YKL-40 is a local marker for inflammation in patients with pseudoexfoliation syndrome

Purpose: To investigate the YKL-40, as a marker of inflammation, in aqueous humor and serum of cataract patients with and without pseudoexfoliation syndrome (PEX). Methods: Aqueous humor and serum samples were obtained from 44 patients who underwent phacoemulsification surgery. All patients were divided into two groups: PEX (n = 24) and control (n = 20). YKL-40 levels were measured with enzyme-linked immunosorbent assay (ELISA). The differences between the groups were assessed by using Chi-square and independent sample t-tests. The Pearson correlation coefficient was used to evaluate the correlation between variables. Results: There was a significant difference between the mean YKL-40 levels in the aqueous humor of PEX group (112.0 ± 35.8 ng/mL) and control subjects (88.2 ± 30.6 ng/mL) (P = 0.025). However, the difference between the mean YKL-40 levels in the serum of PEX group (53.5 ± 29.1 ng/mL) and control subjects (44.6 ± 30.2 ng/mL) was non-significant (P = 0.326). The correlation between aqueous humor and serum YKL-40 concentrations was significant in both the groups (r = 0.833, P < 0.001; r = 0.840, P < 0.001, respectively). Conclusions: Increased aqueous humor levels of YKL-40 demonstrate that it is local, but not a systemic marker for inflammation in patients with PEX. © 2018, The Royal College of Ophthalmologists

Current roles of artificial intelligence in ophthalmology

Artificial intelligence (AI) studies are increasingly reporting successful results in the diagnosis and prognosis prediction of ophthalmological diseases as well as systemic disorders. The goal of this review is to detail how AI can be utilized in making diagnostic predictions to enhance the clinical setting. It is crucial to keep improving methods that emphasize clarity in AI models. This makes it possible to evaluate the information obtained from ocular imaging and easily incorporate it into therapeutic decision-making procedures. This will contribute to the wider acceptance and adoption of AI-based ocular imaging in healthcare settings combining advanced machine learning and deep learning techniques with new developments. Multiple studies were reviewed and evaluated, including AI-based algorithms, retinal images, fundus and optic nerve head (ONH) photographs, and extensive expert reviews. In these studies, carried out in various countries and laboratories of the world, it is seen those complex diagnoses, which can be detected systemic diseases from ophthalmological images, can be made much faster and with higher predictability, accuracy, sensitivity, and specificity, in addition to ophthalmological diseases, by comparing large numbers of images and teaching them to the computer. It is now clear that it can be taken advantage of AI to achieve diagnostic certainty. Collaboration between the fields of medicine and engineering foresees promising advances in improving the predictive accuracy and precision of future medical diagnoses achieved by training machines with this information. However, it is important to keep in mind that each new development requires new additions or updates to various social, psychological, ethical, and legal regulations

The congress held in Brussels in 1902 "amelioration of the life standards of the blinds" and the evaluation of an ophthalmologist attended from Istanbul

Körlerin eğitimi ve öğretimiyle ilgili çabalar 18. yüzyıl sonlarına doğru başlamıştır. Bu sosyal sorunun çözümü için harcanan çabaların önemli bir aşaması 1902 yılında Brüksel’de yapılan “Körlerin Durumlarının Düzeltilmesi Kongresi” dir. Adı geçen kongrede tartışılan konular, Osmanlı Devleti delegesi Dr.Esat Bey tarafından Servet-i Fünun dergisinin 11 Eylül 1329 (miladi 24 Eylül 1903) tarihli, 648 numaralı nüshasında yayınlanmıştır. Bu kongrede yedi ana konu tartışılmıştır. Esat Bey, adı geçen dergide kongre tartışma konularının ayrıntılarının yanında körlerin eğitimiyle ilgili resimleri de sunmuştur. Kongredeki bir sorunun cevabı olarak, İstanbul’da icra ettiği dokuz yıllık göz hekimliği sonucunda, 30 bin hasta üzerinde düzenlediği istatistiği ve kişisel deneyimleriyle görüşlerini ayrıntılarıyla vermiştir. Bu kongreden çıkan sonuçlara dayanarak, Türkiye’deki Körlerin eğitim ve öğretimiyle ilgili çabalar başlatılmıştır. Kongre, Darülaceze’de bir şube kurulması halinde, uygun şartlarda, Belçika Körler Okulundan bir öğretmenin gönderileceğini vaad etmiştir. Esat Bey, bu kongrenin sonuç bildirgesiyle beraber hazırladığı geniş raporu, körler için bir eğitim okulu açılması gereğini, gerekçeleriyle beraber devlet hiyerarşisi kanalıyla Sultan II. Abdülhamit’e arz etmiştir. Yıllar içinde, Darülacezede körlere yönelik bir şube açılması sağlanmış, Acıbadem semtinde körler ile sağır ve dilsizlerin eğitimine yönelik bir okulun inşası için geniş bir arsa tahsis edilmiş, ancak, padişahın tahttan indirilmesi, seferberlik ve ardı ardına gelen savaşlar nedeniyle bu girişimler sonuçsuz kalmıştır. Bu çalışmada, kongre ayrıntıları Osmanlıca’dan Türkçeye aktarılmış, sadeleştirilerek paylaşılmıştır. Ayrıca, körlerin eğitimiyle ilgili gelişmelerin kısa tarihçesi sunulmuş, konu ayrıntıları verildikten sonra, bu kongrenin etkisiyle ülkemizde yapılan ilk girişimler tarihsel süreç içinde tartışılmıştır.The educational attempts for blinds started aproximately at the end of the 18th century. An important step of these attempts was &amp;#8220;The Congress for amelioration of the life standards of blinds&amp;#8221; that had been held in Brussels in 1902. The topics discussed in the above mentioned congress were published by Dr.Esat Bey, the representative of The Ottoman Empire, in the 11 September 1329 (24 September 1903) dated, no 648 offprint of the &amp;#8220;Servet-i F&uuml;nun&amp;#8221; magazine. Dr.Esat Bey also published some photographs about the education of blinds in the same newspaper. While responding to a question in the congress, he presented his personal experience and statistical results based on 30000 patients that he examined as an ophthalmologist in Istanbul in a duration of 9 years. The studies directed to the education of blinds were initiated after the experience obtained from this congress. The Commitee of the Congress accepted to send a teacher from the School for Blinds of Brussels if a branch should be opened in Dar&uuml;laceze. Dr.Esat Bey prepared a report including the results obtained from the Congress and had it presented to Sultan II.Abd&uuml;lhamit with the aim of creating a school for blinds. A school was opened in Dar&uuml;laceze and a land in Acıbadem was spared for the education of blinds, deaf and dumbs. But these could not be realized as the Sultan was taken down from throne and continuing wars. In this study the details about the congress were translated from Ottoman language to Turkish and presented after purification. A brief history about the beginning attempts of the education of the blinds and its development in Turkey with the effect of Brussels congress are discussed

High-Resolution Kinoform X-Ray Optics Printed via 405 nm 3D Laser Lithography

Efficient focusing of X-rays is essential for high-resolution X-ray microscopy. Diffractive X-ray optics called kinoforms offer the highest focusing efficiencies in theory. However, they have long remained unavailable due to their challenging nanofabrication. Recently, various X-ray optic geometries including kinoforms have been realized using 3D laser lithography at near-infrared wavelengths. As the smallest features (period) of the kinoform determines the resolving power, there is a natural drive to find ways to fabricate kinoforms with ever smaller features. Here, a custom-built 3D laser lithography setup with an excitation wavelength of 405 nm is used, which allows to half the smallest period of the kinoforms compared to previous work. A 40% improvement in scanning transmission X-ray microscopy image resolution, that is, a cutoff resolution of 145 nm, and an efficiency of 7.6% at 700 eV is achieved. A reconstructed pixel size of 18.5 nm, reaching the limit imposed by the design of the microscopy set-up, is demonstrated through ptychographic imaging of a magnetic sample which has a strongly reduced contrast mechanism. Moreover, X-ray lenses manufactured by 405 nm 3D laser lithography have the potential to become much less expensive than X-ray lenses made by other means

Anti-inflammatory and ultrastructural effects of Turkish propolis in a rat model of endotoxin-induced uveitis

Introduction. Experimental animal models of acute uveitis, an inflammatory eye disease, can be established via endotoxin-induced inflammation. Propolis, a natural substance collected by honeybees from buds and tree exudates, has antioxidant, antibacterial, antiviral, and anti-inflammatory effects. We investigated the effects of propolis, obtained from the Sakarya province of Turkey, on endotoxin-induced uveitis using immunohistochemical, ultrastructural, and biochemical approaches. Material and methods. Male Wistar albino rats (n = 6/group) received intraperitoneal (ip) lipopolysaccharide (LPS) endotoxin (150 μg/kg) followed by aqueous extract of propolis (50 mg/kg ip) or vehicle; two additional groups received either saline (control) or propolis only. After 24 h, aqueous humor (AH) was collected from both eyes of each animal for analysis of tumor necrosis factor-α (TNF-α) and hypoxia-inducible factor-1α (HIF-1α). Right eyeballs were paraffin-embedded for immunohistochemical staining of nuclear factor κB (NF-κB)/p65 and left eyeballs were araldite-embedded for ultrastructural analysis. Results. Treatment of LPS-induced uveitis with propolis significantly reduced ciliary body NF-κB/p65 immunoreactivity and AH levels of HIF-1α and TNF-α. Ultrastructural analysis showed fewer vacuoles and reduced mitochondrial degeneration in the retinal pigment epithelium, as compared to the uveitis group. The intercellular spaces of the inner nuclear layer and outer limiting membrane were comparable with those of the control group; no polymorphonuclear cells or stasis was observed in intravascular or extravascular spaces. Conclusions. This is the first report demonstrating an anti-inflammatory effect of Turkish propolis in a rat model of LPS-induced acute uveitis, suggesting a therapeutic potential of propolis for the treatment of inflammatory ophthalmic diseases

X-Ray Microscopy of Spin Wave Focusing using a Fresnel Zone Plate

Magnonics, i.e. the artificial manipulation of spin waves, is a flourishing field of research with many potential uses in data processing within reach. Apart from the technological applications the possibility to directly influence and observe these types of waves is of great interest for fundamental research. Guidance and steering of spin waves has been previously shown and lateral spin wave confinement has been achieved. However, true spin wave focusing with both lateral confinement and increase in amplitude has not been shown before. Here, we show for the first time spin wave focusing by realizing a Fresnel zone plate type lens. Using x-ray microscopy we are able to directly image the propagation of spin waves into the nanometer sized focal spot. Furthermore, we observe that the focal spot can be freely moved in a large area by small variations of the bias field. Thus, this type of lens provides a steerable intense nanometer sized spin wave source. Potentially, this could be used to selectively illuminate magnonic devices like nano oscillators with a steerable spin wave beam

Oculomotor Nerve Palsy and Vascular Causes: a Case Report

Seksen iki yaşındaki kadın hasta sağ göz kapağında düşüklük, çift görme ve göz hareketlerinde kısıtlılık şikayetleriyle kliniğimize başvurdu. Yapılan muayenede sağda pitozis ile birlikte içe, yukarı ve aşağı bakış kısıtlılığı görüldü. İki ay önce şikayetleri ortaya çıktığında başka bir merkezde yapılan muayenesinde bulgularımızdan farklı olarak anizokori (sağ>sol)saptanmıştı. Hipertansiyon tedavisi gören hastaya 3. sinir felci ön tanısıyla kranyal manyetikrezonans ve manyetik rezonans anjiyografi tetkikleri yapıldı. Sol mediyal oksipital lob ve para hipokampal girus kortekslerinde subakut dönemde sol posterior serebral arter infarktı ileuyumlu kortikal lezyon izlendi. Sağ internal karotid arterin tam tıkalı, sol vertebral ve posterior komünikan arterin hipoplazik olduğu görüldü. Bir ay sonra tüm belirti ve bulgular kendiliğinden düzeldiA 82 years old female patient admitted to our clinic with ptosis of the right eye, restriction of eye movements and double vision. In physical examination, with ptosis in the right eye, there were also movement restrictions to upward, downward and inward directions. Two months before when first symptoms appeared, in the medical centre that our patient admitted, there was also anisocoria (right&gt;left) that was not present in our physical examination. With possible diagnosis of third cranial nerve palsy, cranial MRI and MRI angiography procedures were performed for our patient taking antihypertensive medications. Lesions suitable for subacute infarction of left posterior cerebral artery watershed were seen in left medial occipital lobe and para hippocampal gyrus cortex. Right internal carotid artery was totally ocluded and left vertebral and posterior comminican artery were hypoplasic. After one month, all lesions were subsided spontaneously

Comparison of corneal endothelial changes after a single-dose ınjection of bevacizumab or ranibizumab

Amaç: Tek doz intravitreal bevacizumab veya intravitreal ranibizumab enjeksiyonu uygulanan olgularda kornea endotel değişikliklerini karşılaştırmak. Ge­reç ve Yön­tem: Kliniğimiz retina biriminde diyabetik maküla ödemi, yaşa bağlı maküla dejenerasyonu gibi nedenlerle 1,25 mg/0,05 ml intravitreal bevacizumab ya da 0,5 mg/0,05 ml ranibizumab enjeksiyonu yapılan herhangi bir kornea patolojisi olmayan 27 hastanın 27 gözü retrospektif olarak incelendi. Ondört hastanın 14 gözüne intravitreal ranibizumab, diğer 13 hastanın 13 gözüne ise intravitreal bevacizumab enjeksiyonu yapılmıştı. Enjeksiyon öncesi ve postoperatif 1. hafta ve 1. ayda görme keskinliği, mm2deki kornea endotel sayısı, göziçi basıncı, pakimetri ölçüm kayıtları incelendi. İstatistiksel analizlerde Mann-Whitney U ve Wilcoxon testleri kullanıldı. So­nuç­lar: Ortalama yaş 69,3±12,5 (44-85 yıl) idi. Bevacizumab ve ranibizumab gruplarında sırasıyla ortalama kornea endotel sayısı enjeksiyon öncesi 2358,1±487 ve 2348,9±598, enjeksiyon sonrası 1. haftada 2360,8±474,1 ve 2398,3±585,6, enjeksiyon sonrası 1. ayda ise 2315,1±465 ve 2407,4±585,6 idi. Enjeksiyon öncesi ile enjeksiyon sonrası 1. hafta ve 1. ay endotel sayılarındaki değişim her iki grupta da anlamlı bulunmadı (Sırasıyla 1. haftada p=0,953 ve p=0,59; 1. ayda p=0,26 ve p=0,555). Bevacizumab ve ranibizumab gruplarında sırasıyla ortalama merkezi kornea kalınlığı enjeksiyon öncesi 527,3±36,9 ve 544,1±55,5 ?m, enjeksiyon sonrası 1. haftada 529,2±49,9 ve 543,5±51,8 ?m, enjeksiyon sonrası 1. ayda ise 530,3±55 ve 543,9±46,4 ?m idi. Enjeksiyon öncesi ile enjeksiyon sonrası 1. hafta ve 1. ay merkezi kornea kalınlığındaki değişim her iki grupta da anlamlı bulunmadı (Sırasıyla 1. haftada p=0,515 ve p=0,838; 1. ayda p=0,678 ve p=0,444). Tar­t fl­ma: İntravitreal olarak tek doz uygulanan 1,25 mg/0,05 ml bevacizumab ya da 0,5 mg/0,05 ml ranibizumab uygulama sonrası 1. hafta ve 1. ayda kornea endotel sayısında anlamlı bir değişikliğe neden olmamaktadır. (Turk J Ophthalmol 2013; 43: 391-4)Pur&shy;po&shy;se: To compare the corneal endothelial changes after injection of a single-dose intravitreal bevacizumab or intravitrearanibizumab. Ma&shy;te&shy;ri&shy;al and Met&shy;hod: In this retrospective study, we evaluated 27 eyes of 27 patients with either diabetic macular edema or senile macular degeneration, who underwent 1.25 mg/0.05 ml intravitreal bevacizumab or 0.5 mg/0.05 ml ranibizumab injection. None of the patients had corneal pathology. Fourteen eyes of 14 patients received intravitreal ranibizumab, other 13 eyes of 13 patients received intravitreal bevacizumab. We evaluated preoperative and postoperative 1st week and 1st month visual acuity, corneal endothelial count at mm2, intraocular pressure, and pachymetry results. For statistical analysis, Mann-Whitney U and Wilcoxon tests were used. Re&shy;sults: Mean age of the patients was 69.3&plusmn;12.5 (44-85 year). Average corneal endothelial cell count for bevacizumab and ranibizumab was preoperatively 2358.1&plusmn;487 and 2348.9&plusmn;598, postoperative 1. week 2360.8&plusmn;474.1 and 2398.3&plusmn;585.6, postoperative 1. month 2315.1&plusmn;465 and 2407.4&plusmn;585.6, respectively. Preoperative and postoperative corneal endothelial cell counts were not statistically significantly different in both groups (respectively, 1. week p=0.953 and p=0.59; 1. month p=0.26 and p=0.555). Average central macular thickness for bevacizumab and ranibizumab was preoperatively 527.3&plusmn;36.9 and 544.1&plusmn;55.5 &amp;#956;m, postoperative 1. week 529.2&plusmn;49.9 and 543.5&plusmn;51.8 &amp;#956;m, postoperative 1. month 530.3&plusmn;55 and 543.9&plusmn;46.6 &amp;#956;m, respectively. Preoperative and postoperative central macular thickness values for both groups were not statistically significantly different (respectively, 1. week P=0.515 and P=0.838; 1. month P=0.678 and P=0.444). Dis&shy;cus&shy;si&shy;on: Injection of a single dose of 1.25 mg/0.05 ml bevacizumab or 0.5 mg/0.05 ml ranibizumab does not affect the corneal endothelial cell count at 1. week and 1. month. (Turk J Ophthalmol 2013; 43: 391-4

The evaluation of the effect of pilocarpine induced accomodation on anterior chamber depth in pseudophakic eyes using magnetic resonance imaging

Amaç: Tek parçalı ve 3 parçalı hidrofobik akrilik göz içi lensi (GİL) implante edilmiş hastalarda, siklopentolat hidroklorür (HCI) ve pilokarpin HCI’nin ön kamera derinliğine (ÖKD) etkisinin karşılaştırılması. Gereç ve Yöntem: Komplikasyonsuz saydam kornea kesili fakoemülsifikasyon ve GİL implantasyonu yapılmış 19 hastanın 19 gözü değerlendirildi. Hastaların 9’una (grup 1) tek parçalı (AcrySof SA60AT, Alcon) ve 10’una da (grup 2) 3 parçalı (AcrySof MA60BM, Alcon) katlanabilir, hidrofobik akrilik GİL implante edilmişti. Hastaların opere edilen gözlerinin ÖKD’ leri üç gün arayla, sırasıyla pilokarpin HCI %2 ve siklopentolat HCI %1 damlatıldıktan sonra T2 ağırlıklı manyetik rezonans görüntüleri kullanılarak aksiyel ve sagittal planda hesaplandı. Cerrahi ile manyetik rezonans görüntüleme arasındaki ortalama süre grup 1’de 16,1, grup 2’de 13.7 aydı. Wilcoxin ve Mann-Whitney U testleri ile grup içi ve gruplar arası kıyaslamalar yapıldı. Bulgular: Pilokarpin HCI sonrası ortalama ÖKD, grup 1 de 3,67 ± 0,39 mm ve grup 2’de 4,06 ± 0,24 mm idi (p=0,35). Siklopentolat HCI sonrası ÖKD, grup 1’de 3,70±0,37 mm ve grup 2’de 4,01 ± 0,20 mm idi (p=0,53). Pilokarpin HCI ve siklopentolat HCI sonrası ÖKD arasındaki ortalama fark, grup 1 ve grup 2’de, sırasıyla 0,027±0,087 mm ve -0,045±0,10 mm idi (p>0,05). Sonuç: Fakoemülsifikasyon ve GİL implantasyonu sonrası uzun dönemde siklopentolat HCI ve pilokarpin HCI, tek parçalı ve üç parçalı hidrofobik akrilik GİL’de anlamlı bir aksiyel harekete neden olmamaktadır.Aim: To compare the effect of cyclopentolate hydrochloride (HCI) and pilocarpine HCI on anterior chamber depth (ACD) between single-piece and three-piece hydrophobic acrylic intraocular lens (IOL) after uneventful phacoemulsification using magnetic resonance imaging. Material and Method: Nineteen eyes of 19 patients who had uneventful sutureless clear corneal phacoemulsification with IOL implantation were included in the study. Nine eyes (group 1) had single-piece (AcrySof SA60AT, Alcon) and 10 eyes (group 2) had three-piece (AcrySof MA60BM, Alcon) foldable hydrophobic acrylic IOL. ACD was measured in the axial and sagittal T2 weighted magnetic resonance images after 2% pilocarpine HCI installation. Three days later, the same procedure was repeated after 1% cyclopentolate HCI installation. The average time interval between surgery and MR imaging was 16.1&plusmn;0.9 months in group 1 and 13.7&plusmn;0.8 months in group 2. Statistical analysis were performed with the Mann-Whitney U test between groups and the Wilcoxon signed rank test within them. Results: The average ACD after pilocarpine HCI instillation was 3.67&plusmn;0.39 mm and 4.06 &plusmn; 0.24 mm in group 1 and group 2, respectively (p=0.35). The average ACD after cyclopentolate HCI instillation was 3.70&plusmn;0.37 mm and 4.01&plusmn;0.20 mm in group 1 and group 2, respectively (p=0.53). The difference between the average ACD after pilocarpine HCI and cyclopentolate HCI instillations were 0.027&plusmn;0.087 mm and -0.045 &plusmn; 0.10 mm in group 1 and group 2, respectively (p&gt;0.05). Conclusion: Pilocarpine HCI and cyclopentolate HCI do not cause a significant axial shift on single-piece and three-piece hydrophobic acrylic IOL in the late period after phacoemulsification and IOL implantation