aerobic conjunctival bacterial flora in pregnant, reproductive-aged and postmenopausal women.

Int J Ophthalmol 2012 18;5(6):731-6. Epub 2012 Dec 18.

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

Aim: To evaluate the effect of hormonal status on aerobic conjunctival flora in women.

Methods: One hundred fifty-eight women [reproductive-aged (n=55), pregnant (n=51), and postmenopausal (n=52)] who admitted to outpatient clinic of Obstetrics and Gynecology Department of Denizli State Hospital were enrolled. Age, body-mass index (BMI), obstetric history, cigarette smoking, drug usage, presence of systemic disease, and intraocular pressure (IOP) were recorded for each patient. The samples were taken from the lower fornix with two culture swabs and directly incubated in culture containing 5% sheep blood, eosin-methylene blue and chocolate agar. The other swab specimen was Gram stained. All growths and microscopic results were analyzed.

Results: The coagulase-negative Staphylococcus was the predominant organism isolated in the conjunctival samples in both three groups. The aerobic microorganism growth rate for all isolated aerobic organisms revealed no significant change in the three groups (P >0.05). The conjunctival culture positivity rates were similar in the three groups (49% in reproductive-aged, 57% in pregnant and 58% in postmenopausal women) (P >0.05). Age, IOP, BMI, gravidity, parity, cigarette smoking, drug usage, and presence of systemic diseases did not have an effect on culture positivity in three groups.

Conclusion: Results of this study showed that conjunctival aerobic flora and bacterial colonization did not differ between reproductive-aged, pregnant and postmenopausal women.
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http://dx.doi.org/10.3980/j.issn.2222-3959.2012.06.15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530817PMC
January 2013

Pasteurella canis and Granulicatella adiacens conjunctivitis outbreak resistant to empirical treatment in a child welfare agency.

J Pediatr Ophthalmol Strabismus 2012 Sep-Oct;49(5):314-9. Epub 2012 Jul 17.

Departments of Ophthalmology, Bagcilar Education and Research Hospital, Istanbul, Turkey.

Purpose: To investigate pathogens associated with bacterial conjunctivitis resistant to the empirical treatment and their antibiotic resistance in a child welfare agency.

Methods: Twenty-eight eyes in 14 children with a median age of 3 months with conjunctivitis resistant to the empirical treatment were included in this study. Samples were taken three times from the inferior fornix in both eyes using cotton swabs, cultured onto chocolate and blood agar, and prepared for Gram staining. Antibiograms were evaluated according to the Clinical and Laboratory Standards Institute criteria by disc diffusion method.

Results: The conjunctival culture positivity rate was 35.7% in eyes with conjunctivitis resistant to the empirical treatment. The most common isolated bacteria were Pasteurella canis (25%), penicillin-nonsusceptible Streptococcus pneumoniae (7.1%), and Granulicatella adiacens (3.6%). According to culture results, ophthalmic solutions of vancomycin (50 mg/mL) or gentamicin (30 mg/mL) were applied in eyes with positive conjunctival culture. Previously applied multiple treatments were stopped in eyes with negative conjunctival culture. All eyes improved clinically during follow-up.

Conclusion: Because unusual pathogens may cause a conjunctivitis outbreak, physicians should not insist on empirical treatment. Taking conjunctival culture and antibiotic switching according to antibiogram may be helpful.
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http://dx.doi.org/10.3928/01913913-20120710-02DOI Listing
July 2013

Effect of doxycycline on postoperative scarring after trabeculectomy in an experimental rabbit model.

J Ocul Pharmacol Ther 2010 Oct;26(5):399-406

Ulucanlar Eye Education and Research Hospital , Ankara, Turkey.

Purpose: To investigate effectiveness of doxycycline after trabeculectomy in rabbits by evaluating bleb appearance, intraocular pressure, and levels of matrix metalloproteinase-1, -2, -3, and -9 and tissue inhibitors of metalloproteinase (TIMP)-1 and -2 in the subconjunctival (sc) area.

Methods: Twenty-nine New Zealand White rabbits were assigned into 1 of 6 groups as follows: topical doxycycline (0.1%), postoperative sc injection of doxycycline (100 mg/2 mL), and intraoperative mitomycin-C (MMC) (0.2 mg/mL) and their respective control groups.

Results: There was significant difference between intraocular pressure in the case groups, but there was no significant difference in topical doxycycline and MMC groups during the follow up. In the topical doxycycline group, levels of TIMP-1 and perifericTIMP-1 were higher and levels of perifericMMP-2 and inflammation were lower than their controls. In the sc doxycycline group, peripheral inflammation was higher than in the corresponding control. Only peripheral inflammation was significantly different between case groups, with the highest level in sc and the lowest level in MMC groups. Further, topical doxycycline group showed no significant difference in bleb appearance or peripheral inflammation compared with MMC group. Conjunctival burn and corneal vascularization were detected only in the sc doxycycline group.

Conclusions: Topical doxycycline is more effective than sc doxycycline but is similar to MMC, and it can be an alternative to MMC in trabeculectomy in rabbits.
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http://dx.doi.org/10.1089/jop.2010.0064DOI Listing
October 2010

Effect of chronic topical glaucoma medications on aerobic conjunctival bacterial flora.

Cornea 2009 Apr;28(3):266-70

Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.

Purpose: To investigate whether the chronic topical medications affect aerobic conjunctival bacterial flora of patients with glaucoma and to compare their findings with the findings of the controls.

Methods: Eighty-one patients and 67 healthy control subjects participated in this case-control study. Duplicate conjunctival swab specimens were collected from each patient at the microbiology laboratory and were investigated for the presence of aerobic bacteria. All bacterial species from isolated colonies were identified.

Results: Thirty seven (45.7%) of the 81 patients and 25 (37.3%) of 67 controls had positive conjunctival cultures. Coagulase-negative Staphylococcus was the most commonly isolated bacterial species in both groups. There were no statistically significant differences between the prevalence of other conjunctival cultures testing positive for any of the isolated organisms. The patients were also evaluated with respect to the presence of a systemic illness. Age, sex, presence of diabetes and asthma, duration of antiglaucomatous medication, and number of medications used did not have an effect on culture positivity in both groups when evaluated by logistic regression model.

Conclusions: The conjunctival culture positivity was higher in patients with glaucoma than in the healthy controls and in patients with diabetes than in patients without diabetes, although both were statistically insignificant. Aerobic conjunctival flora of the patients using topical glaucoma medications and the controls did not differ. Further studies are needed to comment on the clinical importance of these findings.
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http://dx.doi.org/10.1097/ICO.0b013e3181861c11DOI Listing
April 2009