Neslihan SINIM, Sarper KARAKÜÇÜK
Neslihan SINIM, Sarper KARAKÜÇÜK
Purpose: Prostaglandin (PG) analogues are commonly used in the treatment of glaucoma. In this study, we aimed to investigate the posteriorsegment effects of the drug with long-term use of topical PG analogue monotherapy in patients with the diagnosis of primary open angle glaucoma(POAG).Materials and Methods: Patients diagnosed with POAG and treated for 1 to 3 years were included in the study. A total of 25 patients treatedwith latanoprost monotherapy formed the 1st group, 25 patients who received dorzolamide timolol combination monotherapy constitutedthe 2nd group, 25 patients with brimonidine monotherapy formed the 3rd group and 31 healthy volunteers made up the 4th group. Routineophthalmological examination, intraocular pressure (IOP) measurement and fundus examinations were performed thoroughly. Central macularand choroidal thicknesses were measured by optical coherence tomography (OCT).Results: There was no signifi cant difference in the mean macular thickness between the groups. The mean choroidal thickness was signifi cantlyhigher in patients using PG analogue than the other groups. None of the patients had intraocular infl ammation or cystoid macular edema (CME).Conclusion: The choroidal thickness was signifi cantly higher in the group receiving topical latanoprost monotherapy than the other groups.None of the patients had CME or infl ammation. PG analogue monotherapy can be used safely in POAG cases. PG analogue therapy should bekept in mind in clinical conditions where choroidal thickness is signifi cant.
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Gökhan PEKEL, Evre PEKEL, Ebru Nevin ÇETİN
Gökhan PEKEL, Evre PEKEL, Ebru Nevin ÇETİN
Purpose: The aim of this study was to demonstrate the publication trends in the area of pars plana vitrectomy (PPV) in the last ten years.Materials and Methods: All of the PPV related research articles, case reports, letters, reviews and meeting abstracts published betweenJanuary 2009 and December 2018 indexed on the Web of Science Core Collection were evaluated. A bibliometric fi lter was used to capturepublications about PPV by using the key words ‘pars plana vitrectomy’, ‘retina surgery’ and ‘vitreous surgery’ in the ‘topic’ selection mode.Publication years, topics, document types, authors, languages, country origins, institutions, citations and journals of the published documentswere evaluated.Results: A total of 4877 publications was evaluated in this bibliometric study. The total publication counts about PPV had been increasedfrom the year 2009 (368 documents) to 2018 (607 documents). The mostly encountered topics were PPV combined with an anterior segmentprocedure (670 documents, 13.7%), rhegmatogenous retinal detachment (393 documents, 8.1%), and macular hole (388 documents, 8.0%). Themost published document type were research articles and case reports (4029 documents, 82.6%). University of London was the most productiveinstitution (131 documents, 2.7%). The journal that published the most about PPV was ‘Retina’ (615 documents, 12.6%). The average citationcount per PPV document was 7.9.Conclusions: In the area of PPV related publications, the most encountered topics were PPV combined with an anterior segment procedure andrhegmatogenous retinal detachment surgery in the last decade.
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CEMAL ÖZSAYGILI, Necati DURU
CEMAL ÖZSAYGILI, Necati DURU
Purpose: To determine whether the disorganization of retinal inner layers (DRIL) on spectral-domain (SD) OCT is associated with visualoutcomes in eyes with treatment-naive branch retinal vein occlusion (BRVO).Materials and Methods: Thirty-two eyes of 32 treatment-naive patients with macular edema (ME) due to BRVO receiving three initialconsecutive monthly intravitreal ranibizumab were enrolled in this study. SD-OCT images from baseline, 3rd-month, 6th-month visits wereobserved and the presence and extent of DRIL was examined in the central 1-mm-wide foveal area. The effi cacy of the ranibizumab treatment,assessed by best-corrected visual acuity (BCVA), was evaluated at baseline, 3-month and 6-month visits.Results: A total of 32 eyes were included and DRIL was present in 14 (43.7%) eyes at baseline and 9 eyes (28.1%) at 6th month (P:0.01).Baseline DRIL was found to be associated with lower baseline BCVA (0.46 LogMAR for without DRIL vs. 0.65 LogMAR for DRIL, P: 0.013)and higher central retinal thickness (405.7 vs. 442.8, P: 0.016). Decrease in DRIL intensity at 3-month follow-up was associated with increasedvisual acuity (VA) at 6 months (P:0.001) and baseline DRIL extent was a predictive parameter for 6 months improvement in VA (p:0.01). SixmonthDRIL change was related to 6-month VA improvement (Pearson’s correlation test, r=0.726, P<0.001).Conclusion: In the present study, it was observed that the improvement of BCVA was found to be related to the decrease of the DRIL intensity.Therefore, the presence of DRIL at baseline and extent of DRIL following treatment might serve as a potential SD-OCT biomarker for patientswith ME secondary to treatment-naive-BRVO.
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Aylin KARALEZLİ, Sabahattin SUL, Çağrı YİĞİT
Aylin KARALEZLİ, Sabahattin SUL, Çağrı YİĞİT
An 18-year-old female patient applied to our clinic owing to sudden visual loss which started 3 days ago on the right eye. There were +3 cellsin the anterior chamber, +3 cells in the vitreous and multiple serous retinal detachment in the right eye. The anterior segment and fundus werenormal in the left eye. Optic disc leakage in both eyes and hyperfl uorescent areas due to subretinal fl uid pooling in the phase in the right eyewere detected in fundus fl uoresceine angiography. Hypofl uorescent foci were detected in the mid-late phase in both eyes in indocyanine greenangiography. A marked thick choroid (690 μm) in optical coherence tomography and decreased choriocapillaris fl ow rate in right eye comparedto left eye in optical coherence tomografi angiography were detected. Pleocytosis was detected in the lumbar puncture. Based on these fi ndings,the patient was diagnosed as bilateral asymmetric onset acute Vogt-Koyanagi-Harada and treated with 1 g intravenous pulse steroid treatment.On the third day of the pulse steroid treatment, the amount of subretinal fl uid signifi cantly decreased and choriocapillaris fl ow rate signifi cantlyincreased in the right eye and slightly increased in the left eye. On the 7th day, 1 mg / kg / day oral steroid and 100 mg azothiopurine treatmentwere started after complete resolution of subretinal fl uid and increase of visual acuity up to 0.5.
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Ahmed Tamer SAIF, Passant SAIF
Ahmed Tamer SAIF, Passant SAIF
Purpose: To study the Sociodemographic factors leading to blindness or visual impairment in diabetic patients living in Upper Egypt. Setting: The study included 200 patients recruited from screening campaigns in the Fayoum and Beni Suef governorates in Egypt. Methods: Patients included in the study were legally blind diabetics (visual acuity ≤ 6/60), and patients answered a specially designed questionnaire when recruited in the study.Results: Patients’ knowledge of the ophthalmic effects and complications was as low as 31%. Laser treatment patients were more aware ofdiabetic consequences (p≤0.02). However, with the increase in education level, a noticeable increase in patient knowledge regarding diabetic ocular complications also occurred. (p≤0.001), patients obtained their knowledge about diabetic complications from their ophthalmologists (p≤0.02), rather than from the media or the Internet Conclusions: The media and internets should have a greater role in informing diabetics regarding the importance of controlling blood glucose levels and regular follow-ups in reducing ocular diabetic complications. This can be achieved by increasing the patients’ level of knowledge. Keywords: Vision impairment, Sociodemographic factors, Blindness; diabetes mellitus, Diabetic retinopathy.
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Ender SIRAKAYA, Deniz KILIC
Ender SIRAKAYA, Deniz KILIC
Purpose: To investigate the two-year visual and anatomical outcomes of patients who had intravitreal afl ibercept monotherapy for macular edema due to branch retinal vein occlusion (BRVO). Methods: Twenty-nine eyes were included in this retrospective cohort study. All eyes were newly diagnosed as BRVO and were treated with intravitreal injections of afl ibercept. After three-months loading doses, patients were treated with a single dose of afl ibercepts if needed. The best-corrected visual acuity (BCVA) and the central macular thickness (CMT) were recorded at each monthly visit. Results: The mean ages of patients were 61.3±7.6 years. The mean BCVA was 52.2±8.5 letters at baseline, 70.1±11.2 letters at the fi rst year (p<0.001), 69.7±12.5 letters at the second year (p<0.001). The mean CMT was 555±102 μm at baseline; 285±50 μm at the fi rst year (p<0.001), 270±52 μm at the second year (p<0.001). In the fi rst year, the mean number of injections was 5.9±1.2 whereas in the second year it was 2.1±0.9.Conclusion: These long-term real-life results suggest that the intravitreal afl ibercept is an effective treatment regimen for eyes with macular edema in BRVO.
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Erdinc BOZKURT, Abdullah GUMUS, Yaran KOBAN
Erdinc BOZKURT, Abdullah GUMUS, Yaran KOBAN
Purpose: We aimed to evaluate the relationship between serum endocan levels and diabetic retinopathy (DR) severity in diabetic patients.Material and Method: The study included 72 patients with diabetes mellitus (DM) and 28 volunteer control patients without any systemic disease. Patients with no systemic disease were the 1st group (n=28), diabetic patient without DR were the 2nd group (n=21), patients with non-proliferative DR were 3rd group (n=24) and patients with proliferative DR were 4th group (n=27). BMI, serum endocan levels, HbA1c, urea, creatinine levels and macular thickness were measured. Results: Serum endocan levels were 170.05±85.67, 333.91±13.41, 340.42±105.07, 472.83±147.40 ng/L, respectively. BMI was 23.11±1.37 in the 1st group, 28.05±4.62 in the 2nd group, 29.00±5.69 in the 3rd group, and 28.85±5.88 in the 4th group. HbA1c levels were 4.83±0.55 in 1st group, 6.60±1.15 in 2nd group, 8.49±1.24 in 3rd group, and 8.89±1.30 in 4th group. Macular thickness measured with OCT was 216.96±11.64, 253.29±23.62, 274.88±61.11, 352.93±120.08μm in the right eye and 218.96±11.93, 240.65±17.57, 283±62.89, 334.78±127.71μm in the left eye, respectively.Conclusion: In our study, there was a relationship between serum endocan level and DR stage. Serum endocan level can reveal important information about the severity and stage of DR such as serum creatinine and HbA1c level. There is a potential need for further research to demonstrate whether endocan is involved in DR pathogenesis.
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William J. ANDERSON, Levent AKDUMAN
William J. ANDERSON, Levent AKDUMAN
Brolucizumab is the newest anti-vascular endothelial growth factor (anti-VEGF) drug approved for use. The aim of this review is to review the HAWK/HARRIER clinical trials, examine post-marketing experience with the drug, and evaluate the packaging/procedural differences with brolucizumab. Brolucizumab is a more potent and longer lasting anti-VEGF agent, and is an important agent that may be used in the treatment of neovascular age-related macular degeneration. Retinal vasculitis is a rare but very serious complication of brolucizumab that the patient and physician must be aware of.
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Nilay KANDEMIR BESEK, Gurkan ERDOGAN, Erdem ERIS, Mehmet Onur ER, Orcun SONMEZ, Gokhan DEMIR, Zeynep T. ALKIN
Nilay KANDEMIR BESEK, Gurkan ERDOGAN, Erdem ERIS, Mehmet Onur ER, Orcun SONMEZ, Gokhan DEMIR,
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Purpose: To evaluate the functional and anatomical outcomes of patients underwent combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP) using temporary keratoprosthesis (TKP) for vitreoretinal pathology and corneal opacities secondary to severe ocular trauma.Materials and Methods: Medical records of participants that underwent combined PPV and PKP surgery with TKP for severe eye trauma were retrospectively analysed. During the follow-up, functional success (best corrected visual acuity (BCVA)) remained the same or increased, and anatomic success (retinal reattachment, graft transparency) and complications were evaluated.Results: Twenty-two eyes of 22 patients (mean age 43.40±22.43 years, 15 male/7 female) were included in this study. The mean follow-upperiod was 12±7.8 months. At the last follow-up, BCVA increased in 3 patients (13.6%) and remained unchanged in 16 patients (72.7%). Two of 3 patients had decreased BCVA with LogMAR chart from 2.10 to 3.10 logMAR, while 1 patient had decreased from 3.10 logMAR to loss of light sensation (13.6%). At the last follow-up, the retina was attached in 16 patients (72,8%). Corneal graft remained transparent during follow-up in 12 patients (54.5%), while graft failure was seen in 10 eyes (45.5%). Conclusion: PPV and PKP surgery combined with TKP is an alternative method for patients with corneal opacities that not allowed to vitrectomy. Although retinal reattachment is achieved in the majority of patients, corneal graft failure is a common postoperative complication. Patients should be informed about the long-term functional outcomes of this complicated surgery.
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Ziya AYHAN, Sadettin USLU, Sefik Can IPEK, Sinan UNAL, Fatos ONEN, Isil SOMALI, Ali Osman SAATCI
Ziya AYHAN, Sadettin USLU, Sefik Can IPEK, Sinan UNAL, Fatos ONEN, Isil SOMALI,
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Nivolumab is one of the new generation anti-cancer drugs used in the treatment of metastatic malignant melanoma, which acts by stimulating the immune system. Unilateral panuveitis was diagnosed in the left eye of 45 years-old man who was on nivolumab treatment for metastatic cutaneous malignant melanoma and presented with anterior uveitis, vitritis and macular edema. Nivolumab treatment was discontinued and two intravitreal dexamethasone implants were administered to left eye 4-months interval. The signs and symptoms were improved within 6 months of follow-up. We aimed to emphasize the need for the careful review of systemic disease history and the drugs used in patients diagnosed with uveitis and to increase awareness of clinicians regarding potential ocular side effects of new generation anti-cancer drugs.
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