A Rare Cause of Uveitis: Vemurafenib

A 25-year-old female presented with a decrease of vision and redness in both eyes. She had a history of nodular melanoma in her right shoulder, which was excised surgically and she was under oral vemurafenib treatment. She was diagnosed with moderately severe bilateral panuveitis and hospitalized for systemic investigation and workup. The laboratory test results were unremarkable and systemic workup failed to reveal an etiology. The condition was considered vemurafenib-induced uveitis, as the drug is known to be associated with uveitis. After reevaluation with the oncology department, vemurafenib was stopped and topical and systemic corticosteroid therapy was started. The uveitis resolved and her vision returned to normal. No sign of recurrence was detected at 8-month follow-up

Causes of Red Eye-Uveitis

Uveitis, being an important cause of ocular morbidity, must be taken into consideration in the differential diagnosis and the management of patients with red eye. Uveitis entities can demonstrate variable clinical features. Patients presenting with uveitis must undergo careful systemic evaluation for exact diagnosis and treatment. Studies for standardization of uveitis with variable clinical pictures are emerging. Acute anterior uveitis and panuveitis can cause red eye. The purpose of this current study is to summarize the clinical features and laboratory investigations that could help the differential diagnosis of acute anterior uveitis and panuveitis cases. (Turk J Ophthalmol 2012; 42: Supplement 57-6

Sigaranın görme alanı ve oküler kan akımı üzerine etkileri

TEZ5157Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2004.Kaynakça (s. 47-50) var.ix, 50 s. ; 30 cm.

Outcomes of Surgery for Posterior Polar Cataract Using Torsional Ultrasound

Purpose: The aim of this study is to report outcomes of surgery for posterior polar cataract using torsional ultrasound. Material and Method: Medical records of 26 eyes of 21 consecutive patients with posterior polar cataract who had cataract surgery using the torsional phacoemulsification were evaluated retrospectively. The surgical procedure used, phacoemulsification parameters, intraoperative complications, and postoperative visual outcome were recorded. Results: Of the 26 eyes, 24 (92.3%) had small to medium posterior polar opacity. Two eyes had large opacity. All surgeries were performed using the torsional handpiece. Posterior capsule rupture occurred in 4 (15.3%) eyes. The mean visual acuity improved significantly after surgery (p<0.001). The postoperative visual acuity was worse than 20/20 in 5 eyes. The cause of the low acuity was amblyopia. Discussion: Successful surgical results and good visual outcome can be achieved with phacoemulsification using the torsional handpiece. (Turk J Ophthalmol 2013; 43: 345-7

The effect of smoking on visual field and ocular blood flow

Amaç: Çalışmada sigara içiminin görme alanı ve oküler kan akımı üzerine etkilerini inceleme amaçlandı.Yöntem: Çalışma kapsamında benzer yaş ve cins dağılımlarına sahip 35 sigara içicisi ve sigara içmeyen 35 katılımcının oftalmik muayenelerini takiben Humphrey bilgisayarlı perimetre ile görme alanı ve renkli Doppler ultrasonografi ile oküler kan akımı incelendi. Verilerin istatistiksel analizi SPSS paket program 12. sürüm kullanılarak yapıldı. Sonuçlar: İki grup arasında yaş ve cinsiyet dağılımı yönünden istatistiksel olarak anlamlı fark yoktu. Görme alanı parametrelerinin gruplara göre dağılımı incelendiğinde, sigara içicilerinde ortalama retinal duyarlıkta azalama, ortalama pattern deviasyon ve pattern standart deviasyonda artma bulundu; sonuçlar istatistiksel olarak anlamlıydı. Parametrelerdeki değişimin sigara içme indeksi ile de anlamlı olduğu tespit edildi. Sigara içenlerde içmeyenlere göre, oftalmik arter pulsatilite indeksi ve posterior silier arter minimum ve ortalama akım hızlarında anlamlı derecede düşüş saptandı.Tartışma: Sigaranın görme alanını olumsuz etkilediği bulundu. Görme alanı testindeki duyarlık azalmasının sigaranın oküler kan akımı üzerindeki azaltıcı etkisinden çok, sigara içimi ile bozulan oksidan/antioksidan dengesi ve buna bağlı nörotoksisiteden kaynaklandığı düşünülmektedir.Purpose: The aim of this study was to investigate the effect of cigarette smoking on visual field and ocular blood flow. Methods: 35 smoking and 35 non-smoking participants were assessed. After ophthalmolo-gical examination, visual fields were evaluated with Humphrey automated static perimetry and coloured Doppler ultrasonography was performed for the measurement of ocular blood flow. SPSS ver. 12.0 was used to evaluate the statistical data. Results: Age and sex distribution of the two groups were not statistically different. In the smoking group, mean retinal sensitivity was found to be lower and mean pattern deviation and pattern standard deviation values were found to be higher than the non-smoking group; the differences were statistically significant. The changes in the parameters were significant with the smoking index. Pulsatility index of the ophthalmic artery and minimum and average flow velocities of the posterior ciliary artery were decreased in the smoking group, when compared with the non-smoking group. Correlation analysis between visual field parameters and blood flow parameters of ophthalmic, central retinal and posterior ciliary arteries was done.Discussion: Smoking was found to depress the visual field. This depression in the visual field is thought to depend on the neurotoxicity that is induced by the dispaired oxidant/antioxidant balance which is due to smoking, rather than the diminished blood flow

Polymicrobial Infection of the Cornea Due to Contact Lens Wear

A 38-year-old male presented with pain and redness in his left eye. He had a history of wearing contact lenses. His ophthalmic examination revealed a large corneal ulcer with surrounding infiltrate. Cultures were isolated from the contact lenses, lens solutions, storage cases, and conjunctivae of both eyes and also corneal scrapings of the left eye. Fortified vancomycin and amikacin drops were started hourly. Culture results of conjunctivae of each eye and left cornea were positive for Pseudomonas aeruginosa; cultures from the contact lenses, lens solution and storage case of both eyes revealed Pseudomonas aeruginosa and Alcaligenes xylosoxidans. Polymerase chain reaction of the corneal scraping was positive for Acanthameoba. The topical antibiotics were changed with ones that both bacteria were sensitive to and anti-amoebic therapy was added. The patient had two recurrences following initial presentation despite intensive therapy. Keratitis occurred due to multiple pathogens; the relapsing course despite adequate therapy is potentially associated with this polymicrobial etiology

A Rare Cause of Uveitis: Vemurafenib

Yirmi beş yaşında bir kadın hasta her iki gözde görmede azalma ve kızarıklık yakınması ile başvurdu. Sağ omzunda nodüler melanom nedeniyle ameliyat olma öyküsü vardı ve ağızdan vemurafenib tedavisi almaktaydı. Orta şiddette bilateral panüveit tanısıyla sistemik inceleme için hastaneye yatırıldı. Laboratuvar sonuçları ve sistemik değerlendirme ile nedene yönelik veri elde edilemedi. Vemurafenibe bağlı üveit olguları bildirilmiş olduğu için olay ilaca bağlı üveit olarak değerlendirildi. Hasta onkoloji bölümü ile değerlendirilerek vemurafenib kesildi, topikal ve sistemik kortikosteroid tedavisi başlandı. Üveit tablosu geriledi ve hastanın görme keskinliği normale döndü. Hastanın 8 aylık kontrolünde nüks saptanmadı.A 25-year-old female presented with a decrease of vision and redness in both eyes. She had a history of nodular melanoma in her right shoulder, which was excised surgically and she was under oral vemurafenib treatment. She was diagnosed with moderately severe bilateral panuveitis and hospitalized for systemic investigation and workup. The laboratory test results were unremarkable and systemic workup failed to reveal an etiology. The condition was considered vemurafenib-induced uveitis, as the drug is known to be associated with uveitis. After reevaluation with the oncology department, vemurafenib was stopped and topical and systemic corticosteroid therapy was started. The uveitis resolved and her vision returned to normal. No sign of recurrence was detected at 8-month follow-up

Bilateral Electrical Cataract: A Case Report

To present a rare complication, such as bilateral cataracts, in a man who sustained a high-voltage electrical injury. A 35- year-old man was admitted with a complaint of decrease in visual acuity. He had a history of a contact with a power line carrying 30.000 volts of electricity while working at a construction site. Examination at a burn center revealed second-degree facial, neck and left foot burns. One month later, the patient underwent amputation of fourth and fifth toes of his left foot. During the next 6 months, he noted decreasing vision in both eyes. Ocular examination 1 year after the accident revealed that the patient’s visual acuity had deteriorated to 1/10 in both eyes. The cornea on the left eye showed superficial punctate opacities. The lenses in both eyes had anterior subcapsular cortical lens opacities and posterior subcapsular opacities. Uncomplicated bilateral phacoemulsification surgery with intraocular lens implantation was performed and the patient’s visual acuity returned to 10/10 in both eyes. We noted that the fundus remained normal in both eyes. Electrical cataracts are still a serious potential complication that may occur after electrical injury. Awareness of this by burn team members is important for providing optimal treatment to those who have suffered an electrical injury. (Turk J Ophthalmol 2011; 41: 197-9

Familial Exudative Vitreoretinopathy

Ailevi eksudatif vitreoretinopati (AEVR), özellikle çocukluk çağında görme kaybına yol açan kalıtımsal bir hastalıktır. Hastalığa, NDP, FZD4, LRP5 ve TSPAN12 genlerinde mutasyonun neden olduğu gösterilmiştir. AEVR için X'e bağlı resesif, otozomal dominant ve otozomal resesif kalıtım bildirilmiştir. Bununla birlikte, hastalığın hem genotipik, hem de fenotipik özellikleri değişkenlik göstermektedir. Hastalığa neden olan yeni mutasyonlar da bildirilmektedir. Perifer retinanın avasküler olması, hastalığın ilk ve en belirgin bulgusudur. Hastalık ilerledikçe, genotipik özelliklere de bağlı olarak, retinada neovaskülarizayon, subretinal eksudasyon, kısmi veya total retina dekolmanı meydana gelir. Erken tanı ve lazer fotokoagülasyon ve anti-VEGF enjeksiyonlarını içeren dikkatli takip ile görme kaybı önlenebilir. Retina dekolmanı meydana geldiğinde pars plana vitrektomi, tek başına veya skleral çökertme ile birlikte uygulanır. Sessiz bulguları olan asemptomatik aile bireylerinin tespiti önemlidir. Floresein anjiyografi ile kombine geniş açı görüntüleme sistemleri önemli yarar sağlar. Ayırıcı tanıda Norrie hastalığı, premature retinopatisi ve Coat's hastalığı düşünülmelidirFamilial exudative vitreoretinopathy (FEVR) is a hereditary disease associated with visual loss, particularly in the pediatric group. Mutations in the NDP, FZD4, LRP5, and TSPAN12 genes have been shown to contribute to FEVR. FEVR has been reported to have X-linked recessive, autosomal dominant, and autosomal recessive inheritances. However, both the genotypic and phenotypic features are variable. Novel mutations contributing to the disease have been reported. The earliest and the most prominent finding of the disease is avascularity in the peripheral retina. As the disease progresses, retinal neovascularization, subretinal exudation, partial and total retinal detachment may occur, which may be associated with certain mutations. With early diagnosis and prompt management visual loss can be prevented with laser photocoagulation and anti-VEGF injections. In case of retinal detachment, pars plana vitrectomy alone or combined with scleral buckling should be considered. Identifying asymptomatic family members with various degrees of insidious findings is of certain importance. Wide-field imaging with fluorescein angiography is crucial in the management of this disease. The differential diagnosis includes other pediatric vitreoretinopathies such as Norrie disease, retinopathy of prematurity, and Coats’ diseas

Penetrating Needle Injury Associated With Retinal Tear

Yedi yaşında kız çocuğu 12 saat önce sol gözüne enjektör iğnesi batma öyküsü ile başvurdu. Aile, batan iğneyi kendilerinin çıkarttığını ifade ediyordu. Sol gözde görme keskinliği 7/10 düzeyindeydi. Ön segment muayenesinde üst temporalde limbusun 3mm gerisinde transkonjunktival giriş yeri, ön kamarada 3+ tindal mevcuttu; diğer ön segment yapıları doğaldı. Fundus muayenesinde vitreusta inflamatuar hücre, üst temporal kadranda, ekvatorun gerisinde retinada yırtık ve etrafında lokalize vitreus hemorajisi mevcuttu. Hastaya genel anestezi altında retinal yırtık çevresine indirekt lazer fotokoagulasyon, sklera penetrasyon tamiri, intravitreal antibiyotik ve steroid enjeksiyonu yapıldı. Takipte endoftalmi veya retina dekolmanı meydana gelmedi. Enjektör iğnesi nadir olmayan bir göz travması etkenidir ve olası ciddi komplikasyonların önlenebilmesi açısından dikkatli takibi gerekmektedirA seven-year old girl was admitted with a 12 hours history of penetrating ocular injury by syringe. The family told that they removed the syringe from the eye. Visual acuity in the lefte eye was 20/30. In the anterior segment examination, there was a transconjunctival needle entry at the upper temporal quadrant 3mm behind the limbus and 3+ tyndal in the anterior chamber; anterior segment was otherwise normal. In her fundus examination, inflammatory cells in the vitreous, a retinal tear at the upper temporal quadrant behind the equator, and adjacent vitreous hemorrhage was evident. The patient underwent indirect laser photocoagulation, scleral repair, and intravitreal injection of antibiotics and steroid under general anethesia. Endophthalmitis or retinal detachment did not ocur in follow-up. Syringes is not an uncommon cause of ocular trauma and must be promptly followed-up to prevent potential serious complication