Objectives: This study aimed to examine whether infants with and without eye patches differ in terms of vital signs and clinical status after retinopathy of prematurity examination. Methods: Premature infants hospitalized in study center between June 2021-April 2022 were included. Group 1 is consisted of infants whose eyes were not closed after retinopathy of prematurity examination. Those infants whose eyes were closed eye-patches consisted of group 2. Vital signs were followed for 24 hours following the examination. Demographic, medical and follow-up data were all recorded prospectively. Vital signs were evaluated in accordance with birth week and weight. Pain score was evaluated by Neonatal Pain, Agitation, and Sedation Scale. Results: Pain scores were found to be lower in group 2 (p < 0.020). Although the systolic blood pressure, diastolic blood pressure, and mean blood pressure values of group 2 were found to be lower than group 1, they were within normal limits (all p < 0.05). Vomiting was not observed at all in Group 1 (p = 0.036). There was no significant difference between the groups in terms of fever, respiratory rate, heart rate, SpO2, and blood glucose values. Conclusions: This study showed that using an eye patch in infants after an eye examination reduces pain and increases comfort of infants. Although their pain scores are lower, taking necessary precautions are recommended for these patients in terms of vomiting. Thus, eye patches can be suggested as a non-pharmacological pain-reducing method after get advanced stagnation by the support of more studies with a larger number of participants.

Objectives: This study was carried out to determine the traditional practices that women who have just given birth apply to their babies. Methods: The research is descriptive. The participants were recruited from women who had just given birth to 198 women in a maternity hospital. The data was collected through the personal information form. The chi-square test was used to plan the categorical data in detail as the mean of the research data, as numbers, and as percentages. p < 0.05 was accepted as meaning. Results: It was determined that traditional practices frequently used by women; The use of the yellow blanket against jaundice, swaddling so that the waist does not sink in, staying warm, being hard as steel, and having straight legs and the use of salt. It was determined that these practices were applied more by mothers who graduated from primary school. Although the frequency of use of applications such as burying the belly in the garden and throwing it in the water was found to be significant by age, it was determined to be used more in the group aged 31 and over. It has been determined that wearing evil eye beads is more common among mothers under the age of 25. Conclusions: In our study, it was observed that traditional practices were widely applied in the neonatal period. Newborn health should be supported by providing continuous midwifery care to women, education, and health checks.

Pachychoroid neovasculopathy (PNV) is a pachychoroid spectrum disease characterized by macular neovascularization (MNV), dilated outer choroidal vessels (pachyvessels), and/or increased choroidal thickness. In PNV cases, optical coherence tomography angiography (OCTA) can reveal MNV with high resolution. A 65-year-old male patient was admitted to our clinic with the complaint of decreased vision in the right eye. On dilated fundus examination, retinal pigment epithelium changes were present in the foveal and extrafoveal areas in both eyes. There was subretinal fluid in the fovea and irregular pigment epithelial detachment in the right eye. Subfoveal MNV was detected in 3 × 3 mm sections of OCTA. A non-exudative MNV was also detected in a larger 6 × 6 mm area imaged with OCTA. Simultaneous non-exudative quiescent MNV in the extrafo- veal region of the same eye can be observed. To avoid missing those cases, it is critical to perform OCTA imaging sections, including the extrafoveal areas.

This case aims to report a patient who presented with reduced vision in her left eye and was diagnosed with giant cell ar- teritis (GCA) associated with isolated cotton wool spots (CWS). An 82-year-old woman presented with reduced visual acuity of 20/200 in her left eye for a day. Fundus examination revealed only multiple peripapillary CWS in the left eye. She had an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). A preliminary diagnosis of temporal arteritis, intravenous high-dose steroid therapy, was administered for 3 days. Then, the systemic symptoms resolved, and her ESR and CRP dropped. Temporal artery biopsy confirmed the diagnosis of GCA. The next 2 months, in the fundus examination, CWS resolved completely. The patient continued using systemic steroids and subcutaneous methotrexate with long-term gradual reduction. This extreme case should raise awareness for clinicians in the etiological investigation of CWS to identify sight-threatening GCA and promptly initiate appropriate treatment.

The aim of the study was to report the results of phototherapeutic keratectomy (PTK) and toric contact lens fitting for a young man with recurrent gelatinous droplet dystrophy (GDD) after penetrating keratoplasty (PK). A 21-year-old man was referred for pain, photophobia, and decreased vision. The patient who experienced decreasing vision for 15 years had under- gone PK 2 years ago due to GDD. He was having frequent recurrent epithelial erosions lately. Visual acuity (VA) was counting fingers at 3 m in the right eye and 0.8 in the left eye. Biomicroscopic examiantion revealed nodular dystrophic lesions on the nasal side of the graft in the right eye. Keratometric values were K1: 54.5, K2: 52.5 in the right eye and K1: 41.2, K2: 39.7 in the left eye. PTK was performed twice in the right eye and once in the left eye in 3 years. Final VA was 0.5 and 0.8 in the right and left eyes, respectively (with glasses and toric contact lenses) during 10 years of follow-up. A superficial corneal scar was noted on the right graft and the left cornea. No recurrence of dystrophy was observed. PTK decreases photophobia and provides visual improvement in patients with GDD and may help defer PK in case of recurrent GDD.

Orbital rhabdomyosarcoma is the most common malignant orbital tumor of child-hood originating from mesenchymal cells. The presenting symptom is usually acute onset unilateral proptosis. The rapidly progressive course of the findings may resemble infectious and inflammatory orbital diseases. Radiological imaging and histopathological examinations are crucial for differential diagnosis. The main goal of treatment with a multidisciplinary approach is to control both local and distant spread of the tumor and to prevent further damage. With the introduction of chemotherapy and radiotherapy in the treatment, the overall survival rate has in-creased. Thus, aggressive surgical approach for complete removal of the tumor has been abandoned.

Purpose: Study aims to assess the effect of pure blepharoplasty on the eyebrow position in patients with Grade 1 lateral dermatochalasis causing cosmetic complaints. Methods: This retrospective study includes patients undergoing upper eyelid blepharoplasty between December 2019 and November 2021. Patients with prior eyebrow or eyelid surgery and neurotoxins treatment were excluded from the study. Photographs were investigated using NIH ImageJ program to measure eyebrow position from medial canthus, mid pupillary level, and lateral canthus measured before and 6 months after the operation. Results: The mean pre-operative distance between the pupillary light reflex and the lowest eyebrow hair was 16.95 mm, and the mean post-operative height was 16.79 mm. This difference was not statistically significant (P=0.29). The mean pre-opera- tive lateral canthus to the lowest eyebrow hair (LBH) was 17.75 mm, and the mean post-operative height was 17.60 mm. This difference was not statistically significant (P=0.18). The mean pre-operative medial canthus to the LBH was 18.72 mm, and the mean post-operative height was 18.59 mm. This difference was not statistically significant (P=0.24). Conclusion: The present study represents that the position of the eyebrow may not be influenced significantly following a blepharoplasty procedure among female patients with Grade 1 lateral dermatochalasis and coexisting cosmetic complaints.

Purpose: This study’s aim is to evaluate the presence of dry eye in patients who had cataract surgery in the past 3 months and compare the results with the patients’ healthy eyes. Methods: Twenty patients were enrolled and both eyes were examined. Two groups were established, Group 1 was made up of eyes that had cataract surgery in the past 3 months and Group 2 of eyes that had not undergone the intervention. Dry eye presence was tested with tear film break-up time, Schirmer-1 test, Oxford scale, and Ocular Surface Disease Index (OSDI) score assessments. Results: Median tear film break up-time measurement was lower and the difference was statistically significant (p=0.037). Median OSDI and Oxford scale scores were higher in Group 1 and median Schirmer 1 value was lower in Group 1; however, no statistically significant difference was detected (p=0.063, p=0.545, and p=0.825, respectively). Conclusion: Between eyes with prior cataract surgery and those without, there were significant differences in the results of dry eye tests. We advise ophthalmologists to be aware that cataract surgery can trigger the development of dryness of the ocular surface and when any pathology detected on ocular surface after the surgery, it should not be neglected to prevent more serious consequences and to maintain ocular surface homeostasis.

Purpose: The purpose of this study was to determine if eyes with unilateral pterygium are more likely to suffer from dry eye symptoms and more prone to have abnormalities in dry eye parameters than healthy eyes. Methods: Forty eyes of 20 patients were enrolled. The eyes that were diagnosed as having pterygium were considered as Group 1 and other healthy eyes of the same patients were defined as Group 2. The existence of dry eye was tested with tear film break-up time, Schirmer-1 test, Oxford scale, and Ocular Surface Disease Index (OSDI) score assessments. Results: Median tear film break-up-time measurement and Schirmer 1 value were lower in Group 1; however, no statistically significant difference was detected (p=0.06 and p=0.308, respectively). Median OSDI score and median Oxford scale score were higher in Group 1; however, no statistically significant difference was detected (p=0.05 and p=0.250, respectively). Conclusion: Between eyes with pterygium and healthy ones, there was difference in dry eye test results. These results may show that there might be a relationship between pterygium and dry eye disease regardless of the genetic background and environmental factors.

Purpose: The purpose of the study was to evaluate Ocular Response Analyzer (ORA) measurements and endothelial cell density (ECD) in patients who received intravitreal dexamethasone implant (Ozurdex®) injection for diabetic macular edema. Methods: Twenty-three eyes of 13 patients who receive intravitreal dexamethasone implant injection (Group 1) for diabetic macular edema and 33 eyes of 33 healthy individuals (Group 2) were included in the study. All participants underwent a complete ophthalmologic examination including intraocular pressure measurement with Goldmann applanation tonome- ter (IOP-GAT), ORA measurements, and specular microscopy. Results: The mean age of the patients was 65.43±8.20 (49–75) in Group 1 and 61.94±4.52 (56–71) in Group 2 (p=0.114). The mean IOP-GAT was significantly higher in Group 1 (18.22±3.41; range 12–28 mmHg) than in Group 2 (15.41±3.07; range 8–21 mmHg) (p=0.02). The mean ECD was 2632.4±209.6 (2232–3067) cell/mm 2 in Group 1 and 2567±206.37 (2140–2854) cell/mm2 in Group 2 (p=0.60). The mean corneal resistance factor (CRF) was 12.16±2.35 (7.4–15.3) mmHg in Group 1 and 10.18±1.83 (6.7–14.2) mmHg in Group 2 (p=0.02). Mean corneal hysteresis (CH) in Groups 1 and 2 was 8.87±2.45 (4.1–13.4) mmHg and 10.47±1.43 (6.9–13.2) mmHg, respectively (p=0.001). Mean corneal compensated IOP and Goldman correlated IOP (IOPg) were higher in Group 1 (24.72±7.12; range 12.1–36.4 mmHg and 23.21±7.01; range 14.2–36.2 mmHg) than in Group 2 (14.95±3.6; range 8.3–22.9 mmHg and 14.33±3.84; range 6.3–21.7 mmHg) (p<0.001). IOP-GAT was correlated with IOPg (p=0.01). Conclusion: Intravitreal Ozurdex® injection effects IOP, while it has no significant effect on ECD. Ozurdex® injections changed corneal biomechanical properties such as CH and CRF. Thus, ORA may be a useful to avoid underestimating the IOP and missing the alteration of elastic properties of the cornea.

Purpose: Incidence of diabetes mellitus (DM) increases rapidly in our country as well as around the world, posing a serious threat to public health. Diabetic retinopathy (DR) is the most common microvascular complication in patients with DM since microvascular damage secondary to chronic hyperglycemia starts affecting retina in the early stages of the disease. Our aim is to evaluate the real-life outcomes of intravitreal aflibercept monotherapy in treatment naive cases with diabetic macular edema (DME). Methods: This study was retrospective case–control study. Medical charts of 75 treatment naive cases with DME were re- viewed retrospectively. A total of 127 eyes that received intravitreal aflibercept monotherapy between January 2017 and December 2018 in our Retina Unit were enrolled. Demographics and the results of their initial and all follow-up ophthalmo- logic examinations as well as the number and frequency of intravitreal shots were noted for each participant. Chi-square, Mann–Whitney U, and Wilcoxon signed-rank tests were used for statistical analysis. Results: Of the total 75 patients with a mean age of 61.2±10.4 years, 38 (50.7%) were male. Mean follow-up period was 10.2±6.3 months. Mean baseline best-corrected visual acuity and central macular thickness scores were 56.8±19.9 ETDRS let- ters and 397.8±162.4 μm, whereas they were found as 67.9±16.9 ETDRS letters and 311.0±116.8 μm at the last visit (p<0.001 and p<0.001, respectively). Aflibercept monotherapy was found to provide better anatomic prognosis in eyes with serous macular detachment (p<0.001), and better anatomic as well as functional prognosis in eyes without any concomitant vitre- omacular interface disorders (p=0.037 and p=0.042, respectively). Conclusion: Intravitreal aflibercept monotherapy proves to be an effective and reliable treatment option in treatment-naive DME cases, even in those with marked optical coherence tomography biomarkers indicating poor outcomes.

Objectives: We aimed to evaluate the Magnetic Resonance Imaging (MRI) histogram texture analyzis of the optic nerve by comparing patients of isolated optic neuritis with a healthy control group and to provide objective information without using contrast in the diagnosis of the disease. Methods: A total of 40 patients, including 20 patients with isolated optic neuritis (13 females, 7 males) and 20 healthy controls (11 females, 9 males), were included in the study. Non-contrast brain MR images of the patient and control groups were analyzed retrospectively. In the coronal T2-weighted MRI sequence of both groups, the Region of Interest (ROI) was placed in the extraocular anterior 1/3 of the optic nerve of both eyes. Numerical data were obtained using histogram analysis and the data were evaluated in the MATLAB program. The data were compared statistically. In addition, sensitivity and specificity were determined by Receiver Operating Characteristic (ROC) curve analysis. Results: As a result of histogram analysis, a significant difference was found between the mean values in the healthy and affected eye of the patients with isolated optic neuritis and the mean values of the control group (p < 0.05). A significant difference was found in standard deviation, minimum, maximum, median, variance values between both groups. ROC analysis was performed for mean value, AUC = 0.943 and when threshold value was selected as 354.258 Haunsfield Unit, two groups could be differentiated with 84.2% of sensitivity and 92.1% of specificity. We can say that patients with isolated optic neuritis also have histological effects on the clinically asymptomatic eye. Conclusions: Histogram analysis can be used in the diagnosis of the patients with isolated optic neuritis without the need to use contrast in their MRI. In addition, histological effect can be detected in the eye that does not show clinical symptoms with histogram analysis.

Objectives: The aim of this study was to determine the efficacy of mineralocorticoids in the treatment of ocular inflammation, whose potential use has not been assessed. Methods: Thirty-five New Zealand albino rabbits were used in the study. Rabbits were divided into five groups. Only one eye was used for experimental purposes and the other eye was used as control. 11-deoxycortisol, deoxycorticosterone acetate, fludrocortisone acetate, aldosterone and 11-deoxycorticosterone were studied in a rabbit model of ocular inflammation. All animals in a group received the same corticosteroid. Paired t-tests and analysis of variance between subjects (ANOVA) were used to evaluate efficacy. Results: The eyes treated with 11-deoxycortisol, deoxycorticosterone acetate, and fludrocortisone acetate had statistically significant lower fluorescence compared to control eyes. 11-deoxycortisol and deoxycorticosterone acetate provided a greater reduction in fluorescence compared to other corticosteroids. Conclusions: Topical use of corticosteroids, especially those with mineralocorticoid activity can decrease ocular inflammation in a rabbit model. Clinical application of topical mineralocorticoids in human ocular inflammation needs to be performed.

Objectives: Age-related liquefaction of vitreous humor may result in posterior vitreous detachment, retinal tear, and detachment. The purpose of this study is to determine the normative values of age-related changes in the vitreous in the normal population using different MRI sequences. Methods: A total of 180 eyes of 90 healthy cases were enrolled in this retrospective study. Patients were divided into nine groups according to age, and each group was of equal size with 10 patients(5 male and 5 female). The T1, T2, standardized T1, standardized T2 signals and ADC values determined for each vitreous humor of each eye. MRI parameters of the vitreous were compared within and between age groups. Results: No difference was detected within the decadic age groups for mean T1W for the right and left (p = 0.912 and p = 0.903, respectively), T2W for the right and left (p = 0.966 and p = 0.983, respectively), standardized T2W for the right and left (p = 0.915 and p = 0.899, respectively), and ADC for right and left values (p = 0.622 and p = 0.524, respectively). A significant difference was found between decadic age groups in terms of the standardized T1W values for right and left (p < 0.001 and p < 0.001, respectively). Standardized T1W values of vitreous fluid show a moderate degree of correlation with age for the right (r=0.514, p < 0.001) and left eyes (r=0.534, p < 0.001). Conclusions: This study provides comprehensive normative data on the different MRI signal properties of the human vitreous and its change with age. Using MRI, especially with standardized T1 measurements, age-related changes in the vitreous humor can be revealed non-invasively.

Increasing numbers of the papers indicate that SARS-CoV-2 also causes neurological symptoms; the underlying mechanism has not been elucidated yet. Hypothetic mechanisms to explain the CNS involvement of SARS-CoV-2 include the neurotropic mechanisms and the cytokine storm developing during the disease process. A middle age female patient applied to the emergency department with complaints of eye pain, a double, foggy, and blurred vision and a severe throbbing headache. The outward gaze was found to be limited in her right eye. Nasopharyngeal swab for SARS-CoV-2 RNA was positive, radiological findings were supported the COVID pneumonia and diffuse sinonasal inflammation. Cranial imaging showed thickening and contrast involvement in the cavernous sinus in the postcontrast series. While shortness of breath improved, and the headache was completely resolved on the 10th day of treatment the right eye outward gaze restriction was continued. The control MRI reveals a significant reduction in cavernous thickening and contrast enhancement and complete resolution in dural thickening. In our case of COVID, cranial nerve involvement and pansinusitis developed without cytokine storm findings suggests that the virus has spread to the cavernous sinuses and dura by regional neighborhood. Neurological symptoms may appear as the first symptom of COVID.

Bilateral herpetic keratitis is a rare event and can occur in atopy, measles, and immunodeficiency. Long-term use of systemic steroids for any autoimmune condition also creates iatrogenic immunodeficiency. A 62-year-old female with Pemphigus Foliaceus who had been on long-term steroids presented with bilateral epithelial herpetic keratitis. She received topical ganciclovir 5 times daily for a total of 10 days and intravenous (iv) acyclovir 5–10 mg/kg for 2 weeks for diffuse periocular skin involvement. In 2 weeks, corneal lesions completely disappeared with intact epithelium and no stromal involvement. Treatment was discontinued as no further ocular signs were observed. Peroral antiviral prophylaxis was not initiated since systemic steroids were also discontinued. Three months after resolution, she underwent bilateral cataract surgeries with per- operative and post-operative systemic prophylaxis during topical steroid use. Long-term systemic steroid use seems to be a predisposing factor for bilateral herpetic ocular infections.

We report the diagnosis and treatment process of a patient who underwent CyberKnife radiotherapy with diagnosis of optic nerve sheath meningioma (ONSM) to emphasize visual field recovery with an early treatment. A 46-year-old woman pre- sented with puffiness, discomfort, and enlargement in right eye. Right sided proptosis and optic disc edema were detected as accompanying findings. Visual acuity was 20/20 in both eyes. Blind spot enlargement and mild peripheral constriction were found on the right side of visual field test. The diagnosis was made on the basis of clinical and radiological findings. Magnetic resonance imaging demonstrated an ONSM. The lesion was treated by three fraction stereotactic CyberKnife ra- diation therapy with dose of 19.5 Gy. Visual acuity was preserved and visual field was completely recovered after 6 weeks of follow-up. Due to its typical clinical and radiological findings, ONSM can be diagnosed without tissue biopsy. In progressive cases, optic nerve functions may recover by CyberKnife radiation therapy performed before development of significant visual loss. However, patients should be observed for radiation complications.

Fungi are among the most common agents of microbial keratitis, especially in developing countries and tropical regions. Early diagnosis and appropriate antifungal treatment are critical for clinical success in fungal keratitis (FK). A 35-year-old female patient was referred to our hospital because of the diagnosis of keratitis with resistant to topical antibacterial treat- ment. Her visual acuity was counting fingers at one meter for the right eye. Biomicroscopic examination revealed a large, white keratitis center with peripherally extension on cornea. Fungal hyphae were observed in microscopic examination and a filamentous fungus was isolated in culture of the corneal scrapings. It was identified as Scedosporium apiospermum by both phenotypic and molecular methods. She was treated with topical and oral voriconazole according to susceptibility testing result. It is important to early diagnosis, determine the causative agent and perform a susceptibility testing in FK.

Bacillary layer detachment (BALAD) is a relatively new optical coherence tomography (OCT) finding described by the utili- zation of OCT and characterized by the separation within the photoreceptor inner segment. The most common ocular dis- eases associated with BALAD include Vogt-Koyanagi-Harada’s disease, neovascular age-related macular degeneration, and central serous chorioretinopathy, and it is frequently observed in inflammatory, infectious, traumatic, and mass lesions of the choroid. It usually has a benign course and can resolve spontaneously or with treatment in a very short time, accompanied by an increase in visual acuity. However, its prognostic significance is still contradictory, as studies with long-term follow-up have shown that BALAD is related with subretinal fibrosis. In this review, the anatomical definition, multimodal imaging findings, course, and prognosis of BALAD in various ocular diseases are discussed.

Purpose: To predict the post-operative visual outcome considering the pre-operative factors and macular hole (MH) indices based on hole configuration in OCT. Methods: Twenty-six eyes of 26 patients with full thickness MH (Stage II, III, and IV) were enrolled in this retrospective ob- servational study between June 2017 and April 2019. Preoperative morphological parameters of MH such as base and min- imum diameter, vertical height, left arm, and right arm length were calculated manually using the software in the cirrus optical coherence tomography (OCT) machine. MH Index (MHI), hole form factor (HFF), traction hole index, and diameter hole index were calculated and correlated with post-operative best-corrected visual acuity (VA) at last follow-up. 23-gauge pars plana vitrectomy, internal limiting membrane peeling with 12% C3F8 tamponade was performed in all patients and was followed up to 6 months postoperatively. Results: The median value of patient’s age, duration of symptoms, pre- and post-operative best corrected VA were 60 years, 9 months, 1.15 logMAR, 0.80 logMAR, similarly axial length, minimum hole diameter, base diameter of the MH, and central subfoveal macular thickness (CMT) were 22.8 mm, 646.5 μm, 736.5 μm, and 291 μm, respectively. Post-operative visual out- come after MH surgery is better in patients with MHI ≥0.5, HFF ≥0.9, and CMT ≥300 μm. Conclusion: Pre-operative measurement of MH indices calculated from OCT images can be a prognostic factor in determin- ing the post-operative visual outcome of MH surgery.

Purpose: The purpose of this study was to evaluate the treatment results and complications of XEN-45 microstent implan- tation in open-angle glaucoma. Methods: In this study, 17 eyes of 17 patients who underwent XEN-45 implantation with 0.2 mg/cc mitomycin-c between June 2016 and February 2018 were retrospectively examined. Pre- and post-operative best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucomatous drugs, endothelial cell count (ECC), retinal nerve fiber layer (RNFL) thickness, number of post-operative needlings, and post-operative complications were evaluated. Results: The mean age of the patients (11 M, 6 F) was 62.6±19.8 (29–94) years and mean follow-up period was 16.8±3.5 (12–21) months. The mean IOP which was 27.6±6.0 (21–40) mmHg before glaucoma surgery decreased significantly to 14.1±3.3 3.4 (8–20) mmHg at the last visit (p<0.001). The number of antiglaucomatous drugs was 3.9±0.8 (2–5) preopera- tively and 1.7±1.3 (0–3) at the final examination (p=0.001). Pre-operative BCVA was 0.78±0.99 LogMAR and 0.8±0.99 LogMAR at the last visit (Wilcoxon test, p=0.99). The ECC was 2356.8±533.3 (1635–3275) cells/mm2 preoperatively and 2338.7±472.7 (1712–3178) cells/mm2 at the last visit and did not show statistically significant difference (p=0.470). The pre- and post-op- erative RNFL thickness measurements were 61.4±11.8 (43–82) μm and 61.3±11.5 (45–82) μm at the last visit, respectively (p=0.764). Needling was required in 4 (23.5%) eyes. Post-operative complications were observed in four eyes (23.5%). In the early post-operative period (≤1 month), shallow anterior chamber and hypotony were detected in 1 eye and were treated medically. As late complications (>1 month), Tenon’s cyst in two eyes and fibrotic bleb in one eye were observed. Conclusion: XEN-45 implant surgery in open-angle glaucoma patients is an effective surgical procedure for IOP control. With preserved visual acuity and ECC, causing no devastating complications, it can also be considered as a very safe option in open-angle glaucoma cases.

Purpose: The purpose of the study was to investigate detailed optic disc, choroid, and retinal microvascular morphological changes in active Thyroid ophthalmopathy (TO) patients due to thyroid disease using Optical Coherence Tomography An- giography (OCTA). Methods: Forty-six (34 females and 12 males) active TO patients and 41 (28 females and 13 males) healthy participants were included in the study. All patients underwent clinical examinations and ophthalmologic evaluations at first and last visits for visual acuity measurement, eyelid opening measurement, Clinical Activity Score (CAS) assessment (TO patients with CAS ≥3 were recorded, indicating active TO), exophthalmometry, cornea, and fundus examination, and those with initial intraocular pressure range of 14–21 mm Hg were included in the study. The overall degree of TO was assessed using the NOSPECS Score. The diagnosis of TO was made by a specialist according to the Bartley and Gorman Criteria. Results: The mean retinal nerve fiber layer (RNFL) thickness was significantly different between the groups (p<0.001), with active TO patients having a thinner RNFL thickness than the control group (p<0.001). When temporal and inferior RNFL thicknesses were compared (p=0.01, p=0.01), different results were obtained when compared to the control group, but there were no significant differences in upper and nasal RNFL thicknesses (p=0.604, p=0.513). Choroidal thickness (CT) measurements were significantly higher in the macular region in TO patients than in healthy individuals (p<0.05). The mean FAZ area in the TO group was found to be 0.303±0.104 mm2 at a significantly larger level compared to the control group (0.260±0.100) (p=0.037). Conclusion: Significant differences were detected in the RNFL, CT, FAZ area, superficial and deep retinal vessels, and RPC in TO patients. The data obtained showed that the OCTA device is an important guide for diagnosis, treatment and follow-up in the early stages of TO.

Purpose: The purpose of the study was to evaluate the vascular density (VD) in the optic disk (OD) head and macula by optical coherence tomography angiography (OCT-A) in patients with inactive thyroid eye disease (TED), as well as the relationship between extraocular muscle (EOM) thickness and the VD of the retina and OD. Methods: The study group and control group each consisted of 65 eyes of 65 participants. The foveal, parafoveal, and perifoveal VD were examined for both superficial capillary plexus and deep capillary plexus. In addition, choriocapillaris flow, foveal avascular zone (FAZ) areas, and the perimeter were calculated. The thicknesses of the peripapillary retinal nerve fiber layer (RNFL) and VD were recorded. EOM thickness was measured with magnetic resonance imaging. Results: VD was significantly lower in all quadrants for the superficial foveal areas, as well as the deep and superficial parafoveal and perifoveal areas in the study group (p<0.05 for all). The study group had significantly lower choriocapillaris flow area (2.08±0.1; 2.12±0.10 p=0.049) and higher FAZ (0.29 (0.22–0.36); 0.26 (0.17–0.32) p=0.037) and perimeter (2.08±0.46; 1.92±0.35 p=0.03) values compared with the controls. VD was higher in the inferior half of the peripapillary region in the study group than the controls (p=0.045). Conclusion: Macular VD measured using OCT-A was found to be significantly lower in TED patients compared to healthy controls. It is thought that noninvasive quantitative retinal perfusion analysis using OCT-A may be useful in the follow-up of TED, close monitoring of complications, and early treatment decision.

Purpose: Evaluation of visual and refractive effects of collagen cross-linking (CXL) in progressive keratoconus (KCN). Methods: A total of 95 eyes of 77 patients were retrospectively analyzed. The changes in uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively); spherical or cylindrical refraction and spherical equivalent of refractive error (SPH, CYL, and SE, respectively); central corneal thickness (CCT); and mean keratometry values (K) in the Scheimpflug corneal tomography (Pentacam, Oculus®, Germany) were evaluated at the 1st, 3rd, and 6th post-operative months and the past visit, as compared to pre-operative values. Results: During follow-up, there was a progressive improvement in the mean UDVA and CDVA. Significant improvement was seen in CDVA at the 3rd month (from 0.51±0.23 to 0.59±0.22), in UDVA at the 6th month (from 0.34±0.24 to 0.44±0.25), and in SPH and SE values at the last control (from −2.75±3.50D to −1.92±2.52D for SPH; from −3.51±4.45D to −3.07±3.05D for SE). The mean CCT decreased in the post-operative 1st month and gradually increased in the 3rd and 6th months (from 466.87±63.94 μm to 449.76±50.09 μm, 443.92±42.44 μm, and 454.30±46.86 μm for 1st, 3rd, and 6th months, respectively); almost returned to pre-operative values. There was no significant change in mean CYL and K values throughout the follow- up (from −2.40±2.11D to −2.45±1.77D for CYL; from 46.89±3.66D to 47.35±5.04D for K). Conclusion: CXL seems to not only slow down the progression of KCN but also improve the visual acuity, which may be a re- sult of ultrastructural changes that occur in the corneal stroma postoperatively, rather than a simple corneal flattening effect.

The present case reports a 70-year-old female patient who presented with bilateral exophthalmos, lagophthalmus, and ex- posure keratitis. An aggressive topical treatment was commenced that included fortified vancomycin and ceftazidime. She was subsequently diagnosed with severe thyroid ophthalmopathy (TO) due to severe static and dynamic tremor that raised suspicion and abnormal thyroid function tests indicating Graves’ Disease. She was diagnosed with bilateral exposure keratitis secondary to TO in which the clinical activity score was assessed as 5. As her TO was sight-threatening, she was administered intravenous pulse methylprednisolone, followed by bilateral balanced 2-wall (medial and lateral) decompression and lateral temporary tarsorrhaphy surgeries. As her exophthalmos and lagophthalmos improved postoperatively, both eyes’ keratitis significantly regressed, and left scar tissue in the cornea. This extreme case should raise awareness for clinicians in the eti- ological investigation of exposure keratopathy to identify sight-threatening thyroid ophthalmopathy and promptly initiate appropriate treatment.

A 74-year-old male patient, who previously had central corneal opacity, presented to our clinic with decrease in vision, and diffuse corneal edema following uncomplicated phacoemulsification and intraocular lens implantation. With topical treatment of steroids and artificial tears, the edema resolved in peripheral cornea and remained edematous in the central cornea during the following 2.5 months. Optical coherence tomography showed Descemet membrane detachment (DMD) in the edematous area. Intracameral perfluoropropane (C3F8) was injected. In the following days, Descemet membrane reattached and corneal edema resolved. The visual acuity increased to 20/40. Following uneventful phacoemulsification, if corneal edema is refractory to treatment, DMD should be remembered. In cases where corneal opacity interferes with the detailed examination of cornea, optical coherence tomography is helpful. In those patients, C3F8 injection is a viable option even in the late post-operative weeks.

The aim of this study was to assess the efficacy of sutureless amniotic membrane (AM) technique using a symblepharon ring-AM patch on the persistent epithelial defects and resistant to medical treatment. Two patients to whom an AM patch was applied to the ocular surface using a polymethyl methacrylate symblepharon ring due to corneal surface disorders are evaluated. The implantation of ring-AM was not complicated. Irritation and epithelial defect decreased in both cases. Eventually, vascularized leukoma developed. Ring-AM implantation is a non-invasive and easy procedure in the treatment of ocular surface disease. Ring-AM is an effective and safe biologic bandage in patients, who refuse surgical procedure or to whom surgery is contraindicated due to systemic diseases.

Syphilis is a sexually transmitted systemic disease caused by the spirochete Treponema pallidum. If left untreated, syphilis progresses in four stages: Primary, secondary, latent, and tertiary. Since the turn of the 20th century, the global prevalence of syphilis has sharply increased. Syphilis and human immunodeficiency virus (HIV) coinfection are common because they share similar transmission routes. Ocular syphilis (OcS) is a rare syphilis complication, but its prevalence has recently in- creased as a result of the rise in syphilis cases. OcS may occur at any stage of syphilis. However, it may not always be accom- panied by systemic findings. In such cases, ocular involvement may be the disease’s first and only manifestation. OcS can affect any structure of the eye, yet the most common manifestations are posterior uveitis and panuveitis. Due to the variety of clinical manifestations, the disease is known as “the great imitator.” As a result, syphilis serology is advised for any patient with unknown intraocular inflammation. Although clinical signs can be indicative of OcS, it is diagnosed using laboratory tests. Multimodal ocular imaging is required for differential diagnosis, treatment, and follow-up. It is highly recommended that patients with suspected or confirmed syphilis be tested for HIV infection. OcS is treated just like neurosyphilis with systemic penicillin. If OcS is treated promptly and effectively, a good visual prognosis is possible; otherwise, it may lead to permanent blindness.

urpose: The aim of the study was to investigate the possible adverse effect of intracameral cefuroxime (ICC) on corneal endothelium by comparing it with subconjunctival gentamycin (SCG) injection. Methods: Patients were divided in two groups; ICC (1 mg/0.1 ml) and SCG (40 mg/ml). Corrected distance visual acuity, anterior segment examination, intraocular pressure measurement, specular microscopy (endothelial cell density, coefficient of variation (CV), hexagonality, and central corneal thickness (CCT) were performed before surgery and at postoperative controls on week 1, month 1, and month 3. Results: Fifty-one eyes received ICC, 37 eyes SCG, and the mean ages of the patients were 70.0±5.5 and 69.2±6.6 (p=0.644). Endothelial cell loss at month 1 was 17.07% in ICC and 16.75% in SCG group (p=0.899). CCT returned to pre-operative values in SCG group at month 1 (p=0.483). Whereas in ICC eyes, a statistically significantly higher CCT still persisted at month 1 (p=0.015). CV showed no statistically significant difference at three post-operative visits compared to baseline in SCG group. Whereas in ICC group, a statistically significant increase was observed in CV at week 1 (p=0.000) and month 1 (p=0.012). At month 3 visit, a statistically significantly lower hexagonality was observed in ICC when compared with SCG (p=0.019). Conclusion: Results of our study showed that the licensed ICC use after phacoemulsification is safe as SCG in clinical point of view. However, abnormalities in CCT, CV, and hexagonality suggest subclinical endothelial toxicity of cefuroxime.

Purpose: Glaucoma is a progressive, irreversible optic neuropathy that is the leading cause of blindness worldwide. In our study, we aimed to show the neuroprotective effect of erythropoietin (EPO) on glaucoma. Methods: Twelve male and 12 female albino Wistar rats (6 weeks old; 220±40 grams) from Aydin Adnan Menderes University Experimental Animal Center were used. All animals were housed in a fixed room on a 12/12 h light/dark cycle per day, with food and water provided ad libitum. Rats were divided into four groups as control and glaucoma groups, subconjunctival EPO and topical EPO groups. At the end of the 6th week, the right eyes were enucleated and total retinal thickness, ganglion cell complex (GCC), inner plexiform layer (IPL), and ganglion cell layer (GCL) thickness measurements were determined. Tis- sue samples stained with HE were examined under a light microscope and photographed. Retinal layer thickness measure- ments were determined for each eye using the ImageJ program (NIH, USA). The neuroprotective effect of EPO on glaucoma was evaluated by retinal layer thickness measurements. Results: GCL, IPL, retinal thickness, and GCC thickness were observed the least in the glaucoma group and the most in the control group. There was no significant difference between EPO administration routes (p>0.05). Cell layer thicknesses in each group were confirmed by immunohistochemical staining, and apoptotic cells were not detected by bax or bcl-2 staining. Conclusion: The structural contribution of topical and subconjunctival applications of EPO to retinal layers has been demon- strated, and the study needs to be repeated in larger series.

Purpose: The purpose of the study was to evaluate the effect of individual differences in interpupillary distance (IPD) on convergence and divergence amplitudes measured at near and at distant fixation targets. Methods: Ninety-three healthy subjects were enrolled. Group 1 included subjects with smaller than normal IPD (mean IPD = 58.2±1.4; 27 subjects), Group 2 included those with larger than normal IPD (mean IPD = 69.5±1.6; 31 subjects), and Group 3 included those with normal IPD (mean IPD = 63.10±2.22; 35 subjects). Outcome measures were best corrected visual acuity, binocular vision level (TNO test), convergence, and divergence amplitudes at near and at distance. Results: There was no statistically significant difference between Group 1, 2, and 3 regarding age or clinical characteristics. The differences in gender distribution between Groups 2 and 3 and between Groups 1 and 2 were significant (Chi-square test, p=0.001 for both). There was no statistically significant difference between the groups in the values of near conver- gence amplitude, near divergence amplitude, and distant convergence amplitude. There was a statistically significant differ- ence between in mean distant divergence amplitude between Groups 2 and 3 (p=0.01). Conclusion: Differences in IPD can affect an individual’s vergence amplitudes and binocular vision level. Especially, the in- dividuals with IPD larger than normal limits have the lowest mean values for all vergence amplitudes, while the normal IPD group had the highest.

Purpose: The objective of the study was to evaluate the error in predicted residual astigmatism (PRA) using measurements of corneal astigmatism obtained with IOLMaster-700 and Pentacam for toric intraocular lens (IOL) calculation in keratoconic eyes. Methods: For toric IOL calculations, we used keratometric astigmatism obtained by IOLMaster-700 and total corneal re- fractive power (TCRP) values determined by Pentacam Scheimpflug system. Using an online toric IOL calculator, PRA for keratometric astigmatism and TCRP with a toric IOL model suggested for keratometric astigmatism values was recorded. We also calculated the error in PRA as the difference between PRA with keratometric astigmatism and TCRP. For all calculations, vector analysis was used. Results: In our sample of 70 keratoconic eyes of 70 patients, the mean difference in PRA using TCRP instead of keratometric astigmatism measurements was −1.21±0.93 with a centroid of 0.85 at 25. The error in PRA was ≤1.0D in 36 eyes, between 1.0D and 3.0D in 26 eyes, and between 3.0D and 4.0D in eight eyes. Whereas 80% of eyes with with-the-rule astigmatism showed decreased cylindrical IOL power, 88.9% of eyes with against-the-rule astigmatism showed increased IOL power with TCRP instead of keratometric astigmatism. Conclusion: Using TCRP measurements instead of keratometric astigmatism in toric IOL calculations caused a considerable deviation in eyes with keratoconus, most probably due to the posterior corneal astigmatism.

Scleral buckle infection after detachment surgery is a rare condition and it can occur even years after. We report two cases with scleral buckle infection who had undergone detachment surgery 11 and 12 years ago. The first patient was admitted to clinic with pain and discharge. Intense purulent discharge, conjunctival hyperemia, chemosis, and a large mass extending to the corneal surface were seen on her anterior segment examination. The second case had reconstruction surgery with oral mucosal greft for sponge exposure 4 years ago and she had purulent discharge, conjunctival chemosis and sponge were exposed on her anterior segment examination. During the surgery of both cases, yellowish-white multiple foci seen on buckle material which gave an impression of a fungal infection. We performed removal of the mass and scleral buckle in the first case, and removal of the scleral buckle, covering of thinned sclera with oral mucosal greft, and tarsorrhaphy in the second case. After Aspergillus grown on the culture media, lavage with voriconazole and voriconazole eye drop treatments completed and there was no recurrence in terms of detachment and infection.

Hydatid cyst is a rare parasitic disease caused by Echinococcus granulosus or Echinococcus alveolaris tapeworm. The most common sites that are affected are liver, lung, and central nervous system. Other rarely affected sites are orbit and bone. Herein, two cases of isolated primary orbital hydatid cysts that were surgically managed are presented.

Sclerochoroidal calcification is an uncommon degenerative ocular disease that is characterized with calcium deposits at the level of choroid and sclera. This condition could be related to calcium pyrophosphate metabolism disorders such as primary hyperparathyroidism. We presented a case who received the diagnosis of the primary hyperparathyroidism after the detection of asymptomatic fundus lesions on a routine eye examination.

In the first 4 weeks of life, an ocular infection is seen in 1–12% of newborns and this clinical situation is called “ophthalmia neonatorum.” The etiology includes bacterial, viral, and chemical causes. Unfortunately, severe conjunctivitis progressing to corneal ulceration and blindness may develop in the newborns due to inadequate ocular prophylaxis. The development of these cases can be prevented by screening the mothers during pregnancy and giving treatment if necessary and/or providing the newborns with appropriate ocular prophylaxis.

Purpose: The purpose of the study was to compare the effect of biometric formulas used in calculating intraocular lens (IOL) power on target refraction when planning cataract surgery in patients with diabetic macular edema (DME), age-related macular degeneration (AMD), or epiretinal membrane (ERM). Methods: The study was carried out in the Ege University Medicine Faculty Department of Ophthalmology after obtaining local ethics committee approval. Sixty-two eyes with cataracts and ERM, AMD, or DME that increased retinal thickness were included in the study group. Fifty-four eyes with cataracts and no retinal pathology were included in the control group. Lens power calculations based on measurements obtained with optical and ultrasound biometers were made using the SRK-T, Holladay 2, Hoffer Q, Haigis, and Barrett Universal 2 formulas and the results were compared. Results: In the study group, 31 eyes (50%) had DME, 16 (26%) had AMD, and 15 (24%) had ERM. The mean of arithmetic deviations from target refraction was lowest with the Barrett Universal 2 formula (p>0.05). When the Haigis formula was used, there was a significant deviation in both the study and control groups, while only the control group showed a significant deviation with the Hoffer Q formula (p<0.05). There was no significant difference between the groups in terms of absolute deviations (p>0.05). Conclusion: In cataract patients with maculopathy and increased retinal thickness, the likelihood of inaccurate IOL power calculation was lowest with the Barrett Universal 2 and highest with the Haigis formula. These results should be further examined in larger patient series.

Purpose: The purpose of the study was to compare the results of intravitreal bevacizumab in patients with macular edema (ME) due to branch retinal vein occlusion (BRVO) according to different ME morphologies. Methods: In this retrospective study, 24, 13, and 22 patients with ME type due BRVO were included in the serous retinal detachment group, cystoid ME group, and diffuse ME group, respectively. The best-corrected visual acuity (BCVA) was evaluated with an ETDRS chart, and central macular thickness (CMT) was evaluated by spectral domain optical coherence tomography at the 1st, 2nd, and 3rd months. Results: The mean ages of the patients were 64.25±7.80, 64.84±7.96, and 61.81±6.67 years in the serous, cystoid, and diffuse groups, respectively (p=0.414). While no significant difference was observed in the serous group in terms of BCVA and CMT at the 1st month after injection compared with that in the cystoid group (p=0.201 and p=0.986), BCVA and CMT values at the 2nd and 3rd months were statistically different (p=0.021, p=0.003, p=0.015, and p=0.006, respectively). When the serous group and the diffuse group were compared, only a significant difference was found in CMT at the 2nd month (p=0.016). Conclusion: Intravitreal bevacizumab treatment was more effective in terms of anatomical and visual results in the serous group compared with that in the cystoid group; however, at the end of the 3rd month, it showed similar results with the diffuse group.

Purpose: The purpose of the study was to assess the effects of subthreshold yellow pattern laser (SYPL) treatment in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods: Thirty eyes of 30 diabetic patients diagnosed as naïve DME (central subfield thickness [CST] <400 μm) between October 2018 and January 2020 at Ege University Faculty of Medicine, Department of Ophthalmology were prospectively included in the study. Fovea sparing SYPL were performed to the macula. Comprehensive eye examination along with OCTA was performed at baseline, 1st month, and 3rd month of follow-up. Data during the follow-up were compared with the baseline. Results: The mean age of the patients (15 male and 15 female) was 63.7±6.7 (48–74) years. The mean diabetes duration was 17.9±5.4 (13–27) years and mean HbA1c was 6.6±0.5 (5.7–7.7) g/dL. Best-corrected visual acuity (BCVA) did not show significant change during the follow-up (p=0.698). CST measurements were 323.7±40.1 (262–393) μm, 316.8±40.9 (268–377) μm and 318.1±39.9 (226–396) μm at baseline, 1st, and 3rd month, respectively (p=0.591). On OCTA, mean vessel density (VD) in superficial capillary plexus were 44.7±4.6 (37.4–52.3), 45.6±4.7 (38.6–54.9), and 44.6±3.9 (37.5–49.8); while mean VD in deep capillary plexus (DCP) was 43.1±4.8 (36.3–52.7), 45.3±4.8 (38.9–54.2), and 42.7±3.3 (37.4–49.3) at baseline, 1st, and 3rd month, respectively (p=0.383 and p=0.291). Foveal avascular zone area did not change significantly during the follow-up (p=0.998). Conclusion: SYPL treatment in DME appears to be safe with no statistically significant difference in macular capillary perfusion, as well as no change in BCVA and CST during the 3 months of follow-up.

Purpose: The objective of the study was to evaluate the factors affecting visual prognosis and to analyze optical coherence tomography findings after successful pars plana vitrectomy (PPV) surgery for rhegmatogenous retinal detachment (RRD). Methods: Forty-one eyes of 41 patients who underwent PPV for RRD for the 1st time between December 2010 and July 2013 were included in the study with a retrospective design. Patients were divided into two groups according to visual acuity: Group 1 consisted of 24 patients with improved final best corrected visual acuity (BCVA) after post-operative 6th month; Group 2 consisted of a total of 17 patients: 14 patients with stable final BCVA and 3 patients with deteriorated final BCVA after the post-operative 6th month. Correlation between preoperative and postoperative variables was assessed. Results: The mean follow-up period was 16.93±7.5 (range, 7–36) months. While 26 (63.4%) patients had macula-off RRD, 15 (36.6%) patients had macula-on RRD. Pre-operative BCVA (p<0.001) and post-operative BCVA (p=0.002) was significantly better in eyes with macula-on RRD. Pre-operative and post-operative BCVA were found to have positive correlation (p<0.001, r=0.58). The number of eyes with intact photoreceptor inner segment/outer segment (IS/OS) junction, disrupted IS/OS junction, foveal epiretinal membrane (ERM), and parafoveal ERM was 8 (33.3%), 2 (8.3%), 1 (4.2%), and 13 (54.2%) in Group 1, while it was 2 (11.8%), 3 (17.6%), 2 (11.8%), and 10 (58.8%) in Group 2, respectively. Conclusion: Pre-operative BCVA and absence of macular detachment are important prognostic factors in patients with RRD.

Purpose: The objective of the study was to evaluate the refractive outcome in corrected distance visual acuity (CDVA) of adult amblyopic eyes after Wavefront Excimer Laser Correction (WELC) surgery and determine the pre-operative factors that affect the possible visual improvement. Methods: Sixty-two patients (>21 years) with refractive anisometropic, ametropic amblyopia who underwent WELC surgery between 2014 and 2021 in our clinic were enrolled. Patients with an ocular pathology causing a decrease in vision, abnormal corneal topography, abnormal slit lamp, and fundus examinations were excluded from the study. Medical records of the pre-operative and post-operative 6th month–1 year were retrospectively reviewed for CDVA values, refractive status under cycloplegia, manifest refraction values, the binocular sensory status, and the near stereoacuity measurements. The statistical analyses were held by IBM® SPSS® Statistics 19.0 (SPSS Inc., Chicago IL, USA). Results: Sixty-two eyes of 62 patients were included in the study. Correlation analysis revealed that pre-operative logMAR CDVA (r=0.495, p=0.04) and pre-operative astigmatism values (r=0.563, p=0.03) had a statistically significant correlation with increase in visual acuity. It was observed that more significant increase in CDVA was obtained in the high astigmatism (≥3D) group (p=0.045). No statistically significant correlations were detected between post-operative increase in CDVA and age (r=–0.08, p=0.78) and type of refractive error (r=–0.19, p=0.50). There was a significant improvement in near stereoacuity measurements postoperatively (p<0.05). Conclusion: Improvement in CDVA and binocular function was observed in all adult amblyopic eyes after WELC. In adult amblyopic patients, WELC surgery of refractive errors can be an alternative treatment technique.

The aim of the study was to report a patient who developed acute non-arteritic ischemic optic neuropathy following conjunctival melanoma excisional biopsy. An otherwise healthy 55-year-old man presented with a 3-month history of progressively growing pigmented lesion in the left eye. Clinical examination revealed a dark pigmented conjunctival lesion adjacent to temporal limbus with an evident feeder vessel. With the initial diagnosis of conjunctival melanoma; excisional biopsy, alcohol epitheliectomy, cryotherapy (double-thaw), episclerectomy, and amniotic membrane transplantation for ocular surface reconstruction were performed. Histopathological examination confirmed the diagnosis. Four months after surgical intervention, sudden visual loss in the operated eye occurred. According to detailed neuro-ophthalmological examination, patient was diagnosed as acute non-arteritic ischemic optic neuropathy. Non-arteritic ischemic optic neuropathy is a multifactorial disease and may occur after several ophthalmic surgeries. To the best of our knowledge, this is the first reported case of non-arteritic ischemic optic neuropathy following conjunctival melanoma excision.

A 6-year-old boy with left proptosis which was realized 2 months earlier was evaluated. The left eye movements were restricted in all gaze positions. The left lacrimal gland was hypertrophic on examination. An orbital magnetic resonance imaging revealed a mass lesion starting from the lacrimal gland region extending through the superior and lateral orbit causing a pressure on the lateral rectus muscle. An incisional biopsy from both the lacrimal gland and the orbital part of the mass revealed no tumor cells but minimally inflamed lacrimal gland tissue which supported an ectopic lacrimal gland in the orbit. Although rare, ectopic lacrimal gland of the orbit might mimic orbital malignancies in children. Histopathologic confirmation is mandatory for differential diagnosis.

A 53-year-old woman underwent to the right uncomplicated cataract surgery and a trifocal intraocular lens (IOL) implantation. Twenty-six days after the surgery, the patient was admitted to our department with reduced vision. Slit-lamp examination of anterior chamber showed a clear cornea with deep anterior chamber and a centralized IOL. Fundus examination showed macular hole-like lesion in the fovea. Optic coherence tomography showed parafoveal edema, photoreceptor integrity line disruption, and outer retinal atrophy in the fovea. Fluorescein angiography showed corresponding areas of hyperfluorescence without leakage, consistent with phototoxic maculopathy resulting from the operating microscope. She had been diagnosed with systemic lupus erythematosus (SLE) 10 years ago. We aimed to present a patient who had profound visual loss secondary to presumed macular phototoxicity following cataract extraction and IOL implantation possibly related to underlying SLE. Patients with SLE may be prone to phototoxic damage during eye surgery.

Graft-versus-host disease (GVHD) is an important problem of hematopoietic stem cell transplantation. Dry eye disease (DED) is one of the most common complications of ocular GVHD, and patients experience symptoms such as blurred vision, photophobia, sand stinging, pain, burning, and redness. DED can progress to keratopathy, ulceration, and visual loss if treatment is delayed or appropriate treatment cannot be arranged. Treatment of people with GVHD needs a multidisciplinary approach to ensure early diagnosis and to recognize all clinical signs of GVHD and to define disorder category and severity. The aim of the treatment is to improve the quality and quantity of tears, to protect the corneal epithelial integrity, and to reduce the inflammation on the ocular surface to reduce the severity of the symptoms and prevent their progression. In conclusion, patients with GVHD should be evaluated ophthalmologically very carefully, especially the condition of the ocular surface and the findings of DED before and after transplantation, and it is important to carry out ophthalmological examinations and follow-up of these patients at regular intervals. Thus, early diagnosis, prevention of possible complication, and correct planning of treatment, when necessary, are very important before serious, perhaps permanent, and life-threatening consequences are experienced.

Purpose: The objective of the study is to evaluate the effect of mask use on tear meniscus (TM) measurements obtained by anterior segment optical coherence tomography (AS-OCT) and on conventional dry eye tests. Methods: Right eyes of 86 healthy individuals were included in the study. Lower TM parameters were measured with ASOCT and TM height (TMH) and depth (TMD) were calculated with facial masks on and 1 h after taking the masks off. Schirmer’s and tear break up time (TBUT) tests were measured under the same circumstances. Results: Mean age of the individuals was 34.4±9.6 years. Of the 86 individuals, 40 (46.5%) were male and 46 (53.5%) were female. Mean age did not differ between genders (p=0.309). Mean TMH and TMD were significantly lower in individuals with face mask (p<0.001, p<0.001, respectively). TBUT score was significantly lower in individuals with face mask (p<0.001). The mean Schirmer score did not significantly change between measurements (p=0.471). The mean mask on and mask off TMH, TMD, Schirmer’s test, and TBUT outcomes did not significantly differ between males and females in the study (p>0.05 for all). Conclusion: Wearing facial masks seem to affect the TM parameters and decrease TBUT of the patients. This may explain the irritation symptoms in the eyes of the patients when using masks. Appropriate measurements should be taken in order to relieve these ocular symptoms, since wearing masks become a daily routine of our lives for protection against airborne pathogens.

Purpose: The relationship between retinal vein occlusion (RVO) and hematologic parameters has been previously demonstrated. However, there is lacking data regarding the role of C-reactive protein (CRP) to Albumin Ratio (CAR) in patients with RVO. In this study, we aimed to investigate the relationship between CAR and RVO. Methods: A total of 126 people were included in our study, including 63 patients diagnosed with central RVO (CRVO) in our hospital and 63 control patients. All clinical, demographical, and laboratory parameters were entered into a dataset and compared between the CRVO group and the controls. Results: The mean age of the patients was 54±11 years (Female: 47.6%). CRP and CAR were significantly higher in patients with CRVO compared to controls (p<0.001, p<0.001, respectively). Logistic regression analysis demonstrated that high CAR level was an independent determinant of CRVO (Odds Ratio: 3.300, 95% Confidence interval: 1.681–6.480; p=0.001). Conclusion: Higher CAR levels may be an associated predictor of CRVO.

Purpose: The purpose of the study was to evaluate the ocular surface and corneal sensitivity in patients with lamellar ichthyosis (LI). Methods: Eleven eyes of 11 patients with LI (Group 1) and 11 eyes of 11 healthy individuals (Group 2) were enrolled into this cross-sectional study. Detailed ophthalmological examination along with ocular surface fluorescein staining with Oxford scoring, tear film break-up time, Schirmer 1 test, ocular surface disease index (OSDI) score assessment, and evaluation of corneal sensitivity with Cochet-Bonnet esthesiometer was performed. Results: The mean ages of Group 1 and Group 2 were 24.54±10.22 years (range, 11–37) and 26±7.53 years (range, 16–40), respectively (p=0.764). Male/female ratio was 5/6 in Group 1 and 4/7 in Group 2. Mean tear film break-up time and the corneal sensitivity of the superior and inferior region of cornea were lower (p=0.00008; p=0.019; and p=0.006, respectively), and OSDI and Oxford scores were significantly higher in Group 1 (p<0.00001 and p=0.002, respectively). No significant difference in terms of Schirmer 1 test and corneal sensitivity of central, temporal, and nasal regions was detected (p>0.5). Conclusion: LI is not only associated with evaporative type dry eye but also decreased corneal sensitivity of peripheric cornea. Therefore, to prevent uninvited complications, LI patients should be examined for dry eye regularly, even if they do not have any complaints.

Purpose: The study aims to evaluate the clinical features and treatment results of patients with Fuchs uveitis syndrome (FUS). Methods: A retrospective chart review was carried out for all the FUS patients who were treated and followed up at the Uvea Unit of our clinic between 2008 and 2019. Demographic data of all patients and best corrected visual acuity (BCVA), intraocular pressure (IOP) values, anterior and posterior segment examination findings at the time of diagnosis, and the complications along with medical and surgical treatments were analyzed. Results: The mean age of 56 patients included in the study was 40.19±9.69 (20–66) years and the mean follow-up period was 25.91±33.86 (1–154) months. The mean BCVA was 0.43±0.73 (0–3.1) LogMAR, and the mean IOP value was 17.75±9.64 (8–52) mmHg. At the time of admission, 19.6% patients were under systemic immunosuppressive treatment with corticosteroid and/or immunomodulator agents. The most common presenting symptoms were visual disturbance and blurriness (39.2%). Moreover, the most common complications were cataracts (53.5%) and IOP elevation (26.7%). Phacoemulsification was performed in 50% of eyes with cataracts, and BCVA showed a statistically significant increase postoperatively (p<0.0001). While pressure could be controlled with medical treatment in 73.3% of eyes with high IOP, 26.7% of eyes required glaucoma surgery. BCVA was found <2.10 logMAR in 20% eyes with glaucoma at the last visit. Conclusion: In eyes with FUS, the most common presenting symptom was visual loss and blurriness and the most common complications were cataract and IOP elevation. While the surgical treatment of cataracts can be successfully performed, blindness may develop in eyes with glaucoma despite treatment. Therefore, early diagnosis is essential to prevent unnecessary steroid use in these cases.

Purpose: The study aims to evaluate the function and morphology of the meibomian glands and tear function tests in patients with unilateral glaucoma. Methods: The files of 1100 glaucoma patients attending, Ophthalmology clinic from 2014 to 2018 were screened. In total, 38 eyes from 38 out of 84 patients using antiglaucomatous agents in one eye who abided by the criteria and accepted participation were included in the study. After general ophthalmologic examination including best corrected visual acuity, biomicroscopic and ophthalmoscopic examination, ocular surface disease index (OSDI) survey, tear osmolarity, noninvasive tear breakup time (NITBUT), meibography (MEBG) and lower lid tear meniscus height (TMH) measurement, followed by Schirmer test and tear breakup time (TBUT) were measured, respectively. Results: With mean age of 68.6±12.8 years, 13 patients (34.3%) were female and 25 were male (65.7%). Mean duration of medication use was 37.97 months with mean OSDI score of 33.76±16.2 C4.10–77). The difference between NITBUT and atrophy percentage of meibomian glands in glaucomatous and control eyes was identified to be significant (NITBUT: 9.08±2.98; 12.01±4.30; p=0.001, MEBG 41.15%±14.04%, 28.33%±11.77%, p=0.001). A significant decrease was observed for TMH, TBUT and Schirmer test for eyes administered drops compared to control eyes (p=0.001; p=0.0001; p=0.009, respectively) and tear osmolarity was identified to be significantly high (p=0.0001). Conclusion: In addition to the negative effects of topical antiglaucomatous drops on tear aqueous components, patients should be monitored for dry eye findings as closely as for intraocular pressure and popularizing the use of preservative-free medications is important in terms of patients’ treatment compliance.

Basın, var olduğu günden itibaren iktidarların ilgisini üzerine çekmiştir. Yapısı itibariyle halkı etkileme potansiyeli olan bu ürüne iktidarlar kayıtsız kalamamıştır. Etki alanının genişliği hakkında yeterli bilgiye sahip olunmaması, basın ile iktidar arasındaki ilişkinin tarihsel süreçte birçok kırılma yaşamasına sebep olmuştur. Çizgisel bir gelişim göstermemekle birlikte iktidarların basın üzerindeki etkileri tarihsel süreç içerisinde basın lehine hafiflemiştir. Osmanlı Devleti’nde basının gelişimi Avrupalı çağdaşlarına göre geç yaşanmıştır. Avrupa’da ilk gazeteler ortaya çıktığında Osmanlı Devleti’nde henüz Türkler tarafından matbaa dahi açılmamıştı. Bu sebeple Avrupa basınının özgürlük alanını genişlettiği dönem, Osmanlı Devleti’nde basının kontrol altına alınması ve devamında sansürün yoğunlaştığı zamana denk gelmiştir. II. Abdülhamit’in yönetim anlayışı basının kontrol altında tutulmasına uygun olduğundan, yerli basın hareket kabiliyetini kaybederken Avrupa’daki Türkçe yayınlar dönemin Türk basınının lokomotifi halini almıştır. Bununla birlikte II. Abdülhamit dönemi yurtiçi basınının hiçbir etkisinin olmadığı da söylenmemelidir. Her şeyden önce Osmanlı Devleti sınırları içinde basın tarihinin kesintiye uğramamasına vesile olmuşlardır. İlaveten jurnalciliğin adeta meslek haline geldiği ve sansürün dozunun olabildiğince arttığı bir ortamda kendilerine has yöntemler geliştirerek varlıklarını devam ettirmişlerdir. Yurtiçi siyasi olaylara girmeksizin satışlarını belli seviyelerde tutmayı başarmış, aldıkları tahsisatlarla iktidarın beslemesi eleştirilerine rağmen mesleklerini sürdürmüşlerdir. İkdâm da aynı atmosferin ürünü olarak çağdaşı basın ürünlerinin yaşadıklarından nasibini almıştır. Bu yönüyle dönemin basın-iktidar ilişkilerine ayna tutacak verilere sahiptir.

Isolated orbital fungal lesions is an uncommon entity as the already reported cases are secondary to the involvement of paranasal sinuses especially in immunocompetent healthy individuals. Even though it is rare and the paranasal sinuses are the primary site of inoculation of the infective organism, it is a serious infection that may first present to an ophthalmologist. Here, we report a case of an isolated orbital fungal granuloma of a 42-year-old immunocompetent female who exhibited protrusion and watering of the left eye with no vision loss. The patient was diagnosed with an ovoid well-defined solid lesion in the medial extraconal compartment of left eye in magnetic resonance imaging orbit and a hyperdense lesion with erosion of medial orbital wall in computerized tomography nose and paranasal sinus. The patient underwent endoscopic exploration with biopsy which revealed the lesion to be necrotizing fungal granuloma. The patient was put on oral antifungals over a course of 3 months. There was a complete resolution of symptoms at the end of 1-year follow-up.

Karikatür bir düşüncenin ya da bir olayın komik yönlerini ön plana çıkartıp eleştirel bir yorumlama imkânı sunarak insanları güldürürken düşündürmeyi hedefleyen bir mizah türüdür. Karikatürlerde başta siyasi, sosyal, toplumsal, ekonomik vb. olaylar çizimler ve kısa ifadeler kullanılarak bir takım önemli özetlemeler yapılmaktadır. Almanya’nın en büyük göçmen grubu olan Türklerle ilgili Alman basınında her yıl çok sayıda karikatür yayınlanmaktadır. Bu karikatürlerde Almanya’da yaşayan Türklerin nasıl yansıtıldığı önemli bir konu olarak karşımıza çıkmaktadır. Bu bağlamda bu çalışma ile Alman karikatüristlerin Türkleri nasıl ele aldıklarının futbol ve din odağından tespit edilmesi hedeflenmiştir. Bu kapsamda 2011 yılında Türkiye Cumhuriyeti Başbakanlık Yurtdışı Türkler ve Akraba Topluluklar Başkanlığı tarafından Türklerin Almanya’ya göçünün 50. yılında düzenlenen etkinlikler çerçevesinde “50 Yıl 50 Karikatür: Alman Karikatüristlerinin Gözüyle Türkler” başlıklı sergide yer alan ve pek çoğu Almanya’nın saygın yazılı basın organlarında yayınlanmış olan futbol ve din ile ilgili karikatürler rastlantısal olarak seçilmiştir. Bu karikatürler Van Dijk'ın eleştirel söylem analizi ve göstergebilimsel çözümleme yöntemleri kullanılarak incelenmiştir. Futbol ile ilgili karikatürler değerlendirildiğinde Almanya’da yaşayan Türklerin 2010 yılındaki Avrupa Şampiyonası müsabakalarında hem Türkiye’yi hem de Almanya’yı desteklemeleri onların bu bağlamda Almanya’ya entegre oldukları fikrinin ortaya çıkmasına neden olmuştur. Bu durum karikatürlerde de vurgulanmıştır. Dinle ilgili karikatürler değerlendirildiğinde İslam’ın Almanya’da yaygınlaşmaya başlaması neticesinde büyüyenİslamlaşma korkusuna atıf yapılmıştır. İslam inancıyla ilgili bazı Almanların özellikle yetkililerin ne kadar az ve yanlış bilgiye sahip olduğu vurgulanarak bu konuda eleştirel bir söylem geliştirilmiştir.

Objectives: To evaluate the effectiveness of the conjunctival suture tied internally and externally on patient comfort and suture dissolution in the postoperative period in patients who underwent symmetrical strabismus surgery. Methods: In 50 patients who underwent surgery in the Beyoğlu Eye Training and Research Hospital Strabismus Unit, the conjunctiva was closed by tying the conjunctival suture externally in the right eye and internally tying the left eye. Absorbable 8/0 polyglactin suture was used for conjunctival suturing in all patients. Pain, itching, tearing and, discomfort sensations of the patients were questioned and a slit-lamp examination for conjunctival inflammation and dissolution of the suture were evaluated on the postoperative 1st day, 1st week, 1st month, and 6th weeks.Results: Twenty-two patients were female and 28 were male. The mean age of the patients was 7.24 ± 4.83 (range: 4-17) years. When the pain, stinging and discomfort of the patients were questioned, 46% of the patients stated that they felt more comfortable in the left eye on the 1st and 10th days, while 48% of the patients stated that they were equal in both eyes. When we evaluated the melting of the suture and conjunctival redness, it was observed that the suture in the left eye was melted prematurely at a rate of 40% and, the conjunctival redness resolved early in the first month. There were equal pain and redness in both eyes at a rate of 54%. Conclusions: In strabismus surgery, the closure of the conjunctiva by tying the suture internally is thought to increase patient comfort in the postoperative period.

Objectives: The most common opinion about apnea/hypopnea formation in restrictive pulmonary diseases is based on decreased lung volumes causing upper airway collapse. This study targets to reveal some evidence for this pathophysiological pathway in patients with idiopathic pulmonary fibrosis (IPF) and obstructive sleep apnea (OSA).Methods: The clinical, demographical, and polysomnographic characteristics of 19 patients with OSA and IPF who underwent all-night polysomnography (PSG) were retrospectively evaluated for investigating the correlations between lung volumes calculated on the images of high-resolution computed tomography (HRCT) and polysomnographic findings. Supine HRCT images performed at the time of diagnosis of IPF were used for the calculation of total lung volume and low attenuation areas of the lung (LAA). The results were compared with the results of the PSG and pulmonary function tests (PFT).Results: The study group comprised 19 patients (3 female, 16 male) with a median apnea-hypopnea index (AHI) of 23.5/h. AHI in this IPF cohort was not correlated with body-mass index, neck circumference, age, or PFT. However, overall AHI and non-rapid eye movement (non-REM) AHI had a trend of positive correlation with LAA. We also showed a positive correlation between the LAA and forced vital capacity (FVC) (r=0.682 and, p = 0.003).Conclusions: The severity of OSAS in IPF patients is well correlated with LAA. This result supports the gravitational and the volumetric effect of the lung in apnea-hypopnea formation.

Enophthalmos, shallow fornices, and deep superior sulci in the eyelids may be encountered in patients with an anophthalmic socket due to gradual fibrosis of orbital tissues. Herein, a 42-year-old woman presented to our clinic due to dissatisfaction with the sunken appearance of her right upper eyelid. She had undergone evisceration surgery in the past and had been using a prosthesis in the right eye for the last 30 years. Moreover, ophthalmologic examination revealed a deep superior sulcus deformity of the right eyelid. A dermis fat graft was placed and volumetric correction of the right upper eyelid sulcus deformity was performed, which resulted in significant rejuvenation of the upper eyelid sulcus deformity on postoperative follow-up. In conclusion, dermis fat grafts can be used as a safe alternative method for volumetric correction of intraconal or extraconal volume loss that develops in patients with an anophthalmic socket.

Objective: The purpose of the study was to quantify the optical coherence tomography angiography (OCTA) features of non-proliferative and proliferative macular telangiectasia type 2 (MacTel2). The retinal vessel density (RVD) of the superficial and deep layers of the retina were studied.Methods: This cross-sectional and observational study was carried out at İstanbul Beyoğlu Eye Training and Research Hospital. Patients clinically diagnosed with MacTel2 underwent fundus photography, fluorescein angiography, spectral domain OCT, and OCTA imaging. Superficial and deep RVD in the foveal and parafoveal regions were calculated using device automated software. Results: Thirteen eyes of 8 patients (4 male, 4 female) with a mean age of 64.6±3.8 years were included. The mean RVD of the superficial fovea and parafovea were 30.3%±9.3% and 49.5%±6.4% in non-proliferative MacTel2, compared with 39.4%±3.3% and 43.8%±2.9% in the proliferative MacTel2, respectively. No statistically significant difference was found between non-proliferative and proliferative MacTel2 (p=0.31, p=0.41; respectively). The mean deep foveal and parafoveal RVD was 30.4%±7.8% and 50.7%±3.8% in non-proliferative MacTel2 versus 47.5%±0.2% and 55.3%±8.4% in proliferative MacTel2, respectively. There was a significant difference in deep foveal RVD between proliferative and non-proliferative MacTel2 patients, whereas no difference was found in deep parafoveal RVD (p=0.02 and p=0.23, respectively). Conclusion: The mean deep foveal RVD was significantly higher in proliferative MacTel2 than in non-proliferative MacTel2. Measurement of RVD in the deep retinal layers by OCTA may have diagnostic value in patients with proliferative MacTel2.

İnsan gözü, fizyolojik yapısı itibarıyla tehlikeli çevresel koşullarave maddelere maruz kalan hassas bir organdır. Endüstriyel maddeler, çevresel kimyasallar, kozmetikler, kişisel bakım ürünleri ve yanlış uygulandığı takdirde bazı ilaçlar korneada irritasyona, inflamasyona ve hattagörme kaybına bile neden olabilir. Bu nedenle tehlikeli maddelere maruzkalma riskini azaltmak için ilaçların, kozmetiklerin ve bu ürünlerin içerisinde yer alan bileşenlerin test edilerek, göz irritasyon potansiyellerinindeğerlendirilmesi gerekir. Günümüzde birçok ilaç ve kimyasal maddeningöz üzerindeki etkilerini araştırmak için birçok in vitro yöntem geliştirilmektedir. Bu yöntemlerin en sık kullanılanları “yeniden yapılandırılmışinsan korneası (RhCE)” modelleridir. RhCE modellerinde, insan korneahücreleri veya insan derisi keratinositleri gibi hücreler kullanılabilir. RhCEepitel hücrelerinin kullanıldığı sistemlerle ilgili Ekonomik Kalkınma ve İşbirliği Örgütünün Test Kılavuzu, 492 kılavuz yayımlanmıştır. Ayrıca birçok yeni oküler toksisite doku modelinin, gelecekte kullanıma girmesiiçin çalışmalar devam etmektedir. Ancak ilaç ve biyomedikal sektörlerinde göz irritasyonunu değerlendirmek için hâlâ hayvan deneyleri yapılmaktadır. Diğer taraftan, Avrupa Birliği Kozmetik Komitesi tarafındanonaylanan Kozmetik Direktifi (76/768/EEC) ile 2013’ten itibaren kozmetik bileşenler ve bitmiş ürünler için hayvanlar üzerinde test edilmesitamamen yasaklanmıştır. Kozmetik sektöründe hayvan deneylerinin yasaklanmasıyla birlikte, oküler toksisiteyi değerlendirmek için ex vivo vein vitro birçok alternatif yöntem geliştirilmiştir. Bu derlemede, oküler toksisite test yöntemlerindeki en son gelişmeler hakkındaki bilgiler özetlenecek, yöntemlerin avantajları ve dezavantajları tartışılacaktır.

Objectives: During external dacryocystorhinostomy (DSR) - Bicanalicular silicone tube implantation (BSTI), it is aimed to utilize the mechanical pressure effect due to the initiation of silicone knotting inside the lacrimal sac and evaluate the effectiveness of this modified technique in which the sac and nasal mucosa posterior flaps are not sutured. Methods: Sixty-six patients between the ages of 8-57 years who were admitted to Kartal Lütfi Kırdar Training and Research Hospital and Somalia Mogadishu Recep Tayyip Erdogan Training and Research Hospital Eye Diseases outpatient clinic with irrigation and lacrimal secretion complaints between January 1, 2010 and December 31, 2019 were included in the study. In these patients with lacrimal stenosis, external dacryocystorhinostomy (DSR) and Bicanalicular silicone tube implantation surgery method were applied. Results: A total of 66 patients, 3 males (4.5%) and 63 females (95.5%), were included in this study. The mean age of the patients was 45 (8-57) years. It was determined that 4 of the patients who were followed up for an average of 16 months developed atrophic mucosa due to chronic rhinitis, and 6 developed nasolacrimal ductus obstruction due to excessive wound healing due to young age. Conclusions: When the comfort and complications it provides are evaluated together, this technique emerges as a preferred method.

Orbital myositis is a rare manifestation of systemic lupus erythematosus (SLE). Herein, we report a case of orbital myositis in a patient with SLE, along with a literature review. A 45-year-old female patient presented with pain in the right eye, chemosis, proptosis, and limited abduction. Computed tomog-raphy of her orbits revealed thickening of her right lateral rectus muscle. She had no other systemic symptoms. There was no elevation in the biomarkers of inflammation or disease activity. She was treated with high-dose steroids, and her symptoms resolved rapidly. It is important to maintain a high index of suspicion for orbital myositis in patients with SLE even when there are no systemic disease activities, such that early treatment can be initiated. It is also important to rule out other mimickers such as orbital cellulitis and thyroid eye disease.

Objective: Eye injuries are one of the leading causes of disabling ocular morbidity. The objective of this bibliometric study was to evaluate the top 100 cited articles on ocular trauma published between 1975 and 2018 via multidimensional citation analysis. Methods: We analyzed the top 100 cited articles among 3,768 ocular trauma articles published between 1975 and 2018; these articles were obtained from the databases in Web of Science and PubMed based on their citation rates per article, publication years, countries of origin, institutions or organizations, the most common subjects, funding status, article types, and levels of evidence. The data obtained were analyzed with the SPSS® 20.0 software package program.Results: In the top 100 cited articles on ocular trauma, the total number of authors was 420 and the average authorship was 4.20±2.23 (range: 1–14). In our study, 70 of the top 100 cited articles were published in journals with an impact factor (IF) of ≥2.00 (range: 2.016–8.806), and Q index or quartile score of these journals was mostly Q1. Although the most preferred journal was Ophthalmology according to the total number of citations and articles (n=2,183 and n=23, respectively), Eye was the most preferred journal according to the mean number of citations per article. Besides, the three most common topics among the top 100 cited articles were mechanical eyeball injury (40 articles), epidemiology of ocular trauma (19 articles), and traumatic eye infection (17 articles). The average level of evidence was found to be 3.14±0.66 (range: 1–4), and the mean number of citations per article was the highest level at 2. Moreover, we also found that the most commonly preferred article type by authors was clinical research (92 articles), and most of them were in the B level of evidence group (70 articles).Conclusion: Analysis of the top 100 most cited articles on ocular trauma as an update study can provide us scientific contributions and vital current data in clinical implementations.

It can be seen that, especially pearls and corals, among the preciousstones that the nature present to humans as gifts, are frequentlydepicted in the European painting. These stones which are attractivewith their beauty and luminosity, are adorning the canvases for variousreasons. The aim of this study is to look at the history of Europeanpainting through the elegant world of jewelry and gemstones. It isinteresting to see that pearls and corals have rich mythological andbiblical connotations as well as being symbols of status and power.The time scope of the research is between 15th and 17. centuriesbecause of the intensity of the pictures showing pearls and corals in theart historical periods of Renaissance and Baroque. Pearls are amongthe symbols of the love and beauty godddess Venus. It is possible tosee pearls in the pictures that show the birth of Venüs in an oyster orVenus in front of a mirror. Egyptian queen Cleopatra, dropped a beadof pearl in her glass, in the banquet that she organized for Antonius.Painters who depicted the queens and royal ladies of Europe, showedthem in rich jewellery decorated with pearls. In some works of art,pearls are interpreted as the sign of wordly pleasures and ambitions.Corals, believed to be protecting against the evil eye, can be seenin the paintings of young women and little children. Corals, with itsstrong color of red, are depicted in the compositions of Virgin Maryand Christ Child. In the Greek mythology, it is believed that Perseuscreated corals. Some artists, presented scenes of pearl or coral fishingon their canvases.

A 76-year-old lady presented to emergency department for left eye sudden visual loss, and fundoscopy found cherry-red spot over thecentral macula with attenuated retinal vessels. Central retinal artery occlusion (CRAO) was diagnosed. She did not complain of new onsetheadache, but mild tenderness on palpation over left temporal area with vaguely weak pulsation detected. After the acute management ofCRAO pharmacologically, rebreathing into paper bag, and ocular massage; patient underwent hyperbaric oxygen therapy hoping to salvagethe ischemic retina while waiting for the erythrocyte sedimentation rate result. Result was >100 mm/hr, and high dose oral steroid wasstarted immediately. Superficial temporal artery biopsy (TAB), performed 2 days after steroid treatment, was diagnostic of giant cell arteritis(GCA). Positron emission tomography and computerized tomography scan revealed vasculitis over thoracic aorta, left common carotid andsubclavian artery. Ocular imaging of CRAO, histology of GCA on TAB are discussed with the interesting images.

Objective: Our aim in this study was to compare the neutrophil to lymphocyte ratio (NLR) in rapid eye movement (REM) related obstructivesleep apnea (RRO) syndrome (OSAS) and position related OSAS (SRO) to habitual snorers (HSN) and try to find out the phenotype that increasesthe physical stress more.Methods: The patient charts and polysomnograms of all subjects referred to Yedikule medical center for chest diseases sleep departmentbetween June 2019 and January 2020 were reviewed and classified as RRO, SRO and HSN. Fasting blood tests were performed in the morningfollowing polysomnography. The phenotypes of OSAS were compared to each other by means of NLR.Results: A total number of 147 cases were reviewed. Forty eight cases were SRO, 49 cases were RRO and 50 were simple snorer. The NLR in RROwas statistically significant from those of SRO and HSN subgroups (p=0.001), whereas NLR in groups SRO and HSN were identical (p=0.650).Apnea Hypopnea index and O2 nadir in all groups were statistically significant from each other.Conclusion: Our data suggests that the REM related OSAS increases NLR as a predictor of inflammation, but NLR stays constant in Positionrelated OSAS and simple snorers.

Image segmentation is a significant step in image processing that applies to various fields. These fields include machine vision, object detection, astronomy, biometric recognition systems (face, fingerprint, plate, and eye), medical imaging, video surveillance, and many other image-based technologies. Efficient image segmentation is one of the most important tasks and critical roles in automatic image processing. Especially in engineering studies, finding the most suitable solutions for problems is one of the important research topics. Bio-inspired algorithms such as Particle Swarm Optimization (PSO), Ant Colony Optimization (ACO), Artificial Bee Colony (ABC), and Bat Algorithm (BAT), etc. are used to find the optimal solutions in search spaces and Ant Lion Optimization (ALO) is one of these algorithms. In recent years, bio-inspired algorithms are used to optimize the segmentation parameters of the images. This research proposes a modified region growing (RG) image segmentation approach using bio-inspired ALO. Region growing (RG) has three main problems as the selection of the right seeds, the number of seeds, and the region growing strategy. Therefore, ALO was used to solve seed selection problems in RG. In this study, firstly, the median filter was applied to the inputs to improve the quality of the images. Subsequently, the region growing segmentation was carried out using optimal seed points obtained from the ALO. For obtaining the optimal seeds, ALO was used to solve the limitations of RG during the segmentation process. The success of the proposed approach was tested using some images taken from the BSDS300 (Berkeley) dataset. The experimental results show that the proposed method segments almost all the images.

Objectives: To investigate the efficacy of the bleb needling revision (BNR) procedure with the adjunctive useof 5-Fluorouracil (5-FU) in encapsulated bleb after unsuccessful trabeculectomy.Methods: We reviewed 16 eyes of 15 subjects who underwent BNR procedure due to encapsulated bleb afterunsuccessful trabeculectomy. Demographic data, type of glaucoma, intraocular pressure (IOP) values of preBNR, IOP values of post-BNR at first day, first week and first month, follow up time and complications wererecorded from patients’ files, retrospectively.Results: The mean follow up time was 53.1 ± 26.4 weeks. The average time between previous unsuccessfultrabeculectomy and BNR was 11.12 ± 8.79 weeks. The mean IOP of pre-BNR was 26.0±4.4 mmHg andsignificantly decreased to 12.4 ± 5.0 mmHg post-BNR at the first day (p < 0.001). The mean IOP values ofpost-BNR at the first week was 13.3 ± 4.9 mmHg and at the first month was 14.8 ± 4.8 mmHg. According tothe mean IOP of pre-BNR, the mean IOP values of post-BNR at the first week and at the first month weresignificantly lower (p < 0.001 and p < 0.001, respectively). Seven (44%) eyes were achieved success and eight(50%) eyes were achieved qualified success. One (6%) eye was classified as the failure.Conclusion: The bleb needling revision procedure with the adjunctive use of 5-FU in encapsulated bleb afterunsuccessful trabeculectomy is a simple, useful and repeatable method to restore the dysfunctional bleb.

Objectives: Aim of this study is to investigate the effect of intravitreal aflibercept therapy in an 18-monthperiod in patients with recurrent neovascular age-related macular degeneration resistant to intravitrealranibizumab.Methods: This is a prospective study of eyes with neovascular age-related macular degeneration switched tointravitreal aflibercept with at least 18 month of follow-up after the switch. All patients had had a minimum of6 injections of ranibizumab before the switch. All patients received a loading dose of three intravitreal 2 mgaflibercept injections at 4-week intervals. Changes in best-corrected visual acuity, central macular thicknessand the frequency of injections were compared.Results: The study included 39 patients, each with one diseased eye. The studied eyes had received an averageof 10.74 ± 4.38 previous intravitreal ranibizumab injections over a period of 28.31 ± 18.08 months. During thestudy, an average of 6.94 ± 2.58 intravitreal aflibercept injections were given in a period of 18 months. Meancentral macular thickness at baseline, before switching to aflibercept, 6, 12, and 18 months after the afliberceptinjection were 327.44 ± 120.57, 354.50 ± 127.79, 290.20 ± 112.25, 311.70 ± 119.47, and 299.29 ± 98.38 μm,respectively. A significant change was found in the macular thickness measured at intervals throughout thestudy. However, no significant improvement was found in visual acuity after 18 month after switching toaflibercept.Conclusions: Switching from intravitreal ranibizumab, an inhibitor of vascular endothelial growth factor-A,to aflibercept, another inhibitor for such factors, has increased central macular thickness significantly withoutchanges in visual acuity.

Objectives: Behçet's disease is an inflammatory rheumatic disease with recurrent scarring in the oral andgenital area, as well as skin, eye, joint, vein, and nerve involvement. The aim of the study was to investigatethe level of hearing in Behçet’s disease and whether there is a change in hearing levels as the level of thedisease increases.Methosd: In this study we examined 32 patients with Behçet’s disease and 50 healthy volunteers. All patientswere evaluated with audiometry, tympanometry and acoustic reflex tests, as well as detailed ear, nose, andthroat examinations.Results: Sensorineural hearing loss was observed in 9.3% of the patients with Behçet's disease, according tothe audiological data, and all patients were bilateral. We also observed sensorineural hearing loss to be the fifthmost common symptom in our study. Especially in high frequencies, there was positive correlation betweenhearing levels and disease exposure time (p < 0.05).Conclusions: We think that the audiological examinations should be included in the routine check-ups ofBehçet's patients. In addition, a follow-up assessment of the hearing level of these patients with high frequencyaudiometry may be more meaningful.

Objective: The purpose of this study was to compare the efficacy of two different intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents in two treatmentnaiveand statistically equal cohorts of diabetic macular edema patients.Methods: In this retrospective study, 81 eyes of 64 treatment-naive diabetic macular edema (DME) patients were enrolled. Patients were divided into two groups andboth groups were treated [37 eyes with intravitreal 0.5 mg ranibizumab (IVR) and 44 eyes with intravitreal 2 mg aflibercept (IVA)] with three consecutive injections atintervals of one month. All patients underwent a detailed eye examination including optic coherence tomography and best corrected visual acuity (BCVA; Snellen),biomicroscopy, fundoscopy and applanation tonometry at preoperative, 1st, 2nd and 3rd month. BCVA values were converted into logarithm of the minimum angle ofresolution (logMAR) for statistical analyses. Data were evaluated with SPSS 25.0.Results: Mean BCVA (logMAR) increased from 0.58±0.28 to 0.43±0.29, 0.39±0.25 and 0.32±0.26 (p=0.001, p<0.001, p<0.001) in the IVR group and from 0.54±0.28 to0.41±0.34, 0.43±0.39 and to 0.32±0.37 (p=0.004, p=0.023, p<0.001) in the IVA group. Mean central macular thickness (CMT) decreased from 406±82 μm to 345±65μm (1st month), 332±83 μm (2nd month) and finally to 303±60 μm (3rd month) (p<0.001) in the IVR group and from 415±88 μm to 328±79 μm, 297±54 μm and finallyto 277±54 μm (p<0.001) in the IVA group, respectively. There was no significant difference between the groups in terms of BCVA (p>0.05). In the subgroup analysis, CMTgain in patients with moderate DME (CMT ≤385 μm) was found significantly better in the IVA group compared to the IVR group (1st month: 36.9 vs. 83.6, 2nd month: 36.2vs. 106.3, 3rd month: 3nd 72.7 vs. 125.1; p<0.05).Conclusion: Both anti-VEGFs were equally effective in visual outcomes. Compared to ranibizumab, aflibercept has a rapid and superior therapeutic effect in anatomicalresults, especially in moderate DME cases.

Objective: Dermoid cysts are developmental malformations originating from ectoderm and mesoderm. They are congenital and usually localized inthe head and neck region. Their walls are covered with squamous epithelium and may contain different skin patches and tissues (multiple sebaceousglands, hair follicles, sweat glands, fat, nail, eye, teeth, cartilage). The purpose of this study was to present an approach to the masses in the headand neck region, to evaluate the relationship between preoperative imaging, final pathology and differential diagnosis, and to discuss how treatmentplanning should be done.Methods: In this study, 37 patients, who admitted to our clinic for masses in the head and neck region and who underwent surgery after necessaryconsultations and preoperative evaluation between January 2010 and July 2017 were retrospectively reviewed. Patients were evaluated in terms ofage, gender, lesion size, lesion location, preoperative imaging, intracranial involvement, treatment and complications.Results: Of the 29 patients included in this study, 15 were male (51.7%) and 14 were female (48.2%). The age of the patients ranged from 1 to 28 yearsand the mean age was 10 years. Twenty-two of the lesions were localized on the lateral side of the eyebrows (75.8%), two on the glabella (6.8%), twoin the temporal region (6.8%), one in the occipital region (3.4%), one on the forehead (3.4%), and one in the medial canthal region (3.4%). At the timeof admission, all patients complained of swelling under the skin at the localization of the lesion. At least one imaging modality, primarily computedtomography, was requested to assess intracranial involvement in all patients’ preoperatively. The main reason for the removal of lesions was cosmeticproblems.Conclusion: Dermoid cysts are operated not only for the removal of poor cosmetic appearance, but also for the prevention of possible leakage andinfection, for definite pathologic diagnosis and for prevention of secondary bone changes.

Objective: The aim of this study was to measure and report the pupillary diameter of myopic refractive surgery candidates and to identify the associated factors.Methods: This was a retrospective, descriptive, cross-sectional study. Consecutive patients withmyopia or myopic astigmatism were included in the study. Patients with accompanying ocular pathologies were excluded. Only one eye of the remaining patients was selected using a randomnumber table. Age, sex, spherical equivalent of manifest refraction (SE), and axial length (AL) wererecorded. Scotopic, mesopic, and photopic pupillary diameters were measured with dynamic pupillometery (Sirius, Schwind Eye Tech Solutions AG, Germany).Results: Eighty eyes of 80 patients were included in the study. The mean age of the patients was 28±6years, and mean SE was -5.25±2.26 D. The mean AL was 25.41±1.41 mm. The mean scotopic, mesopic,and photopic pupillary diameters were 6.26±0.60, 5.81±0.61, and 4.43±0.68 mm, respectively. SE andAL were not found to be correlated with pupillary size. The mesopic pupillary diameter was slightlyhigher in females than in males (5.98±0.50 vs. 5.62±0.68; Student t test; p=0.037). There was a statistically significant negative correlation between mesopic and scotopic pupillary diameters and age.Conclusion: This study investigated the pupillary diameters of myopic refractive surgery candidates and showed that age and sex are the most important determinants of pupillary diameter.

OBJECTIVEIn this study, three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated RT(IMRT), and volumetric-modulated arc therapy (VMAT) techniques were compared in patients withglioblastoma multiforme (GBM) receiving RT. Comparisons were made in terms of sparing the organsat risk (OAR), by using European Organisation for Research and Treatment of Cancer-Advisory Committee on Radiation Oncology Practise (EORTC-ACROP) guideline.METHODSRT in 10 patients was replanned. Treatment volume was created according to the EORTC-ACROP, and60 Gy/30 fraction dose was prescribed for planning target volume (PTV). PTV-less brain volume (BPTV) Dmean, OARs doses; V5Gy and V50Gy of B-PTV volumes; conformality, and homogeneity indices were analyzed.RESULTSB-PTV was spared better in IMRT. The optic chiasm, contralateral optic nerve, ipsilateral/contralateralcochlea were significantly spared in IMRT and VMAT. The best sparing for brainstem, pituitary gland,ipsilateral eye, ipsilateral lacrimal gland was obtained with VMAT. B-PTV volume received at least 5 Gywas similar in three plans, but lower with 50 Gy in IMRT and VMAT (p<0.001). Although homogenousdose distribution was obtained with similar homogeneity index in all three planning techniques, conformity index was the best in VMAT (p<0.001).CONCLUSIONVMAT provides improved conformity index and good homogeneity in GBM RT using the EORTCACROP target and dose definition. The best sparing for OAR was obtained with VMAT.

Tooth color is one of the most important factors in dental and facial esthetics. Theaim of this study was to determine the tooth color of the upper frontal teeth insubjects and to provide comparisons with different skin and eye colors.Material and methodsTooth color was determined in 255 patients in the intercanine sector of the maxillausing an intraoral spectrophotometer Vita Easyshade® (Vita Zahnfabrik. H RauterGmbH & Co. KG. Bad Sackingen. Germany). Skin and eye color was determined byvisual perception. The shades of the Vita Tooth Guide 3D Master (Vita Zahnfabrik,H Rauter GmbH & Co, KG, Bad Sackingen, Germany) were registered by thespectrophotometer. Pearson’s chi-squared test was used to examine the differencesbetween tooth color and skin and eye color.ResultsThe most frequent shade registered in the central incisors was 2M1 (62 subjects,8.10%); in the lateral incisors, 1.5M1.5 (65 subjects, 8.50%); and in the canines, 2M3(142 subjects, 18.56%). Pearson’s chi-squared test results showed a statisticallysignificant difference in the relations between skin and eye color and central incisorcolor (p<0.01; p<0.001), lateral incisor color (p<0.001), and canine color (p<0.001;p=0.001). On the other hand, no significant difference was observed in the relationof the lateral incisors and canines with eye color.ConclusionSkin and eye color significantly correlate with tooth color; however, the color oflateral incisors and canines does not correlate significantly with eye color.

Medically unexplained physical symptoms (MUPS) are physical complaints which are difficult to diagnoseby the medical analysis. According to studies, traumatic life events, and adverse childhood experiences underliethe occurrence of MUPS. Eye movement desensitization and reprocessing (EMDR) is a therapy that is appliedto treat post-traumatic stress disorder (PTSD), and recently it is known that EMDR can be used in the treatmentprotocol of other mental health problems. This case report demonstrates efficaciousness of EMDR therapy onPTSD-related daytime blindness (hemeralopia).

Objective: The present study aims to determine the number and position of the nutrient foramina (NF) of the human femur, tibia,and fibula and to observe the size, direction, and obliquity of the nutrient foramina.Methods: We observed 265 adult human, lower limb long bones in the Department of Anatomy of the Gaziantep University. Thenutrient foramina were identified with naked eyes, and the obliquity was determined with a hypodermic needle. Gauge 20 and 24needles were used for size determination. Shape was observed with the naked eye and classified into oval and round types. Thenutrient foramina location was determined by dividing total bone length into three segments, and the locations were validatedby calculating foraminal index (FI).Results: Results showed that 79% of the long bones had a single nutrient foramen. More than 96% of the nutrient foramina weredirected away from the knees. A total of 87% of the femoral foramina were located in the middle third, 72% of the tibial foraminawere located in the proximal third, and 98% of the fibular nutrient foramina were located in the middle third of the specimens.Overall, no foramina were found on the distal third of the studied bones.Conclusion: Our study findings are in accordance to the findings from several research studies. The assessment of pathologicalconditions associated with the findings of foramen nutricium in our study may help clinicians and surgeons in planning treatmentsfor applications to be performed in this region. However, it is thought that literature will be a source for basic and clinical sciencesby providing reference values.

Fungal keratitler patojen fungusların korneada yaptığı fırsatçı bir enfeksiyondur. Fungal keratitlerden en sık sorumlu olan etkenler filamentöz funguslardır. Fusarium ve Aspergillus en sık keratit yapan iki filamentöz funguslardır. Göz travması, topikal antibiyotik ve steroid kullanımı, kontakt lens kullanımı, sistemik hastalıkların varlığında (diyabetes mellitus), immun sistemin zayıflaması oluşan keratit olgularında fungusların etken olabileceği akılda tutulmalıdır. Olgumuzda Tip 2 diyabetes mellitusu olan 54 yaşındaki erkek bir hastada izole edilen Aspergillus flavus'un, kötü prognozlu, tedavisi zor, görme kaybına yol açabilmesi nedeniyle öneminin vurgulanması amaçlandı.

Parasitic infestations of the external eye are uncommon and more often prevalent in tropical and developingcountries. We present three cases with ocular infestation caused by three different arthropods admitted to theophthalmology department of a tertiary health care centre during two months. The first case was infected withthe larvae of Oestrus ovis, the second case with Phthiriasis palpebrarum, and the third case with a tick, Ixodesricinus. All patients in this report were living in city center of Bursa, one of the most industrialized cities ofTurkey. Ocular ectoparasitic infestations should be taken into consideration in differential diagnosis ofconjunctivitis, blepharitis and eyelid mass, even if patients living in urban areas. Due to the rarity of ocularectoparasitic infestations and overlapping symptoms with more commonly occuring ophthalmic conditions, acareful ophthalmic examination is required to avoid misdiagnosis and delay in treatment

Dış dünyadan kaynaklanan tehdit ile kişinin bu tehditle başetme kapasitesi arasında ortaya çıkan yaşamsal bir dengesizlik ruhsal travmaya yol açar. Olağan gündelik yaşamı aşan şiddette stres verici olayları artırması nedeniyle (Örn. bedensel yaralanma ve diğer olumsuz etkenler) savaş ve terör ruhsal travma riskini artırmaktadır. Bu gibi koşullar aniden ortaya çıkan tekil olaylara yol açabileceği gibi, kronik ya da birikimli travma anlamına gelen gelişimsel nitelikli çocukluk çağı stres verici yaşantılarını ya da kitleleri topluca olumsuz yönde etkileyen olayları artırarak uzun vadeli zihinsel süreçlere de yol açmaktadır. Bunlar sırası ile Tip I, Tip II, ve Tip III travma yaşantısı oluştururlar. Terör kaynaklı bir bombalama olayına tanık olanlarda ilk aylarda travma sonrası stres bozukluğu sıklığı yaklaşık %10 olarak bildirilmekte olup, kadınlarda bu tanıya daha sık rastlanmaktadır. Savaş ortamında bulunanlarda ve savaş ortamından kaçan sığınmacılarda bu oran %50 dolayına kadar tırmanmaktadır. Bu durumlara müdahelede öncelikle doğal ve toplumsal baş etme mekanizmalarından yararlanılması, ortaya çıkan tepkileri patolojik olarak görmekten kaçınma, kurbandan çok üstesinden gelen kişi rolünün desteklenmesi, duyguların kişinin kendisi için kabul edilebilir bir çerçevede tutulması, matem süreçlerinin yaşanabilmesine olanak tanınması yerinde olacaktır. Çok sayıda kişiyi aynı anda etkileyen travmatik yaşantılarda devlet kurumları, medya, sağlık ve hukuk sisteminin desteği önem taşırken, görece maladaptif tepki geliştiren kişilere tedavi yaklaşımlarında bireysel yaşam öyküsü ön plana çıkmakta ve değişik türde travmatik olayların oluşturduğu örgünün yol açtığı tıkanıklık yaşanmış olayların kişi için öncelik sırasının yeniden düzenlenmesi ve geleceğe bakışı daraltmasını önüne geçilmesi başlıca işlemler olarak kendini göstermektedir. Son birkaç on yıldır gelişen psikotravmatolojinin ilkelerine uyulması yanı sıra göz hareketleri eşliğinde duyarsızlaştırma ve yeniden işleme (EMDR) gibi görece kısa sürede olumlu etki yaratabilen psikolojik destek yaklaşımlarından yararlanılmasının yaşamsal kırılmaya uğrayan zihinsel süreçlerin kişinin ve toplumun geleceğini karartmasını önlemede yararlı olduğu görülmektedir.

This work presents the diagnosis of iris nevus using a convolutional neural network (CNN) and deep belief network (DBN). Iris nevus is a pigmented growth (tumor) found in the front of the eye or around the pupil. It is seen that racial and environmental factors affect the iris color (e.g., blue, hazel, brown) of patients; hence, pigmented growths may be masked in the eye background or iris. In this work, some image processing techniques are applied to images to reinforce areas of interests in them, after which the considered classi ers are trained. We describe the automated diagnosis of iris nevus using neural network-based systems for the classi cation of eye images as nevus affected" and unaffected". Recognition rates of 93.35% and 93.67% were achieved for the CNN and DBN, respectively. Hence, the systems described in this work can be used satisfactorily for diagnosis or to reinforce the con dence in manual-visual diagnosis by medical experts.

Son yıllarda elde edilen birçok teknolojik ve tıbbi gelişmelere rağmen, modern dişhekimliğinde halen dikkate değer sayıda mesleki sağlık sorunları yaşanabilmektedir. Göz yaralanmalarına yol açan risk etkenleri içerisinde en önde gelenleri yüksek hızlı el aletleri ve ultrasonik cihazların kullanımı sırasında ortaya çıkan travmalardır. Dişhekimliği klinikleri, mekanik, kimyasal, mikrobiyolojik ve elektromanyetik iritanların yaygın olarak kullanılmaları nedeniyle göz yaralanmalarına ve enfeksiyonlarına sık rastlanan ortamlardır. Bu ortamda yaşanan kazalar, hekimlerin, hastaların ve yardımcı sağlık personelinin yüz bölgesinde gözleri de içeren yaralanmalara sebep olabilirler. Bu yaralanmalar sonucunda gözlerde hafif iritasyon bulgularından kalıcı körlüğe kadar değişen klinik tablolar ortaya çıkabilir. Özel gözlükler ve yüz maskeleri gibi koruyucu malzemelerin kullanımı, tehlikeli ve fırlayan maddelerin etkilerine bağlı olan göz hasarlarının ve görme kayıplarının ortaya çıkma riskini azaltır. Bu yüzden, risk beklentisi düşük olan sıradan günlük işlemlerde bile bütün önlemler alınmalıdır. Dişhekimleri, hem kendilerine hem de hastalara ve yardımcı sağlık personeline yönelik koruyucu önlemleri almaktan sorumlu olduklarını unutmamalıdırlar

Parry-Romberg sendromu ya da progresif hemifasiyal atrofi; yüz bölgesinde kas, kemik ve cilt dokusunda genellikle tek taraflı olarak görülen, yavaş ve progresif atrofi ile karakterize bir klinik tablodur. Normal ve anormal dokular arasındaki belirgin çizgiye kılıç darbesine benzetilerek "coup de sabre" adı verilmiştir. Yüz deformitesinin ciddiyeti hastalığın ortaya çıktığı yaşa göre değişir. Bu hastalarda kozmetik tedavi başlıca seçenek olmasına karşılık yüz gelişimi tamamlanıncaya kadar ertelenmelidir. Bu olgu bildirisinde 10 aylıkken progresif hemifasiyal atrofi teşhisi koyulan 43 yaşındaki bir kadın hasta sunulmuştur. Sendromun erken yaşta başlamasına ve neredeyse yüzün sağ yarısının tamamını etkilemesine rağmen hastada gözlerle ilgili bir bulguya ya da dişlerle ilgili bir gelişim bozukluğuna rastlanmamıştır

Yüksek Doz Oral Fluoksetin Alımı Sonrası Gelişen Oküler Herpes Simpleks Virus AktivasyonuElli bir yaşında erkek hasta, kliniğimize yüksek göz içi basıncı nedeniyle refere edilmiş. Öncesinde hastaya tam antiglokomatöz tedavi ve lazer iridotomi uygulanmış. Hastanın sol gözünde fikse dilate düzensiz pupilla ve eşlik eden hafif kornea ödemi, parasantral stromal korneal bulanıklık, yama şeklinde iris atrofisi, keratik presipitatlar, ön kamarada eser miktarda hücre ve pigment kümeleri ve açık iridotomi izlendi. Medikal öyküsünde 7 yıl önce geçirilmiş herpetik atak öyküsü belirlendi ve major depresyon nedeniyle 2 yıldır fluoksetin kullanan hastanın göz yakınmalarının başlamasından 5 gün öncesinde ilacı yüksek dozda aldığı belirlendi. Oküler herpes simpleks virus aktivasyonunun yüksek doz fluoksetin alımından olabileceğinden şüphelenildi. Fluoksetin kesildi. Oral asiklovir, topikal steroid ve anti-glokomatöz tedavi başlandı. Bir hafta sonra, hastanın kontrol muayenesinde göz içi basıncının normale geldiği ve klinik bulguların yatışmış olduğu izlendi. Fluoksetin, selektif serotonin geri alım inhibitörü olup, bazı diğer antidepresan ilaçlar gibi, hücresel immüniteyi baskıladığı kanıtlanmıştır. Bu olguda olduğu gibi hastanın gizlice yüksek doz fluoksetin alımı sonrası gelişen herpes simpleks virus aktivasyonu tesadüf olmasından daha olasıdır. Fluoksetin kullanımıyla ilişkili oküler herpes aktivasyonu olgusu ilk kez rapor edilmektedir.

Objectives. To analyse 1.5-year data of our newly established eye bank and to evaluate the factors affectingdonor quality. Methods. Our bank's donor cornea data between July 2013 and November 2014 were retrospectively analysed. The effects of donor age, sex, and time from death to harvesting on the findings of specularmicroscopy were assessed. Results. A total of 139 corneas retrieved from 70 donors. The mean age of donorswas 34.2±14.6 years. The mean time from death to harvesting was 6.7±2.9 hours; the mean timefrom collection to transplantation was 5.2±2.8 days. Age had a significant negative correlation withmean endothelial cell count (ECC), a significant positive correlation between mean cell area (MCA) and standard deviation (SD). Time from death to harvesting had a significant negative correlation with cell count and6A; it had a significant positive correlation with SD, the coefficient of variation, and MCA. Conclusion. According to the results of the present study, ECC, MCA, and SD levels were greater in younger donors. Endothelial morphology was altered as the time from death to harvesting was prolonged; however, the alterationin cell morphology was not severe enough to alter transplantation success with the corneas being harvestedwithin the first 13 hours.

Objectives. To investigate the  characteristics of occupational chemical eye injuries. Methods. Medical records of patients, who were registered to hospital officially as occupational chemical eye injuries between January 2010 and December 2013, were reviewed. The age, gender, injured eye, chemical agent, nature of the chemical, ocular findings, emerging complications and the information whether the patients knew the chemical agent causing the injury was recorded. Results. One hundred one eyes of 82 patients (2 women, 80 men) were included in the study. The mean age of the patients was 32.9±8.6 years (range: 19-59 years). Injury was bilateral in 19 patients. Chemical agents were not known by 53% of the patients. The most known agents were caustic agents (23%). Sulfuric acid (9%) and calcium hydroxide (4%) were other known chemical agents. The most common injury was superficial punctate epitheliopathy. Ten eyes of 9 patients had corneal edema. This injury was caused by acidic agents in 5 and alkaline agents in 3 patients. Corneoscleral perforation accompanied by chemical injury in one patient with car battery explosion. Conclusions. Most of the workers, who had eye injuries with chemicals, do not know the nature of chemical agent which caused the injury. Ocular morbidities may be decreased with the education of the workers about chemicals, working environment and protective measures. 

Objectives. To evaluate the effects of microincision cataract surgery on dry eye-associated symptoms and signs. Methods. This prospective study included 40 eyes of 32 patients. Microincision cataract surgery was performed to eyes through 2.2 mm superior clear corneal incision. Dry eye-associated symptom scoring, corneal sensitivity test, Schirmer 1 test, tear break-up time (tBUT) were measured at 3 days before and 3 days, 10 days, 1 month, 3 months after surgery. ‘One way ANOVA for repeated measures’, and Pearson correlation tests were used for statistical analysis. Results. The postoperative symptom scores were significantly different from preoperative value at all consecutive examinations (p<0.01). The decrease in superior corneal sensitivity was significant at 3 and 10 days (p<0.001), and recovery to preoperative level had occured at 1 month. The decrease in tBUT was significant up to 1 month (p=0.007 for 3 days, p=0.008 for 10 days, and p=0.018 for 1 month). The difference in Schirmer 1 test between pre- and postoperative each visit was not significant (p=0.32, p=0.12, p=0.092 and p=0.088; respectively). Symptom score was highly correlated with operative time (r=0.72, p<0.01), and there was an inverse correlation between operative time and postoperative mean tBUT values (r=-0.52, p<0.01). Conclusions. Despite microincision cataract surgery, an aggravation of dry-eye associated symptoms, and temporary dry eye-associated signs might develop. Operative time and exposure to operating microscope light seem to an important factor on symptoms and tear film stability.

Amaç: Göztepe Eğitim ve Araştırma Hastanesi Göz Hastalıkları Kliniğinde muayenesi yapılan prematüre bebeklerde prematüre retinopatisi (PR) risk faktörlerini ve insidansını araştırmak.Gereç ve Yöntemler: Nisan 2007-Ağustos 2011 tarihleri arasında kliniğimizde muayenesi yapılan prematüre bebeklere ait veriler retrospektif olarak incelendi. Olası risk faktörleri ve göz muayeneleri kaydedildi ve ki-kare, tek değişkenli ve çok değişkenli regresyon analizleri ile değerlendirildi. Bulgular: Çalışmaya alınan 1043 bebeğin 321'inde (% 30,8) PR saptandı. Retinopatili bebeklerin 290'ınde (% 90,3) hafif PR, 31'inde (% 9,6) ağır PR mevcuttu. Evre 3 PR tespit edilen 28 hastadan 8'i tedavisiz düzeldi, 16'sı argon lazer ile düzeldi, 4'ü tedaviye rağmen, evre 4'e ilerledi. PR nedeniyle tedavi edilen hastaların ortalama doğum ağırlıkları 1249.8 g (± 334,2) ve ortalama gestasyon yaşları 29,1 (±3,1) hafta idi. Bu bebeklerden 6'sının doğum yaşı >= 32 hafta idi ve 8'inin doğum ağırlığı >=1500 g idi. Risk faktörleri arasında yapılan logistik regresyon analizinde gestayon yaşı, doğum ağırlığı ve oksijen tedavisinin PR'nde bağımsız faktörler olarak rol oynadığı saptandı.Sonuç: Çalışmamızda, düşük doğum ağırlığı, düşük gestasyon yaşı ve oksijen tedavisi bağımsız risk faktörleri olarak saptandı. Çalışmamızda PR sıklığı, gelişmiş ülkelerdekinden daha yüksek bulundu ve daha matür bebeklerin etkilendiği görüldü. Prematüre retinopatisinde kalıcı hasarların önlenmesinde topluma uygun tarama kriteleri oluşturularak etkin tarama yapılması, prematüre doğumların önlenmesi ve oksijen tedavisinin monitorizasyonu için rehberler oluşturulması önemlidir.

The aim of this paper is to document the presence of the avian trematode Collyriclum faba in Egypt. During bird migration, parasitological research was carried out along the East European bird migration flyway (Jordan, Palestine, Egypt) in 2012 2014. A total of 1783 birds belonging to 87 species, mainly passerines, were macroscopically examined for the presence of parasites. An adult male individual of the willow warbler, Phylloscopus trochilus, examined in Aswan, southern Egypt, presented 5 subcutaneous cysts containing parasites identified as C. faba located on its thighs, above the eye, and on the body under the wing. The parasites were probably transported by the migrating bird over the Balkan Peninsula or Turkey. Collyriclum faba had never been recorded from Africa before.

Dentijeröz kistler, çenelerin en yaygın gelişimsel odontojenik kistleridir. Sıklıkla erkeklerde görülür ve en çok maksillar kanin, mandibular üçüncü molar dişleri etkilerler. Süpernumere ve ektopik olarak sürmüş dişlerle ilişkili olabilirler. Bu makalede; maksiller sinüste ektopik üçüncü molar dişle ilişkili dentijeröz kistin tedavisini sunmayı amaçladık. 16 yaşında kadın hasta, yaklaşık altı aydır olan, sağ yanağının üzerinde ağrılı şişlik şikâyeti ile kliniğimize başvurdu. Tüm daimi dişler sağ üst üçüncü molar dışında mevcuttu. Ekstraoral muayenede yüzde asimetri, göz kürelerinin seviyelerinin eşit olmadığı görüldü. Radyografik muayenede, sol maksiller sinüste ektopik üçüncü molar dişle ilişkili kistik lezyon saptandı. Lokal anestezi altında marsüpyalizasyon yapıldı. Altı aylık takipten sonra genel anestezi ile cerrahi operasyonu yapıldı. Hastanın şikâyetlerinin operasyondan sonra tamamen geçtiği görüldü ve 3 yıllık takipte herhangi bir problemle karşılaşılmadı.Dentijeröz kistin istenmeyen etkilerinden kaçınabilmek için, sürmemiş dişlerin radyolojik incelemeleri dikkatle yapılmalıdır. Tedavi edilmeyen dentigeröz kistler büyük boyutlara ulaşabilir. Ayrıca odontojenik tümör oluşturma potansiyeline sahiptirler

Diabetes mellitus hem sistemik kronik metabolik bir hastalık olarak hem de mikroanjiopatik karakteriyle göz yapısındaki birçok dokuda patolojilere yol açabilmektedir. Korneal yüzey ve gözyaşı sistemini bozmakta, lenste refraktif değişiklikler ya da katarakt gelişimine yol açmakta, retinada diyabetik makulopati ve retinopatiye neden olarak ağır görme kaybına neden olabilmektedir. Diyabetik hastaların uygun aralıklarla oftalmolog tarafından takip edilmesi, diyagnostik ve terapödik uygulamaların profilaktik olarak yapılabilmesi ile görme kaybınının engellenmesi olasıdır

Objective. To evaluate the differential diagnosis and therapy of patients who had ophthalmomyiasis externa, which is a self-limiting parasitic disease and is formed as a result of infestation of ocular surface with myiasis flies. Method. A retrospective study. Result. In our series we evaluated 12 patients attending intense eyelid edema and mimicking an acute catarrhal conjunctivitis, with symptoms of burning, stinging, itching, and increase in lacrymation as well as the sense of foreign body moving in the eye. After further biomicroscopic examination 1 - 2 mm size of mobile, black headed transparent larvae were seen. After mechanical removal of larvae from the eye, topical antibiotic and mild steroid drops were sufficient for improvement. Conclusion. We hereby want to emphasize the importance of careful examination and detailed anamnesis even in conjuncitivitis cases.

Amaç: Göztepe Eğitim ve Araştırma Hastanesi Göz Hastalıkları Kliniğinde muayenesi yapılan prematüre bebeklerde prematüre retinopatisi (PR) risk faktörlerini ve insidansını araştırmak. Gereç ve Yöntemler: Nisan 2007-Ağustos 2011 tarihleri arasında kliniğimizde muayenesi yapılan prematüre bebeklere ait veriler retrospektif olarak incelendi. Olası risk faktörleri ve göz muayeneleri kaydedildi ve ki-kare, tek de- ğişkenli ve çok değişkenli regresyon analizleri ile değerlendirildi.Bulgular: Çalışmaya alınan 1043 bebeğin 321inde (% 30,8) PR saptandı. Retinopatili bebeklerin 290ında (% 90,3) hafif PR, 31inde (% 9,6) ağır PR mevcuttu. Evre 3 PR tespit edilen 28 hastadan 8i tedavisiz düzeldi, 16sı argon lazer ile düzeldi, 4ü tedaviye rağmen evre 4e ilerledi. PR nedeniyle tedavi edilen hastaların ortalama doğum ağırlıkları 1249,8 g (± 334,2) ve ortalama gestasyon yaşları 29,1 (±3,1) hafta idi. Bu bebeklerden 6sının doğum yaşı ≥32 hafta idi ve 8inin doğum ağırlığı ≥1500 g idi. Risk faktörleri arasında yapılan logistik regresyon analizinde gestayon yaşı, doğum ağırlığı ve oksijen tedavisinin PRnde bağımsız faktörler olarak rol oynadığı saptandı. Sonuç: Çalışmamızda, düşük doğum ağırlığı, düşük gestasyon yaşı ve oksijen tedavisi bağımsız risk faktörleri olarak saptandı. Çalışmamızda PR sıklığı, gelişmiş ülkelerdekinden daha yüksek bulundu ve daha matür bebeklerin etkilendiği görüldü. Prematüre retinopatisinde kalıcı hasarların önlenmesinde topluma uygun tarama kriteleri oluşturularak etkin tarama yapılması, prematüre doğumların önlenmesi ve oksijen tedavisinin monitorizasyonu için rehberler oluşturulması önemlidir.

Kalite yönetimi uygulamalarının yaygınlaştırılarak kamu örgütlerinde hizmet kalitesinin arttırılmasına yönelikyapılan bu araştırmanın amacı, çağdaş yönetim teorilerinden olan toplam kalite yönetiminin, kamu yönetimindeuygulama ve kurumsal özdeğerlendirme modellerinden olan Avrupa Birliği Ortak Değerlendirme Çerçevesinin, çalışanalgılarına göre kamu örgütü üzerinde oluşturduğu etkiyi, kurumsal özdeğerlendirme yaparak ortaya koymaktır. Araştırmagrubunu, Ortak Değerlendirme Çerçevesinin (ODÇ) uygulandığı Çalışma ve Sosyal Güvenlik Bakanlığı merkezteşkilatında (ÇSGB) anketi yanıtlayan 379 çalışan ile ODÇnin uygulanmadığı Gençlik ve Spor Bakanlığı Spor GenelMüdürlüğü merkez teşkilatında (SGM) anketi yanıtlayan 247 çalışan oluşturmaktadır.Bu araştırma, tarama modelininkullanıldığı betimsel (tasviri-niceliksel) bir çalışmadan oluşmuştur. Araştırmada veri toplama aracı olarak tarafımızcageliştirilen Likert tipi bir ölçek olan Ortak Değerlendirme Çerçevesi Kurumsal Kalite Ölçeği (ODÇ-KKÖ) kullanılmıştır.Ölçeğin kapsam geçerliliği için 11 kişiden oluşan uzman görüşünden ve pilot uygulamadan yararlanılmış, yapıgeçerliliğine yönelik olarak ise açımlayıcı faktör analizi yapılmıştır. Ölçeğin güvenirliğinin belirlenmesine yönelik olarakda Cronbach alfa katsayısı hesaplanmıştır.Özdeğer grafiğine göre ölçek, tek faktörlü bütüncül bir yapıya sahiptir. Açıklanan varyans % 69.53 çıkmış, buda ölçeğin, kurumsal kalite adı verilen tek faktörlü değişkenini yaklaşık %70 gibi bir oranla ortaya koyduğunugöstermiştir. Bir maddenin faktöre ait olup olmadığını gösteren faktör yük değerlerinin, yaklaşık .80 ile yaklaşık .90arasında olması, maddelerin kurumsal kalite faktörüyle yüksek ilişkide olduğunu ortaya koymuştur. Madde-toplamkorelasyonları yaklaşık .70 ile .90 arasındadır ve maddelere ait Cronbach alfa değeri .98 dir. Kurum değişkeni açısındançalışanların kurumsal kalite algılamalarında ODÇnin uygulanıp uygulanmamasına göre ÇSGB ortalamasının ( =71.37)SGM ortalamasından ( =57.16) yüksek olduğu görülmüş, bu farkın anlamlılığına ilişkin t testi sonuçları da ÇSGBortalamasının SGM ortalamasından anlamlı şekilde yüksek olduğunu ortaya koymuştur. Bu bulgu da bize ODÇninuygulandığı kamu kuruluşunun kurumsal kalitesinin en azından çalışanların gözünde pozitif yönde etkilendiğinigöstermiştir. Sonuç olarak, Avrupa Birliği Ortak Değerlendirme Çerçevesinin uygulandığı kamu örgütüne etkisini ortayakoymak için, önce Ortak Değerlendirme Çerçevesi ölçütleri temelinde bir ölçek geliştirilmiş, sonra kurumsal kaliteyi ölçenbu ölçek ile iki bakanlık merkez teşkilatına kurumsal özdeğerlendirme yapılarak Ortak Değerlendirme Çerçevesininuygulandığı kamu örgütü üzerindeki olumlu etki ortaya konulmuştur.

Amaç: Sarkoidoz nedeni bilinmeyen sistemik granü- lomatöz bir hastalıktır. akciğerler en yaygın etkilenen organ olmasına rağmen, hastalık vücudun herhangi bir bölümünü tutabilir. Doğru tanı için klinik, radyo- lojik multimodal yaklaşım ve histopatolojik değerlen- dirilme önerilir. Çeşitli klinik seyir nedeni ile, standart tanı algoritması yoktur. Sarkoidoz kendiliğinden dü- zelebilir veya aynı kalabilir veya ilerleyebilir. Tedavisi standart değildir ve prognozu kolayca tahmin edile- mez. Bu çalışmada 7 yıl suresi içinde tanı koyduğumuz sar- koidozlu hastaların, klinik ve radyolojik özellikleri, tanı yöntemleri, laboratuar bulguları, organ tutulum- ları ve diğer karekteristik özellikleri konusunda ki bul- gularımızı aktardık. Gereç ve Yöntem: Bu çalışmada merkezimizde 2002- 2009 yılları arasında sarkoidoz tanısı konulan 58si (% 82.9) kadın ve 12ü (% 17.1) erkek toplam 70 hasta retrospektif olarak incelendi. Bulgular: Hastaların yaş ortalaması 43.94 (15-68) idi. Tanı Şekli: Klinik-radyolojik: 6, mediastinoskopi: 30, transbronşiyal biyopsi: 16, bronş mukoza biyopsisi: 6, cilt biyopsisi: 8, periferik LAP biyopsisi: 2, dalak biyop- sisi (splenektomi): 1, torakotomi: 1 idi. Evre, akciğer grafi, bilgisayarlı tomografi, fiberoptik bronkoskopi ve HRCT bulguları, sedimantasyon, WBC, hemoglobin, CRP, ACE, kan kalsiyum ve 24 saatlik idrarda kalsiyum, EKG ve Holter bulgular, göz tutulumu, deri ve diğer akciğer dışı organ tutulumu ve solunum fonksiyon tes- ti bulguları, DLCO, PPD ve patoloji sonuçları açısından değerlendirildi.

Zigomikoz, hızlı ilerleyen ve sıklıkla ölümcül seyreden, Mucorales takımında bulunan Mucor, Rhizopus, Rhizomucor ve Absidia cinsi küf mantarlarının neden olduğu invazif bir fungal enfeksiyondur. Kontrolsüz diyabet, hematolojik maligniteler, uzun süreli kortikosteroid kullanımı veya immünosüpresif tedavi, mukormikoz için predispozan faktörlerdir. Bu çalışmada, Türkiye’den yerli ve yabancı dergilerde son 17 yılda yayınlanmış zigomikoz olgularının yaş, cinsiyet, altta yatan hastalıklar, klinik bulgular, tanı yöntemleri, tedavi şekilleri ve mortalite açısından havuz analizi yöntemi ile incelenmesi amaçlanmıştır. Çalışmamızda iki ulusal (http://uvt.ulakbim.gov.tr, http://www.turkmedline.net) ve iki uluslararası (www.ncbi.nlm. nih.gov, http://apps.webofknowledge. com) veri tabanı kullanılmıştır. Yapılan taramada, 1995-2012 yılları arasında yayınlanmış, çalışma kriterlerine uygun ve tam metnine ulaşılan 64 makale (34’ü uluslararası, 30’u ulusal veri tabanlarında) analize dahil edilmiştir. Bu çalışmalardaki, Avrupa Kanser Araştırma ve Tedavi Derneği (EORTC)’nin kriterlerine göre kesin invazif fungal enfeksiyon tanısı olan toplam 151 (71’i kadın ve 80’i erkek, yaş ortalaması 45.4 ± 21.4 yıl) zigomikoz olgusu değerlendirilmiştir. Hastaların 91 (%60)’i rinoserebral, 42 (%27.8)’si sinoorbital, 7 (%4.6)’si akciğer, 6 (%3.9)’sı disemine, 3 (%1.9)’ü deri, 2 (%1.3)’si gastrointestinal sistem zigomikozu tanısını almıştır. En sık görülen semptom ve bulgular; gözde ve yüzde şişlik (n= 95, %63), ateş (n= 72; %48), nazal obstrüksiyon (n= 60; %40), baş ağrısı (n= 58; %38) ve oftalmopleji (n= 48; %32) olarak izlenmiştir. En sık saptanan risk faktörlerinin, diyabet (%49) ve hematolojik malignite (%39.7) varlığı olduğu belirlenmiştir. Mikolojik kültür 82 olguda yapılmış ve 51 olgunun klinik örneklerinin kültüründe üreme saptanmıştır. Kültürde üreyen etkenlerin dağılımı; Mucor spp. (n= 19, %37.2), Rhizopus spp. (n= 13, %25.5), Zygomycetes (n= 9, %17.6), Rhizopus oryzae (n= 4, %7.8), Rhizopus spp. + maya (n= 3, %5.9), Rhizomucor spp. (n= 2, %3.9) ve Rhizosporium spp. (n= 1, %1.9) şeklindedir. Tanı için, 133 olguda patolojik inceleme ve 126 olguda radyolojik görüntüleme kullanılmıştır. Olguların 115’ine cerrahi girişim ile birlikte antifungal tedavi verilmiş; 30 olgu sadece antifungal tedavi, dört olgu sadece cerrahi tedavi almıştır. Antifungal tedavi olarak; 77 olguya klasik amfoterisin B (AMP-B), 60 olguya lipozomal AMP-B, altı olguya lipozomal AMP-B + posakonazol kombinasyonu ve iki olguya da lipid kompleks AMP-B başlanmıştır. Değerlendirilen olgularda mortalite oranı %54.3 (82/151) olarak tespit edilmiştir. Bu analiz sonucunda elde edilen veriler, mukormikozun tanı ve tedavisinde, ilerlemelere rağmen mortalitenin hala oldukça yüksek olduğunu göstermektedir. Dolayısıyla riskli hasta gruplarında, erken tanı için mukormikozun akılda tutulması ve tedavide cerrahi girişimle birlikte uygun antifungal tedavinin en kısa zamanda başlanması gereklidir.

Amaç: Açık kalp cerrahisinde morbidite ve mortalitenin postoperatif kardiyak pompa yetersizliği ile ilgili olduğu düşünülmektedir. KABG cerrahisinde postoperatif kardiyak pompa yetersizliğinin nedeni iskemik kardiyak arrest ve reperfüzyon sırasında oluşan miyokardiyal hasardır. Bu çalışmanın amacı; KABG uygulanacak hastalarda uygulanan desflurane anestezisinin miyokardiyal korumaya olan etkisini, sevofluran ile karşılaştırmaktır. Yöntemler: Çalışma elektif KABG planlanan ASA II-IV 18-69 yaş arası 40 hasta üzerinde yapıldı. Hastalar rastgele 20şer kişilik 2 gruba ayrıldı. Operasyon masasına alınan hastalarda SKB, DKB, OAB, KAH, SpO2, CVP monitorizasyonu yapıldı. İntravenöz 0,3 mg/kg etomidat, O,1 mg/kg panküronyum ve 1 μ/kg remifentanil uygulandı. Grup Ddeki hastalara % 1-4 desflurane, Grup Sdeki hastalara % 2-4 sevoflurane verildi. Her 2 gruptaki hastalara 0,1-0,4 μ/kg/dk.dan remifentanil infüzyonu başlandı. Cerrahinin sona ermesiyle yoğun bakım ünitesine alınan hastalar SIMV modunda mekanik ventilatöre bağlandı. Bulgular: Olguların demografik verileri benzerdi. Troponin I, CK ve CKMB düzeyleri her iki grupta da preoperatif değere göre postoperatif 6. ve 24. saatlerde artış gösterdi. Ancak, sevofluran grubunda operasyon sonrası 24. saatteki artış desfluran grubuna göre daha az bulundu. Sonuç: KABG cerrahisinde kullanılan desfluran ve sevofluranın yeterli anestezi düzeyi ve hemodinamik stabilite sağladığı, peroperatif miyokardiyal hasarı azalttığı sonucuna varıldı. Miyokardiyal hasarlanma işaretleyicileri olan troponin I, CK, CKMB düzeylerinin sevofluran grubunda daha düşük olması sevofluranın miyokardiyal korumayı desflurana göre daha iyi sağladığını düşündürmektedir.