Effects of moderate smoking on the central visual field

Purpose: To investigate whether moderate cigarette smoking has any effects on the central visual field. Methods: This study included 30 healthy, moderate cigarette smokers (10-20 cigarettes per day for at least the past 5 years) and 22 healthy non-smokers. After two training test sessions, all individuals underwent computerized visual field examinations (Humphrey 30-2 Full Threshold Test) with both white-on-white (W-W) perimetry and blue-on-yellow (B-Y) perimetry. One eye of each subject with reliable visual field test results was evaluated. The foveal threshold, mean deviation (MD), pattern standard deviation (PSD), short-term fluctuation (SF), corrected pattern standard deviation (CPSD), glaucoma hemifield test (GHT) and number of significantly depressed points deviating at p 0.55). The number of depressed points deviating at p 0.05). The number of significantly depressed points deviating at p 0.05). No significant difference in GHT was determined with either perimetry for the smokers compared with the non-smokers (p > 0.05). Conclusion: This study suggests that moderate cigarette smoking is associated with both diffuse and localized reductions in retinal sensitivity with W-W perimetry. Only reduction in the foveal threshold was observed with B-Y perimetry, with no hints of diffuse and localized reductions

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

 Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin. Material and methods: Forty-four women who underwent intracytoplasmic sperm injection cycles (ICSI) were enrolled in the study. On the third day (D3) of the menstrual cycle, venous blood samples were drawn for serum measurements of leptin and ghrelin. The follicular fluid (FF) and the corresponding oocyte were obtained from a single dominant preovulatory follicle at the time of oocyte pick-up. The FF and D3 serum leptin and ghrelin concentrations were measured by enzyme-linked immunosorbent assay. The relationship between pregnancy rate and serum, follicular fluid levels of leptin and ghrelin were analyzed. Results: Of the 44 cases included, nineteen achieved clinical pregnancy (43.18%). Follicular fluid ghrelin levels were significantly lower in the pregnant group than non-pregnant group (p < 0.05) With respect to FF leptin, there was no statistically significant differences between the pregnant and non-pregnant women (p > 0.05). There was no statistically significant difference in D3 serum ghrelin between pregnant and non-pregnant groups (p > 0.05). However, D3 serum leptin levels were significantly lower in pregnant women than non-pregnant women (p < 0.05). Conclusions: Lower ghrelin levels in the follicular fluid were associated with higher pregnancy rates. Also, D3 serum leptin levels were inversely correlated with clinical pregnancy rates. These findings support the potential role of these molecules on IVF outcomes

Silicone intubation with the Ritleng method in children with congenital nasolacrimal duct obstruction

Bu çalışma, 23 Ekim 2004'de New Orleans, Los Angeles[ABD]'de düzenlenen 35. Annual Meeting of the American-Society-of-Ophthalmic-Plastic-and-Reconstructive-Surgery'de sözlü bildiri olarak sunulmuştur.Purpose: To evaluate the technical properties and clinical efficacy of bicanalicular silicone intubation with the Ritleng method in children with congenital nasolacrimal duct obstruction. Methods. The Ritleng method was used for lacrimal intubation in 50 eyes of 42 consecutive patients (mean age, 37.3 months). All procedures were done by or under the supervision of one surgeon. The hollow Ritleng probe was inserted via the canaliculus into the inferior meatus. The polypropylene (Prolene) thread-guide, attached to the silicone tube, was advanced through the probe. Either the Prolene emerged from the nose spontaneously or it was retrieved using a hook without visualization. The tube ends were sutured to the nasal wall. Tube removal was planned for 3 months postoperatively. Resolution of signs and symptoms of lacrimal obstruction was assessed. The mean follow-up time was 18.1 months (range, 3 to 48 months). Results. The silicone tube was placed successfully in all eyes except 1 (98%). The mean procedure time was 26 minutes for each eye (range, 15 to 45 minutes). Both Prolene guides spontaneously emerged from the nose in only 8 eyes (16%). In the others, one or both Prolene guides were retrieved with a hook. Inadvertent tube dislodgement occurred in 21% of the eyes and required early tube removal. Success, ie, relief of signs and symptoms, was achieved in 86% of eyes. Conclusions:The Ritleng method of intubation for congenital nasolacrimal duct obstruction yields a high rate of success. Contrary to previous reports, our experience suggests that the surgeon must be prepared to retrieve the Prolene guide from the nose.Amer Soc Ophthalm Plast & Reconstruct Sur

Silicone intubation with the Ritleng method in children with congenital nasolacrimal duct obstruction

35th Annual Meeting of the American-Society-of-Ophthalmic-Plastic-and-Reconstructive-Surgery -- OCT 23, 2004 -- New Orleans, LAYazici, Bulent/0000-0001-8889-1933WOS: 000240459300009PubMed: 16935232Purpose: To evaluate the technical properties and clinical efficacy of bicanalicular silicone intubation with the Ritleng method in children with congenital nasolacrimal duct obstruction. Methods. The Ritleng method was used for lacrimal intubation in 50 eyes of 42 consecutive patients (mean age, 37.3 months). All procedures were done by or under the supervision of one surgeon. The hollow Ritleng probe was inserted via the canaliculus into the inferior meatus. The polypropylene (Prolene) thread-guide, attached to the silicone tube, was advanced through the probe. Either the Prolene emerged from the nose spontaneously or it was retrieved using a hook without visualization. The tube ends were sutured to the nasal wall. Tube removal was planned for 3 months postoperatively. Resolution of signs and symptoms of lacrimal obstruction was assessed. The mean follow-up time was 18.1 months (range, 3 to 48 months). Results. The silicone tube was placed successfully in all eyes except 1 (98%). The mean procedure time was 26 minutes for each eye (range, 15 to 45 minutes). Both Prolene guides spontaneously emerged from the nose in only 8 eyes (16%). In the others, one or both Prolene guides were retrieved with a hook. Inadvertent tube dislodgement occurred in 21% of the eyes and required early tube removal. Success, ie, relief of signs and symptoms, was achieved in 86% of eyes. Conclusions:The Ritleng method of intubation for congenital nasolacrimal duct obstruction yields a high rate of success. Contrary to previous reports, our experience suggests that the surgeon must be prepared to retrieve the Prolene guide from the nose.Amer Soc Ophthalm Plast & Reconstruct Sur

Adie’s tonic pupil following retinal detachment surgery

Amaç: Tek taraflı retina dekolman cerrahisi sonrasında anizokori gelişen 22 yaşında bayan bir olguyu sunmak. Gereç ve Yöntem: Yirmi iki yaşında bayan hastanın sağ gözüne yırtıklı retina dekolmanı tanısı ile silikon bant çevreleme ve kriyo terapi uygulandı. Başarılı dekolman cerrahisi sonrasında, üst ve alt temporal kadranlardaki yırtıklar argon laser fotokoagülasyon uygulanarak çevrelendi. Tedaviden bir ay sonra, göz bebekleri arasında büyüklük farkı olduğu yakınması ile kliniğimize müracaat etti. Bulgular: Oftalmolojik muayenede, sağ göz bebeğinin oda ışığında sola oranla daha büyük olduğu saptandı. Sağ göz bebeği topikal olarak uygulanan %0.1 pilokarpin'e belirgin duyarlılık göstererek daralmasına rağmen sol göz bebeğinde kontraksiyon izlenmedi. Orbita ve beyin manyetik rezonans görüntüleme normal olarak değerlendirildi. Retina dekolman cerrahisinden 3 ay sonra yapılan kontrolde ise sağ göz bebeğinin yakın objelere bakıldığında küçüldüğü ama benzer reaksiyonu ışık ile vermediği izlendi. Sonuç: Böyle bir bulguya neden olacak hasar muhtemelen silier ganglion veya ganglion sonrası parasempatik liflerdedir. Bu olgu sunumunda tonik pupilde patofizyoloji genel olarak gözden geçirilmiştir.Purpose: A 22-year-old woman is presented because of persistent anisocoria following unilateral retinal detachment surgery. Methods: A 22-year-old woman was diagnosed as rhegmatogenous retinal detachment. She was treated with buckle and cryotherapy, and additional laser photocoagulation was needed after the surgery to surround the retinal tears in the upper temporal and lower temporal quadrants. One month later, she noticed that she had anisocoria. Results: Ophthalmic examination showed that the right pupil was a bit larger than the left pupil in room light. Topical administration of 0.1% pilocarpine demonstrated marked supersensitivity of the right pupil and little effect on the left pupil. Cerebral and orbital magnetic resonance imaging was normal. Three months later, she also exhibited light-near dissociation. Conclusions: The probable basis for this phenomenon is the lesion, which exists at the ciliary ganglion or at the parasympathetic postganglionic fibres. Review of the pathophysiology is presented

Effect of cigarette smoking on the blood flow velocities in the ophthalmic and central retinal arteries

Amaç: Sigaranın, oftalmik arter ve santral retinal arter kan akım hızlarına olan etkisini renkli Doppler ultrasonografi ile araştırmak. Gereç ve Yöntem: En az 2 yıldır günde 10 adetten fazla sigara içen 49 (27 erkek ve 22 kadın) olgunun 49 gözü sigara grubunu oluştururken, sigara içmeyen 40 (18 erkek ve 22 kadın) sağlıklı olgunun 40 gözü kontrol grubunda yer aldı. Renkli Doppler görüntüleme ile oftalmik arter ve santral retinal arterde maksimum sistolik kan akım hızı, diyastol sonu kan akım hızı ve rezistans indeksi saptandı. Sigara grubundan elde edilen kan akım hızları ile rezistans indeksleri, kontrol grubundan elde edilen değerler ile istatistiksel olarak karşılaştırıldı. Bulgular: Sigara grubu ile kontrol grubu arasında yaş, cins, sistemik parametreler ve göz içi basıncı açısından istatistiksel olarak anlamlı bir fark saptanmadı (p0.05). Sigara grubu ile kontrol grubu karşılaştırıldığında, oftalmik arterde saptanan diyastol sonu kan akım hızı sigara grubunda daha düşük (p0.05), rezistans indeksi ise daha yüksek olarak tespit edildi (p0.05). Oftalmik arter maksimum sistolik kan akım hızı ise iki grupta benzerdi (p0.05). Sigara grubunda, santral retinal arter maksimum sistolik kan akım hızı (p0.05) ve diyastol sonu kan akım hızı (p0.05) kontrol grubundan istatistiksel olarak daha düşük saptandı. İki grup arasında santral retinal arter rezistans indeksi açısından fark tespit edilmedi (p0.05). Sonuç: Sigara içmek oftalmik arter ve santral retinal arter kan akım hızlarında anlamlı değişikliklere yol açmaktadır.Purpose: To evaluate the effect of cigarette smoking on the blood flow velocities of the ophthalmic artery and central retinal artery. Materials and Methods: Forty-nine eyes of 49 (29 male, 22 female) cigarette smokers (at least for 2 years and at least 10 cigarettes a day) constituted the smoker group. Forty eyes of 40 healthy nonsmokers were recruited for the control group. The peak systolic and end-diastolic blood flow velocities and resistivity indices of the ophthalmic artery and central retinal artery were measured in each eye, using color Doppler imaging. The parameters measured in the smokers were compared with those of the healthy nonsmokers. Results: There was no difference between the groups regarding age, sex, systemic parameters, and intraocular pressure (p>0.05). The mean end-diastolic blood flow velocity was lower (p0.05). Conclusions: This study suggests that cigarette smoking is associated with impaired blood flow in the ophthalmic and central retinal arteries

Long-term outcomes of low-dose 5-fluorouracil versus mitomycin-C in high-risk glaucoma surgery

Amaç: Yüksek riskli glokom olgularında, ameliyat sonrası düşük doz 5-florourasil (5-FU) ile ameliyat sırasında mitomisin-C (MMC) uygulamalarının etkinliğini ve güvenirliğini karşılaştırmak. Çalışmanın Yapıldığı Yer: Gazi Üniversitesi Tıp Fakültesi, Göz Hastalıkları A.D. Gereç ve Yöntem: Yüksek risk glokom özelliklerini taşıyan 36 olgunun 36 gözü, retrospektif, kontrollü çalışmada değerlendirildi. On dokuz göze trabekülektomi sonrasında subkonjonktival 5-FU (toplam 15-25 mg) enjeksiyonları yapıldı. On yedi göze ise operasyon sırasında MMC (0.4 mg/ml, 3 dk) uygulandı. Göz içi basıncının (GİB) ilaçla veya ilaçsız 21 mm Hg ve altında olması başarı olarak kabul edildi. Bulgular: Bir yıl sonunda başarı, 5-FU grubunda %73.6, MMC grubunda %82.3 idi. Beş yıl sonunda toplam başarı 5-FU grubunda %52.6 ve MMC grubunda %63.5 olarak saptandı. Başarı oranları arasındaki fark istatistiksel olarak anlamlı değildi (p0.5). Beş yıl sonunda ortalama GİB, MMC grubunda anlamlı olarak daha düşük saptandı (p0.001). İlaç kullanımı (p0.80), bleb görünümü (p0.20), son görme keskinliği (p1.00) ve komplikasyonlar (p0.05) açısından iki grup arasında fark tespit edilmedi.Sonuç: Bu çalışma sonucunda, hem 5-FU'in hem de MMC'in yüksek riskli glokom olgularında uzun dönemde, GİB'nı etkin şekilde düşürdükleri ancak, MMC'nin GİB'nı daha iyi kontrol ettiği kanısı ortaya çıkmıştır.Objective: To compare low dose postoperative 5-fluorouracil (5-FU) with intraoperative mitomycin-C (MMC) for efficacy and safety as an adjunct to trabeculectomy in high-risk glaucoma patients. Institution: Department of Ophthalmology, School of Medicine, Gazi University, Ankara.Materials and Methods: In a retrospective, nonrandomized comparative trial, 36 eyes of 36 patients at high-risk for failure of trabeculectomy underwent glaucoma filtering surgery with either postoperative subconjunctival low-dose (total 15-25 mg) 5-FU injections (19 eyes) or intraoperative application of MMC (0.4 mg/ml, 3 min, 17 eyes). Success was defined as intraocular pressure (IOP) of ? 21 mmHg with or without medications.Results: Overall success at 1 year was 73.6% in the 5-FU group and 82.3% in the MMC group. The cumulative 5 years success was 52.6% in the 5-FU group and 63.5% in the MMC group. The difference between the groups was not statistically significant (p0.5). The postoperative mean IOP at 5 years was lower in eyes receiving MMC than that of eyes receiving 5-FU (p0.001). There was no significant difference in number of medications (p0.80), appearance of blebs (p0.20), final visual acuity (p1.00), and complications (p>0.05). Conclusions: Although both 5-FU and MMC appear to have good IOP control in high-risk patients, MMC results in a greater decrease in IOP than 5-FU

Post-thymectomy, seronegative myasthenia gravis

Kansu, Tulay/0000-0002-1986-4680; Kansu, Tulay/0000-0002-1986-4680WOS: 000253089500003Patients with thymoma associated myasthenia gravis (MG) usually present with severe disease unresponsive to usual treatment and almost all have antibodies against acetylcholine receptors (AChR). We like to present a case of post-thymectomy, seronegative MG. A 55-year-old man was referred with horizontal diplopia and abduction deficit in the right eye two years after he had thymectomy for a thymoma. Single-fiber electromyography was diagnostic for MG and AChR titer was undetectable. Ocular signs did not response to pyridostigmine, prednisolone and immunoglobulin treatments and the patient also suffered from proximal weakness and pain in the extremities. Cyclosporine-A was started and the initial response was favorable with a decrease in general weakness

Grid or focal argon laser photocoagulation for diabetic maculopathy: Results and predictors of visual outcomes

Amaç: Diabetik makulopati nedeniyle argon lazer fotokoagülasyon uyguladığımız olgularımızı değerlendirmek, tedavinin başarısını ve son görmeyi etkileyen faktörleri incelemek. Gereç-Yöntem: Diabetik makulopati nedeniyle argon lazer fotokoagülasyon uyguladığımız 31 hastanın 58 gözü retrospektif olarak incelendi. Tüm olguların tedavi öncesi ve sonrası renkli fundus fotoğrafı ve fundus floresein anjiografisi çekildi. Bunun yanısıra tüm olgular Dahiliye kliniğine konsülte edildi ve açlık kan şekeri, hipertansiyon ve sistemik damar hastalığı incelendi. Fokal makulopati saptanan 30 göze fokal, diffüz makulopati saptanan 28 göze grid tarzı argon lazer uygulandı. Olguların tedavi öncesi ve sonrası görme keskinlikleri değerlendirildi. Bulgular: Otuz yedi gözde (%63.8) nonproliferatif diabetik retinopati, 21 gözde (%36.2) proliferatif diabetik retinopati saptandı. Fokal makula ödemi saptanarak fokal lazer uygulanan hasta grubunda; 12 (% 40) gözde görme keskinliğinde artma, 18 (% 60) gözde korunma belirlenirken, hiçbir gözde görme keskinliğinde azalma izlenmedi. Diffüz makula ödemi saptanarak grid lazer uygulanan hasta grubunda ise görme keskinliğinde 3 gözde (% 10.7) artma, 18 göz de (%64.3) korunma ve 7 gözde (%25) ise azalma saptandı. Açlık kan şekeri yüksek olan olgularda, hipertansiyon ve sistemik damar hastalığının eşlik ettiği olgularda tedaviye yanıtın istatistiksel olarak anlamlı düzeyde düştüğü belirlendi. Sonuç: Diabetik makulopatili olgularda lazer uygulaması sonrasında büyük oranlarda görme korunmaktadır. Sistemik sorunların eşlik ettiği olgularda tedaviye yanıt azalmaktadır.Purpose: To evaluate the results of argon lazer photocoagulation for diabetic maculopathy and to determine the predictors of visual outcome. Methods: Fifty-eight eyes of 31 patients who underwent argon lazer photocoagualtion for diabetic maculopathy were evaluated retrospectively. Routine ophthalmic examination including fluorescein angiography and fundus photography were performed. Blood glucose level and presence of systemic vascular disease and/or hypertension were evaluated from patients' records. Thirty eyes with focal maculopathy were treated with argon green focal photocoagulation and 28 eyes with diffuse maculopathy were treated with argon green grid photocoagulation. Visual improvement, visual loss, and the association between visual outcomes and hypertension or systemic vascular disease were assessed. Results: Thirty seven (% 63.8) eyes had non-proliferative diabetic retinopathy and 21 (% 36.2) eyes had proliferative diabetic retinopathy. However, 12 (% 40) eyes had improved visual acuity, 18 (% 60) eyes had stable visual acuity and no eyes had worsened visual acuity in the focal lazer group. Whereas, 3 (% 10.7) eyes had better, 18 (% 64.3) eyes had stable and 7 (% 25) eyes had worse visual acuity after grid lazer photocoagulation in the diffuse maculopathy group. If hypertension and systemic vascular disease were associated with macular edema, there were a significant decline in the outcomes after lazer photocoagulation. Conclusions: The results of our study support previously published reports, suggesting the beneficial effects of grid or focal lazer photocoagulation in diffuse or focal macular edema. The treatment greatly maintain pretreatment visual acuity. But, we found statistically significant association between systemic problems, systemic vascular disease and bad visual outcomes