Topical Ophthalmic Cyclosporine in the Treatment of Toxic Epidermal Necrolysis

Aim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine. Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2 mm of symblepharon in the lower fornix as the sole pathologic finding. Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease

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

Intraocular lens haptic extruded from cornea

Beş ay önce ekstrakapsüler katarakt ekstraksiyonu olan 65 yaşındaki kadın hastada nadir görülen bir klinik durumu ra porlamaktayız. Hasta sağ gözünde yabancı cisim hissi ile başvurdu. Muayenede, sulkusa yerleştirilmiş tek parça polimetil metakrilat arka kamara lensinin haptiği kornea yara yerinden dışarı çıkmıştı. Arka kamara lens haptiğinin yara yerinden hereket etmesi katarakt cerrahisinin nadir bir komplikasyonudur. Cerrahın daha başka sorunla karşılaşmamak için lens yerleştirilmesi esnasında haptik pozisyonunu kontrol etmesi yararlı olacaktır.We report a rare clinical condition in a 65-year-old woman who had undergone an extracapular cataract extraction 5 months ago. The patient admitted with foreign body sensation in the right eye. On examination, one haptic of a single piece, poly methylmethacrylate posterior chamber intraocular lens (PC-IOL) fixated in the ciliary sulcus was protruding from the corneal surgical scar. Migration of PC-IOL haptic into the surgical wound is a very rare complication of cataract surgery. Surgeon should check for the positioning of the haptics during lens implantation to avoid further complications

Retinopathy of prematurity

Erken doğan retinopatisi (EDR) çocukluk çağının önde gelen ve önlenebilir körlük nedenlerindendir. Neovasküler ve proliferatif bir hastalık olan EDR erken doğum ve düşük doğum ağırlığına ek olarak oksjen tedavisi ile ilişkilendirilmektedir. Bu makalede EDR'nin insidansı; retina damarlarının gelişimi, EDR'nin histopatolojisi ve risk faktörleri; uluslararası EDR sınıflandırması; hastalığın taranması ile mevcut ve gelişen tedavi yöntemleri tartışılmıştır.Retinopathy of prematurity (ROP) is a leading and potentially avoidable cause of blindness in pediatric population. ROP is a retinal neovascular and proliferative disorder of premature infants associated with prematurity and low birth weight related with receiving oxygen therapy. In this article, we discuss the data of ROP incidence; the vascular development of the retina, the histopathology and risc factors of ROP; the international classification of ROP, screening of the disease, current and developing treatment strategies of ROP

Refractory cystoid macular oedema due to intraocular lens haptic perforating the iris

WOS: 000307881000015PubMed: 22420405Cystoid macular oedema is a well-known complication of cataract surgery associated with intraocular lens decentration or dislocation. A 55-year-old man, who had undergone a phacoemulsification and intraocular lens implantation surgery two months previously was referred because of reduced vision in the right eye. Ocular examination revealed that one of the haptics had perforated the iris at 6 o'clock. There was cystoid macular oedema of the right eye. A topical non-steroid anti-inflammatory drug, followed by intravitreal injections did not produce a significant regression. Finally, the haptic was repositioned surgically and the macular oedema dramatically resolved. Correct placement of the intraocular lens might avoid post-operative complications including cystoid macular oedema

Bilateral non-arteritic anterior ischemic optic neuropathy following second-trimester spontaneous abortion-related haemorrhage

WOS: 000309640500026PubMed: 22898194Bilateral anterior ischemic optic neuropathy is a rare complication of massive haemorrhage and related hypotension and anaemia in young individuals. We report a 34-year-old woman with bilateral non-arteritic ischemic optic neuropathy (NAION) after a massive spontaneous abortion-related haemorrhage who presented with sudden painless visual loss in her left eye. Visual acuity was 20/20 in the right eye with only hand motion discernible in the left eye. There was a left relative afferent papillary defect (RAPD). Fundus examination revealed bilateral swollen, hyperaemic optic discs and nerve fiber layer haemorrhages. Brain MRI and magnetic resonance venography were normal. The diagnosis of bilateral NAION was made and intravenous pulse corticosteroid therapy (1000 mg/day) was administered for three days. On the sixth clay, optic disc oedema regressed bilaterally and on the third week, the visual acuity improved to 20/80 in the left eye. The visual field showed only a small spared area in the nasal region, and persistent RAPD was present. After two months, fundus examination showed a small and crowded optic disc on the right and a pale optic disc on the left. Severe acute haemorrhage is an important risk factor for NAION in healthy young individuals. In addition to correction of hypotension and anaemia, intravenous high dose corticosteroid might be beneficial for treatment. (C) 2012 Elsevier Ltd. All rights reserved

Two rare forms of slit lacrimal canaliculus; self-inflicted and congenital

Lakrimal punktal veya kanaliküler yarık genellikle bikanaliküler silikon entübasyonunun bir komplikasyonu olarak görülür ve bunun dışında nadir karşılaşılır. Bu yazıda kendine zarar verme ve doğumsal gelişim anomalisine bağlı yarık kanalikülleri olan iki olgu sunulmakta ve ilgili literatür tartışılmaktadır. Yirmi beş yaşında psikotik bozukluğu olan erkek hasta, kesici cisimlerle her iki gözünde üst kanaliküllerde yarıklanma ve alt kanalikül tıkanıklığı, semblefaron ve restriktif myopati oluşturmuştu. Diğer hasta, 70 yaşında bir kadındı ve tüm kanaliküllerinde punktumdan medial kantüse değin uzanan bir mukozal açıklık vardı. Yarık kanalikül, belirgin anatomik deformite oluşturmasına karşın, her iki hastada da lakrimal yakınmalara neden olmamıştıLacrimal punctal or canalicular slitting is usually seen as a complication of bicanalicular silicon intubation and, except that, is rarely encountered. Here we report two cases of slit canaliculus due to self-inflicted trauma and congenital developmental anomaly and discuss the relevant literature. Twenty-five-year-old male patient with psychotic disorder presented with bilateral upper canalicular slitting and lower punctal stenosis as well as symblepharon and restrictive ocular myopathy due to self-mutilation with sharp objects. The other patient was a 70-year-old female who had a mucosal opening from the punctum to the medial canthus in all four canaliculi. Although slit canaliculus constitute a significant anatomic deformity, it did not cause lacrimal complaints in both patients

Retinal vasculitis following pars plana vitrectomy for retained lens material

WOS: 000285755000016PubMed: 20608945

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