Histopathologic Distribution of Eyelid and Periocular Region Tumors

Amaç: Kırıkkale ili ve çevresinde biyopsi alınarak histopatolojik değerlendirmesi yapılan göz kapağı ve perioküler bölge tümörlerinin epidemiyolojisinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: 2008-2016 yılları arasında 217 hastaya ait 239 lezyonun histopatolojik tanısı, yerleşim yeri ve lateralizasyonu geriye dönük olarak taranmış ve sınıflandırılmıştır. Hastalara ait demografik bilgiler derlenmiştir. Bulgular: 217 hastanın 104' ü erkek (%47.9), 113'ü kadın (%52.1) idi. Hastaların Yaş ortalaması 46.0±2.04 olarak bulundu.Lezyonların 117'si sağ (%48.9) 122'si (%51.1) sol tarafta yerleşmiş idi. Olguların 99'u alt kapaktan (%41.4), 120'si üst kapaktan (%50.2), 17'si (%7.1) medial kantus 3'ü (%1.3) ise dış kantusta idi. 239 olgunun %36.8'i epitelyal tümör (n=88), %5.8'i adneksiyal (n=14), % 3.8'i vasküler (n=9), %5'i ksantomatöz (n=12), %15.8 pigmente - melanositik (n=38), %21.3 inflamatuvar veya enfeksiyöz (n=51) , %11.2 u ise malign (n=27) olarak dağılım göstermekteydi. Sonuç: Yaklaşık olarak yapılan her 10 biyopsiden birinin malignite tanısı aldığı görülmektedir. Bir kısım literatür ile uyumlu olan sonuçlarımızın bazıları ile ise farklılık göstermesinin çevresel faktörlerden kaynaklanabileceği düşünülmüştürAim: The aim of the study was to explore the distribution of eyelid and periocular mass lesions in kırıkkale , Middle Anatolia, Turkey, from a histopathological point of view.Methods: Two hundred and thirty nine lesions in 217 patients were classified according to their diagnosis, location and lateralization who admitted between 2008-2016. Demographic data were also reviewed.Results: One hundred and four (47.9%) were female and 113 (52.1%) were female patients. Mean age was 46.0 ±2.04 years. One hundred seventeen (%48.9) of the lesions were on the right side and 122 (%51.1) were on the left. Ninety nine lesions were located at lower eyelid (%41.4) 120 at upper eyelid, 17 (%7.1) at medial canthus (%5.6), 3 (%1.3) at lateral canthus. Two hundred twelve (%88.70) of the lesions were benign. Of these, %36.8 were epithelial (n=88), % 5.85 adnexial (n=14), % 3.7 vascular (n=9), %5 xanthomatous (n=12), %15.9 pigmentary (n=38), and %21.3 inflammatory (n=51) in nature. The rest 27 (%11.29) lesions were malign. Conclusions: Approximately one of every 10 biopsies is diagnosed as malignancy. Some of our results were consistent with literature. We think that inconsistencies were based on as a results of regional difference

Purtscher-Like Retinopathy Associated with Synthetic Cannabinoid (Bonzai) Use

Purtscher’s retinopathy is a microvascular occlusive disease initially described as retinal edema, cotton wool-like exudation, and hemorrhages occurring after severe head trauma. A similar clinical presentation called Purtscher-like retinopathy is associated with systemic diseases instead of trauma. In the present case, ophthalmic eksamination of a patient with complaints of blurred vision related to substance (Bonzai) use revealed bilateral cotton-wool spots. Purtscher-like retinopathy was diagnosed based on fluorescein angiography and optical coherence tomography findings. This is the first case of Purtscher-like retinopathy associated with Bonzai use described in the literature

The Effects of Intravitreal Dexamethasone Implant (Ozurdex®) on Intraocular Pressure and Anterior Chamber Angle

Amaç: İntravitreal deksametazon enjeksiyonunun göz içi basıncı (GİB) ve ön kamara açısı (ÖKA) üzerine etkisini incelemek. Gereç ve Yöntem: Otuz sekiz hastanın 40 gözü incelendi. Hastaların yaş ortalaması 61.39 yıl (aralık: 36-83) olup, %63.2’i kadın, %36.8’i erkekti. %70'i retina ven tıkanıklığı, %20’i diabet, %7.5‘i arka üveit ve %2.5’i psödofakik makula ödemi olgusuydu. GİB Goldmann ap- lanasyon tonometresi ile ölçüldü. GİB ve gonyoskopik muayene enjeksiyondan önce ve enjeksiyondan sonra 1.hafta, 1. 3. ve 6. aylarda ölçüldü. Spektral domain optik koherans tomografi (OKT) enjeksiyon öncesi ve sonrası 1. ay, 3. ay ve 6. ay da üst, nazal, alt, temporal kad- ranlardan alındı. OKT ile ön kamara açı derecesi (ÖKA), trabeküler iris yüzey alanı (TIYA500) ve açı açılma mesafesi (AAM500) ölçüldü. Bulgular: Enjeksiyon yapılan gözlerin GİB'ı enjeksiyon öncesi, enjeksiyon sonrası 1. hafta, 1. ve 3. aylardakine göre anlamlı düşük sap- tandı (sırasıyla p= 0.004, p= 0.002, p= 0.003). Enjeksiyon sonrası 6. ay ile enjeksiyon öncesi arasında ortalama GİB değerleri açısından anlamlı fark izlenmedi. Nazal kadranda enjeksiyon öncesi ve sonrası 1. haftadaki gonyoskopik derece, enjeksiyon sonrası 3. ve 6. aylara göre anlamlı yüksek saptandı (p= 0.007, p= 0,006; p= 0.008, p= 0,008). Gonyoskopide diğer kadranlarda anlamlı fark saptanmadı. Nazal kadranda OKT-ÖKA'nın enjeksiyon sonrası 3. ve 6. aydaki değerleri, enjeksiyon öncesi ve sonrası 1. aya göre anlamlı dar saptandı (p= 0.008, p= 0,008; p= 0.009, p= 0,008). Üst kadranda göz kapağı güvenilir ölçüm alınmasına engel olmuştur. Uygulama yapılan gözlerin alt kadran 3. ve 6. aylardaki OKT-AAM500 ve TİYA500 sonucu enjeksiyon öncesinden anlamlı olarak düşük saptanmıştır (p= 0.002, p= 0.004; p= 0.005, p= 0.001). Sonuç: İntravitreal deksametazon enjeksiyonu sonrası göz içi basıncı artabilir fakat çoğu olguda medikal tedaviyle kontrol altına alınabilir. Enjeksiyon sonrası gonyoskopide ve OKT’de bazı kadranlarda ön kamara açısında daralma olabilir.Purpose: To investigate the effects of intravitreal dexamethasone injection on intraocular pressure (IOP) and anterior chamber angle (ACA). Materials and Methods: Forty eyes of 38 patients were studied. The mean age of the patients was 61.39 years (range: 36-83), 63.2% female and 36.8% male. 70% were retinal vein occlusion, 20% were diabetic, 7.5% were posterior uveitis and 2.5% were pseudophakic macular edema. IOP was measured by Goldman applanation tonometry. IOP and gonioscopic examination were performed before and after injection on the 1st week 1st, 3rd, and 6th months. Spectral domain optic coherence tomography (OCT) was performed on the superior, nasal, inferior, temporal quadrants before and after injection on the 1st, 3rd, and 6th months. Anterior chamber angle (ACA), trabecular iris surface area (TISA500) and angle opening distance (AOD500) were measured by OCT

Diyabetik retinopatili gözlerde katarakt ameliyatı sonunda ön kamaraya deksametazon verilmesinin makula ödemi üzerine etkisi

Tez (Tıpta Uzmanlık) -- Kırıkkale Üniversitesi78479

Effect of intracameral dexamethasone on diabetic macular edema injected at the end of cataract surgery in eyes with diabetic retinopathy

YÖK Tez ID: 271808Amaç: Diyabetik retinopatili hastalarda, katarakt ameliyatı sonunda ön kamaraya verilen deksametazonun maküla ödemi üzerine muhtemel etkilerinin araştırılması amaçlanmıştır.Gereç ve yöntem: Çalışmaya diyabetik retinopatisi ve kataraktı olan 30 hasta dahil edildi. Bütün hastalara katarakt operasyonu öncesinde en iyi düzeltilmiş görme keskinlikleri, slit lambasıyla biyomikroskopik ön segment değerlendirmesi, Goldmann üç aynalı lensi ile fundus muayeneleri ve Goldmann aplanasyon tonometresi ile göz içi basınç ölçümlerinden oluşan tam bir oftalmolojik muayenenin ardından maküla ödeminin değerlendirilmesi amacıyla fundus floresein anjiografi (FFA) çekildi. Katarakt operasyonunun sonunda hastalara kesi yerinden 0.1 cc deksametazon verildi. Hastalar birinci ay sonunda düzeltilmiş en iyi görme keskinliği, göziçi basıncı ölçümü ve floresein anjiyografi ile değerlendirildi.Bulgular: Çalışmaya yaşları 52-87 arasında değişen ve diabetik makula ödemi olan 18 (% 64,3) kadın ile 10 (% 35,7) erkek hastanın 31 gözü dahil edildi. Hastaların tamamında tip 2 diabet mevcuttu. Olguların ortalama yaşı 65.25±8.57 olup gözlerden 16 (% 25.8)'sında diffüz, 8 (% 25.8)'inde kistoid, 7 (% 22.6)'sinde hem diffüz hemde kistoid makula ödemi mevcuttu. Tüm hastalaların 19 (%61.3)' unda postoperatif makula ödemi aynı kalırken, 12 (%38.7)'inde mevcut durumda bir azalma sözkonusuydu. Operasyon öncesi düzeltilmiş görme keskinliği 0,10±0.11 olup, operasyon sonrası 1.ay görme keskinliği 0,2±0,22 düzeylerindeydi. Postoperatif görme artışı istatistiksel olarak anlamlı bulundu (p?0.001).Sonuç: Diabetik makula ödemi ve kataraktı olan gözlerde katarakt ameliyatı sonunda intrakameral deksametazon uygulamasının, cerrahinin makula ödemine etkisini azalttığı görülmektedir.Purpose: To evaluate the effect of intracameral dexamethasone on diabetic macular edema injected at the end of cataract surgery in patients with diabetic retinopathy.Materials and methods: Thirty patients with diabetic retinopathy and cataract were included in this study. All patients underwent a complete ophthalmic examination which consisted best-corrected visual acuity, anterior segment evaluation with slit lamp microscopy, fundus examination with Goldmann three mirror lens, intraocular pressure measurement with applanation tonometry before cataract surgery. Fundus fluorescein angiography (FFA) was taken following each ocular examination. At the end of cataract surgery 0,1 cc dexamethasone was given intracamerally from the cataract incision. Each patient was reevaluated with best corrected visual acuity, intraocular pressure measurement and FFA at fourth weeks?s visit.Results: 31 eye of 18(% 64,3) womens and 10 (% 35,7) mans who ages ranging from 52 to 87 were enrolled in this study. All of patients had type 2 diabetes. Mean age of the paients was 65.25±8.57 and 16 (% 25.8) eyes had diffuse diabetic macular edema, 8(% 25.8) eyes had cystoid macular edema and 7(% 22.6) eyes had both diffuse diabetic macular edema and cystoid diabetic macular edema. Macular edema did not change in 19(%61.3) eyes and decreased in 12 (%38.7) eyes. The mean corrected visual acuity was preoperatively 0,10±0.11, postoperatively 0,2±0,22 at first month. Postoperative increase in visual acuity was found statistically significant (P<0,001).Conclusion: Intracameral dexamethasone injection appears to be effective in reducing the effect of surgery on diabetic macular edema in eyes with diabetic retinopathy and catarac

Comparison of 25 Gauge Transconjunctival (Sutureless) Vitrectomy and Classical Sutured Vitrectomy Surgical Systems in the Surgical Treatment of Vitreoretinal Diseases

In the 20 Gauge vitrectomy system, which is one of the modern vitreous surgery techniques in use today, sclerotomies entered into the eye must be closed with sutures at the end of the operation. The use of sutureless incision technique in phacoemulsification surgery has shortened the surgical trauma and operation time. With the same thought, a 25 Gauge transconjunctival vitrectomy system has been developed for sutureless vitrectomy surgery. With our prospective study, we aim to create a more appropriate treatment methodology in the surgical treatment of vitreoretinal diseases by comparing 25 Gauge transconjunctival (sutureless) vitrectomy and classical sutured vitrectomy surgical systems in terms of patient comfort, complication rates, length of hospital stay, and efficacy-cost. Within the scope of the research, 20 or 25 Gauge pars plana vitrectomy system will be applied to patients who apply to Kırıkkale University Faculty of Medicine, Department of Ophthalmology with vitreoretinal pathologies such as vitreous hemorrhage, macular epiretinal membrane, macular hole, vitreomacular traction syndrome, endophthalmitis, dislocation of lens fragments to the vitreous. Those using 20 G systems will be called group 1, and those using 25 G systems will be called group 2. A total of 50 patients, 25 patients in each group, will be included in the study. The patients to be included in group 1 and group 2 will be randomly selected, and the randomization will be made on the randomr.org website. Groups will be formed from consecutive cases matched for age and sex. The research will last 12 months

Are The Patients Who Use Antiglaucomatous Therapy Really Glaucoma Patient?

Amaç: Glokom olmadığı halde glokom tanısı konularak yıllardır göz tansiyonu damlası kullanmak zorunda kalan hastalara nasıl tanı konduğu, hangi ilaçları kaç yıl süreyle kullandığı ve bu ilaçların hasta üzerinde olan etkileri araştırıldı.Gereç ve Yöntemler: Çalışma retrospektif olarak kullandığı glokom ilacını tekrar reçete etmeye ya da raporu bittiği için raporunu yenilemeye gelen hastalar ile glokomu olduğunu söyleyip kontrole gelen hastalar arasında yapıldı. Tüm hastalar glokomu olmayan, oküler hipertansiyonu olan ve gerçekten glokomu olan hastalar olarak 3 guruba ayrıldı. Bu hastalara rutin göz muayenesinden sonra santral kornea kalınlığı(SKK) ölçümleri, görme alanı testi ve sinir lifi analizleri yapıldı. Muayene sonrası hastalara hangi ilaçları kaç yıldır kullandıkları, yöntemler tarif edilerek hangi yöntemle göz içi basıncı (GİB) ölçüldüğü, SKK'nın ölçülüp ölçülmediği, daha önce görme alanı testi ve düzenli kontrol yaptırıp yaptırmadıkları soruldu. Hastalardan ilaçlarını kesmeleri istenerek 2 hafta sonra GİB takibine çağrıldı.Bulgular: Tüm hastalar değerlendirildiğinde hastaların yalnız %7.1'inde (8/113) gerçekten glokom mevcuttu. Hastaların ilaç kullanım süreleri ortalama 3.84±1.24 yıldı. Hastaların ortalama SKK sağlıklı gurupta 583.51±27.55 ?, oküler hipertansiyonu olan gurupta 558.12±36.80 ?ve glokomu olan hastalarda 552±23.10? idi. Hastaların yalnız 12'si(%10.6) daha önce tansiyonlarının aplanasyon tonometrisi ile ölçüldüğünü ifade etti, geri kalan tamamında ölçümler non-kontak tonometri ile yapılmıştı. Sonuç: Günlük uygulamada glokomun yanlış teşhisi yaygın bir konudur, glokom hastaları glokom kriterleri açıkça karşılanmadığında yeniden değerlendirilmelidirPurpose: We investigated that how glaucoma diagnosis was made, which drops were prescribed and the effects of these drugs on patients who were misdiagnosed as having glaucoma and have been using drops for years. Materials and Methods: The study was conducted retrospectively among the patients either those admitted for prescription of their antiglaucoma drops or to update their drop reports and the patients who came for glaucoma control. All patients were divided into 3 groups as non-glaucoma, ocular hypertension, and truly glaucoma patients. After routine eye examinations central corneal thickness (CCT) measurements, visual fi eld test and nerve fi ber analyzes were performed. The patients were questioned for the drops and duration they used, the methods used for intraocular pressure (IOP) measurement, whether CCT was measured or not, whether they had been subjected to visual fi eld testing and regular controls. Patients were asked to interrupt their medication and instructed to come 2 weeks later for IOP follow-up.Results: The glaucoma diagnosis was confi rmed in only 7.1% (8/113) of all the patients. Mean duration of medication use was 3.84 ± 1.24 years. The mean CCT of the patients was 583.51? ± 27.55 in the healthy group, 558.12? ± 36.80 in the group with ocular hypertension and 552? ± 23.10 in the patients with glaucoma. Only 12 (10.6%) of the patients stated that their IOP was measured by applanation tonometry, while the rest were measured with non-contact tonometry. Conclusion: Misdiagnosis of glaucoma seems to be a common issue in daily practice and glaucoma patients should be re-evaluated especially when the glaucoma criteria are not met clearl

Intravitreal Bevacizumab for Diabetic Papillopathy

WOS: 000276990000014PubMed: 20334555A 43-year-old woman presented with a visual acuity of 1/10 in the right eye and 3/10 in the left eye. Ophthalmologic examination disclosed optic disc swelling on both sides with mild nonproliferative diabetic retinopathy. The pupils were equal and reactive without an afferent pupillary defect. Visual field testing showed no significant defect in both eyes. Systemic investigations revealed no abnormality. The patient was injected with bevacizumab intravitreally with the diagnosis of diabetic papillopathy (DP). Three weeks later, the vision increased to 7/10 in the right eye and optic disc edema disappeared. Intravitreal injection of bevacizumab effectively treated DP

0.1% Nepafenac reduces pain and increases patient comfort during cataract surgery

WOS: 000443453300009PubMed: 29807771Purpose: To evaluates analgesic effectiveness of 0.1% nepafenac during cataract surgery. Methods: This prospective randomized randomized double-masked, placebo-controlled study comprised 80 eyes of 40 consecutive patients who underwent bilateral cataract surgery and implantation of foldable intraocular lens with topical anesthesia with and without topical nepafenac drops. Each eye of patients was assigned to group 1 and group 2. Topical anesthesia combined with 0.1% nepafenac used three times a day the day before the surgery and once half an hour just before the surgery was group 1, consisting of 40 eyes, and topical anesthesia with using placebo was group 2 consisting of 40 eyes. Patients were asked to score their pain using a visual analog scale (VAS) and verbal pain scale (VPS) immediately following the surgery. When the patient moved or squeeze the eye during surgery, the surgical comfort was evaluated as bad and otherwise, it was evaluated as good. Results: When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild or no pain in group 1 was %825 and in group 2 was %45. Mean VAS pain score and mean VPS pain score in group 1 was significantly lower than that in group 2(p = 0.024, p < 0.001). Surgical comfort in group 1 was %825 and in group 2%65(P = 0.075). Conclusion: 0.1% nepafenac reduces pain of patients who undergone routine clear corneal phacoemulsification with topical anesthesia and may increase patient comfort during the surgery when used preoperatively

Endophthalmitis after tooth extraction in a patient with previous perforating eye injury

WOS: 000376481700003PubMed: 26090030The aim of this stuty is to describe a case of endophthalmitis after tooth extraction in a patient with previous perforating eye injury. 50 years old male patient attempted to our clinic with complaints of sudden severe pain, reduced vision, light sensitivity and redness in the right eye. The patient stated that severe pain in his eye began approximately 12 hours following tooth extraction. The patient's ocular examination revealed a visual acuity of hand motion in the right eye. Anterior segment examination of the right eye showed intense conjunctival hyperemia, chemosis, a fine keraticprespitat and corneal edema. Dental procedures of the patients who had recently underwent ocular surgery or trauma should be done in a more controlled manner under anti -infective therapy or should be postponed in elective procedures