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Purpose: To investigate the possible changes in retinal nerve fiber layer (RNFL) by optic coherence tomography and in the amplitudes and peak times (PTs) in pattern visual evoked potential (pVEP) and to compare them in obstructive sleep apnea syndrome (OSAS). Methods: This prospective study included patients with mild OSAS (n = 30), severe OSAS (n = 30), and 30 control subjects. All patients were assessed after obtaining the approval from our hospital’s ethics committee. Results: There was no difference in age and gender between the groups (p = 0.184, p = 0.954). By analysis of variance, there was a significant difference in RNFL values among patients with mild OSAS, severe OSAS, and control for three measures of RNFL (average p = 0.044, nasal p = 0.003, inferior p = 0.027). In severe OSAS group, nasal and inferior quadrants of the RNFL were found to be thinner than the control group (p = 0.008, p = 0.031). We showed that the PT of P100 and N145 was prolonged in severe OSAS compared to the control group (p < 0.001) and that PT of P100 was prolonged in mild OSAS compared to the control group (p < 0.05). The amplitude of N75-P100 was significantly decreased in patients with both severe OSAS and mild OSAS compared to the control group (p < 0.001). Correlation of RNFL and pVEP values showed that the inferior quadrant RNFL thickness is correlated with both P100 and N145 PTs (r = 0.271*, p = 0.036 and r = 0.290*, p = 0.043, respectively) and N75-P100 amplitude (r = 0.378**, p = 0.003) in severe OSAS group. Conclusions: In mild and severe stages of the disease, edema and inflammation were evident and VEP PT and amplitudes were affected in both groups. Furthermore, thinning in RNFL in the severe stage of the disease might be associated with higher atrophy levels and prolonged exposure to hypoxia. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Purpose: To conduct a multimodal ophthalmic evaluation of systemic sclerosis (SSc) in patients using ocular response analyzer (ORA), Pentacam, and specular microscopy (SM). Methods: Thirty-one SSc patients and a group of age- and sex-matched controls were enrolled in this cross-sectional study. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with ORA. Anterior chamber depth (ACD), central corneal thickness (CCT), and corneal volume (CV) measurements were obtained using Pentacam. Corneal endothelial cell density (ECD) and CCT were evaluated by SM. Results: SSc patients had significantly lower CH, ACD, and ECD values compared to the control group (p = 0.018; < 0.001; < 0.001, respectively). There was no significant difference regarding CRF, IOP, CV, or CCT measurements acquired by Pentacam and SM. Regarding CCT, SM and Pentacam showed relatively better agreement in SSc patients. Conclusions: Multimodal imaging can provide more comprehensive and useful information regarding the ocular involvement of systemic diseases. The multimodal evaluation in our study demonstrated that the pathologic effects of SSc may manifest as reductions in ACD, corneal elasticity, and ECD before there are any detectable changes in corneal thickness or IOP. © 2019, Springer Nature B.V.

Introduction: Hypoxia during sleep in obstructive sleep apnea syndrome (OSAS) increases intracranial pressure, decreases cerebral perfusion pressure, and alters vascular supply to the optic nerve. Pattern visual evoked potential (pVEP) has revealed that it causes alterations in the optic nerve, and optic coherence tomography has shown that it causes alterations in the retinal and macular layers. Objectives: To detect and compare possible alterations in macula and peripapillary retinal nerve fiber thickness (pRNFL) using OCT and in the optic nerve pathways using pVEP before and after positive airway pressure (PAP) in the patients with severe OSAS. Materials and methods: Thirty patients who were diagnosed as having severe OSAS in the neurology-sleep outpatient clinic and 30 healthy control subjects were included in the study. Ophthalmic examinations were performed prior to (month 0) and after (month 6) PAP treatment, and pVEP (peak time [PT] and amplitude) and OCT parameters (peripapillary retinal-macular layers) were compared. Results: In the comparison between the severe OSAS (before treatment) and control groups, thinning was found in pRNFL (average, nasal, inferior) and in the macular layers (external and internal superior quadrants) (p < 0.05). pVEP investigation revealed increased PT in P100 and N145 waves and decreased amplitude of N75–P100 waves. In the comparisons before and after PAP treatment, a decrease in PT of N75 and P100 waves and increase in N75–P100 amplitudes were found. In the pRNFL, significant thickening was found in the layers with thinning before treatment, whereas no significant thickening was found in macular layers, except for the fovea. Discussion: It was shown that PAP treatment in patients with severe OSAS prevents hypoxia without causing alterations in intraocular pressure and thus reduces inflammation and causes thickening in the pRNFL and macular layers. © 2020, Springer Nature B.V.

Objectives: To compare intraocular pressure (IOP) measurements obtained with the Icare Pro tonometer used in clinical practice and the Icare One self-tonometer. Materials and Methods: Fifty-two eyes of 52 healthy, right-handed individuals with no prior intraocular surgery or ocular trauma, structural ocular pathology, or systemic disease were evaluated. IOP was first measured using the Icare Pro tonometer. The participants were then told how to use the Icare One tonometer and asked to measure their own IOP. The results were analyzed statistically using SPSS v.24. Results: Of the 52 healthy participants, 16 (30.7%) were male and 36 (69.3%) were female. Their mean age was 31.6±6.3 (23-47) years. Mean IOP measured with the Icare Pro was 17.10±6.2 (11.5-25.2) mmHg, and the mean self-measured IOP with Icare One was 14.01±3.4 (7-24) mmHg. When the two methods were compared using Levene’s t-test, there was a significant mean difference of -3.08±0.6 (95% confidence interval: -4.39 -1.78; p

1903’de ilk başarılıuçuşun gerçekleşmesinden sonra havacılık,dünya ordularıiçinde hızla kendisine yer bulmuştur. Askeri kıymetini ise ilk kez Trablusgarp Savaşısırasında göstermiştir. Bu savaşöncesinde kuruluşçalışmalarına başlanan Türk havacılığıda ilk kez Balkan Savaşlarısırasında harekât görevi üstlenmiştir. Birinci Dünya Savaşıile birlikte, Türk havacılığıbüyük bir gelişme içine girmiştir. Büyük Millet Meclisi’nin açılışından sonra bir grup Türk havacısı, İstanbul Maltepe’de konuşlu Tayyare İstasyonu’ndan uçaklarıyla birlikte firar ederek Millî Mücadele’ye katılma isteklerini ortaya koymuşlardır. Ancak, bu havacıların uçaklarıyla birlikte Milli Mücadeleye katılma girişimleri, başarılıolamamıştır. 7 Haziran 1920 günü sabaha karşıdört uçak ile gerçekleştirilen firar girişiminde ancak bir uçak havalanmayıbaşarabilmiş, diğer üç uçak ise kalkışta hasara uğramıştır. Havalanmayıbaşarabilen uçak ise İzmit’e inişte telgraf tellerine takılarak kullanılamaz hale gelmiştir. Bu makalede Mondros Mütarekesi sonrasıTürk havacılığının durumu ile İstanbul’da bulunan bir grup havacının Milli Mücadele’ye katılma girişimleri ve bu girişimin başarısızlığa uğrama nedenleri ele alınacaktır.

Performans sistemi hekimin hizmet başı her işleminin ücretlendi-rilmesidir. Bu uygulama ile üretilen hizmet karşılığı ek ücret alınacak olmasının personelin motivasyonunu arttıracağı, hekim seçme hakkı, nitelikli ve verimli hizmet ile de sağlık hizmeti alanların da hoşnutluğu nun artacağı düşünülmektedir. Ancak diğer basamaklara sevkin azaltıl-ması, motivasyonun arttırılması gibi avantajlara vurgu yapılırken, aşırı maliyet artışı, ekip çalışmasını zayıflatması, gereksiz tanı ve tedavi uy-gulamalarının düzeyini yükseltmesi, yönetim maliyetlerini yükseltmesi ve coğrafik olarak dağılımın dengesiz olması gibi dezavantajları göz ardı edilmektedir. Çalışmamız bir anket çalışmasıdır. Manisa Celal Bayar Üniversite-si Tıp Fakültesi Hafsa Sultan Hastanesi ile Sağlık Bilimleri Üniversitesi İzmir Bozyaka Eğitim ve Araştırma Hastanesinde görevli olup çalışmaya katılmayı kabul eden 210 hekime uygulanmıştır. Hekimlere yaş, cinsi-yet, uzmanlık alanı ve ünvanı ile hekimlik sürelerini içeren sosyo-demografik veriler, ayrıca performans sistemi ve ofansif tıp uygulamala-rı üzerine kendi düşünce ve uygulamaları sorgulanan toplam 33 soru yöneltilmiştir. Çalışmaya katılmayı kabul edip yazılı onam veren 210 hekimden 124’ü (%59) erkek 86’sı (%41) kadındır. Hekimlerin yaşları 24-64 ara-sında değişmekte olup ortalama yaş 37,07± 10,672 olarak, ayrıca meslek tecrübeleri 1-39 yıl arasında değişmekte olup ortalama yıl 12,62 ± 10,835 olarak bulunmuştur. Katılımcıların %89,5’i performansa dayalı çalışmanın mesleki etiği ve deontolojiyi olumsuz etkilediğini, %78,6’sı aşırı rekabet sonucu iş barışının bozulduğunu, %83,3’ü klinikler arası ilişkilerin olumsuz etkilendiğini düşündüğünü belirtmektedir. Aynı za-manda katılımcıların %97,6’sı performansa dayalı ödemelerin adaletli yapılmadığını düşündüğünü, %87,6’sı mevcut sisteminin hizmet kalite-sini düşürdüğünü, %61,9’u ise muayene ve tedavi süresini azalttığını bildirmektedir. Bu çalışmada; hekimlerin performansa dayalı sistem hakkındaki görüşleri ve ofansif tıp uygulamalarının neler olduğunun araştırılması ile çözüm yollarının tartışılması amaçlanmıştır. The performance system is the remuneration of service of the phy-sician. It is considered that additional remuneration will increase the motivation of the personnel and satisfaction will increase in the fields of health service by the right to choose physician, qualified and efficient service.While emphasizing on the advantages such as decreasing the referral to other fields and increasing the motivation, disadvantages such as excessive cost increase, weakening team work, increasing the level of unnecessary diagnosis and treatment applications, increasing management costs and being unbalanced geographic distribution are ignored. Our study is a survey study. The survey study was administered to 210 physicians who agreed to participate in the study and who were working at ManisaCelal Bayar UniversityHafsa Sultan Hospital and İzmir Bozyaka Training and Research Hospital. A total of 33 questions were asked to the physicians regarding their thoughts and practices on socio-demographic data including age, gender, field of expertise and occupational experience duration, as well as performance system and offensive medicine applications. Of the 210 physicians who agreed to participate in the study and gave written consent, 124 (59%) were male and 86 (41%) were female. The ages of the physicians ranged from 24 to 64 years and the mean age was found to be 37.07 ± 10.672. In addition, the occupational experience ranged from 1 to 39 years and the average year was found to be 12.62 ± 10.835. 89.5% of the participants stated that performance-based study adversely affected the vocationalethics and deontology, 78.6% stated that the work peace was impaired as a result of excessive competition and 83.3% of the participants thought that the inter-clinic relations were negatively affected.Moreover, 97.6% of respondents believe that perfor-mance-based payments are not fair, 87.6% of the current system reduces the quality of service and 61.9% of them reduce the time of examination and treatment. The aim of this course is to discuss the opinions of physicians about performance-based system and to investigate the solutions of of-fensive medicine applications.

A 72-year-old woman presented with redness and swelling in the left eye. She had a traffic accident one month ago. Her best-corrected visual acuity was hand movement level in the left eye. Slit-lamp examination revealed hyphemia, scleral perforation and subconjunctival dislocation of intraocular lens. Pars plana vitrectomy was performed for hyphemia and intraocular lens extracted from subconjunctival area. Patient didn’t want seconder intraocular lens implantation and followed as aphakic. As a result, in patients with pseudophakia, intraocular lens may replace under conjunctiva after blunt traumas to the eye., 72 yaşında kadın hasta sol gözde kızarıklık ve şişlik nedeniyle kliniğimize başvurdu. Hastanın öyküsünde yaklaşık 1 ay önce araç dışı trafik kazası geçirdiği öğrenildi. Düzeltilmiş en iyi görme keskinliği sol gözde el hareketi düzeyinde idi. Biyomikroskobik muayenede hifema, skleral perforasyon hattı ve göz içi lensin üst subkonjonktival alanda olduğu görüldü. Hastanın intravitreal hemorajisinin olması nedeniyle hastaya sol pars plana vitrektomi ve göz içi lensinin subkonjonktival alandan çıkarılması ameliyatı yapıldı. Olgumuz başka bir operasyon istemediğinden afak olarak takip edildi. Pseudofakik hastalarda oküler künt travmalar sonrası göz içi lensinin konjonktiva altına yer değiştirebileceği akılda tutulmalıdır.

Amaç: Kliniğimizde prematüre retinopatisi (ROP) ile tedavi edilen hastaların özelliklerini paylaşmakGereç-Yöntem: Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hastanesinde Temmuz 2013-Aralık 2017 tarihleri arasında prematürite retinopatisi açısından değerlendirilen 36.gebelik haftasından önce doğmuş bebeklerin verileri incelendi. Prematürite retinopatisi saptanmayan bebekler periferik retinal vaskularizasyon tamamlanana,retinopati saptanan tedavi gereksinimi olmayan bebekler postnatal 45.haftaya kadar 1-2 haftalık aralıklarla takip edildi.Retinopatisi ileri derecede olan veya takiplerinde ilerleme saptanan bebeklere indirekt laser oftalmoskopi ile diod laser tedavisi uygulandıBulgular: 1394 bebek değerlendirildi.İleri evrede retinopati saptanan ve indirekt laser oftalmoskopi ile diod laser tedavisi uygulanan bebek sayısı 106(%7,6)idi.Bebeklerin 44’si(%41,5)kız, 62’si(%58,4)erkekti, 32 (%30,1) bebek çoğul gebelik sonucunda dünyaya gelmişti.Bu bebeklerin 89’u(%83,9)solunum cihazına bağlı,17’u(%16,1)bağlanmamış idi. Doğum haftası ortalama 27,7 (±2,5) (22-33) hafta,ortalama doğum ağırlığı 1113,94(±362)(500-2020) gramdı. 106 hastanın 212 gözüne tedavi uygulandı.Bu gözlerden 53’inde(%25)zon 1’de 151’ünde(%71,2)zon 2’de,9’sında(%4,2)zon 3’te ROP izlendi.Laser tedavisi uygulanan retinopatili bebeklerin hepsinde evre 2-3/plus hastalığı ve en az sekiz saat kadranını içeren lezyon mevcuttu.Hastalara her göz için ortalama 827,5±300,1(150-1450) atış yapıldı.Tedavi uygulanan bebeklerin işlem sonrası kontrollerinde 2 hasta haricinde hepsinde retinopatide gerileme izlendi. Retinopatisi gerilemeyen ve retina dekolmanı izlenen 2 hasta vitrektomi yapılmak üzere dış merkeze sevk edildi. Bir hastada ise takiplerinde katarakt gelişimi izlendi.Sonuç: Takip ettiğimiz bebeklerin 106(%7,6)‘sına laser tedavisi uygulandı. Tedavi sonrası 2 hasta dışında bütün bebeklerde retinopati geriledi, 1 hastada ise takiplerde katarakt gelişti. Prematürite retinopatisi çocukluk çağı körlük nedenlerinin başındadır ve risk faktörleri barındıran prematür doğumlar dikkatlice muayene ve tedavi edilmeleri önemlidir.

This study aimed to investigate opinions of health workers about workplace on behalf of workers’ rights, occupational safety and relations withadministration in a public hospital. Data were gained from 93 healthworkers working in a district of Diyarbakır , Bismil Public Hospital. Asurvey was conducted among health staff face to face and obtained datawere analyzed by SPSS 15.0 package program. Findings showed that 34,4%of participants were between age of 26-30, 49,5% were female and 83,9%were married. While 53,8% of health staff expressed that they were able toreport their problems to hospital management, 6,5% of them stated thatdirectory of hospital didn’t mind problems of workers. 44,1% of health staffstated that hospital management didn’t take enough measures in order toprovide safety at work. It was also found that 78,5% of participants weresatisfied with trainings for vision and quality of hospital but 33,6% wereunsatisfied with trainings for reporting workplace violence in the hospital.74,2% expressed that employees were not awarded frequently in thehospital. It was found that there was a negative relationship between ageand satisfaction about management relations in the hospital (-,245,p

We studied whether there was an association between development of background or proliferative retinopathy and changes in plasma lipid, lipoprotein, and lipoprotein (a) levels in 112 patients with type 2 diabetes mellitus and in 57 controls. Serum lipoprotein (a) levels were higher in patients with retinopathy than in individuals without retinopathy. Increased serum lipoprotein (a) levels correlated with higher degrees of retinopathy. Thus, lipoprotein (a) may play a role in the development of diabetic retinopathy.

This study investigated whether the degree of diabetic retinopathy correlates with degree of sensorineural hearing loss. Seventy-five diabetic patients and 45 sex- and age-matched healthy controls were evaluated audiologically. Patients were classified into groups by severity of retinopathy: group 1 (n=28), no retinopathy, group 2 (n=4), background retinopathy; and group 3 (n=23), proliferative or end-stage retinopathy. Diabetics had a statistically significant difference at all frequencies of hearing loss, as compared with controls.

PurposeTo evaluate the effectiveness of phenylephrine 2.5% and flurbiprofen 0.03% combined in inducing and maintaining mydriasis during extracapsular cataract extraction (ECCE).MethodsOne hundred patients undergoing ECCE + intraocular lens (IOL) implantation were randomly divided into four groups. The first group was given phenylphrine 10%, the second group phenylephrine 10% + flurbiprofen, the third group phenylephrine 2.5% and fourth group phenylephrine 2.5% + flurbiprofen. Cyclopentolate 1% was used in all patients. Phenylephrine and cyclopentolate were instilled preoperatively four times during 1 hour and flurbiprofen was given four times the day before surgery and twice with an hour's interval before operation. Pre-operative and post-cortex aspiration horizontal pupil diameters were measured with callipers viewed through the operating microscope.ResultsPupil diameters in pre-operative and post-cortex aspiration were no different in the 2.5% and 10% phenylephrine groups (p>0.05). Both diameters were larger and pupillary constriction was smaller in the flurbiprofen groups (pConclusions2.5% phenylephrine was as effective as 10% phenylephrine, with and without flurbiprofen, in inducing and maintaining pupil dilatation during ECCE surgery.

Purpose: To investigate the effect of propolis, a natural resin produced by honeybees, in the treatment of alkali-injured rabbit eyes. Method: A corneal alkali burn was induced by applying filter paper immersed in 1 N NaOH on the central axis of the right corneas of 24 rabbits for 30 s. The animals were divided into three treatment groups: group 1 (control) was given 0.3% tobramycin and phosphate-buffered solution; group 2 was treated with antibiotic coverage and topical 1% ethanolic extract of propolis; group 3 received antibiotic coverage and topical 1% dexamethasone. The dexamethasone-treated group was maintained as the positive control. Drugs were instilled 4 times a day for 7 days. The corneal inflammation was evaluated by calculating the average inflammatory index obtained from clinical observation of the ciliary hyperemia, central and peripheral corneal edema at 24 h, 48 h, on day 5 and day 7, before sacrificing the animals. Then, the corneas underwent routine histological examination. Results: The effects of dexamethasone and propolis on healing of injured corneas were similar (p > 0.05) and significantly better than controls at 24 h (p < 0.01, p < 0.05, respectively), and on day 7 (p < 0.05) with respect to the inflammatory index. On histological observation, inflammatory cell infiltration was lower as compared to control in both the dexamethasone and propolis groups (p < 0.001) and similar with each other (p > 0.05). Conclusions: Our study shows that propolis has an anti-inflammatory effect comparable to dexamethasone in chemical corneal injury.

The tilted disc syndrome is a benign congenital abnormality of the optic nerve head. Since it can be confused with papilledema and chiasmal lesions, differential diagnosis is important. The tilting anomaly may be associated with other abnormalities along the optic nerve. Visual field defects may be similar to those in chiasmal lesions. In order to determine whether the normal crossover of nerve fibers at the chiasm is altered, the crossed and the uncrossed fibers were investigated using the pattern visual evoked responses (PVER) test. Thirty-four eyes of 17 patients diagnosed with tilted disc syndrome were evaluated for refraction, keratometry, color vision with Ishihara, visual field, and PVER. The presence of abnormal nerve fiber decussation was determined by recording PVER from the electrodes mounted on the scalp of both hemispheres. The amplitude and latency differences between the ‘crossed’ and ‘uncrossed’ fibers were not statistically significant (p>0.05). As a result, the tilting abnormality of ...

To test the anti-inflammatory effect of propolis, a natural bee-produced compound, and compare it with corticosteroids for the treatment of endotoxin-induced uveitis (EIU).EIU was produced in all rabbits by unilateral intravitreal injection of 2,000 ng Salmonella typhimurium endotoxin. The animals were then divided randomly into three groups as follows: group A received no treatment (control); group B received methylprednisolone (5 mg/0.1 mL) (positive control); and group C received propolis (5 mg/0.16 mL) by anterior sub-Tenon injection at the time of uveitis induction and at 4 and 8 hours after induction. Inflammation was evaluated by clinical manifestations and by measuring the protein concentration and inflammatory cell content of the aqueous humor.The clinical grade, cell count, and protein levels in the aqueous humor were: control group (6.0 +/- 0.8, 2,519 +/- 470 cells/microL, 32.9 +/- 2.4 mg/mL); methylprednisolone group (1.8 +/- 0.7, 572 +/- 137 cells/microL, 15.2 +/- 1.8 mg/mL); and propolis group (2.3 +/- 0.5, 503 +/- 124 cells/microL, 13.8 +/- 1.5 mg/mL). Statistically significant differences were recorded in the treatment groups when compared to the control group (P.001). The effects of methylprednisolone and propolis on EIU were similar (P.05).Propolis showed significant anti-inflammatory effects on EIU in rabbits. The mechanism of its action warrants further investigation.

Purpose: This study was carried out to get an insight into the ofloxacin elimination after intravitreal injection in rabbits. We also studied the effects of trauma and inflammation on the vitreous ofloxacin levels after intravitreal injection of ofloxacin. Methods: A penetrating eye injury in the right eye was inflicted on 24 rabbits and another 12 animals were used as control. A standardized intraocular inflammation was induced by intravitreal injection of a suspension of Staphylococcus aureus in half of the traumatized eyes. Ofloxacin (200 µg/0.1 ml) was injected into the midvitreous cavity of both traumatized and control right eyes, and samples were obtained at 2, 8, 24 and 48 h after injection. Drug concentrations were measured using high-pressure liquid chromatography analysis. Results: Vitreous levels of ofloxacin were above the MIC90 at 2 and 8 h in all groups for most of the common microorganisms causing endophthalmitis and also at 24 h in traumatized-infected eyes. At the second hour, the mean vitreous concentrations of ofloxacin both in traumatized and traumatized-infected eyes were lower than that in the control eyes (p < 0.05). At 8 h, the mean vitreous concentrations of ofloxacin in the traumatized and in the traumatized-infected eyes were higher than that in the control eyes (p < 0.05). At 24 h, the mean ofloxacin concentration was higher in the traumatized-infected eyes than that in control (p < 0.01) and traumatized eyes (p < 0.05), and also higher in the traumatized eyes than that in the control eyes (p < 0.05). The mean ofloxacin concentrations in the traumatized and traumatized-infected eyes were significantly higher (p < 0.01) than those in the controls at 48 h. The elimination half-life of ofloxacin in the control eyes was 5.65 h and trauma and inflammation prolonged the half-life to 9.47 and 9.72 h, respectively. Conclusion: Clearance of ofloxacin is fast and appears to be reduced by trauma and inflammation. Therapeutic drug levels in traumatized-infected eyes were maintained up to 24 h. This may be an important pharmacokinetic advantage in treating endophthalmitis unless the dose used has local toxicity and allows a longer dose interval when the dose is repeated.

It is possible that corticosteroids administered via nasal spray might reach ocular structures in levels sufficient to provoke an ocular hypertensive response and cause posterior subcapsular cataracts (PSCs) in susceptible individuals. In the present study, 26 patients who had undergone endoscopic sinus surgery were evaluated prospectively with respect to intraocular pressure and PSC formation following the use of nasal steroids for at least three months. Eighteen patients (69%) self-administered 200 micrograms/day of budesonide nasal spray twice daily, and eight patients (31%) self-administered 200 micrograms/day of beclomethasone dipropionate nasal spray twice daily, for a period of three to 19 months (mean 8.8 +/- 3.6 months). Ophthalmologic examination, tonometry, visual field testing and biomicroscopic studies revealed no evidence of ocular hypertension or PSCs during postoperative follow-up. We conclude that intranasal corticosteroids can be used safely for prolonged periods without increasing the risk of ocular hypertension or PSCs.

Amaç: Tek taraflı idiopatik maküla deliği (İMD) olan hastaların asemptomatik diğer gözlerindeki vitreoretinal ara yüzey özelliklerini, yine tek taraflı idiopatik epiretinal membranı (ERM) olan hastaların diğer gözleri ve sağlıklı bireylerin gözleri ile karşılaştırmak. Gereç ve Yöntem: Çalışmaya 33 tek taraflı İMD hastası (1. grup), 33 tek taraflı ERM hastası (2. grup) ve 33 sağlıklı bireyin (3. grup) gözleri dahil edildi. Hastalara ayrıntılı oftalmolojik muayene ve spektral domain optik koherens tomografi (OKT) incelemeleri yapıldı. ERM ve İMD olan hastaların asemptomatik sağlam gözleri ve kırma kusuru dışında oftalmolojik problemi olmayan sağlıklı bireylerin rastgele seçilmiş birer gözlerinde OKT ile elde edilen vitreoretinal arayüz özellikleri ve foveal mikro-yapısal değişiklikler karşılaştırıl- dı. Total arka vitreus dekolmanı (AVD) tanısı ya biyomikroskop ile fundus muayenesinde Weiss halkasının görülmesi ya da OKT’de fovea üzerinde arka hyaloid membrana ait hiperreflektif bandın görülmesi sonucu konuldu. Bulgular: Perifoveal AVD gelişimi 1. grupta %45.5, 2. grupta %21.2 ve 3. grupta %24.2 saptandı. Total AVD olmayan ve vitreofoveal yapışıklığı olan gözlerde OKT kesitleri; farklı foveal deformasyon tipleri ortaya çıkardı. Vitreofoveal yapışıklıkla ilişkili foveal de- formasyon oranı tek taraflı İMD olan hastaların diğer gözlerinde (%27), diğer gruplara göre (%0) istatistiksel olarak belirgin yüksek saptandı (p=0.039). OKT kesitleri, benzer şekilde total AVD olan gözlerde de rezidüel foveal deformasyonlar ortaya koydu. Total AVD olan gözlerde rezidüel foveal deformasyon oranı İMD ve ERM gruplarında birbirine benzer (%33-%27, p=0.75), ancak sağlıklı bireyle- rin gözlerinden (%19, p

Standard treatment of corneal epithelial loss includes an eye patch with antibiotic ointment. We compared the efficacy of eye patching with no eye patching on corneal epithelial healing of 84 patients after foreign body removal. Since no significant difference between two groups for corneal healing was found, antibiotic treatment alone may be sufficient for treatment of corneal epithelial loss after foreign body removal.

To determine the possible relation between pseudoexfoliation (PSX) and sensorineural hearing loss.This study was carried out in Afyon Kocatepe University, Afyon, Turkey between July 2002 and June 2005. Sixty-three patients who were found to have ocular PSX on routine biomicroscopic examination, and 38 age-matched control subjects were evaluated for evidence of audiometric abnormality. The sum of pure-tone hearing threshold measured at 250-2000 Hz, 2000-6000 Hz, and 250-6000 Hz in each ear was compared with controls for the same frequencies.The mean age of the patients was 68.4+/-10.3 years. All patients had PSX affecting at least one eye. Fifty (79.4%) patients with PSX, and 10 (26.3%) control subjects were found to have hearing loss (p=0.00, chi-square). From the 50 patients with PSX who had hearing loss, 34 patients had bilateral PSX, and 16 patients had unilateral PSX. Twenty-nine patients had high frequency hearing loss, while 20 patients had hearing loss in all frequencies. Forty-eight patients with PSX and 7 controls had bilateral sensorineural hearing loss (p=0.030).Sensorineural hearing loss was seen more frequently in patients with PSX in comparison with age-matched control subjects.

In Diyarbakir, the rate of falls from height increases during summer months since people sleep on the unprotected balconies and roofs of their houses. We aimed to determine the frequency of falls from height and the related risk factors.We used questionnaire method and clinical data in this study. The questionnaire was administered in 1445 residences. Clinical data were obtained from files of patients hospitalized due to trauma in the Neurosurgery Clinic of Dicle University over the last six years.In this questionnaire study, it was determined that 246 people had fallen, their average age was 15.4 years, 98% of them had fallen accidentally (mostly from 3.6 m height in summer months), mortality was 6.9%, and the prevalence of falls from height over the previous six years was 472/100,000. Of 464 patients who were hospitalized during the last six years, 326 were cases of fall from height and 59% of these patients were falls from a roof. The average age of these patients was 8.9 years, and average height of the fall was 4.2 m.Falls from height, particularly from roofs in Diyarbakir, remain a serious problem in terms of public health.

The author describes the case of a girl with bilateral persistent pupillary membranes and good visual acuity. An otherwise healthy 10-year-old girl presented with persistent pupillary membranes in both eyes since childhood. The patient had ametropic amblyopia, which was treated with spectacles and part-time occlusion therapy, with the patient responding conventionally. After therapy, her best-corrected visual acuity was 20/25 in both eyes. She had stereopsis of 50 seconds of arc, orthophoria, and normal extraocular movements. The remainder of the examination was normal. Patients with bilateral persistent pupillary membranes may not require surgery if there is adequate opening. The author suggests a trial of refractive correction and occlusion therapy before deciding on surgical and laser intervention, even if it seems an absolute requirement.

Background: Numerous syndromes with myopia and hearing loss have been described up to now. We present a family with pathologic myopia, corneal dystrophy, and deafness distinct from these syndromes. Cases: Ten patients in the same Turkish family were evaluated by ophthalmologic, audiologic, physical, radiologic, genetic, serologic, and biochemical examinations. Observations: Ophthalmic examination indicated that all the cases had myopia, 7 of them had pathologic myopia, 1 had intermediate, and 2 had mild. Four of the patients with pathologic myopia had corneal dystrophy that was bilaterally manifest as white opacities in the posterior stroma near Descemet's membrane in an axial distribution; 1 of these 4 patients also had a tilted disc. Otolaryngologic examination revealed conductive hearing loss in 3 cases, mixed hearing loss in 2, and sensorineural hearing loss in 1. The results of karyotypic analyses of all cases were normal. The pedigree analysis showed the disease was inherited through successive generations as an autosomal dominant trait. The results of biochemical, serologic, and radiologic investigations were normal. The same pathophysiologic process in all cases seemed to account for the myopia, the corneal dystrophy and the deafness. Conclusions: To our knowledge, this type of case has not been reported in the literature. Therefore, we named this syndrome “familial pathologic myopia, corneal dystrophy and deafness.”

To determine whether an intraoperative single dose of dexamethasone, diclofenac, ethylenediaminetetraacetic acid (EDTA), a combination of EDTA and RGD peptide (arginine-glycin-aspartic acid sequence), or mitomycin-C (MMC) is a pharmacological means of preventing or reducing the development of posterior capsule opacification (PCO).Department of Ophthalmology, Celal Bayar University, School of Medicine, Manisa, and Department of Pathology, Dokur Eylül University, School of Medicine, Izmir, Turkey.Fifty-four rabbits were randomly divided into 6 groups. Dexamethasone (4 mg/cc), diclofenac (2.5 mg/cc), EDTA (8 mg/cc), a combination of EDTA and RGD peptide (2.5 mg/cc), or MMC (0.04 mg/cc) was given, 0.1 cc by hydrodissection and 0.9 cc into the capsular bag after phacoemulsification. The sixth group served as a control group. After 3 months, the PCO was graded clinically and the proliferation of lens epithelial cells (LECs) was evaluated histologically.The drugs were significantly effective in preventing PCO compared with the control (P.005). Dexamethasone had a weaker effect than the other drugs. In histological analysis, although monolayer LECs in the dexamethasone and diclofenac groups were observed, there was no proliferative activity on the posterior capsules in the EDTA, EDTA+RGD, and MMC groups in contrast to the multilayer cells in the control.Intraoperative single-dose application of EDTA, EDTA+RGD peptide combination, and MMC significantly prevented the development of PCO in rabbit eyes. Diclofenac was less effective but also reduced PCO. Although dexamethasone did not prevent the proliferation of LECs, it decreased PCO clinically.

To study the aqueous and vitreous penetration of ciprofloxacin after prolonged acute topical administration and to investigate the effects of inflammation on drug penetration.A standardized model of intraocular infection after penetrating injury was made in the right eyes of eight rabbits. The intact left eyes were maintained as the control. Two drops of ciprofloxacin 0.3% eyedrops were instilled topically every 1 h for 7 h to all eyes of the rabbits. Aqueous and vitreous samples (100 microl) were obtained half an hour after the last drop. Instillation was continued for 7 h more and samples were obtained as before. Drug concentrations were measured using HPLC.The mean aqueous humor levels of ciprofloxacin were: in control eyes 1.31 +/- 0.78 microg/ml after 7 h and 1.85 +/- 1.69 microg/ml after 14 h of instillation: in inflamed eyes 2.18 +/- 1.02 microg/ml after 7 h and 2.91 +/- 2.12 microg/ml after 14 h. The mean vitreous humor levels were: in control eyes 0.65 +/- 0.44 microg/ml after 7 h and 0.72 +/- 0.8 microg/ml after 14 h of instillation; in inflamed eyes 0.67 +/- 0.77 microg/ml after 7 h and 1.01 +/- 0.43 microg/ml after 14 h. However, the differences among the groups were not significant (P0.05).Ciprofloxacin penetration into aqueous humor was higher in 14-h topical application than that for 7 h. Inflammation increased the penetration of topical ciprofloxacin into aqueous while administered for 7 h and into both aqueous and vitreous humor while administered for 14 h. c

Purpose: This study aimed to investigate the penetration of topical and oral ofloxacin into aqueous humor and vitreous humor in post-traumatic endophthalmitis model in rabbits. Methods: A standardized intraocular infection after penetrating injury was made in the right eyes of 16 rabbits. Intraocular infection was induced by intravitreal injection of a suspension of Staphylococcus aureus . The intact left eyes were maintained as controls. The animals were divided randomly into two groups. (1) In the topical group, two drops of ofloxacin 0.3% eyedrops were instilled to both eyes every 30 min for 4 h. (2) In the topical-oral group, two doses of 25 mg/kg of ofloxacin at 12-h intervals were given orally, then the protocol of the first group was applied. Aqueous and vitreous humor samples were taken 30 min after the last drop. Ofloxacin concentrations were measured by using HPLC. Results: Mean aqueous levels of ofloxacin in control eyes were: 3.25±2.55 μg/ml in topical group, 4.58±5.39 μg/ml in topical-oral group. Mean aqueous levels in inflamed eyes were: 5.21±4.55 μg/ml in topical group, 10.34±8.88 μg/ml in topical-oral group. Mean vitreous levels of ofloxacin in control eyes were: 0.17±0.07 μg/ml in topical group, 1.30±1.23 μg/ml in topical-oral group. Mean vitreous levels in inflamed eyes were: 0.35±0.22 μg/ml in topical group, 3.48±2.69 μg/ml in topical-oral group. There was no significant difference among the groups ( P >0.05), however. Conclusions: The result of this study suggests that oral supplementation of ofloxacin to topical instillation increased the ocular levels of ofloxacin in the post-traumatic endophthalmitis model. Mean drug concentrations in aqueous and vitreous humors were above the 90% minimum inhibitory concentrations (MIC 90 ) for most of the common microorganisms causing endophthalmitis in all eyes, except in the vitreous humors of the intact eyes instilled topically.

To study the penetration of ofloxacin into the aqueous and vitreous humors after long-term topical administration and to investigate the effects of inflammation on drug penetration in rabbits.A standardized model of intraocular infection after penetrating injury was achieved in the right eyes of 16 rabbits. The animals were randomly and equally divided into two groups. The intact left eyes of the groups were maintained as the control. Ofloxacin eyedrops (0.3%) were instilled into all eyes at a frequency of 2 drops every hour for 7 hours in the first group and for 14 hours in the second group. Half an hour after the last drop, samples of the aqueous and vitreous humors were taken and ofloxacin concentrations were measured by using HPLC.The mean aqueous humor concentrations of ofloxacin in control eyes after 7 and 14 hours of instillation were: 1.45 +/- 0.93 microg/ml and 2.48 +/- 0.33 microg/ml, respectively; those in infected eyes 2.35 +/- 1. 84 microg/ml and 3.49 +/- 1.47 microg/ml, respectively. However the differences among the groups were not significant (p0.05). The vitreous ofloxacin concentrations in the control eyes were similar after 7 and 14 hours of instillation (0.23 +/- 0.14 microg/ml, 0.27 +/- 0.10 microg/ml, respectively). In infected eyes, the mean vitreous ofloxacin concentration after 14 hour of instillation was significantly higher than that in control eyes (p0.05; 0.4 +/- 0. 09 microg/ml, 0.29 +/- 0.11 microg/ml, respectively). The mean vitreous ofloxacin concentration in infected eyes after 14 hours instillation was not significantly higher than that after 7 hours instillation.Topical ofloxacin instillation for 7 or 14 hours yields aqueous concentrations above the MIC(90) for common ocular pathogens. Prolonged application and the presence of inflammation increased the penetration of ofloxacin into the vitreous humor.

To investigate the effects of topical acetylcholine and topical administration of propolis, a natural beehive product, on corneal epithelial wound healing.The whole corneal epithelium was debrided in 42 eyes of 21 rats by mechanical scraping with a dulled scalpel blade. Animals were divided into three groups. Group 1 received topical 1% water extract of propolis (WEP), group 2 received topical acetylcholine (ACh), and group 3 (control group) received topical phosphate-buffered saline, 6 times a day for 3 days, starting immediately after debridement. The area of the corneal epithelial defect was stained with fluorescein, photographed, and then measured every 12 h. The mean epithelial defect area and the mean percentage of epithelial defect remaining at each follow-up were compared between the groups.The mean epithelial defect area and the mean percentage of epithelial defect remaining at each time were significantly smaller (p0.001, p0.05, respectively) in the ACh and propolis groups as compared with control groups. There was no statistically significant difference between the propolis or ACh groups at any time (p0.05). At 72 h, the mean percentage of defect remaining was 2.58% in the ACh group, 1.3% in the propolis-treated group, and 8.68% in the control group.This study demonstrated that ACh and propolis facilitated corneal epithelial wound healing of rats. Although the mechanisms of the effect of propolis on wound healing and its clinical use still remain to be determined, ACh may have a place in the treatment of corneal epithelial injuries.

OBJECTIVE: This study was designed to determine the effects of trauma and infection on vitreous ciprofloxacin levels after intravitreal injection of ciprofloxacin in rabbits. METHODS: A penetrating injury was made in the right eyes of 24 rabbits. In the eyes of half of the traumatized animals, a standardized intraocular infection was induced by intravitreal injection of a suspension of Staphylococcus aureus. The intact left eyes of the traumatized group were maintained as controls. Ciprofloxacin (200 microg/0.1 mL) was injected into the midvitreous cavity of both eyes in all animals and samples were obtained at 2, 8, 24, and 48 hours after injection. Drug concentrations were measured using high-pressure liquid chromatography analysis. RESULTS: At the second hour, the mean vitreous concentration of ciprofloxacin in the traumatized eyes was lower than that in control eyes (P