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Background: It is to examine how child psychiatry admissions, diagnosis and treatment trends in the second wave (September–December 2020/SD20) of the coronavirus disease 2019 (COVID-19) pandemic change compared to the pre-pandemic (SD19) and the first wave (March–June 2020/MJ20). Methods: Our study was planned as a multicenter, retrospective cross-sectional. Data were obtained from hospital computer systems databases. All patients admitted to the child psychiatry clinic on SD19 and SD20 constituted the study sample. In total, 5244 admissions were assessed. Results: Of the admissions, 1459 were repeat exams, and 3785 were cases. 50.9% (n=1927) of the cases came in SD19 and 49.1% (n=1858) in SD20. In 2019, 37% (n=825) of cases were girls, compared to 41.6% (n=646) in 2020 (P=.004). The mean age of those who came in 2019 was 9.61 ± 4.08; The mean age of those who came in 2020 was 10.15 ± 5.38 (P=.002). In 2020, oppositional defiant conduct disorder, major depressive disorder, social anxiety disorder, obsessive-compulsive disorder, sleep-wake disorder, and dysthymia were significantly higher, while specific learning disorders, separation anxiety disorder, and intellectual disability were found to be lower. Conclusion: The decrease in second-wave admissions is less than in the first wave. In the second wave, externalizing and internalizing problems have increased. Drug therapy was prioritized. Postponing admissions was less in the second wave.

INTRODUCTION: A significant rise in the number of trans adolescents seeking medical interventions has been reported in recent years. The aim of this study was to report the clinical features, treatment, and follow-up of adolescents with gender dysphoria (GD) with our increased experience. METHODS: Twenty-six male-to-female (MTF) and twenty-seven female-to-male (FTM) adolescents who were referred to the GD-outpatient clinic between 2016 and 2022 were reviewed. The clinical and laboratory findings of thirty transgender adolescents (15 FTM /15 MTF) who received medical intervention were evaluated retrospectively. RESULTS: Most individuals (60.4%) were admitted between 2020 and 2022, and the remaining (39.6%) were admitted between 2016 and 2019. At the time of referral, median age was 16.3 years [interquartile range (IQR) 1.53; range 13.2-19.4] in 26 MTF, and 16.4 years (IQR 1.74; range 11.7-21.6) in 27 FTM adolescents. The median age at pubertal blockage with gonadotropin-releasing hormone analog and androgen receptor blocker was 16.4 years (IQR 1.4; range 11.7-17.8) in 22 adolescents (9 MTF, 13 FTM), and 17.4 years (IQR 1.4; range 15.5-19.4) in 6 MTF individuals, respectively. Cross-sex hormone therapy was commenced in 21 adolescents (12 MTF, 9 FTM) at the median age of 17.7 years (IQR 0.61; range 16-19.5). Fifteen individuals (8 MTF, 7 FTM) have been transferred to the adult endocrinology department in transition clinics. DISCUSSION AND CONCLUSION: All treatments were generally well tolerated and effective, including bicalutamide, and no significant side effects were observed. Transition clinics played an important role in the better management of gender reassignment processes.

Afetler gibi travmatik yaşam olaylarına maruz kalan bireylerde fiziksel ve psikolojik bazı olumsuz etkilerin görülmesi beklendik bir durumdur. Ancak afetlerin, olaya doğrudan maruz kalmayan bireyler üzerinde de birtakım etkileri olabilir. Bilhassa travmanın mağdurlarına hizmet veren sağlık, medya, arama kurtarma gibi meslek gruplarında, afetin etkilerini medya yoluyla takip edenlerde, mağdurlarla benzerliklere sahip olduklarını düşünen ve özdeşim kuranlarda, travmanın mağdurlarında görülen etkilere benzer ikincil belirtilerin ortaya çıkması beklenebilir. Türkiye ve Dünya, 6 Şubat 2023 sabahına sarsıcı ve yıkıcı etkileri olan büyük bir afet haberiyle uyanmıştır. Kahramanmaraş ve Pazarcık merkezli iki büyük deprem, geniş bir alanda 11 ili ve içinde yaşayanları doğrudan etkilemiş, büyük kayıplara yol açmıştır. Afetin ilk saatlerinden itibaren tüm ülke insanları ve ülke dışında yaşayan vatandaşlar, deprem bölgesinden haber alabilmek için medyayı yoğun biçimde takip etmiştir. Bu çalışmanın amacı, (I)Türkiye’nin 11 ilinde yakın zamanda yaşanan iki büyük deprem olayının, afete doğrudan maruz kalmayan, yaşananları medya yoluyla takip eden bireyler üzerindeki ilk psikolojik etkilerini incelemek ve (II) bu etkilerle başa çıkmada başvurulan yöntemleri belirleyerek, bu başa çıkma yöntemleri arasında dini başa çıkmanın yerini belirlemektir. Veri toplama süreci, afetin ilk etkilerini henüz bellekte taze iken belirleyebilmek amacıyla afetin 40. günü itibariyle başlatılmış ve 6 gün içinde tamamlanmıştır. Veri toplama sürecinde dahil etme kriterleri 18 yaş ve üzeri olmak, Türkiye Cumhuriyeti vatandaşı olmak, 6 Şubat deprem olayını bizzat yaşamamış ve medyadan takip etmiş olmak olarak sıralanmıştır. Çalışmada nitel araştırma yöntemlerinden yapılandırılmış görüşme formu ile online platformlardan ulaşılan 75 kişiden “Yaşanan deprem afetinin duygu ve düşüncelerinizde oluşturduğu olumsuz etkiler nelerdir?” ve “Yaşanan afetin olumsuz etkileriyle baş etmek için neler yaptınız?” sorularına cevap alınmıştır. Katılımcılar afetin yaşandığı bölgenin dışında, Ankara, İstanbul, Kırklareli, Çorum, Konya, Eskişehir, Afyon, Bursa, Kocaeli, Aydın, Kastamonu, Isparta, İzmir, Berlin ve Tilburg’da yaşamakta olan, 21-65 yaş aralığında Türkiye vatandaşı 50 kadın ve 25 erkekten oluşmaktadır. Veriler titiz bir süreç gerektiren tematik analizle incelenmiştir. Araştırmanın sonucu belirlenen iki ana tema; psikolojik sağlık üzerindeki etkiler ve başa çıkma stratejileridir. Psikolojik sağlık üzerindeki etkiler teması altında; ikincil travmatik stres tepkileri ve yas tepkileri alt temalarına ve bu alt temalarla ilişkili kategorilere ulaşılmıştır. Başa çıkma stratejileri temasında ise; kendine yardım, olumlu dini başa çıkma, prososyal davranışlarda bulunma alt temalarına ve bu alt temalarla ilişkili kategorilere ulaşılmıştır. İkincil travmatik stres tepkileri alt teması altında belirlenen kategoriler, aşırı düşünme, gelecekle ilgili olumsuz inançlar, kendini ya da başkalarını suçlama, olumsuz duygu durum (kaygı-korku-panik-stres-donukluk hissi-çaresizlik yetersizlik hissi-aşırı empati), hayatta kalma suçluluğu, aşırı uyarılma, uyku bozukluğu/kabuslar, anlamsızlık ve rutinden kopma; yas tepkileri alt teması altında belirlenen kategoriler şok/inkâr, öfke duyma ve suçlu arama, yoğun kederdir. Başa çıkma stratejileri teması altında, kendine yardım alt temasında; meşguliyetlere yönelmek, sosyal destek almak, deprem haberlerinden uzak durmak, deprem farkındalığı kazanmak ve önlem almak kategorilerine; olumlu dini başa çıkma alt temasında ise dua etmek, ibadete yönelmek, tövbe/şükür/tevekkül etmek ve dini bilgi edinmek kategorilerine ulaşılmıştır. Katılımcıların başa çıkma sürecinde yoğunlukla başvurdukları başa çıkma yönteminin olumlu dini başa çıkma olduğu, bunu prososyal davranışlarda bulunma ve kendine yardım davranışlarının takip ettiği görülmüştür. Elde edilen bulgular literatür ışığında değerlendirilmiştir.

Objectives:This survey study of ophthalmologists investigated the prevalence and clinical manifestations of ocular surface disease (OSD) in glaucoma patients, assessment methods used, risk factors, glaucoma drugs considered responsible, and treatment approaches.Materials and Methods:A questionnaire prepared jointly by the Turkish Ophthalmological Association Cornea and Ocular Surface Society and Glaucoma Society using SurveyMonkey was sent to ophthalmologists via e-mail. The distribution of parameters was compared with chi-square test and p

Background: GM1 gangliosidosis is an autosomal recessive lysosomal storage disease caused by biallelic mutations in the GLB1 gene. Neurodegeneration, hypotonia, visceromegaly, macular cherry-red spots, skeletal dysplasia, and coarse and dysmorphic face are the major clinical features. Aims: To evaluate the demographic and clinical data of patients with GM1 gangliosidosis in a single center. Study Design: A retrospective clinical study. Methods: This study included patients followed at Hacettepe University İhsan Doğramacı Children’s Hospital Pediatric Metabolism Unit with the diagnosis of GM1 gangliosidosis between 1988 and 2021. Hospital records of the patients were reviewed for demographic, clinical, and laboratory findings. Results: Fourteen patients were included in the study and 10 (71.4%) were male. The age at onset of clinical symptoms was between 0 and 5 months, and the median time to diagnosis after the first symptom was 4.3 (0-13) months. Motor delay (54%) was the most common initial symptom. The median follow-up period was 14.8 (0.4-92.2) months. Twelve patients (85.7%) died, and all deaths occurred before the age of 24 months. The median survival was 21.3 (95% confidence interval, 15.5-24.9) months. Higher leukocyte beta-galactosidase activity correlated with later age at onset (ρ = 0.575), later age at diagnosis (ρ = 0.618), and longer diagnostic delay (ρ = 0.702) (ρ < 0.05). Conclusion: Median survival in patients with GM1 gangliosidosis is less than 24 months. Beta-galactosidase enzyme activity may be associated with clinical onset and time of diagnosis in these patients.

Ergenlikten yetişkinliğe geçiş aşamasındaki üniversite öğrencilerini kampüste bilişsel ve sosyal gelişim bakımdan önemli görevler, güçlükler ve sorgulamalar beklemektedir. Aileden ayrılma ve yaşanan bu tür gelişim sorunlarının zamanında, yerinde ve yabancılaşma olmadan onların değerleri çerçevesinde çözümlenmesi son derece önemlidir. Aksi takdirde zamanında müdahale edilmeyen ve çözülemeyen sorunlar onların marjinal tutumlar ve yaşam tarzları geliştirmelerine ve ruh sağlığı bakımdan daha fazla zorlanmalarına yol açabilir. Bu çalışmanın amacı İngiltere’deki üniversitelerde din görevlileri tarafından yürütülen kampüs manevi bakım (MB) hizmetlerinin nasıl yürütüldüğünü göstermek ve benzer bir modelin Türkiye üniversitelerinde geliştirilmesine ön ayak olmaktır. Bu amaçla çalışmada İngiltere’nin Birmingham şehrindeki iki üniversitede çalışan biri Müslüman 4 MB görevlisi ile yapılan nitel çalışmaya yer verilmiştir. Nitel veriler iki ayrı araştırmacı tarafından literatür bilgileriyle karşılaştırılarak analiz edilmiştir. Sonuçta kampüs MB hizmetleriyle ilgili aşağıdaki ana konular ortaya çıkmıştır: Kampüs MB hizmetlerinin tanımı, yapılanması ve organizasyonu, amacı, görevlilerinin eğitimi, uygulamada kullanılan yeterlilikler ve beceriler, temel destek biçimleri, genel stratejiler, danışanlar ve sorunları (sosyal kimlik, aidiyet, inanç ile ilgili konular, ruh sağlığı konuları, yakın ilişkiler), MB görevlilerinin karşılaştıkları güçlükler ve yapılan öneriler yer almaktadır. Çalışma literatür incelendiğinde Türkiye’de ilk çalışma olması bakımından tarihi önemli bir konuma sahiptir ve bu alandaki bulgular Türkiye’de benzer bir modelin geliştirilmesine öncülük edebilecek niteliktedir.

Objectives:To investigate the indications for and results of treating scleral surface problems with donor corneal grafts that are not used in keratoplasty surgery or are left over from keratoplasty.Materials and Methods:The records of 16 patients in whom corneal tissue was used to repair a scleral tissue defect or cover an exposed glaucoma drainage implant were evaluated retrospectively. Partial-thickness grafts were prepared using a combined microkeratome system with artificial anterior chamber in 10 eyes and by manual dissection in 3 eyes. Full-thickness grafts were used in 3 eyes.Results:There were 8 female and 8 male patients aged 5-79 years (mean: 39.37±24.68). Indications for the use of corneal tissue on the scleral surface were limbal dermoid excision (n=2), pterygium surgery (n=1), intraocular lens removal and scleral fixation intraocular lens (SFIOL) implantation (n=1), exposed SFIOL suture coverage (n=1), trauma (n=2), scleral tissue loss due to repeated glaucoma surgeries (n=5), and exposed glaucoma drainage implant (n=4). The patients were followed for 6-42 months (mean: 14.37±9.14). None of the patients had graft infection, thinning, immunological graft rejection, or vision loss during follow-up. Tectonic lamellar grafts did not adversely affect final visual acuity in any case. At final examination, a good combination of graft and recipient tissue, a smooth ocular surface, and a cosmetic appearance were achieved in all eyes.Conclusion:Donor corneas that are not suitable for corneal transplantation or left over from the cornea transplant can be used in patients with scleral tissue loss due to various pathologies and in the treatment of glaucoma drainage implant erosion. In these cases, the use of corneal grafts provides a good ocular surface restoration and cosmetic appearance. The effectiveness and safety of this method should be investigated with large patient series and long follow-up times.

Objectives:To compare our combined surgery (CS) and sequential surgery (SS) results.Materials and Methods:The files of 44 patients who underwent CS (penetrating keratoplasty [PK], cataract extraction, and intraocular lens [IOL] implantation) and 126 patients who underwent SS (cataract extraction and IOL implantation in a second session after PK) between January 2009 and December 2018 were evaluated retrospectively. One eye of the patients who were followed up for at least 1 year was included in the study. The two groups were compared in terms of indications, corrected distance visual acuity (CDVA), refractive results, complications, and graft survival.Results:In the CS and SS groups, the median age was 63 (30-79) and 43 (18-73) years (p

Aim:Hyponatremia is a common electrolyte abnormality in hospitalized patients. Administration of isotonic maintenance fluids is recommended to prevent hyponatremia. The present study was conducted to evaluate the frequency and severity of hyponatremia in children with acute lymphoblastic leukemia (ALL).Materials and Methods:The frequency, severity and possible causes of hyponatremia in children with ALL throughout their entire intensive treatment were retrospectively evaluated. All children in this study received isotonic fluids as maintenance IV treatment during the hospitalization period.Results:In a five-year period, 618 hyponatremia episodes seen in 92 children with ALL (median age 59 months), treated with ALLIC 2002 protocol were entered into the study. The median number of hyponatremia episodes per patient was 6. All patients had at least one hyponatremia episode of which 83.2% were classified as mild, 13.2% as moderate, 2.9% as severe and 0.6% as very severe. The median duration of hyponatremia episodes was 5 (range between 1-43) days. The total duration of all hyponatremia episodes of each patient varied from 6 to 138 days with a median of 30 days. In 241 episodes of 68 children, there was inadequate salt intake secondary to oral feeding intolerance, nausea, vomiting and oral aphthous stomatitis. In four patients, seizure was seen during the hyponatremia period and thought to be secondary to hyponatremic encephalopathy. No patient developed central pontine myelinolysis.Conclusion:Hyponatremia is very frequent in ALL patients. Despite the use of isotonic IV fluids, it seems it cannot be completely prevented.

One of the mechanisms of expulsive suprachoroidal hemorrhage is pressure to the sclera that causes stretching and rupture of posterior ciliary arteries in the presence of full thickness wounds. With this report we present a case of expulsive suprachoroidal hemorrhage in the presence of a full thickness graft–host junction wound. A 73-year-old female patient had a full thickness rupture of the graft–host junction in the 4 o’clock hour quadrants. Expulsive suprachoroidal hemorrhage occurred shortly after the initiation of continuous positive airway pressure therapy, and light perception was negative. The intraocular tissues were replaced in the globe after the drainage of the intraocular hemorrhage and the existing graft was sutured to the host under sub-Tenon’s anesthesia. Although the wounds and sutures remained stable, visual acuity did not improve.

Aims. To compare anatomical and functional success rates in patients with primary acquired nasolacrimal duct obstruction undergoing external dacryocystorhinostomy (EX-DCR) either with adjunctive 5-fluorouracil (5-FU) or silicone tube intubation. Methods. In this retrospective comparative study, 37 eyes in 32 patients who underwent EX-DCR with adjunctive 5-FU (5-FU group) and 43 eyes in 40 patients who underwent EX-DCR with silicone intubation (controls) between 2018 and 2019 were included. Results. The mean age of patients in 5-FU and control groups was 59.8 ± 9.4 and 57.0 ± 15.3 years, respectively. The mean follow-up was 18.70 ± 3.47 months in the 5-FU group and 21.38 ± 7.76 months in the control group. Anatomical success was determined based on patency rates at the time of irrigation and recurrence, while subjective symptoms (improvement in tearing) were used to evaluate the functional success. Lacrimal patency rates in 5-FU and control groups were 83.3% and 86.0%, respectively, while recurrence was observed in 16.2% of 5-FU and 14.0% of control subjects. The two groups were comparable in terms of patency and recurrence rates (p=0.777) as well as rates of epiphora (p=0.212). Conclusion. Both EX-DCR procedures were effective in the management of nasolacrimal duct obstruction. Our results suggest that EX-DCR augmented with 5-FU may represent a more feasible and cost-effective therapeutic option as compared to silicone tube placement in these patients.

Purpose: To detect the factors affecting the final visual acuity in open globe injuries. Material And Methods: Fifty eight eyes of 58 patients who were treated for open globe injuries were analysed prospectively. Factors which are deemed to have effect on visual prognosis were examined statistically. Results: Forty five patients (%77.6) were male, with a mean age of 29.6 ±19.4. Final visual acuity was 0.1 and lower in 28 (%48.3) cases. The prognostic factors predicting the final visual acuity were initial visual acuity, wound size, mechanism of the injury, presence of relative afferent pupillary defect (RAPD), zone of the injury, anterior chamber finding, lens injury, posterior segment finding, uveal injury and Ocular Trauma Score . According to multiple retrospective logistic regression analysis, those factors having the highest effect on final visual acuity were found to be presence of an RAPD, female gender, old age and large laceration respectively. Conclusion: Initial examination findings are helpful for predicting the visual outcome in open globe injuries. Therefore, standardization in classification of the initial examination findings is compulsory.

Objective:Invasive breast carcinomas of no special type (IC-NST) are the heterogeneous tumours showing distinct prognostic features even in patients with similar clinicopathological characteristics. To date, many clinicopathological data have been analyzed to make a guess about prognosis and to determine treatment modality. In this study, HER-2/neu status was analyzed by using both immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) methods, and its correlations with hormone receptor status and clinicopathological parameters were investigated.Materials and Methods:The study was included 112 female patients with diagnosis of IC-NST. FISH for HER-2/neu was applied in only primary tumour tissues, while IHC analyses for HER-2/neu, estrogen (ER) and progesterone receptors (PR) were applied on both primary and metastatic lymph node foci. The results were compared with appropriate statistical methods.Results:Our rates of HER-2/neu overexpression and gene amplification in the overall study group were 22.3 and 25%, respectively. In the metastatic group, these rates were higher than those of the overall study group (34% and 40%, respectively). Gene amplification rate of the axilla positive group was 40%, while this rate in non-metastatic group was 6.7% (p=0.015). Overexpression and amplification results were compliant (χ2=77,591, p

Infectious keratitis after corneal lamellar surgery is a rare complication. In this report, we present unexpected complications after crescentic lamellar wedge resection (CLWR) and their treatment in a patient with pellucid marginal degeneration. A 42-year-old male patient developed fungal keratitis due to Candida parapsilosis in the late postoperative period after CLWR. Infection was controlled with medical treatment. However, recurrent intraocular infections and cataract formation occurred, probably due to capsular damage and inoculation of microorganisms into the crystalline lens during antifungal drug injection. Lensectomy was performed due to cataract progression and recurrence of the infection when treatment was discontinued. Amphotericin B was administered to the anterior chamber at the end of the operation. Four months later, an intraocular lens was implanted and corneal cross-linking treatment was performed. At the last visit, visual acuity reached 9/10. This case shows that good visual acuity can be achieved with appropriate treatment of fungal keratitis and all associated complications after CLWR.

Objective: Deviations in the apoptotic process have been demonstrated in prostate carcinogenesis. We aimed to evaluate especially the process of extrinsic apoptosis in the spectrum of neoplastic lesions of the prostate epithelium so as to reveal the variations in the apoptotic process. Material and Method: The study included 20 benign prostatic hyperplasia, 8 high-grade prostatic intraepithelial neoplasia and 82 prostatic carcinoma patients. Immunohistochemistry was performed on sections obtained from materials of suprapubic prostatectomy, tru-cut biopsy, transurethral resection and radical prostatectomy. While Fas and FasL were evaluated in glandular and stromal areas, DcR1 and FLIP were evaluated in only glandular areas. Intensity and extent of immunostaining for Fas and FasL antibodies were separately scored and both scores were summarized. The total score of ≥ 4 both for Fas and FasL, expressions of FLIP and DcR1determined in more than 5% of glandular areas were accepted as positive. Results: Glandular FasL positivity was observed in 63.8 and 20% of the cases with prostatic carcinoma and benign prostatic hyperplasia, respectively (p=0.001). The loss of stromal Fas expression in PCa was obvious (p

Objectives: To compare clinical outcomes of cases who underwent deep anterior lamellar keratoplasty (DALK) and cases who were converted to penetrating keratoplasty (PKP) from DALK surgery. Materials and Methods: The records of 54 patients for whom DALK surgery was planned and were operated for different diagnoses between March 2013 and June 2015 were retrospectively analyzed. Patients were divided into two groups: group 1 (PKP group) consisted of 23 cases who were converted to PKP due to Descemet’s membrane perforation at any stage of surgery; group 2 (DALK group) consisted of 31 patients whose surgery could be completed as DALK. Preoperative and postoperative follow-up results were evaluated in each group. Results: Corrected distance visual acuity (CDVA) increased in the postoperative period according to baseline in both groups. However, there was no statistically significant difference in the rates of CDVA increase between the groups (p=0.142). The mean astigmatism measured by corneal topography at final examination was 5.8±2.3 diopters in group 1 and 5.4±1.8 diopters in group 2. The difference between groups was not statistically significant (p=0.430). The groups were not statistically different regarding postoperative pachymetry (p=0.453). The grafts in all 54 patients (100%) were clear at final postoperative examination. There were no statistically significant differences between the groups in terms of postoperative complications. Conclusion: Similar clinical outcomes were obtained in our study for patients who underwent DALK and those whose procedure was converted from DALK to PKP.

A 72-year-old woman presented with acute onset of double vision, bilateral complete blepharoptosis, and nearly complete ophthalmoplegia. Orbital and brain magnetic resonance imaging were normal. Further investigation revealed bicytopenia with hepatosplenomegaly. Liver biopsy revealed mantle cell lymphoma. Cytology later showed the presence of mantle cells in cerebrospinal fluid analysis. Her ophthalmoplegia improved from her first cycle of systemic and intrathecal chemotherapy. To the best of our knowledge, this is the second case in the literature of mantle cell lymphoma with central nervous system involvement presenting with ophthalmoplegia. This symptom should be considered one of the initial signs of mantle cell lymphoma.

Objectives: To investigate the correlation of visual field (VF), pattern electroretinography (PERG) and Fourier domain optical coherence tomography (FD-OCT) results in patients with ocular hypertension (OHT) and early primary open-angle glaucoma (POAG). Materials and Methods: The study included 72 eyes of 37 patients with early POAG, 76 eyes of 38 patients with OHT, and 60 eyes of 30 controls. All subjects underwent full ophthalmologic examination, VF assessment with 24-2 Humphrey standard automated perimetry (Swedish Interactive Thresholding Algorithm (SITA)-Standard), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness measurement with FD-OCT, and PERG P50 and N95 wave latency and amplitude measurements with electroretinography (Nihon Kohden). Results: With the exception of the nasal quadrant, all GCC parameters and RNFL results were significantly lower in the POAG group compared to the OHT and control groups. There was no statistically significant difference between the OHT and control group. PERG amplitudes were lower in the POAG and OHT groups than in the control group. Reduction in N95 amplitude was greater than that of P50 amplitude. No difference was detected in PERG latencies among groups. GCC was significantly correlated with VF and RNFL in the POAG group. Conclusion: Significant thinning of the GCC and RNFL occurs in addition to VF pathologies in patients with early POAG, and these examinations should be concomitantly evaluated. During diagnostic assessment of patients with early POAG, GCC and RNFL analysis by FD-OCT are highly effective. GCC is as reliable as RNLF in the early diagnosis of glaucoma and there is a highly significant correlation between them. Dysfunction of ganglion cells in patients with OHT may be detected earlier using PERG amplitude analysis.

Objectives: To report the results of tectonic corneal patch graft (TCPG) in patients with progressive peripheral corneal thinning (PCT). Materials and Methods: In this study, we included 8 patients who underwent TCPG for PCT or perforated corneal ulceration at Ankara Training and Research Hospital. Results: We performed TCPG in 7 patients for PCT and in 1 patient for perforated corneal ulceration. Mean age was 57.2±16.7 (38- 82) years. Postoperative follow-up time ranged from 6 to 24 months (mean 13.9±6.7). Possible etiologies leading to progressive PCT were trachoma, infectious corneal ulcer, and rheumatoid arthritis-severe dry eye in 2 patients each. Other 2 patients had a progressive PCT following ocular surgery. One of the patients with infectious corneal ulcer also had a trauma caused by a scissor. Amnion membrane transplantation was performed in 3 patients prior to TCPG. While the anatomic success was achieved in all 8 patients, best-corrected visual acuity (BCVA) was 0.1 or better in 4 patients (50%). Postoperative BCVA was better than preoperative BCVA in 6 patients (75%). Local peripheral anterior synechiae developed in two eyes. Conclusion: TCPG is a useful therapeutic option in selected cases of corneal thinning and perforations because it effectively restores the integrity of the globe and allows acceptable visual results. (Turk J Ophthalmol 2014; 44: 440-4)

Objectives: Comparison of central corneal thickness (CCT) measurements by ultrasonic pachymetry and Orbscan II corneal topography and evaluation of ultrasonic pachymetry repeatability for same observer. Materials and Methods: The study included 132, 82, and 80 eyes of 66 patients with primary open-angle glaucoma (POAG), 41 patients with ocular hypertension (OHT), and 40 controls, respectively. All subjects were subjected to routine ophthalmic examination. Orbscan II (Bausch&Lomb) corneal topography and ultrasonic pachymetry (Nidek Ultrasonic Pachymetry UP-1000) were used for measurement of CCT. ANOVA (Turkey test) was used for variable distribution, paired sample t-test was used for repeated measurements, and the analyses were done by SPSS 20.0. Results: Mean CCT was 558.9±37.2 µm by ultrasonic pachymetry and 553.4±37 µm by corneal topography. There was a significant difference between the two measurements (p0.05). CCT was 555±39.2 µm, 564.3±28.4 µm, and 559.7±41.5 µm by ultrasonic pachymetry in POAG, OHT, and control subjects, respectively; CCT was 550.3±38.3 µm, 558.5±28 µm, and 553.2±42.5 µm by Orbscan II corneal topography in POAG, OHT, and control subjects, respectively. There was a significant linear correlation between Orbscan II corneal topography and ultrasonic pachymetry in CCT measurements (r=0.975, p

Purpose: To determine the factors that influence the surgical success in patients with infantile esotropia and to evaluate the relationship between amount of bilateral medial rectus recession and convergence. Material and Method: We retrospectively investigated the records of 188 patients with infantile esotropia who were operated on. The surgical success rate, the factors that influence the surgical success, and the relationship between amount of bilateral medial rectus recession and convergence deficiency were evaluated. Successful outcome was defined as deviation amount lower than 10 prism diopters postoperatively. Results: The mean age of the 188 patients included in the study at presentation was 54.9±56.8 (5-276) months, and the mean surgical age was 60.7±54.8 (7-276) months. Success was provided in 70.7% of patients after the first surgery and in 86.7% of patients after repeated surgeries. It was seen that gender, surgical age, refractive error, surgical procedure and the presence of fusion before surgery did not affect surgical success. Residual esotropia was found more frequently in patients with large-angle preoperative deviation, whilst both residual esotropia and consecutive exotropia were found more frequently in patients with amblyopia. It was observed that augmented bilateral medial rectus recession did not cause an increase in postoperative convergence deficiency. Discussion: Since the presence of amblyopia affects the surgical success negatively, it must be identified and treated preoperative. Residual esotropia is more frequently seen in patients with large-angle deviation preoperative, and more than one surgery may be required to provide orthophoria. In these cases, augmented bilateral medial rectus recession is a safe and effective method that rescues the patient from repeated surgeries and may be preferred to three-or four-muscle surgeries. (Turk J Ophthalmol 2013; 43: 413-8)

Keratoconus (KC) is a common bilateral, non-inflammatory, and progressive ectatic disease of the cornea. KC is a complex condition of multifactorial etiology; the exact etiology is unknown. The onset of the disease is at around puberty; it progresses slowly thereafter and may become stationary at any time. Management of keratoconus has advanced during the last few years and is still in progress. Spectacles and contact lenses can be sufficient to correct the refractive error in early and some moderate cases of KC. In the past, penetrating keratoplasty was the only surgical treatment in advanced KC with corneal opacities. Nowadays, modern managements have been developed to stop the progression of the disease, to rehabilitate vision, or to achieve both. The purpose of this article is to collect literature about current interventional methods in the treatment of KC, such as corneal collagen cross-linking, intracorneal rings, conductive keratoplasty, intraocular refractive lenses, lamellar keratoplasty, and to take notice of important parameters that affect the decision of the proper management. (Turk J Ophthalmol 2013; 43: 263-9)

Purpose: To evaluate the effect of amniotic membrane transplantation (AMT) in the treatment of corneal ulcers resulting from herpetic keratitis (HK) and bacterial keratitis (BK). Material and Method: Forty-six patients (25 HK, 21 BK) treated with AMT for HK or BK-related corneal ulcers between January 2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization) prior to AMT and epithelialization time, as well as final visual acuities after AMT, were evaluated. Results: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33) months and 10.2±6.8 (3-27) months, respectively. The ulcers were mostly central in HK (72%) and paracentral in BK (52.4%) (p=0.03). Ulcer depth was deeper than 1/2 of the cornea in 14 (56%) HK and in 7 (33.3%) BK (p=0.290). Eight HK patients had scars from previous herpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50) days in HK and 22.1±10.9 (8-45) days in BK (p=0.488). While epithelialization was achieved in all the patients with BK, 3 HK patients needed adjunctive surgeries (conjunctival flap, tectonic penetrating keratoplasty) in spite of three AMTs. Although visual acuities improved significantly in both groups, this improvement was more evident in BK cases (p=0.018 for HK and p

Corneal ectasia or recurrent keratoconus after penetrating keratoplasty is rare, and few case reports exist in the literature concerning this condition. Computerized corneal topography is quite useful to identify and manage this disorder. Management consists of several methods ranging from spectacle and contact lens correction to repeated penetrating keratoplasty. Clinical and computerized topography findings of two patients with keratectasia following penetrating keratoplasty are presented in this article. Two healthy 45-year-old and 25-year-old male patients complained of decreased visual acuity following penetrating keratoplasty. Clinical and topographical data were consistent with recurrence of corneal ectasia. After repeated penetrating keratoplasty, best-corrected distance Snellen visual acuity of 0.7 was obtained in the 45-year-old patient. The other patient underwent collagen cross linking, received antiglaucomatous therapy, and his visual acuity reached 0.5. During the follow-up period, ectasia progression did not occur. (Turk J Ophthalmol 2013; 43: 124-8)

Pur po se: To determine the factors affecting the outcome of best-corrected visual acuity (BCVA) in blunt ocular trauma cases. Ma te ri al and Met hod: 142 eyes of 142 patients, who were admitted to the 2nd Eye Clinic Emergency Service of M.H. Ankara Training and Research Hospital between June 2007 and August 2008, with blunt ocular trauma were prospectively included in the study in terms of the last-measured BCVA, the factors affecting it, and the ensuing complications. Re sults: Patient age ranged from 3 to 76 years (mean age: 31.9 ± 17.6 years). One hundred and seven cases (75.4%) were male and 35 (24.6%) were female. The last-measured BCVA in 120 cases (84.5%) was found to be log MAR ≤ 1.00 and in 22 cases (15.5%) was log MAR > 1.00. According to the one-way analysis of variance, the effect of initial visual acuity (p = 0.039), incision size (p = 0.029), relative afferent pupillary defect (RAPD) (p

Pur po se: To review the surgical results in patients who underwent an eyelid reconstruction with rhomboid flap after periorbital and medial canthal tumor excision. Ma te ri al and Met hod: This study included 18 patients who underwent eyelid reconstruction with rhomboid flap after periorbital and medial canthal tumor excision. The patient charts were reviewed for topographic data, tumor features, surgical technique, and postoperative results. Re sults: The mean age of the patients (10 women, 8 men) was 58 years (age range: 22-78 years). The lesion was located in the inferior periorbital-malar area in 8 patients, in the medial canthal area in 8 patients and in the lateral periorbital area in 2 patients. Mean tumor diameter was 8.9 mm (range: 5-13.5 mm). Rhomboid flap was used alone in 14 patients (78%) and in combination with nasojugal advanced flap and semicircular flap in 2 patients (11%) each. The skin defect could be closed primarily in all patients, except one. A secondary surgical intervention was required for ectropion and pyogenic granuloma excision in 1 patient each. The aesthetic outcome was satisfactory in all patients. Mean follow-up time was 23 months (range: 2-64 months). Dis cus si on: Rhomboid flap can be used for medial canthal and periorbital eyelid reconstruction after tumor excision. This flap technique can be combined with other reconstruction methods for large defects. After surgery, aesthetic and functional results are satisfactory in most patients, whereas surgical complications and need for a secondary surgery are rare. (Turk J Ophthalmol 2012; 42: 280-3)

Möbius syndrome is a congenital disease which is characterized by horizontal ophthalmoplegia and facial paralysis. Four patients who were referred to our clinic and were diagnosed as Möbius syndrome were included in the study. Of these, two cases were followed up on a regular basis. In one of these two cases, bilateral medial rectus recession and inferior oblique tenotomy were performed. The other case underwent strabismus surgery followed by amniotic membrane transplantation. In this patient, lateral rectus muscle was determined as hypoplastic during the surgery and medial rectus muscle resection was performed. It was observed that satisfactory refractive and surgical outcomes could be achieved in patients with esotropia. It should be considered that structural muscle anomalies and/or horizontal gaze palsy may accompany this condition, therefore, cranial and orbital magnetic resonance imaging can be helpful in determining these anomalies before the surgery. (Turk J Oph thal mol 2011; 41: 417-22)

Pur po se: The aim of this study was to investigate the effect of ultrasound time on macular thickness and the influence of macular thickness on visual acuity after uneventful phacoemulsification surgery. Ma te ri al and Met hod: In this study, 42 eyes of 30 cataract patients who underwent uncomplicated phacoemulsification surgery were evaluated. The phacoemulsification was performed using 20% “pulse mode” ultrasound energy. The ultrasound time of each case was noted. Visual acuity (logMAR) and macular thickness were measured pre- and postoperatively. Macular thickness was measured by “spectraldomain” optical coherence tomography using “macular map 6” (MM6) programme. Re sults: All patients who underwent uncomplicated phacoemulsification surgery showed a statistically significant improvement in bestcorrected visual acuity in postoperative first and third months (p=0.001). When minimum central macular, mean central zone, mean parafoveal and mean perifoveal macular thicknesses in the postoperative first week, first month and third month were compared with the preoperative values, a statistically significant increase in all zones was detected (p=0.001). The mean ultrasound time applied was 128 sec. ±11 SD: 70.17. No statistically significant correlation was found between ultrasound time and increase in macular thickness in the postoperative first week, first month and third month. There was no significant correlation between best-corrected visual acuity and minimum central macular/central zone macular thickness. Dis cus si on: This study shows that in patients who underwent uneventful phacoemulsification surgery, there is an increase in macular thickness independent of ultrasound time. We also found no correlation between macular thickness and visual acuity. (Turk J Ophthalmol 2011; 41: 286-90)

AbstractThe purpose of this study was to develop a scale to measure the traumatic religious experiences among Muslims and assess its validity, reliability, and factor structure. Data were collected from 452 (25.9% men and 74.01% women) Muslim participants in Turkey aged 18–60 or over (the average age group was 30–33) on an online platform. Measures included an original Muslim Religious Trauma Scale comprising newly constructed religious trauma items, Religiosity Scales, the Subjective Happiness Scale, the Brief Trauma Questionnaire, the Post-Traumatic Symptom Scale, and the Dissociation Scale. The results of exploratory factor analysis revealed six factors: spiritual incongruence, spiritual disappointment, social or peer pressure, feelings of sin and guilt, sexual abuse, and corporal punishment. It was found that the association of religious trauma with general trauma, post-traumatic symptoms, and dissociation supported the assumption of concurrent validity of the newly developed Muslim Religious Trauma Scale. Additionally, it also confirmed the idea that some of the adverse religious experiences could be traumatic. [ABSTRACT FROM AUTHOR]

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There is a limited number of studies comparing the levels of inflammation in adolescent patients with anorexia nervosa (AN) and healthy controls based on complete blood count and platelet parameters. This study is a retrospective cross-sectional analysis of 53 drug-naive patients with AN and 53 healthy controls. Significant differences were observed for WBC (white blood cell), neutrophil, MCV (mean corpuscular volume), MCH (mean corpuscular haemoglobin) and neutrophils/lymphocytes ratio (NLR) between the study groups. Patients with AN had lower WBC, neutrophiles and NLR values. But there was no difference between the groups in terms of inflammation-related platelet parameters. A strong positive correlation between BMI (body mass index) and PLT (platelet), PCT (plateletcrit) was determined in the patient group (r = 0.454, p = 0.001; r = 0.386, p = 0.007). Inflammation-related parameters may increase as BMI increases with nutrition and weight restoration. The present study provides further evidence for level of inflammation in these patients does not increase during the acute period, unlike other mental diseases. [ABSTRACT FROM AUTHOR]