Search

The aim of this pilot study was to quantify the meibography changes in patients administered with oral isotretinoin. Methods: This prospective pilot study included 30 eyes of 30 patients who received oral isotretinoin treatment due to acne. Each patient underwent a general ophthalmological examination. After fluorescence staining of the ocular surface, the tear film break-up time (TFBUT) test, meibography and Schirmer test were carried out and noted. All of these procedures were applied before the treatment and repeated at 1, 3, and 6 months after the treatment. Results: The percentage of upper meibomian gland (MG) loss at 3 and 6 months after the treatment was 22.2% (p = 0.001) and 23.6% (p = 0.001), respectively. The percentage of lower MG loss at 3 and 6 months after the treatment was 18.7% (p = 0.001) and 20.7% (p = 0.001), respectively. The corneal fluorescein staining score at 3 and 6 months after treatment was 0.57 (p = 0.001), and 0.47 (p = 0.012), respectively. Conclusion: These findings show that oral isotretionin treatment may affect MG morphology. The study findings also suggest that isotretinoin may cause tear film instability with Meibomian gland dysfunction and may cause evaporative type of dryness.

Gürlevik, Uğur ( Aksaray, Yazar ), Purpose: To investigate the effect of oral isotretinoin use on refractive error, axial length, and anteroposterior segment parameters. Materials and methods: In this prospective study, 50 eyes of 50 patients using isotretinoin with a diagnosis of acne vulgaris and 50 eyes of 50 healthy control subjects were included. After detailed biomicroscopy, measurements were taken of axial length, lens thickness, central corneal thickness, anterior chamber depth, central retinal thickness, and subfoveal choroidal thickness. The pupils of both eyes were dilated with one drop of cycloplegic drops after refraction measurement. Visual acuity examination was performed with a Snellen chart the next day. The same procedure was repeated at the end of the third and sixth month of drug treatment. Results: Forty-seven patients with acne vulgaris and 45 healthy controls met the inclusion criteria and were included in the analysis. The mean ages of the patients and the controls were 21.7 ± 2.5 years (range, 18–28 years) and 22.6 ± 2.7 years (range, 19–27 years), respectively. No significant changes were observed in any parameters in the third and sixth month in the control group (p > 0.05). The most important result was significant increases in myopia and axial length in the sixth month of isotretinoin use (p = 0.01, p = 0.04, respectively). There were no significant relationships between increases in myopia and axial length and patients’ age, sex, drug dose, and initial refraction (p > 0.05). The changes in spherical equivalent and axial length differed significantly between the drug group and the control group (p = 0.001, p = 0.001, respectively). Conclusions: Isotretinoin is one of the important molecules in the aetiology of myopia. Oral isotretinoin treatment may increase myopia and axial length, although not to a clinically significant degree. However, as this was a pilot study, there is a need for further studies with more patients and longer follow-up periods.

Yaşar, Erdoǧan ( Aksaray, Yazar ), Purpose: Fabry disease (FD) is characterized by a deficiency in α-galactosidase A activity that leads to the cumulative deposition of unmetabolized glycosphingolipids within organs, including the vascular endothelium and the eyes. The purpose of this study was to assess the effects of FD on the retinal microvasculature, foveal avascular zone (FAZ), macular thickness and retinal nerve fiber layer (RNFL) using optical coherence tomography angiography (OCT-A). Methods: Twenty-five patients (14 female and 11 male; mean age 33.16 ± 11.44) with genetically verified FD were compared with 37 age- and sex-matched healthy controls (mean age 32.36 ± 15.54). The vessel density (VD) values of the superficial and deep capillary plexuses (SCP and DCP), the area of the FAZ, the density of radial peripapillary capillaries (RPC), the macular thickness and the retinal nerve fiber layer thickness were measured by OCT-A examination. Results: The patients showed significantly lower VD values than controls in the foveal regions of both SCP and the DCP (21.15 ± 5.56 vs. 23.79 ± 4.64 (p = 0.048), 37.92 ± 6.78 vs. 41.11 ± 5.59 (p = 0.048), respectively). The FAZ was significantly larger in the FD group than in the control group (0.3 ± 0.1 vs. 0.24 ± 0.08 (p = 0.011)). No significant difference was identified in measurements of RPC density, peripapillary RNFL thickness or macular thickness between the two groups (p > 0.05 for all). Conclusion: Decreased VD and an enlarged foveal avascular area suggest possible changes in the retinal microvasculature of patients with FD. OCT-A can serve as a useful, noninvasive, quantitative tool for diagnosing FD and monitoring its progression.

Amaç: Bu çalışmanın amacı, pterjiyum cerrahisi sonrası otolog serum ve dekspantenol jelin subjektif semptomlar üzerindeki etkisini araştırmaktır.Metod: Haziran 2017 ve Aralık 2017 tarihleri arasında aynı cerrah tarafından yapılan pterjiyum cerrahisi uygulanan hastaların değerlendirilmesi yapıldı. Hastalar 2 gruba ayrıldı. Grup 1’de (n: 18) ameliyat sonrası otolog serum kullananlar ve grup 2’de (n: 12) %5 dekspantenol jel kullanılar vardı. Her iki grupta da postoperatif ağrı, batma, tahriş, kızarıklık ve greft ödemi yönünden değerlendirme yapıldı.Bulgular: Gruplar arasında 1., 3. ve 7. günlerde ağrı, batma ve tahriş açısından istatistiksel olarak anlamlı fark yoktu. Dekspantenol kullanan grupta 3 ve 7. günlerde 1. güne göre bu şikayetlerde istatistiksel olarak anlamlı bir azalma gözlendi. Gruplar arasında kızarıklık ve greft ödemi açısından 1., 3. ve 7. günlerde istatistiksel olarak anlamlı fark yoktu. Her iki grupta da, bu bulgularda 3. ve 7. günlerde 1. güne göre istatistiksel olarak anlamlı bir artış tespit edildi.Sonuç: Pterjiyum cerrahisi sonrası birçok ajan hasta konforunu arttırmaktadır. Otolog serum en güvenilir ve en çok araştırılan ajandır. %5 Dexpanthenol jel, hastanın konforu ve yara iyileşmesi açısından ön segment cerrahisine alternatif olabilir., Purpose: The aim of this study was to investigate the effect of autologous serum and dexpanthenol gel on subjective symptoms after pterygium surgery.Methods: An evaluation was made of patients who underwent the same technique of pterygium surgery between June 2017 and December 2017. Patients were divided into 2 groups with autologous serum used postoperatively in Group 1 (n: 18) and 5% dexpanthenol gel in Group 2 (n: 12). Evaluation was made of both groups in respect of postoperative pain, stinging, irritation, redness and graft edema.Results: There was no statistically significant difference between the groups in respect of pain, stinging and watering on the 1st, 3rd and 7th days. A statistically significant decrease in these complaints was observed on days 3 and 7 in the group using dexpanthenol. There was no statistically significant difference between the groups on days 1, 3 and 7in respect of redness and graft edema. In both groups, a statistically significant increase was determined in these findings on days 3 and 7.Conclusion: After pterygium surgery, many agents increase the comfort of patients. Autologous serum is the most reliable and most investigated agent. Dexpanthenolmay be an alternative to anterior segment surgery in respect of patient comfort and wound healing.

OBJECTIVES Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2-VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2-VASC score in patients with acute ischemic stroke who underwent endovascular intervention. MATERIALS AND METHODS A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2-VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2-VASc score was evaluated. RESULTS CHA2DS2-VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 ± 1.44, 5.02 ± 1.77 p

Early detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 ± 2.32 vs 2.15 ± 1.79, P

Apart from the known factors that cause toxic optic neuropathy, there may be factors that have not yet been identified. We report a 32-year-old man who presented with a complaint of decreased vision. His optic discs were diffusely covered with a black pigment, and below were atrophic. The vessels appeared to have disappeared below the pigmentation. He reported smoking tobacco, drinking alcohol, and using cannabis. His vision in both eyes began decreasing gradually after he started using bonsai, a synthetic cannabinoid, 2 years previously. No case of toxic optic neuropathy with bilateral severe vision loss and intense pigmentation with the use of bonsai has been reported before, and our case will be reinforced if other such cases are reported in the future.

Background Methylphenidate (MPH) hydrochloride is used as a first-line treatment for attention deficit hyperactivity disorder (ADHD). However, there is concern that this treatment may be associated with increased risk of refractive disorder. The aim of this study was to investigate the effect of MPH therapy on myopic shifts in refraction in children diagnosed with ADHD. Methods This study, children with ADHD and meeting inclusion criteria were examined before the initiation of MPH treatment and 3, 6 and 12 months after the initiation of treatment. Twenty age-gender-matched participants who applied to the outpatient ophthalmology clinic with various complaints were included in the study as a control group. Cycloplegic refraction examination and detailed eye measurements were performed at each visit. Results Nineteen patients were included in this study and the group consisted of 11 (57.9%) females and 8 (42.1%) males. The mean age of patients was 11.3 +/- 2. (range: 8-18) years. During 12 months of use of MPH, the spherical equivalent changed from -0.36 +/- 1.08 to -0.39 +/- 1.05, and this difference was not statistically significant (P = .187). Axial length ranged from 22.92 +/- 0.66. There was a change to 22.93 +/- 0.62, and this difference was not statistically significant (P = .076). In the control group, the spherical equivalent changed from -0.43 +/- 0.62 to -0.56 +/- 0.84, and this difference was statistically significant. (P = .012) There was a change in the axial length from 22.97 +/- 0.78 to 22.99 +/- 0.62, and this difference was statistically significant (P = .015). Conclusions No significant changes spherical equivalent and axial length were detected during 12-month MPH use, but the increased spherical equivalent and axial length in the control group in the similar age group may indicate that MPH may reduce myopic shifts in refraction progression through dopamine, similar to in vivo studies. What's newWhat's known Myopia is spreading rapidly in technologically advanced societies. There is strong evidence that myopia develops as the axial length of the eye increases as a result of spending more time indoors and working in close distances in parallel with the increase in education level. Animal studies have shown that decreased dopamine release plays an important role in the development of myopia. The effect of dopamine in slowing or stopping myopia in experimental studies has also been demonstrated in human studies. No significant change in spherical equivalent and axial length was observed in methylphenidate users compared with control patients of similar age group. A significant increase in spherical equivalent and axial length was detected in the control group. This pilot study will shed light on future studies on the safe use of dopamine in the treatment of myopic shifts.

Diyabetes Mellitus, gozun cesitli yapilarini (kornea, ektra-okuler kaslar, intra-okuler kristalin lens, optik sinir, retina ve koroid) etkileyerek gormeyi ciddi sekilde azaltan, giderek prevelansi artan ve birden cok organ sistemini etkileyen kompleks metabolik bir hastaliktir. Pro-aktif ve multi-disipliner yaklasim hastalarda hem gormeyi tehdit eden komplikasyonlari azaltmakta hem de hayat kalitesinde anlamli duzelmeler saglamaktadir. Ciddi gorme kayiplarinin onlenmesi; optimal glisemik kontrol, hipertansiyon vb. gibi sistemik risk faktorlerinin tedavisi ve duzenli taramalar ile okuler komplikasyonlarin erken tani ve tedavisi ile mumkun olabilmektedir.

In the last few decades, Duane’s syndrome (DS) has begun to be classified under as one of the congenital cranial dysinnervation syndromes (CCDDs), as its primary cause is neurogenic. Incomplete forms of DS have been described very recently. This case appears to be the first report of the association of an incomplete DS with synkinesis of the levator and lateral rectus as a severe and complex example of a CCDD.

Objective: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders. Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined. Results: The average age of patients in the study was 15,4 ± 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D ± 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D ± 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D ± 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount. Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase. doi: https://doi.org/10.12669/pjms.37.5.3991 How to cite this:Kara H, Yasar E, Gurlevik U. Is pseudomyopia associated with anxiety and related disorders? Pak J Med Sci. 2021;37(5):1514-1518. doi: https://doi.org/10.12669/pjms.37.5.3991 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Subconjunctival hemorrhage(SCH) is a painless disease that occurs as a result of the localized extravasation of blood to subconjunctival tissue and episcleral space by suddenly rupturing conjunctival vessels. Our aim is evaluate the refractive status, axial length and anterior segment parameters in patients with subconjunctival hemorrhage in this study. A fifty-one eye of 51 patients with subconjunctival hemorrhage and 40 eyes of 40 healthy individuals were enrolled in this prospective study. In detail, systemic diseases, used drugs, and other risk factors were questioned. After demographic questioning, a detailed biomicroscopy eye examination was performed for risk factors. Then refractive error, intraocular pressure, axial length, lens thickness, central corneal thickness, and anterior chamber depth were measurements performed. The mean age of patients with SCH was 49.4±6.8 (28-59) and the mean age of the control group was 50.4±6.8 (32-57). In terms of risk factors of SCH, the patients were divided into 3 groups that had sufficient statistical analysis (HT, use of anticoagulants and history of Valsalva). According to results, a significant difference was found between patients with HT and control groups in terms of spherical refraction (hyperopia) (p 0.05). If the hyperopia, short axial length, and narrow anterior camera are detected in the examination of patients with SCH, the patients should be investigated in detail in terms of HT. In addition, eye related parameters were found to be important in SCH etiology.

To evaluate P-wave dispersion before and after antiepileptic drug (AED) treatment as well as to investigate the risk of ventricular repolarization using the Tpeak-Tend (Tp-e) interval and Tp-e/QT ratio in patients with epileptic disorder.A total of 63 patients receiving AED therapy and 35 healthy adults were included. ECG recordings were obtained before and 3 months after anti-epileptic treatment among patients with epilepsy. For both groups, Tp-e and Tp-e/QT ratio were measured using a 12-lead ECG device.Tp-e interval, Tpe/QT and Tp-e/QTc ratios were found to be higher in the patient group than in the control group (p0.05, for all), while QTmax ratio was significantly lower in the patient group. After 3 months of AED therapy, significant increases in QT max, QTc max, QTcd, Tp-e, Tp-e/QT, and Tp-e/QTc were found among the patients (p0.05). When the arrhythmic effects of the drugs before and after treatment were compared, especially in the valproic acid group, there were significant increases in Tp-e interval, Tp-e/QT and Tp-e/QTc values after three months of treatment (p0.05). Carbamazepine and levetiracetam groups were not statistically significant in terms of pre- and post-treatment values.It was concluded that an arrhythmogenic environment may be associated with the disease, and patients who received AED monotherapy may need to be followed up more closely for arrhythmia.A P-hullám-diszperzió értékelése antiepileptikus kezelés (AETh) előtt és után, valamint a ventricularis repolarizáció kockázatának vizsgálata a Tpeak-Tend (Tp-e) intervallum és a Tp-e/QT arány használatával epilepsziás betegek körében.Hatvanhárom, AETh-ban részesülő beteget és 35 egészséges kontrollszemélyt vontunk be a vizsgálatba. Az epilepsziás betegek körében az EKG-vizsgálatot az AETh előtt és utána három hónappal végeztük. A Tp-e intervallumot és a Tp-e/QT arányt mindkét csoport esetében 12 elvezetéses EKG-berendezéssel mértük.A Tp-e intervallum hosszabbnak, a Tp-e/QT és a Tp-e/QTc arányok magasabbnak bizonyultak a betegcsoportban, mint a kontrollok között (p0,05, mind­egyik esetében), ugyanakkor a QTmax-arány szignifikánsan alacsonyabb volt a betegcsoportban. Három hónap AETh után a betegek körében szignifikáns mértékben növekedett a QTmax, a QTcmax, a QTcd, a Tp-e, a Tp-e/QT és a Tp-e/QTc (p0,05). Miután értékelték az AETh arrhythmiás hatását, három hónapos kezelés után különösen a valproinsavval kezeltek esetében észlelték a Tp-e intervallum, a Tp-e/QT és a Tp-e/QTc arányok szignifikáns növekedését (p0,05). A carbamazepinnel és a levetiracetammal kezeltek esetében nem különböztek szignifikáns mértékben a terápia előtti és utáni értékek.Az epilepszia arrhythmogen környezettel társulhat, és az AETh-ban részesülő betegeket szorosan monitorozni érdemes az arrhythmia kiszűrése érdekében.

Objective: To evaluate corneal parameters of rheumatoid arthritis (RA) patients by corneal topography. Methods: One hundred two RA patients and 60 control subjects were enrolled. Corneal topography measurements and ophthalmologic findings were examined from all participants’ files. Results: Corneal thickness measurements were significantly lower in the RA group (p = 0.025). All values of corneal curvatures (K1, K2, Kmean) in 3 mm, 5 mm, and 7 mm zones were found statistically significantly higher in the RA group compared with the control group. Forty-five RA patients had a dry eye. Disease duration was correlated with dry eye in the RA group. There was a significant correlation between the duration of disease in RA patients and mean corneal curvatures (p 0.012/0.010/0.007, 3/5/7 mm respectively) and central corneal thickness (p 0.025). There is no statistical difference between other topographic measurements. Conclusions: The results suggest that RA patients have thinner and steeper corneas compared with control subjects. These parameters change in negative correlation as the duration of the disease increases.Key Points• Rheumatoid arthritis is an autoimmune disease with systemic involvement.• In rheumatoid arthritis, systemic involvement is affected in the eyes.• When it comes to eye involvement, it comes to mind that it makes the eyes more dryness.• In addition to dryness in the eyes, rheumatoid arthritis makes morphological changes in the cornea.

To investigate the association between overactive bladder (OAB) and coronary artery disease (CAD) as demonstrated on coronary angiography in patients > 65 years. The patients who were > 65 years completed an OAB-V8 form before undergoing coronary angiography at a tertiary care hospital. The presence of OAB was documented using the self-administered OAB-V8 questionnaire. Formal stratification of the coronary vessels plaque burden was assessed by calculation of a Gensini score for each patient. Body mass index (BMI) blood urea nitrogen (BUN), serum lipid profile, fasting plasma glucose, urinalysis, urine culture, uroflowmetry, and postvoiding residual urine volume were measured for each patient. A total of 308 patients were analysed. Before coronary angiography, the patients were divided into two groups according to the score on the OAB-V8 questionnaire. The OAB group (n: 153) comprised those with a score ≥ 8 and the non-OAB group (n: 155), those with a score

To evaluate the dry eye disase and meibomian gland dysfunction with meibography of Seborrheic Dermatit patients.A hundred-ten of 50 patients with Seborrheic Dermatitis (group 1) and 100 eyes of 50 healthy individuals (group 2) were enrolled in this prospective study. All subjects were performed a comprehensive ophthalmic examination including lid margin alterations and meibomian gland obstruction assessment, Ocular Surface Disease Index assessment, tear film break-up time test, corneal and conjunctival fluorescein staining assessment, Schirmer test. In addition, upper and lower lids were evaluated for meibomian gland loss with non-contact meibography. The Meibomian glands were graded from grade 0 (no loss of Meibomian glands) to grade 3 (gland loss2/3 of the total Meibomian glands).The mean ages of Group 1 and Group 2 were 29.1 ± 9.1(range, 18-48) and 30.6 ± 6.3(range, 20-49) years, respectively. MGD(n = 19, %34.5), Meibium gland loss(%36.4 ± 18.1), upper meiboscore (0.7 ± 0.8), lower meiboscore(0.6 ± 0.7) and DED (n = 10, %18.2) were significantly higher in the SD patients compared with the control participants (p = 0.002, p 0.001, p = 0.011, p = 0.005, p = 0.048, respectively). There was significant relationship between age with Meibomian gland loss, MGD and DED (p = 0.017, p = 0.004, p = 0.002, respectively).Seborrheic Dermatitis may influence meibomian gland morphology and as a result causing meibomian gland dysfunction and dry eye disase. For this reason, patients with Seborrheic Dermatitis should be evaluated for meibomian gland dysfunction and dry eye disase, and start treatment when needed.

WOS: 000459824600002, PubMed: 30829017, Objectives: To investigate the relationship between pseudoexfoliation syndrome (PES) and the use of antidepressant medications. Materials and Methods: This population-based, cross-sectional study included 2,017 of 2,356 invited subjects who were randomly selected from the Turkish Statistical Institute database (www.turksat.gov.tr/) as part of an epidemiologic study which specifically aimed to detect the prevalence of PES in the province of Eskisehir. During the examination, a detailed questionnaire was administered to determine physician-diagnosed systemic disease and drug use. Results: Eight of the 2,017 participants in the study were excluded for various reasons (2 with posterior synechiae, 2 with corneal opacity, 1 uncooperative patient, 1 eviscerated patient, 1 with active adenoviral keratoconjunctivitis, and 1 with a history of angle closure). PES was detected in 100 (5%) of the 2,009 patients whose data were analyzed. The percentage of subjects with concurrent antidepressant drug use in the PES and non-PES non-glaucoma groups were 4.1% (n=3) and 1.1% (n=21), respectively. The difference between the two groups was statistically significant (p=0.024). In addition, the use of medications for hypertension (p

WOS: 000465583400005, Amaç: Fibromiyalji (FM), etiyolojisi tam olarak bilinmeyen, yaygın vücut ağrısına sebep olan romatizmal bir hastalıktır. FM hastalarında, diğer romatizmal hastalıklarla birlikte veya tek başına çok çeşitli göz bulguları ortaya çıkmaktadır. Bu göz bulguları romatizmal hastalıklarda tanı için klinisyeni uyaran ilk bulgular olabilir. Bizim bu çalışmadaki amacımız FM’li hastalardaki göz bulgularının klinik olarak değerlendirmesini yapmaktır. Gereç ve Yöntem: Çalışmaya, Aksaray Üniversitesi Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Polikliniği’ne başvurup FM tanısı almış ve daha sonrasında göz polikliniğine de muayene olmuş 18-75 yaş arası hastalar alındı. Hastaların dosyaları retrospektif olarak tarandı. Hastaların dosyalarından klinik tanıları, sosyo-demografik özellikleri, göz muayene bulguları, özgeçmişleri, soygeçmişleri ve yapılan tedavilerinin sonuçları not edildi. Çalışmaya özgeçmişinde göz ameliyatı geçirmiş olanlar, romatolojik hastalık, diyabetik retinopati, glokom, sistemik enfeksiyon, otoimmuün hastalık, serebrovasküler hastalık, majör depresyon, anormal laboratuvar değerleri ve malignensi öyküsü olanlar dahil edilmedi. FM tanısı 2016 yılında güncellenen Amerikan Romatizma Birliği kriterlerine göre konuldu. Bulgular: Çalışmaya, uygun kriterleri karşılayan 94 hastanın dosyası alındı. Hastaların ortalama yaşı 38,2 (18-75) idi. Hastaların 80’i (%85) kadın, 14’ü (%15) erkekti. Göz bulgularına göre 57 hastada (%57,4) göz ağrısı, %28,2’sinde kızarıklık, %26,9’unda yanma-batma, %15,1’inde bulanıklık, %6,3’ünde çapaklanma ve %3,7’sinde kaşıntı bulundu. Göz ağrısının nedenleri arasında ise %49,1’inde kuru göz, %24,6’sında refraksiyon kusuru, %12,3’ünde blefarit, %3,5’inde alerji bulunurken, %10,5’inde herhangi bir neden saptanmadı. Sonuç: Çalışmamızda FM hastalarında büyük oranda göz ağrısı tespit edilmiş olup, göz ağrısının da en önemli sebebi olarak göz kuruluğu saptanmıştır. Bu sonuç bize FM’li hastalarda kronik yaygın vücut ağrısına çeşitli göz bulgularının eşlik edebileceğini ve FM gibi kronik hastalıklara multidisipliner yaklaşımın önemli olduğunu göstermektedir. Anahtar kelimeler: Fibromiyalji, göz ağrısı, göz kuruluğu, romatizmal hastalık., Objective: Fibromyalgia (FM) is a rheumatic disease which exactly unknown etiology, causes widespread body pain. In FM patients, a large variety of ocular findings, especially dry eye, occur with and without other rheumatic diseases. These ocular findings may be the first findings to warn the clinician for diagnosis in rheumatic diseases. The aim of this study is to evaluate the eye findings as clinically in patients with FM. Materials and Methods: The patients of those between the ages of 18-75, who were admitted to the Aksaray University Training and Research Hospital, Physical Medicine and Rehabilitation Polyclinic and diagnosed with FM, and then examined in the Ophthalmology Polyclinic, were included in the study. Patients' files were reviewed retrospectively. The clinical diagnosis, socio-demographic characteristics, ocular examination findings, history, family history and the results of the treatments were recorded. Those who had undergone eye surgery, rheumatologic disease, diabetic retinopathy, glaucoma, systemic infection, autoimmune disease, cerebrovascular disease, major depression, abnormal laboratory values, and history of malignancy, were not included in the study. The diagnosis of FM was determined according to the American College of Rheumatology updated in 2016. Results: The files of 94 patients who met the appropriate criteria were included in the study. The mean age of the patients was 38.2 (18-75), and 80 (85%) were female and 14 (15%) were male. According to the ocular findings, 57 patients (57.4%) had eye pain, 28.2% had redness, 26.9% had burning-stinging, 15.1% had turbidity, 6.3% had burring, and 3.7% had itching. Among the causes of eye pain were 49.1% dry eye, 24.6% refractive failure, 12.3% blepharitis, and 3.5% allergy, while no cause was found in 10.5%. Conclusion: In our study; it was detected that the patients with FM have a large extent of eye pain, and the most important cause of the eye pain was dry eye. The result of study shows that patients with FM may be accompanied by various ocular findings in addition to chronic widespread body pain and multidisciplinary approach is important in chronic diseases such as FM.

*Yaşar, Erdoğan ( Aksaray, Yazar ), Objectives: To investigate the frequency of retinal tear, retinal hole, and lattice degeneration in peripheral retinal examination of patients with macular hole. Materials and Methods: The files of patients who underwent pars plana vitrectomy surgery with a diagnosis of macular hole at Eskisehir Osmangazi University Department of Ophthalmology between 2008 and 2018 were retrospectively analyzed. A total of 106 patients with primary macular hole who underwent peripheral retinal examination were included in the study. The frequency of retinal tears, holes, and lattice degeneration associated with macular hole was investigated. Results: Peripheral retinal examination of 106 patients who underwent macular hole surgery revealed retinal tear in 3 patients (2.8%), retinal hole in 4 patients (3.8%), and lattice degeneration in 10 patients (9.4%). Retinal hole and lattice degeneration were observed concomitantly in 1 patient. Conclusion: This study showed that patients with macular hole have concomitant retinal tears and holes, which are also thought to arise due to vitreoretinal traction, at a frequency similar to that in the general population. This result suggests that both the anterior and posterior vitreous may have different pathologies at the same time related to these diseases.

WOS: 000440051200002, Object: We aimed to compare the Retinal Nerve Fiber Layer (RNFL), ganglion cell layer (GCL), and the optic nerve thicknesses (ONT) of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) to a healthy control group; and the possible worse effect of the Oppositional Defiant Disorder (ODD). Methods: 31 patients, (n=16 ADHD and n=15 ADHD+ODD) and a control group of 31 participants included. The Conners' Teachers Rating Scale and the Conners' Parent Rating Scale were used for the severity of the symptoms in children. Ophthalmologic measurements performed with optic coherence tomography device. Results: In this study, different ophthalmologic measurements (RNFL, GCL and optic nerve thicknesses) are compared between ADHD children and controls. Results show primarily bilateral thinner GCL in ADHD children compared to controls, which is the first demonstration. Optic nerve thicknesses of right eye inferior quadrant and left eye superior quadrant, as well as mean optic nerve thickness of left eye, and furthermore both eyes total GCL thickness measurement averages with also their thicknesses in superior, inferior area of patient group were found as statistically lower (p

WOS: 000437525400009, PubMed: 29988879, A 21-year-old male patient with no history of systemic disease or drug use presented to our clinic with redness and pain in the right eye. Best corrected visual acuity was 20/20 in both eyes. Inflamed pinguecula was observed on slit-lamp examination and the patient was prescribed ophthalmic nepafenac eye drops. After instilling the drops that day and the next day, the patient presented again due to pruritus and rash. Upon consultation with the dermatology department, the patient was diagnosed with drug-induced allergic urticaria and the nepafenac drops were discontinued. Although urticaria has been reported as a side effect after systemic non-steroidal anti-inflammatory drug (NSAID) use, such a reaction has not been reported with an ophthalmic NSAID and ours is the first reported case of urticaria following ophthalmic nepafenac use. This unique case highlights the fact that ophthalmologists must also keep urticaria in mind as a potential side effect when prescribing this drug.

WOS: 000405083400007, PubMed: 28604573, Purpose Our objective was to evaluate the diagnostic value of a handheld pupillometer in differentiating eyes with pseudoexfoliation syndrome (PXS) from healthy controls. Methods This population-based, cross-sectional study was conducted in the province of Eskisehir, Turkey. Subjects 40 years of age and older were randomly recruited using stratified two-stage cluster sampling from the database of the Turkish Statistical Institute office in Eskisehir. Recruitment took place between June and October 2014. The inclusion criteria were healthy subjects who did not have a previous diagnosis of glaucoma or other issues affecting pupil dynamics. After an extensive ophthalmic examination, pupillometry was performed under standard photopic room lighting conditions. After pupillometry, the pupil was dilated and digital images of the anterior segment were taken for confirmation of PXS. An inter-eye pupil diameter difference of 0.4 mm was defined as pupil asymmetry. Results Of the 2356 invited subjects, 2017 agreed to participate (85.6%), and 1559 subjects were eligible for the study. An age-matched subgroup consisting of 529 healthy controls was randomly selected to compare with the 60 subjects who were diagnosed with PXS. The mean pupil diameters of subjects with PXS and healthy controls were 3.57 0.68 mm and 3.68 +/- 0.63 mm, respectively (P = .652). In the ROC analysis, the precision of pupil diameter in discriminating PXS was low (AUC 0.56, sensitivity 14%, specificity 94%). Pupil asymmetry increased the chances of having PXS by 3.46-fold. Conclusions Pupillometry performed poorly in the detection of PXS scoring a positive predictive value of 26%.

AIM To investigate the prevalence of pseudoexfoliation syndrome (PEX) and its associations with ocular and systemic diseases in a population sample aged over 40y. METHODS A total of 2356 subjects were randomly chosen for the sample population based on the database of the Turkish Statistical Agency in Eskisehir. Of the invited 2356 subjects, 2017 subjects participated, out of which 2009 were eligible for the study. Systemic diseases, drug use, smoking and body mass index were assessed using questionnaires. Measurements of central corneal thickness (CCT), anterior chamber depth (ACD) and intraocular pressure (IOP) were performed during June to December, 2015. After pupillary dilation, the anterior segment and lenses were evaluated using a slit lamp. RESULTS Prevalence of PEX in this sample was 5.0% (n=100). Of patients with PEX, 26% also had glaucoma. Incidence of cataracts, and using drugs for hypertension, cardiac and psychiatric conditions was higher in patients with PEX compared to normal cases (P

Background and aim: Recently, monocyte to high density lipoprotein (MHR) has been recommended as a new prognostic factor of cardiovascular diseases. the value of this scoring system have been documented by previous studies in predicting prognosis ST elevation myocardial infarction (STEMA°). However, no study is currently available regarding the association of MHR and the selvester score in predicting the outcomes among patients with STEMA°. Materials and methods: We evaluated a cohort of 99 consecutive patients who were admitted to our tertiary referral centre with STEMA° and under-went first primary percutaneous coronary intervention (pPCI) between June and September in 2016. The Selvester QRS score was estimated on the first electrocardiogram (ECG) after hospital admission. MHR was calculated for all patients. A total of 99 patients with ST elevation ACS were included in the study. They were divided into two groups. These were 52 patients in the low selvester score and 44 patients in the high selvester group. We investigate the relationship between selvester score and MHR ratio in Results: MHR was positively correlated with the Selvester score (r=0.467, P

Objective: To analyze the coronary angiograms of patients with symptomatic heart disease in order to determine the frequency and characteristics of coronary-cameral communications (CCCs) in a single center. Subjects and Methods: The coronary angiograms of 16,573 patients with symptomatic heart disease performed from November 2001 to January 2011 were analyzed. The diagnosis of coronary fistula and coronary-cameral microcommunications (CCMCs) was made according to previously defined criteria. Results: Of the 16,573 patients, 15 (0.09%; 8 males and 7 females, mean age 63 ± 12 years) had CCCs, while coronary fistulas were identified in 2 (0.01%). In the first patient, the coronary fistula arose from the branches of the left anterior descending (LAD) artery and the right coronary artery (RCA) and drained into the right ventricle. In the second patient, the fistula originated from branches of the LAD artery, the circumflex (Cx) artery and the RCA and drained into the left ventricle. In 7 patients, the CCMCs originated from the LAD artery. In 3 patients, the Cx artery was the origin. The CCMCs originated from the RCA in 2 patients. In 1 patient the CCMC took its origin from the RCA and the Cx artery, while in 2 patients the CCMCs were associated with intracardiac masses in the left atrium and the right atrium, respectively. Conclusion: The prevalence of CCCs in adult patients was low and that of large coronary fistulas was even lower; coronary fistulas are probably very rare in adult patients because the majority of them are detected and treated during childhood.

*Gürlevik, Uğur ( Aksaray, Yazar ), Aim: The aim of the study was to investigate the serum and vitreous levels of resistin in patients with the proliferative diabetic retinopathy (PDR) and to compare those with agematched control subjects. Methods: The study included 45 eyes with PDR (group 1) and a control group of 22 (group 2). All eyes underwent vitrectomy surgery. The lipid profile, fasting blood glucose (FBG), HbA1c and resistin levels were investigated in blood samples of all subjects. Complete ophthalmological examinations were evaluated. Vitreous samples were collected from both groups during vitrectomy surgery and resistin levels were investigated in those samples. The results were evaluated using SPSS 9.0 software. Results: The demographic characteristics of the diabetic group and the control group were similar (p > 0.05). There was no significant difference between the groups in respect of mean visual acuity (VA), body mass index (BMI) values, or lipid profiles (p ˃ 0.05). There was no measurable value of resistin in the vitreous samples of all the eyes. The mean blood resistin level was 367 ng/ml in the control group and 387 ng/ml in the study group and the difference was not statistically significant (p > 0.05). Conclusions: In the light of the findings of this study, it can be assumed that resistin did not pass through the vitreous at measurable levels. However, the serum resistin levels of the diabetic patients were higher than those of the control group although not statistically significant. Therefore, it can be considered that resistin does not play a major role in retinal neovascularization.

Objective: Slow coronary flow (SCF) is characterized by angiographically normal coronary arteries with delayed opacification of the distal vasculature. The peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with ventricular arrhythmias. Neutrophil to lymphocyte ratio (NLR) is a new inflammatory marker using for cardiovascular risk prediction. The aim of this study was to evaluate the relationship between ventricular repolarization and inflammation in patients with SCF. Methods: Forty-six SCF patients and 44 controls were enrolled to the study. Coronary flow rates were measured by Thrombolysis in Myocardial Infarction frame count (TFC). Tp-e interval and Tp-e/QT ratio were measured from a 12-lead electrocardiogram, and Tp-e interval was corrected for heart rate (cTp-e). NLR was calculated as the ratio of neutrophil to lymphocyte count. These parameters were compared between groups. Results: Corrected Tp-e interval and Tp-e/QT ratio were significantly higher in SCF patients (94.5 ± 14.9 vs 88.1 ± 6.3 ms, 0.23 ± 0.03 vs 0.21 ± 0.02; P=0.009, and P=0.002, respectively). Also, NLR was increased in SCF patients (2.40 ± 0.9 vs 1.67 ± 0.5, P

Background: The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Thus, we aimed to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio. Methods: The present study included 50 patients whose EFT thickness ≥ 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. Results: QTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7 ± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8, p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001), Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001). Conclusion: The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia. Resumo Fundamento: A associação entre a adiposidade periatrial e arritmias atriais foi demonstrada em estudos anteriores. No entanto, não há dados disponíveis suficientes sobre a associação entre a espessura do tecido adiposo epicárdico (TAE) e parâmetros de repolarização ventricular. Assim, objetivou-se avaliar a associação da espessura do TAE com índices de repolarização ventricular usando o intervalo Tpeak-Tend (Tp-e) e a relação Tp-e/QT. Métodos: O presente estudo incluiu 50 pacientes com espessura do TAE ≥ 9 mm (grupo 1) e 40 indivíduos do grupo controle cuja espessura do TAE era < 9 mm (grupo 2). O exame ecocardiográfico transtorácico foi realizado em todos os participantes. Os parâmetros QT, os intervalos Tp-e e a relação Tp-e/QT foram medidos a partir do eletrocardiograma de 12 derivações. Resultados: QTd (41,1 ± 2,5 vs. 38,6 ± 3,2, p < 0,001) e QTd corrigido (46,7 ± 4,7 vs 43,7 ± 4, p = 0,002) foram significativamente maiores no grupo 1 quando comparados com o grupo 2. O intervalo Tp-e (76,5 ± 6,3, 70,3 ± 6,8, p < 0,001), intervalo cTp-e (83,1 ± 4,3 vs. 76 ± 4,9, p < 0,001), as relações Tp-e/QT (0,20 ± 0,02 vs. 0,02 ± 0,2, p < 0,001) e Tp-e/QTc (0,2 ± 0,01 vs. 0,18 ± 0,01, p < 0,001) estavam aumentados no grupo 1 em comparação ao grupo 2. Correlações positivas significativas foram encontrados entre a espessura do TAE e o intervalo Tp-e (r = 0,548, p < 0,001), intervalo cTp-e (r = 0,259, p = 0,01), e as relações Tp-e/QT (r = 0,662, p < 0,001) e Tp-e/QTc (r = 0,560, p < 0,001). Conclusão: O presente estudo mostra que os intervalos Tp-e e cTp-e, e as relações Tp-e/QT e Tp-e/QTc estavam elevados nos indivíduos com TAE aumentado, o que pode sugerir um maior risco de arritmia ventricular.

WOS: 000234021900010 PubMed: 16310433 Percutaneous coronary intervention has been known to cause myocardial damage as a result of microvascular dysfunction due to microembolization and microinfarction. Previous studies have shown that glucose-insulin-potassium. (GIK) infusion decreases mortality in patients with acute myocardial infarction. Therefore, in this study, we aimed to investigate the effect of GIK infusion on myocardial damage due to percutaneous coronary revascularization. A total of 52 consecutive nondiabetic patients diagnosed with non-ST-elevation acute coronary syndrome and designated for elective percutaneous coronary intervention were randomized in a double-blind fashion into GIK and normal saline groups. GIK infusion (30% dextrose, 300 U insulin, and 60 mEq potassium chloride) at a dose of, 1.5 ml/kg/hour was initiated 24 hours before the intervention and continuing during and until 1 hour after the intervention. Troponin I levels were recorded in venous blood samples before and 12 and 24 hours after the intervention. The increase in troponin I was significantly lower at 12 and 24 hours in the GIK group compared with those of the saline controls (p = 0.022 and p = 0.005, respectively). GIK infusion initiated 24 hours before coronary stenting for non-ST-elevation acute coronary syndrome resulted in less myocardial damage as determined by postprocedure troponin I levels. (c) 2005 Elsevier Inc. All rights reserved.