Publications by authors named "Oya Tekeli"

26 Publications

  • Page 1 of 1

Macular integrity assessment microperimeter, humphrey field analyzer and OCT in glaucoma practice: a correlation study.

Can J Ophthalmol 2021 Aug 3. Epub 2021 Aug 3.

Department of Ophthalmology, Istanbul Hospital, Baskent University, Istanbul, Turkey. Electronic address:

Objective: To compare and correlate retinal sensitivities measured with macular integrity assessment microperimetry (MAIA-MP) and Humphrey field analyzer (HFA) 10-2 tests with structural parameters obtained from optical coherence tomography (OCT) in primary open-angle glaucoma (POAG) and ocular hypertension.

Methods: This study included 63 participants (22 with POAG, 20 with ocular hypertension, and 21 control individuals). All participants underwent HFA 10-2 and MAIA-MP (macular retinal sensitivity tests) and measurements for optic nerve head (ONH), peripapillary retinal nerve fibre layer thickness (PRNFLT), and ganglion cell inner plexiform layer thickness (GCIPLT) using OCT. The relationship between macular retinal sensitivity and OCT parameters was evaluated by Pearson correlation analysis and linear regression modelling.

Results: POAG cases had a strong association between the MAIA-MP and ONH parameters (optic disc area [ODA], p = 0.037; cup volume, p = 0.043), PRNFLT (average, p = 0.009; inferior PRNFLT, p = 0.004), and GCIPLT in all macula sectors (p ≤ 0.005 for all). HFA 10-2 had a moderate correlation with the ONH parameters (cup-to-disc ratio [CDR], p = 0.042; vertical CDR, p = 0.037; cup volume, p = 0.037; ODA, p = 0.014), PRNFLT (average, inferior, and nasal, p < 0.05 for all), and GCIPLT in all macula sectors (p < 0.005 for all). OHT cases had a weak correlation between HFA 10-2 and nasal and superior PRNFLTs (p = 0.035 and p = 0.047, respectively).

Conclusion: MAIA-MP and HFA 10-2 functional parameters have strong correlations with the structural parameters obtained by OCT in POAG cases. Both devices are useful in assessing the central visual field in glaucoma, with MAIA-MP potentially beneficial in patients with limited cooperation or poor vision.
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http://dx.doi.org/10.1016/j.jcjo.2021.07.004DOI Listing
August 2021

Comparative efficacy and safety of micropulse transscleral laser cyclophotocoagulation using different duration protocols in eyes with good visual acuity.

Graefes Arch Clin Exp Ophthalmol 2021 Jul 5. Epub 2021 Jul 5.

Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, Ankara, 06620, Turkey.

Purpose: To compare the success rates and safety of micropulse transscleral laser cyclophotocoagulation (MP-TSCPC) for the treatment of refractory glaucoma using the 240-s and 160-s duration protocols in eyes with good visual acuity.

Methods: A retrospective analysis of patients with refractory glaucoma who underwent MP-TSCPC from December 2017 to September 2019 with baseline best-corrected visual acuity (BCVA) of ≥ 20/60. Laser treatments for the moderate and short duration protocols were defined as 240 s and 160 s with settings of 2000 mW/Cm2 and a duty cycle of 31.3%. Follow-up examinations were performed regularly until 12 months after the procedure.

Results: Seventy-six eyes of 76 patients were included with BCVA ranging from 20/60 to 20/20. Forty-four eyes were treated with 240 s and 32 eyes were treated with 160-s duration protocols. There was no significant reduction in mean logMAR BCVA and visual field parameters from baseline at any follow-up point in both groups. Visual acuity remained unchanged or improved in 39 of 44 patients (88.6%) in 240-s group and in 28 of 32 patients (87.5%) in 160-s group. Seven of 44 eyes (15.9%) in 240-s group and 12 of 32 eyes (37.5%) in 160-s group required re-treatment for adequate IOP control. After the re-treatments, both protocols showed similar success rates of 79.5% in 240-s group and 75% in 160-s group at 12 months, respectively (p > 0.05).

Conclusions: MP-TSCPC can be offered as a primary surgical treatment for the management of refractory glaucoma in patients with good visual acuity. Considering the high re-treatment rates in 160-s group, the 240-s duration protocol appears to be more effective than 160-s protocol for adequate IOP control.
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http://dx.doi.org/10.1007/s00417-021-05265-2DOI Listing
July 2021

Characteristics of uveitic glaucoma in Turkish patients.

Eur J Ophthalmol 2021 Jul 17;31(4):1836-1843. Epub 2020 Aug 17.

Dünyagöz Hospital, Ankara, Turkey.

Purpose: To evaluate the prevalence of uveitic glaucoma (UG) in the Turkish population and investigate the primary underlying diseases.

Methods: This multicenter, cross-sectional, prospective study included patients who presented to the glaucoma units of 10 tertiary ophthalmology departments in Ankara, Turkey from 15th March to 16th May 2015 and fulfilled the criteria of UG. Patients were inspected for age, sex, medical history, best corrected visual acuity, biomicroscopic findings, intraocular pressure values, and visual field results.

Results: During the study period, 4604 eyes of 2541 patients with glaucoma were screened and 145 eyes of 104 patients (4.1%) were identified as having UG. One hundred and thirty-four eyes (92.4%) had open-angle glaucoma and 11 eyes (7.6%) had closed-angle glaucoma. The mean patient age was 47 ± 16 (6-90) years. Idiopathic uveitis (54 eyes), Behçet's disease (26 eyes), Fuchs heterochromic cyclitis (21 eyes), Herpes Simplex virus infectious uveitis (14 eyes), and ankylosing spondylitis (six eyes) were the leading types of uveitis associated with glaucoma. Acute anterior uveitis was the most common type of uveitis diagnosed in 72 patients (105 eyes), whereas 21 patients (27 eyes) had panuveitis, eight patients (nine eyes) had intermediate uveitis, and three patients (four eyes) had posterior uveitis. The need for surgical intervention was 37.2% among all cases and the most common surgery was trabeculectomy in 45 eyes.

Conclusion: UG is a vision-threatening complication commonly seen in patients with uveitis. This study demonstrates the epidemiological features and underlying etiologies of UG in the Turkish population. The most common primary causes of UG were Behçet's disease and Fuchs heterochromic cyclitis.
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http://dx.doi.org/10.1177/1120672120950932DOI Listing
July 2021

Optical coherence tomography angiography of the peripapillary region and macula in normal, primary open angle glaucoma, pseudoexfoliation glaucoma and ocular hypertension eyes.

Int J Ophthalmol 2020 18;13(5):744-754. Epub 2020 May 18.

Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara 06620, Turkey.

Aim: To evaluate and compare the peripapillary and retinal vasculature changes in primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), ocular hypertension (OHT) and normal eyes using optical coherence tomography angiography (OCTA).

Methods: A total of 114 POAG, PXG and OHT eyes of 60 patients and 46 eyes of 23 healthy control participants with good quality OCTA images were included. The PXG, POAG, OHT, and control groups (aged 68.17±6.30y, 61.11±10.26y, 58.1±8.9y, and 56.9±4.6y, respectively) contained of 46, 36, 32, and 46 eyes, respectively. Measurements of vessel density (VD) in the peripapillary region and macula, average retinal inner thickness, and retinal nerve fiber layer thickness (RNFLT) were compared among groups. In order to test the accuracy of differentiation between eyes with and without glaucoma, the area was calculated under the receiver operating characteristic (ROC) curves.

Results: The VD in glaucomatous eyes was significantly lower than the control group in all peripapillary sectors (44.35%±6.78% 50.47%±1.83%, <0.001), the superficial (44.08%±5.46% 51.28%±2.85%, <0.001) and the deep (45.13%±8.55% 54.20%±5.44%, <0.001) vascular plexus. There was a significant difference in peripapillary VD between glaucomatous and OHT eyes (44.35%±6.78% 49.86%±2.45%, <0.001). The OHT group featured a lower superficial (48.06%±4.32% 51.28%±2.85%, =0.027) and deep plexus (48.70%±5.99% 54.20%±5.44%, =0.013) whole image vessel density (wiVD) than did the control group. The average macular superficial plexus wiVD was significantly lower in eyes with PXG than in eyes with POAG (42.22%±5.36% 46.54%±5.56%, =0.046).

Conclusion: OCTA can measure reduced peripapillary and macular VD in eyes with glaucoma and OHT, and these results are correlated to functional and structural glaucomatous alterations. Peripapillary and macular superficial plexus VD is lower in eyes with PXG than in eyes with POAG. Furthermore, the OHT eyes demonstrate impaired macular vasculature in both superficial and deep plexus.
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http://dx.doi.org/10.18240/ijo.2020.05.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201354PMC
May 2020

Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma.

Eur J Ophthalmol 2021 May 31;31(3):1113-1121. Epub 2020 Mar 31.

Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey.

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma.

Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C).

Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20-91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12-16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05).

Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.
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http://dx.doi.org/10.1177/1120672120914231DOI Listing
May 2021

The Significance and Reliability of Imaging Findings in Pseudotumor Cerebri.

Neuroophthalmology 2019 Apr 19;43(2):81-90. Epub 2018 Jul 19.

Department of Neurology, Ankara University Faculty of Medicine, Ankara, Turkey.

The objective of our study was to provide a comparative assessment of previously reported magnetic resonance imaging (MRI) parameters in primary and secondary pseudotumor cerebri (PTC) patients, to examine their diagnostic contribution, and to evaluate their association with symptoms, neuro-ophthalmological findings, laboratory results, and cerebrospinal fluid characteristics. Twenty-eight consecutive patients with PTC were included in the study. Age- and sex-matched 20 individuals with normal neurologic examination served as the control group. Modified Dandy Criteria were used for the diagnosis of PTC. Orbital and cranial MRI and MR venography of all patients and controls were assessed by three radiologists. According to our study, posterior flattening of the globe (64% sensitive, 100% specific), optic nerve sheath distention (46% sensitive, 100% specific), vertical tortuosity of the optic nerve (30% sensitive, 95% specific), and partial empty sella (43% sensitive, 100% specific) emerged as particularly valuable markers for a diagnosis of PTC.
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http://dx.doi.org/10.1080/01658107.2018.1493514DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619944PMC
April 2019

Investigation of the Presence of Glaucoma in Patients with Obstructive Sleep Apnea Syndrome Using and Not Using Continuous Positive Airway Pressure Treatment

Turk J Ophthalmol 2019 06;49(3):134-141

Ankara University, Faculty of Medicine, Department of Chest Diseases, Ankara, Turkey

Objectives: To evaluate the frequency of glaucoma in patients with obstructive sleep apnea syndrome (OSAS) using and not using continuous positive airway pressure treatment.

Materials And Methods: This prospective study included 59 patients diagnosed with OSAS based on the Apnea-Hypopnea Index (AHI). OSAS patients were divided into 3 groups according to their AHI scores: 5-15 was considered mild (19 patients), 16-30 was considered moderate (16 patients), and >30 (24 patients) was considered severe. Twenty-eight (47.5%) of the OSAS patients had been using continuous positive airway pressure treatment. The control group included 19 healthy subjects. Retinal nerve fiber layer and ganglion cell complex (GCC) thickness analyses were performed.

Results: Average GCC thickness in left eyes was significantly lower in the mild OSAS group than in the control group (p=0.013). The GCC was significantly thinner in the inferior and inferonasal sectors of both eyes in the mild OSAS group compared to the control group (p=0.029, p=0.022, p=0.037, and p=0.019 respectively). Minimum GCC thickness in the left eyes of all OSAS groups was significantly lower than in the control group (p<0.05).

Conclusion: In OSAS patients, there may be changes in retinal nerve fiber layer and ganglion cell complex thickness before alterations in the visual field emerge.
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http://dx.doi.org/10.4274/tjo.galenos.2018.88614DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6624468PMC
June 2019

Evaluation of the retinal nerve fiber layer and ganglion cell complex thicknesses in patients with exfoliation syndrome

Turk J Med Sci 2019 Feb 11;49(1):272-278. Epub 2019 Feb 11.

Background/aim: This study aimed to evaluate retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses using spectral domain optical coherence tomography (SD-OCT) in both unilateral and bilateral exfoliation syndrome (XFS) patients

Materials And Methods: Twenty-four patients with unilateral XFS, 20 patients with bilateral XFS, and 23 healthy subjects were enrolled in this study. Eyes with XFS were compared with both fellow eyes and age-matched control subject eyes in terms of mean and segmental RNFL thickness and minimum, mean, and segmental GCC thickness.

Results: In the bilateral XFS group, minimum GCC of the right eye (75.80 ± 11.6 μm) was significantly thinner compared with the right eyes of the control group (81.83 ± 6.6 μm) (P < 0.05). Also, superior RNFL was thinner in the right eye (106.90 ± 16.7 μm) compared with left eye (114.15 ± 18.1 μm) in the bilateral XFS group (P < 0.05). No significant differences in the unilateral XFS group were detected in GCC and RNFL analysis.

Conclusion: Minimum GCC value may be the first parameter affected in the conversion of XFS to exfoliative glaucoma followed by RNFL changes.
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http://dx.doi.org/10.3906/sag-1803-27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350790PMC
February 2019

Assessment of the Anterior Chamber Flare and Macular Thickness in Patients Treated with Topical Antiglaucomatous Drugs.

J Ocul Pharmacol Ther 2017 04 6;33(3):170-175. Epub 2017 Feb 6.

Department of Ophthalmology, Faculty of Medicine, Ankara University , Ankara, Turkey .

Purpose: To determine the changes in the anterior chamber flare and central macular thickness (CMT) under topical antiglaucomatous therapy.

Methods: This study included 121 eyes of 73 patients and 36 eyes of 18 controls. Glaucoma patients were divided into 3 groups (timolol maleate, latanoprost, and bimatoprost). Control eyes did not receive any medications. Flare and CMT measurements were performed at baseline and follow-up visits (15th day, and 1st, 3rd, 6th, and 12th month).

Results: Statistically significant increases were detected in the flare values in the bimatoprost and latanoprost groups (P < 0.001, P = 0.011, respectively). Significant increases were also found in CMT values measured in these 2 groups (P < 0.001, P = 0.002, respectively). However, increased flare and CMT values were not clinically manifested as uveitis and macular edema. Flare and CMT values did not change statistically in the timolol maleate and control groups.

Conclusions: Although the use of prostaglandin (PG) analogs was found to be associated with increased flare and CMT, these increases were not clinically significant. PG analog monotherapy may be safely and effectively used in the treatment of glaucoma.
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http://dx.doi.org/10.1089/jop.2016.0128DOI Listing
April 2017

Optic disc area in different types of glaucoma.

Int J Ophthalmol 2016 18;9(8):1134-7. Epub 2016 Aug 18.

Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara 06590, Turkey.

Aim: To evaluate the possible relationship of optic disc area with retina nerve fiber layer in different glaucoma subtypes.

Methods: One eye each was chosen from 45 patients with ocular hypertension, 45 patients with primary open angle glaucoma, 45 patients with pseudoexfoliation glaucoma and 45 healthy controls followed in our hospital. The records of the patients were reviewed retrospectively. Optic disc area and circumpapillary retina nerve fiber layer measurements were obtained using optical coherence tomography. Central corneal thickness was measured by ultrasound pachymetry.

Results: The median disc area in the patients with primary open angle glaucoma was significantly higher than the patients with ocular hypertension (2.19 vs 1.90 mm(2), P=0.030). The median retina nerve fiber layer was thinner in the patients with primary open angle glaucoma and pseudoexfoliation glaucoma than the patients with ocular hypertension for superior, inferior and temporal quadrants. After adjustment for age, no difference in central corneal thickness was found between the groups. Greater disc area was associated with thicker retinal nerve fiber layer for superior, inferior and nasal quadrants in the patients with primary open angle glaucoma. There was no correlation between disc area and central corneal thickness measurements of the groups.

Conclusion: Disc size affects the retinal nerve fiber layer thickness in eyes with primary open angle glaucoma and is a possible risk factor for glaucomatous optic nerve damage.
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http://dx.doi.org/10.18240/ijo.2016.08.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990577PMC
September 2016

Periocular changes in topical bimatoprost and latanoprost use.

Turk J Med Sci 2015 ;45(4):925-30

Background/aim: To evaluate the periocular changes due to topical bimatoprost and latanoprost use and to investigate their effects on the lacrimal drainage system.

Materials And Methods: All participants (69 eyes of 43 patients, 52 eyes of 26 controls) were classified into three groups: bimatoprost (0.03%) users, latanoprost (0.005%) users, and healthy controls. Each patient was examined before prostaglandin therapy, and then at the first, third, sixth, and twelfth month of therapy. Palpebral fissure height, upper eyelid crease, and levator function were measured, and lacrimal system drainage irrigation was performed. Periocular hyperpigmentation and upper eyelid sulcus were also examined.

Results: No significant change was identified in palpebral fissure height or levator function in any group. However, in upper eyelid crease, among bimatoprost users, a statistically significant increase was observed when compared to the control group (P < 0.001). Patients with skin type II and III, in bimatoprost users, and patients with skin type III, in latanoprost users, had statistically significant hyperpigmentation (P < 0.001) after the third month of therapy. During follow-up, no lacrimal drainage system obstruction was seen.

Conclusion: Topical bimatoprost therapy causes more periocular changes than latanoprost therapy. Thus, in unilateral cases, patients should be well informed about these probable changes before therapy.
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October 2015

SLITRK6 mutations cause myopia and deafness in humans and mice.

J Clin Invest 2013 May 1;123(5):2094-102. Epub 2013 Apr 1.

John P. Hussman Institute for Human Genomics and Dr. John T. Macdonald Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.

Myopia is by far the most common human eye disorder that is known to have a clear, albeit poorly defined, heritable component. In this study, we describe an autosomal-recessive syndrome characterized by high myopia and sensorineural deafness. Our molecular investigation in 3 families led to the identification of 3 homozygous nonsense mutations (p.R181X, p.S297X, and p.Q414X) in SLIT and NTRK-like family, member 6 (SLITRK6), a leucine-rich repeat domain transmembrane protein. All 3 mutant SLITRK6 proteins displayed defective cell surface localization. High-resolution MRI of WT and Slitrk6-deficient mouse eyes revealed axial length increase in the mutant (the endophenotype of myopia). Additionally, mutant mice exhibited auditory function deficits that mirrored the human phenotype. Histological investigation of WT and Slitrk6-deficient mouse retinas in postnatal development indicated a delay in synaptogenesis in Slitrk6-deficient animals. Taken together, our results showed that SLITRK6 plays a crucial role in the development of normal hearing as well as vision in humans and in mice and that its disruption leads to a syndrome characterized by severe myopia and deafness.
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http://dx.doi.org/10.1172/JCI65853DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635725PMC
May 2013

Tumor necrosis factor alpha-308 gene polymorphism and pseudoexfoliation glaucoma.

Mol Vis 2008 30;14:1815-8. Epub 2008 Sep 30.

Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.

Purpose: To investigate the possible association between tumor necrosis factor alpha (TNF-alpha)-308 G/A polymorphism and pseudoexfoliation (PEX) glaucoma.

Methods: One hundred and ten Turkish PEX glaucoma patients and 110 healthy control subjects were enrolled in the study. All participants underwent a complete ophthalmic examination. TNF-alpha-308 was genotyped by polymerase chain reaction and restriction endonuclease analysis.

Results: We found a high prevalence of the G/G genotype in PEX glaucoma patients (OR=2.88, 95% CI 1.15-7.20). The A polymorphic allele frequency was 3.2% in patients with PEX compared with 8.2% in controls (p=0.023).

Conclusions: Our results suggest that TNF-alpha-308 G/A genotype is not associated with PEX glaucoma. The -308G/A variant may be a possible protective factor against PEX.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565691PMC
December 2008

Bevacizumab sterility in multiple doses from a single-use vial.

Ann Pharmacother 2008 Oct 2;42(10):1425-8. Epub 2008 Sep 2.

Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey.

Background: Recent reports have demonstrated that refrigerated bevacizumab can be stored for up to 3 weeks at 4 degrees C without loss of efficacy. There have been no previous reports addressing bevacizumab's sterility when stored and used as multiple doses from a single-use vial.

Objective: To evaluate the sterility of bevacizumab when used as multiple doses from a single-use vial.

Methods: Four groups of vials were used to simulate the storage and use conditions for bevacizumab. Each group contained 11 doses of 0.2 mL of bevacizumab. One sample from each group was cultured once each day at 37 degrees C for 10 days; one sample from each group was left for 15 days. MacConkey agar, blood agar, thioglycollate broth, and Sabouraud medium were used to assess bacterial and fungal growth.

Results: A total of 44 samples of bevacizumab were included in this study. Each sample was placed on 4 growth media for microbial readings. All samples were found to be negative for microbial growth. No significant differences were observed among the groups. Possible limitations of this study included the number of samples for each group and in vitro design of the study, which might have affected the growth of bacterial organisms.

Conclusions: Storage and multiple use of bevacizumab from single-use vials does not seem to result in microbial contamination.
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http://dx.doi.org/10.1345/aph.1L270DOI Listing
October 2008

Evaluation of the optic nerve head with the heidelberg retina tomograph in diabetes mellitus.

Ophthalmologica 2008 22;222(3):168-72. Epub 2008 May 22.

Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.

Background: To evaluate the optic nerve head by means of the Heidelberg retina tomograph (HRT) in patients with diabetes mellitus (DM).

Methods: The study group consisted of 47 patients with DM [group 1; 29 patients without diabetic retinopathy (DR) and 18 patients with non-proliferative DR] and 50 normal subjects (group 2). All patients and controls underwent a complete ophthalmological examination, and the optic nerve head topography of both eyes was evaluated by using HRT-I. One eye of these cases was randomly selected for statistical analysis. Glycosylated haemoglobin (HbA(1c)) levels of all the study participants were measured.

Results: The HRT parameters were similar between diabetic and control groups (p > 0.05). In group 1, in the patients with duration of diabetes < or =10 years, when compared with the patients with duration of diabetes >10 years, we did not detect any statistically significant difference between the HRT parameters (p > 0.05). There was no statistically significant correlation between HBA(1c) levels and rim volume (r = -0.078, p = 0.601), and mean retinal nerve fibre layer thickness (r = 0.058, p = 0.700) in DM patients.

Conclusion: These results suggest that non-glaucomatous diabetic patients had no decreased neuroretinal rim when compared with non-diabetic patients.
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http://dx.doi.org/10.1159/000126079DOI Listing
July 2008

No relation between angiotensin-converting enzyme gene polymorphism and pseudoexfoliation.

Ophthalmic Res 2008 27;40(1):32-4. Epub 2006 Nov 27.

Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey.

Aims: To determine the association between the angiotensin-converting enzyme insertion/deletion (I/D) polymorphism and pseudoexfoliation (PEX) in Turkish patients.

Methods: This prospective study consisted of 89 patients with PEX, and 120 controls. The I/D polymorphism of the angiotensin-converting enzyme gene was measured with the use of the polymerase chain reaction method.

Results: The distribution of the polymorphism was not significantly different in cases with PEX and controls. The frequencies of the I and D alleles were not significantly different between the groups.

Conclusion: According to our findings, I/D polymorphism in the angiotensin-converting enzyme gene does not play any role in the pathogenesis of PEX.
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http://dx.doi.org/10.1159/000111156DOI Listing
January 2008

Sensorineural hearing loss in pseudoexfoliation.

Can J Ophthalmol 2007 Feb;42(1):56-9

Department of Ophthalmology, Ankara University School of Medicine, Turkey.

Background: Pseudoexfoliation (PEX), which affects anterior segment structures, is thought to be a systemic disorder. The purpose of this study was to determine the possible relation between PEX and sensorineural hearing loss.

Methods: The study group included 51 patients with PEX and 22 controls without PEX. The patients and controls underwent complete ophthalmic and otorhinolaryngologic examinations. Hearing levels were evaluated with audio-tympanogram battery in all cases, and pure-tone audiogram hearing levels were classified into 6 groups.

Results: The mean age of PEX subjects was 67.5 years. All patients had PEX in at least one eye. Seventeen eyes had no evidence of PEX syndrome or glaucoma, 14 eyes had PEX but no glaucoma, and 71 eyes had both PEX and glaucoma. Thirty-four patients had bilateral PEX while 17 patients had unilateral PEX. One hundred and two ears of the 51 PEX patients and 44 ears of 22 controls were evaluated with pure-tone audiogram after otologic examination. In PEX patients 34/102 ears (33.3%) had normal hearing level, and 68 (66.7%) had hearing loss at various levels. The mean age of the control group was 61 years. In this group, 27/44 ears (61.4%) had no hearing loss, and 17 (38.6%) ears had hearing loss. There was a statistically significant difference between control and PEX subjects (p<0.01) in terms of hearing loss.

Interpretation: This study shows that sensorineural hearing loss appears to be associated with PEX.
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http://dx.doi.org/10.3129/can j ophthalmol.06-087DOI Listing
February 2007

Pattern electroretinography and visual evoked potentials in optic nerve diseases.

J Clin Neurosci 2006 Jan;13(1):55-9

Department of Ophthalmology, School of Medicine, Ankara University, Ankara, Turkey.

Background: To evaluate transient pattern electroretinography (PERG) and pattern visual evoked potential (VEP) for the diagnosis, differential diagnosis and follow-up of optic nerve diseases.

Methods: Twenty-nine consecutive patients (14 female, 15 male) with the diagnosis of ischaemic optic neuropathy (n=14) and optic neuritis (n=15) were included in this study. Mean age of the patients with ischaemic optic neuropathy was 63.3+/-3.3 (60-78) years and the mean age of the patients with optic neuritis was 28.3+/-8.4 (19-43) years. In each patient ophthalmological examination and systemic evaluation were done and VEP and PERG were recorded. As a control group, VEP recordings of 35 healthy subjects were included.

Results: In the ischaemic optic neuropathy group (group 1), mean VEP amplitude (+/-SD) (1.96+/-0.95 microV) was found to be decreased significantly in the affected eyes in comparison to the control group and the unaffected eyes. The delay in latency (116.3+/-20.14 msec in the affected eyes compared with 101.31+/-6.19 msec in unaffected eyes) was statistically significant when compared with the healthy subjects. In the optic neuritis group (group 2), VEP amplitude was decreased (4.13+/-4.04 microV vs 6.97+/-3.35 microV and 6.97+/-4.43 microV) and latency was increased (122.59+/-20.09 msec vs 101.31+/-6.19 msec and 108.76+/-13.57 msec) in affected eyes significantly in comparison to the unaffected eyes and control group, respectively. Even though there were no significant differences for P50 latency and N95/P50 ratios between affected and unaffected eyes in both groups, N95 amplitude decreased significantly in the affected eyes of the ischaemic optic neuropathy patients and N95 latency was found to be decreased in optic neuritis patients. There was no correlation between VEP and PERG findings in both groups.

Conclusion: VEP amplitude decreased significantly in ischaemic optic neuropathies while latency delay was more significant in patients with optic neuritis. PERG findings showed decreased N95 amplitude in ischemic optic neuropathy without associated latency changes.
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http://dx.doi.org/10.1016/j.jocn.2005.02.007DOI Listing
January 2006

Methylenetetrahydrofolate reductase 677 C-T and homocysteine levels in Turkish patients with pseudoexfoliation.

Clin Exp Ophthalmol 2005 Oct;33(5):505-8

Department of Ophthalmology, School of Medicine, Ankara University, Ankara, Turkey.

Purpose: The 677 C-T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene is associated with hyperhomocysteinaemia. This study aimed to investigate the frequency of MTHFR 677 C-T polymorphism and homocysteine (Hcy) levels in Turkish patients with pseudoexfoliation (PEX).

Methods: This prospective study consisted of 60 patients with PEX glaucoma, 16 with PEX syndrome and 34 controls. All patients and control subjects were of Turkish origin. All participants underwent a complete ophthalmic examination. Plasma Hcy levels were measured using fluorescence polarization immunoassay (Abbott Diagnostics). Hyperhomocysteinaemia was defined as a plasma Hcy level above 14 micromol/L. MTHFR 677 C-T was genotyped by real-time polymerase chain reaction (Roche Diagnostics).

Results: There was no statistically significant difference in patient and control groups for the age and sex (P > 0.05). The mean plasma Hcy levels were 15.76, 14.98 and 17.43 micromol/L in patients with PEX glaucoma, with PEX syndrome and controls, respectively. No significant differences between Hcy levels among the three groups (P > 0.05) were found. MTHFR 677 polymorphism did not show significant differences between the total patients with PEX (PEX glaucoma + PEX syndrome) and control subjects (CC: 51.3%n = 39, CT: 40.8%n = 31, TT: 7.9%n = 6 for patients with PEX; CC: 52.9%n = 18, CT: 35.3:%n = 12, TT: 11.8%n = 4 for controls) (P > 0.05). Frequency of T allele was 28.28% and 29.41% for the total patients with PEX and controls, respectively.

Conclusion: In Turkish patients with PEX, the authors could not find any association between Hcy levels, MTHFR 677 C-T polymorphism, and the disease.
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http://dx.doi.org/10.1111/j.1442-9071.2005.01070.xDOI Listing
October 2005

Anterior megalophthalmos with pigmentary glaucoma.

Graefes Arch Clin Exp Ophthalmol 2005 Oct 20;243(10):1066-8. Epub 2005 Oct 20.

Faculty of Medicine, Department of Ophthalmology, Ankara University, Ankara, Turkey.

Purpose: To describe the ocular findings and clinical characteristics of two sisters having anterior megalophthalmos with megalocornea and pigmentary glaucoma.

Material And Methods: A complete ophthalmological examination was performed.

Results: Megalocornea and transillumination defects of the irides were observed associated with deep anterior chambers in both cases. In these cases, a diagnosis of anterior megalophthalmos with pigmentary glaucoma was made.

Conclusion: Anterior megalophthalmos is a rare hereditary condition. The ophthalmologist should be made aware of the many ocular findings that may be associated with megalophthalmos.
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http://dx.doi.org/10.1007/s00417-005-1157-2DOI Listing
October 2005

Infantile glaucoma in a patient with Rothmund-Thomson syndrome.

Can J Ophthalmol 2004 Oct;39(6):674-8

Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey.

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http://dx.doi.org/10.1016/s0008-4182(04)80036-xDOI Listing
October 2004

Quantitative lacrimal scintigraphy after dacryocystorhinostomy.

Ophthalmic Surg Lasers Imaging 2004 Jan-Feb;35(1):37-40

Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey.

Background And Objective: To evaluate lacrimal drainage in patients who have undergone successful dacryocystorhinostomy using quantitative dacryoscintigraphy.

Patients And Methods: This study included 72 eyes of 72 patients. There were 26 males and 46 females, with a mean age of 39.6 years (range, 8 to 67 years). The patients were subdivided into three groups. Group 1 consisted of 35 eyes with external dacryocystorhinostomy, group 2 consisted of 15 eyes with endoscopic dacryocystorhinostomy, and group 3 consisted of 22 eyes with conjunctival dacryocystorhinostomy with a Jones tube. There was no epiphora in patients and the lacrimal drainage systems were patent by irrigation. The other normal eyes of the patients were evaluated as controls.

Results: In groups 1 and 2, the mean T(1/2) values for the palpebral aperture were lower than those for normal eyes, and this difference was statistically significant (P < .01). In group 3, no significant difference was detected in the mean T(1/2) values for the palpebral aperture.

Conclusions: Tear flow was slower in patients who had had external and endoscopic dacryocystorhinostomy, but conjunctival dacryocystorhinostomy did not affect T(1/2) values for the palpebral aperture.
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April 2004

Effects of intracameral lidocaine on ocular tissues.

Clin Exp Ophthalmol 2003 Feb;31(1):73-7

Departments of Ophthalmology and Histology and Electron Microscopy, School of Medicine, Ankara University, Ankara, Turkey.

Purpose: To investigate the ultrastructural changes in iris and corneal tissue induced by intracameral 1% lidocaine infusion applied during lens extraction in a rabbit model.

Methods: The study was conducted using New Zealand rabbits. Eight rabbits received 0.2 mL 1% lidocaine hydrochloride intracamerally and lens extraction was performed, keeping the posterior capsule intact. After lens extraction, cornea and iris tissue samples were obtained for electron microscopy. Eight eyes were included as a control group.

Results: Electron microscopy revealed morphological abnor-malities in both cornea and iris of the lidocaine injected eyes, different from the control group. Cytoplasmic vacuolization, phagosomes and residual bodies were observed in epithelial cells. Corneal fibroblasts contained fluid-filled vacuoles, which could be due to the influx of water into the cells as a result of corneal endothelial damage. Mitochondrial swelling and residual bodies were also seen in the cytoplasm of fibroblasts. Blood vessels in the iris contained fluid material composed of fibrin and proteinaceous material and many vacuoles showed vascular endothelial injury.

Conclusion: Even a short period of exposure of intra-cameral lidocaine to the ocular tissues can induce histo-logical changes that may result in functional defects.
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http://dx.doi.org/10.1046/j.1442-9071.2003.00604.xDOI Listing
February 2003

Anterior uveitis and Sjögren's syndrome in a patient with primary biliary cirrhosis.

Can J Ophthalmol 2002 Oct;37(6):359-60

Department of Ophthalmology, Faculty of Medicine, Ankara University, Turkey.

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October 2002

Results of endoscopic endonasal non-laser dacryocystorhinostomy.

Doc Ophthalmol 2002 Jul;105(1):57-62

Ankara University, Faculty of Medicine, Department of Ophthalmology, Turkey.

Endoscopic dacryocystorhinostomy (EN-DCR) is a procedure that presents itself as an alternative choice to the conventional external approach. This study describes the results of endoscopic endonasal non-laser lacrimal surgery. We reported the data of 64 procedures of 63 patients with epiphora or chronic dacryocystitis who underwent primary EN-DCR by means of a microdrill or revision EN-DCR. One of these cases had bilateral surgery. There were 42 women and 21 men. Thirty-four cases had primary EN-DCR and 30 cases had revision EN-DCR secondary to previously failed external DCR. Mean follow up time was 11.34 months. The procedure was successful in 79.4% of primary EN-DCR cases and in 80% of revision EN-DCR cases. The overall success rate was 79.6%. Postoperative complications included periorbital edema, eyelid ecchymosis, punctal granuloma, cyst of the punctum, adhesion between the superior and inferior punctum. Tube dislocation occurred in 3 patients. Premature loss of silicone tube was determined in 5 patients and granulation tissue occurred at the internal osteum in 11 cases. EN-DCR, when compared with external dacryocystorhinostomy (EX-DCR), has lower success rate, but provides the potential advantages of better intraoperative hemostasis, and lack of cutaneous scar.
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http://dx.doi.org/10.1023/a:1015702902769DOI Listing
July 2002

The role of enophthalmos in the development of involutional ectropion.

Orbit 1999 Mar;18(1):7-9

Department of Ophthalmology, Ankara Numune Hospital, Ankara, Turkey

PURPOSE: This prospective study was performed to evaluate whether there is an association between enophthalmos and involutional ectropion. METHODS: Hertel exophthalmometric measurements were obtained from 31 patients with involutional ectropion and from 30 control patients who were age- and sex-matched. RESULTS: Eighteen patients had bilateral ectropion and 13 patients had unilateral ectropion. The mean of the exophthalmometric measurements of the eyes with ectropion was 12.67 +/- 2.48 (SD) mm. The mean of the exophthalmometric measurements of the control patients was 12.80 +/- 2.87 (SD) mm in the right eye and 12.83 +/- 2.93 (SD) mm in the left eye. The difference between the eyes of the patients and the controls was not statistically significant (p>0.05). In the affected eyes of the patients with unilateral ectropion, the mean exophthalmometric value was 13.15 +/- 2.51 (SD) mm, and in the unaffected eyes of the patients, the mean exophthalmometric value was 13.07 +/- 2.56 (SD) mm. This difference was not statistically significant either (p>0.05). CONCLUSION: Patients with involutional ectropion do not have more enophthalmos than the age- and sex-matched normal population. This study does not suggest an association between enophthalmos and involutional ectropion.
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http://dx.doi.org/10.1076/orbi.18.1.7.2727DOI Listing
March 1999
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