Konjonktival Pterjium Etyopatogenezinde Sistemik İnflamasyonun Rolünün Değerlendirilmesi

Amaç: Konjonktival pterjiumlu hastalarda hemogram parametreleri ve kan temelli sistemik inflamasyon belirteçlerinindüzeylerinin incelenmesidir.Gereç ve Yöntemler: Çalışmaya konjonktival pterjiumu olan 30 hasta ve yaş-cinsiyet uyumlu 31 sağlıklı gönüllü dahiledildi. Tüm olgulara detaylı oftalmolojik muayene yapıldı. Ayrıca pterjium grubundaki olgularda pterjiumderecelendirilmesi yapıldı. Tüm olgulardan serum örnekleri toplandı ve nötrofil/lenfosit oranı, platelet/lenfosit oranı vesistemik immün-inflamasyon indeksi hesaplandı. Gruplar arasında nötrofil sayı-yüzdesi, lenfosit sayı-yüzdesi,hemoglobin, eritrosit sayısı, lökosit sayısı, ortalama trombosit hacmi, eritrosit dağılım genişliği, trombosit sayısı,nötrofil/lenfosit oranı, platelet/lenfosit oranı, sistemik immün-inflamasyon indeksi arasında ilişki olup olmadığıincelendi. İstatistiksel analizde Ki-kare testi, Bağımsız örneklemler t-testi, Mann-Whitney U testi, Pearson ve Spearmankorelasyon analizleri kullanıldı. P<0.05 düzeyi istatistiksel olarak anlamlı kabul edildi.Bulgular: Gruplar hücre sayıları açısından benzerdi. Nötrofil/lenfosit oranı ve platelet/lenfosit oranı pterjium grubundahafifçe yüksek olmakla birlikte bu fark istatistiksel açıdan anlamlı değildi (sırasıyla P=0.141, P=0.480). Sistemikimmün-inflamasyon indeksi gruplar arasında benzerdi (P=0.897). Ayrıca, pterjium grubunda korelasyon analizinde dehemogram parametreleri, nötrofil/lenfosit oranı, platelet/lenfosit oranı, sistemik immün-inflamasyon indeksi ve pterjiumderecesi arasında istatistiksel olarak anlamlı ilişki olmadığı görüldü.Sonuç: Çalışmamızın sonuçlarına göre pterjiumun sistemik inflamatuar etiyolojisini destekleyebilecek kanıtbulunamamıştır. Bu iki antite arasında ilişki olup olmadığını kesin olarak ortaya koyabilmek için geniş hastapopülasyonlarında yapılacak ileri randomize çalışmalara ihtiyaç vardır.Aim: To assess the complete blood count parameters and blood-based systemic inflammatory markers in patients with conjunctival pterygium. Materials and Methods: Thirty patients with conjunctival pterygium and 31 age and sex-matched control subjects included in the study. All patients underwent detailed ophthalmologic examination. Pterygium was also graded in pterygium group. Serum samples were obtained from all subjects, and neutrophil\lymphocyte ratio, platelet\lymphocyte ratio and systemic immune-inflammation index were calculated. It is examined whether or not there exits an association between groups in terms of neutrophil count\percentage, lymphocyte count\percentage, hemoglobin, red blood cell count, white blood cell count, mean platelet volume, red cell distribution width, platelet count, neutrophil\lymphocyte ratio, platelet\lymphocyte ratio and systemic immune-inflammation index. The statistical assessment was performed with the assistance of Pearson’s Chi-square test, Independent samples t-test, Mann-Whitney U test, Pearson and Spearman correlation analysis. P<0.05 was considered statistically significant. Results: The groups were similar in terms of cell counts. Although neutrophil\lymphocyte ratio and platelet\lymphocyte ratio are slightly higher in pterygium group, this difference is not statistically significant (respectively P=0.141, P=0.480). Systemic immune-inflammation index was similar between groups (P=0.897). Moreover, no statistically significant correlation found among complete blood count parameters, neutrophil\lymphocyte ratio, platelet\lymphocyte ratio, systemic immuneinflammation index and grade of pterygium in the pterygium group. Conclusion: According to our study results, no evidence supporting potential systemic inflammatory origin of pterygium was found. Further randomized studies with larger sample size are needed to discover if there is a relationship between these two entities

A comparison of mechanical transnasal endoscopic dacryocystorhinostomy, transcanalicular diode laser dacryocystorhinostomy and transcanalicular multidiode laser dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction: A prospective clinical trial

Bu çalışmada epifora tedavisinde güncel olarak uygulanan üç ayrı dakriyosistorinostomi tekniğinin prospektif olarak karşılaştırılması amaçlanmıştır. Gazi Üniversitesi Tıp Fakültesi Oküloplastik ve Orbita Cerrahisi Kliniği'ne göz sulanması şikayeti ile başvuran hastalardan primer kazanılmış nazolakrimal kanal tıkanıklığı tanısı alan 45 olgu çalışmaya alınmıştır. Bu olgular 15'şer hastalık üç gruba ayrılmıştır. Birinci gruba Mekanik Endoskopik DSR; ikinci gruba Diod Lazer ile transkanaliküler dakriyosistorinostomi (TK-DSR); üçüncü gruba ise Multidiod Lazer ile TK-DSR cerrahileri uygulanmıştır. Hastalar birinci gün, birinci ay ve sonrasında üç ayda bir olmak üzere prospektif olarak takip edilmiş ve bulgular istatistiksel olarak karşılaştırılmıştır. Olguların 7'si erkek, 38'i bayan olup ortalama yaş 40,53±3,96 yıl olarak saptanmıştır. Ortalama takip süresi gruplara göre sırasıyla; 26,13±1,03 ay, 35,80±5,54 ay ve 7,0±2,9 aydır. Epiforanın tamamen düzelmesi ile birlikte nazolakrimal lavajda pasajın açık olması başarı olarak kabul edilmiştir. Çalışma sonunda birinci gruptaki olgularda tam düzelme sağlanırken, üçüncü gruptaki bir olguda kanaliküler stenoza bağlı, ikinci gruptaki sekiz olguda ise ostium fibrozisine bağlı başarısızlık izlenmiştir. Altıncı aydaki başarı düzeyi; birinci grupta %100, ikinci grupta %73,3, üçüncü grupta ise %90,9'dür. Diod Lazer DSR grubundaki olguların başarı yüzdesi dokuzuncu aydan itibaren %46,7'ye gerilemiş ve çalışma süresince aynı düzeyde kalmıştır. Mekanik Endoskopik grupta ortalama 26,13±1,03 aylık takipte başarısızlık izlenmemiştir. Multidiod grubundaki olguların uzun dönem takibi mevcut değildir. Sonuç olarak; Mekanik Endoskopik DSR uzun dönem tatminkar sonuçları ile eksternal DSR'ye iyi bir alternatiftir. Transkanaliküler Diod Lazer DSR erken dönemdeki başarısını uzun vadede koruyamamıştır. Transkanaliküler Multidiod Lazer DSR ise erken dönem sonuçlarıyla ümit vadetmekle birlikte bu gruptaki olguların prospektif takibi ile uzun dönem başarısı anlaşılacaktır.The purpose of this study is to compare three recent dacryocysorhinostomy techniques in epiphora treatment prospectively. Among those who applied to Gazi University Medical School Oculoplastics and Orbital Surgery division with tearing complaint, 45 patients presenting persistent epiphora due to acquired nasolacrimal duct obstruction were included in the study. The patients were divided into 3 groups of 15 persons. Mechanical Endoscopic DCR, Transcanalicular Dacryocysorhinostomy (TC-DCR) with Diode Laser and TC-DCR with Multidiode Laser techniques applied in the groups respectively. Follow-up is conducted in the first day, first month and then in three-month periods prospectively and results were compared using statistical methods. 7 patients were male, 38 were female and mean age was 40,53±3,96 years. Mean follow-up times were; 26,13±1,03, 35,80±5,54 and 7,0±2,9 months respectively. The main outcomes were the relief of epiphora and the patency on lacrimal irrigation. Complete resolution is achieved in first group whereas failures recorded in the third due to 1 patient suffering canalicular stenosis and in the second due to 8 patients with fibrosis at rhinostomy site. Six-month success rates were 100% in the first, 73,3% in the second and 90,9% in the third group. Success rate in Diode Laser DCR group regressed to 46,7% following 9th month and remained so. In 26,13±1,03 month-period no failure detected in endoscopic group. Multidiode Laser group lacks long-term results. Thus, Mechanic Endoscopic DCR is a strong substitute for External DCR. Transcanalicular Diode Laser DCR could not perform well in the long-term. Transcanalicular Multidiode DCR looks promising with early results yet no long-term results exist

Mevsimsel Alerjik Konjonktivitli Çocuklarda Sistemik İnflamasyon Biyobelirteçlerinin İncelenmesi

Amaç: Oküler alerjinin en sık formu olan mevsimsel alerjik konjonktivit ağırlıklı olarak genç popülasyonu etkilemesive son yıllarda artan insidansı nedeniyle dikkat çekmeye devam etmektedir. Daha çok lokal inflamatuar bir konjonktivahastalığı olduğu düşünülen bu rahatsızlığın sistemik kökenleri belirsizdir. Bu çalışmada mevsimsel alerjik konjonktivitliçocuklarda tam kan sayımı parametreleri ve kan temelli sistemik inflamasyon biyobelirteçlerinin düzeylerininincelenmesi amaçlanmıştır.Gereç ve Yöntemler: Mevsimsel alerjik konjonktivit dışında herhangi bir oküler ya da sistemik hastalığı olmayan 26çocuk hasta ve yaş-cinsiyet uyumlu 31 sağlıklı gönüllü çalışmaya dahil edildi. Retrospektif olarak olguların son bir ayiçindeki hemogram sonuçlarına bakılarak nötrofil sayı/yüzdesi, lenfosit sayı/yüzdesi, hemoglobin, eritrosit sayısı,lökosit sayısı, ortalama trombosit hacmi, eritrosit dağılım genişliği ve trombosit sayıları belirlendi ve nötrofil/lenfositoranı, trombosit/lenfosit oranı, sistemik immün-inflamasyon indeksi hesaplandı. İstatistiksel değerlendirmede ki-karetesti, bağımsız örneklemler t-testi ve Mann-Whitney U testi kullanıldı.Bulgular: Gruplar arasında lökosit, eritrosit, trombosit sayı ve yüzdelerinin benzer olduğu görüldü. Hemoglobin,eritrosit dağılım genişliği ve ortalama trombosit hacmi açısından da anlamlı fark saptanmadı. Nötrofil/lenfosit oranı,trombosit/lenfosit oranı ve sistemik immün-inflamasyon indeksi oranları da benzerdi (sırasıyla P=0,848 P=0,276 veP=0,701).Sonuç: Mevsimsel alerjik konjonktivitli çocuklarda kan temelli sistemik inflamasyon biyobelirteçlerinin düzeylerindeanlamlı farklılık görülmemiştir. Bu hastalığın sistemik inflamatuar temeline yönelik daha geniş çaplı araştırmalargereklidir.Aim: Seasonal allergic conjunctivitis, the most frequent form of ocular allergy, keeps drawing attention as it predominantly affects the young population and its incidence rate increases recently. The systemic origins of this disorder, which is thought to be a more local inflammatory conjunctival disease, are uncertain. In this study, we aimed to examine the complete blood count parameters and blood-based systemic inflammatory markers in children with seasonal allergic conjunctivitis. Materials and Methods: 26 children with no ocular or systemic disease apart from seasonal allergic conjunctivitis and 31 age and sex-matched healthy volunteers were included in the study. Retrospectively, by recording the complete blood count for previous month, neutrophil count/percentage, lymphocyte count/percentage, hemoglobin, red blood cell count, white blood cell count, mean platelet volume, red cell distribution width and platelet count were determined and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and systemic immune-inflammation index were calculated. Chisquare test, independent samples t-test and Mann-Whitney U test were used for statistical evaluation. Results: The number and percentage of leukocytes, erythrocytes, platelets were observed to be similar in groups. There was no significant difference in terms of hemoglobin, erythrocyte distribution width and mean platelet volume as well. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and systemic immune-inflammation index were also similar (P=0.848 P=0.276 and P=0.701 respectively). Conclusion: No significant difference was observed in the level of blood-based systemic inflammatory biomarkers in children with seasonal allergic conjunctivitis. Further research is required to explore the systemic inflammatory basis of this disease

Piterjiumlu Hastalarda Seruloplazmin, Albümin, İskemi-Modifiye Albümin ve Miyeloperoksidaz Düzeylerinin Belirlenmesi

Amaç: Biyobelirteçler vücuttaki birçok hastalığın varlığının ya da ciddiyetinin ölçülebilir bir göstergesidir. Öte yandanyapılan birçok klinik çalışmaya rağmen yaygın bir göz hastalığı olan konjonktival piterjium etiyopatojenezi tam olarakaydınlatılamamıştır. Fakat multifaktöriyel olduğu düşünülen etiyolojisinin bazı biyobelirteçlerle olan sıkı ilişkisi de iyibilinmektedir. Bu çalışmada piterjium hastalığı ile serum seruloplazmin, albümin, iskemi-modifiye albümin vemiyeloperoksidaz düzeyleri arasındaki ilişkinin incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Çalışmaya konjonktival piterjiumu olan 40 hasta ve yaş-cinsiyet uyumlu 40 sağlıklı gönüllü dâhiledildi. Tüm olgulara detaylı oftalmolojik muayene yapıldı. Ayrıca piterjium grubundaki olgularda piterjiumderecelendirilmesi yapıldı. Tüm olgulardan serum örnekleri toplandı ve seruloplazmin, albümin, iskemi-modifiyealbümin ve miyeloperoksidaz düzeylerine bakıldı. İstatistiksel analizde Ki-kare testi, Bağımsız örneklemler t-testi,Mann-Whitney U testi ve Spearman korelasyon analizi kullanıldı. P<0,05 düzeyi istatistiksel olarak anlamlı kabuledildi.Bulgular: Gruplar demografik açıdan benzerdi. Gruplar arasında seruloplazmin, albümin, iskemi-modifiye albümin vemiyeloperoksidaz düzeyleri açısından anlamlı fark saptanmadı (sırasıyla P=0,762 P=0,572 P=0,202 ve P=0,176).Piterjium grubunda korelasyon testinde albümin düzeyleri ile piterjium derecesi arasında negatif ilişki olduğu görüldü(P=0,011).Sonuç: Konjonktival piterjium ile serum seruloplazmin, albümin, iskemi-modifiye albümin ve miyeloperoksidazdüzeyleri arasında istatistiksel anlamlı bir ilişki görülmemiştir. Bununla birlikte, albümin düzeyleri ile piterjiumderecesi arasındaki negatif ilişki geniş hasta gruplarıyla yapılacak ileri randomize çalışmalara ihtiyaç olduğunudüşündürmektedir.Aim: Biomarkers are a measurable indicator of the presence or severity of many diseases in the body. On the other hand, despite many clinical studies, the etiopathogenesis of conjunctival pterygium which is a common eye disease has not been fully clarified. However, it is well known that the etiology, which is thought to be multifactorial, is closely related to some biomarkers. In this study, we aimed to investigate the relationship between pterygium and serum ceruloplasmin, albumin, ischemia-modified albumin and myeloperoxidase levels. Materials and Methods: Forty patients with conjunctival pterygium and 40 age and sex-matched voluntary control subjects were included in the study. All patients underwent detailed ophthalmological examination. Pterygium was graded in pterygium group. Serum samples were obtained from all subjects and ceruloplasmin, albumin, ischemiamodified albumin and myeloperoxidase levels were determined. The statistical assessment was performed using Chisquare test, Independent samples t-test, Mann-Whitney U test and Spearman’s correlation analysis. P<0.05 was considered as statistically significant. Results: The groups were similar in terms of demographic parameters. There were no statistically significant difference between groups with regards to the level of ceruloplasmin, albumin, ischemia-modified albumin and myeloperoxidase (P=0.762 P=0.572 P=0.202 and P=0.176 respectively). A negative correlation was found between albumin levels and grade of pterygium in the pterygium group (P=0.011). Conclusion: No statistically significant relationship between conjunctival pterygium and serum ceruloplasmin, albumin, ischemia-modified albumin and myeloperoxidase levels was observed. However, the negative relationship between albumin levels and grade of pterygium suggests that further randomized trials with large patient groups are needed

Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

Objectives: To evaluate ocular surface health in obstructive sleep apnea syndrome (OSAS) and to investigate the tendency of these patients toward dry eyes. Materials and Methods: Fifty patients who underwent polysomnography and were diagnosed with OSAS and 50 normal control subjects were compared with respect to ocular surface disease index (OSDI), Schirmer I test and tear film break-up time (TBUT) values. Results: Patients were grouped as mild (n=15, 30%), moderate (n=15, 30%) and severe (n=20, 40%) according to apnea-hypopnea index values. The right eyes of patients were included in both groups. OSDI values were as follows: control group, 18.7±8.5; mild OSAS group, 40.2±2.8; moderate OSAS group, 48.5±2.2 and severe OSAS group, 62.7±2.3 (p<0.001). TBUT values were as follows: control group, 12.3±4.9; mild OSAS group, 8.2±4.7; moderate OSAS group, 5.8±2.1 and severe OSAS group, 4.2±3.7 (p<0.001). Schirmer values were as follows: control group, 18±6.1 mm; mild OSAS group, 12.9±6.7 mm; moderate OSAS group, 8.5±5.2 mm and severe OSAS group, 7.9±4.7 mm (p<0.001). Conclusion: Patients with OSAS seem to have a tendency toward dry eyes. Clinicians should be aware of dry eye development in these patient

Keratoconus Could Be Associated With Psoriasis: Novel Findings From a Comparative Study

Karagun, Ebru/0000-0002-5032-7429WOS: 000509673000013PubMed: 31574049Purpose: To explore the relationship between keratoconus (KC) and psoriasis. Methods: One hundred ten eyes of 55 patients with psoriasis (study group, SG) and 110 eyes of age-sex-matched 55 healthy volunteers (control group, CG) were included in the study. All cases underwent a detailed dermatological and ophthalmological examination including corneal topography. Moreover, Psoriasis Area and Severity Index (PAST) scoring of the patients was carried out in the SG. A thorough comparison of pachymetric, aberrometric, and topometric values between the groups was performed, and the results were interpreted. A chi(2) test, Mann-Whitney U test, and Pearson correlation test were used for statistical assessment. Results: Although the average Kmax (44.6 in the SG; 44.5 in the CG; P = 0.613) and Belin/Ambrnsio enhanced ectasia total deviation value (1.34 in SG; 1.20 in CG; P = 0.880) were similar between the groups, the mean index of vertical asymmetry value in the SG (0.14 mm) was significantly higher than that in the CG (0.11 mm) (P = 0.041). Moreover, 28 eyes from 16 patients with psoriasis were found to be associated with KC because 26 of those 28 eyes were KC suspects and 2 of them were definite KC. A positive correlation was found among topometric parameters, especially between duration of the disease and PASI score. A negative correlation was discovered between topometric parameters and the early beginning of psoriasis. Conclusions: Serious changes in topography maps may occur in psoriatic patients. The changes were found to be more evident in the presence of a higher PAST score and the early beginning and longer duration of the disease. The results hinted a potential relationship between psoriasis and KC

The use of Osseointegration and Orbital Implants in the Management of Orbital Exenteration or Severe Contracted Sockets

Objectives: To evaluate the results of bony integrated implants used in the management of exenterated or contracted sockets. Materials and Methods: Ten eyes of 10 cases underwent bony integrated implants for the management of exenterated (7 eyes) or contracted (3 eyes) sockets. The procedure was performed in two steps in a two-month period. The first step included placement of screws by preparing the osteotomy site, whereas the second step included implantation of magnetic implants over these screws that will adhere to the orbital implant. The patients were retrospectively evaluated for age, gender, etiology, surgical timing, history of radiotherapy, and time of application of epithesis. The presence of infection at the surgical site, implant loss, functional or cosmetic problems at the perisurgical area, the usage of epithesis during the social life were evaluated. Results: There were 7 female and 3 male patients. The mean age was 34 (5-75) years. The indications for enucleation or exenteration were: retinoblastoma (4 cases), malignant melanoma (2 cases), basal cell carcinoma (1 case), squamous cell carcinoma (1 case), rhabdomyosarcoma (1 case) and sinoorbital mucormycosis (1 case). The epitheses were applied 3 to 156 months (mean 51 months) following the intervention. All of the implantations were performed successfully. During follow-up, one case had lost the implant and one case had local infection that responded to antibiotic treatment. Three cases were reoperated and the implants were replaced after a 2-year follow-up time due to the deterioration of the magnetic effect of the implants. Conclusion: Bony integrated orbital implants have an important role in solution of esthetic problems encountered in the exenterated orbit and severe contracted socket. (Turk J Ophthalmol 2014; 44: 127-31

Evaluation of Ocular Surface Health in Patients with Obstructive Sleep Apnea Syndrome

Objectives: To evaluate ocular surface health in obstructive sleep apnea syndrome (OSAS) and to investigate the tendency of these patients toward dry eyes. Materials and Methods: Fifty patients who underwent polysomnography and were diagnosed with OSAS and 50 normal control subjects were compared with respect to ocular surface disease index (OSDI), Schirmer I test and tear film break-up time (TBUT) values. Results: Patients were grouped as mild (n=15, 30%), moderate (n=15, 30%) and severe (n=20, 40%) according to apnea-hypopnea index values. The right eyes of patients were included in both groups. OSDI values were as follows: control group, 18.7±8.5; mild OSAS group, 40.2±2.8; moderate OSAS group, 48.5±2.2 and severe OSAS group, 62.7±2.3 (p<0.001). TBUT values were as follows: control group, 12.3±4.9; mild OSAS group, 8.2±4.7; moderate OSAS group, 5.8±2.1 and severe OSAS group, 4.2±3.7 (p<0.001). Schirmer values were as follows: control group, 18±6.1 mm; mild OSAS group, 12.9±6.7 mm; moderate OSAS group, 8.5±5.2 mm and severe OSAS group, 7.9±4.7 mm (p<0.001). Conclusion: Patients with OSAS seem to have a tendency toward dry eyes. Clinicians should be aware of dry eye development in these patient