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Öğe Dirençli Glokom Olgularında Transskleral Diod Lazer Siklofotokoagülasyon(2012) Bitirgen, Gülfidan; Okka, Mehmet; Bozkurt, Banu; Doğru, İsmail; Kerimoğlu, Hürkan; Öztürk Turgut, Banu; Kamış, ÜmitAmaç: Medikal veya cerrahi tedavilerle kontrol edilemeyen ileri evre glokom olgularında transskleral diod lazer siklofotokoagülasyon (TSDLS) uygulamasının güvenilirliğinin ve etkinliğinin değerlendirilmesi. Gereç ve Yöntem: 2009-2011 yılları arasında TSDLS tedavisi uygulanan olgular retrospektif olarak incelendi. Tedavi öncesi ve sonrası göz içi basıncı (GİB) değerleri, görme keskinlikleri, kullanılan antiglokomatöz tedavi sayıları ve komplikasyonlar kaydedildi. TSDLS başarı kriteri, son kontrolde GİB ölçümünün 6-22 mmHg (ilaçlı ya da ilaçsız) olması olarak belirlendi. Sonuçlar: Çalışmaya 37 olgunun 37 gözü dahil edildi. Olguların yaş ortalaması 61,7317,13 yıl (19-80 yıl) ve ortalama takip süresi 8,065,81 ay (3-22 ay) idi. Tedavi öncesi ortalama GİB değerleri 38,688,94 mmHg, tedavi sonrası 2. haftada 26,4611,34 mmHg (p 0,01) ve son kontrolde 24,9710,84 mmHg (p0,01) idi. Olguların %40,5’inde son kontrolde ölçülen GİB değerleri 22 mmHg ve altındaydı. Göz başına ortalama diod lazer seans sayısı 1,480,73 olarak saptanırken birden fazla tedavi seansı gerektiren olgu sayısı 13 (%35,1) idi. Kullanılan antiglokomatöz tedavi etken madde sayısı tedavi öncesi 3,141,18 iken tedavi sonrası 2,761,23 olarak saptandı. Takip süresince olguların hiçbirinde fitizis bulbi ya da persistan hipotoni gelişmedi. Tart›flma: TSDLS uygulaması, dirençli glokom olgularında GİB düşürülmesinde etkin ve güvenilir bir tedavi yöntemidir. Aynı zamanda antiglokomatöz tedavi kullanımında azalma sağlayarak hastaların tedaviye uyumunu ve yaşam kalitesini artırmaktadır.Öğe Diurnal Variation of Anterior Chamber Flare(Turkish Ophthalmological Soc, 2015) Adam, Mehmet; Okka, Mehmet; Ozturk, Banu Turgut; Bozkurt, Banu; Kerimoglu, Hurkan; Pekel, Hamiyet; Okudan, SuleymanObjectives: To investigate the ideal time and reproducibility of anterior chamber flare measurements. Materials and Met-hods: Anterior chamber flare measurements were performed with laser flaremetre device at 8 am to 45 volunteers and these measurements were repeated on the same day at 12 pm and 4 pm. Results: Twenty- five (55.5%) of the volunteers were women and 20 (44.5%) were men; mean age was 28.67 +/- 7.40 (18- 49) years. The mean anterior chamber flare measurements taken following the ophthalmologic examination were 5.94 +/- 1.41 foton/msn at 8 am, 5.65 +/- 1.45 foton/msn at 12 pm, and 5.79 +/- 1.20 foton/msn at 4 pm. No statistical difference was found between the measurements (p=0.08). Subgroup analysis according to eye color, revealed no significant difference between flare measurements in brown, hazel, and green eyes (p=0.21). Correlation analysis demonstrated association between age and all flare measurements within the day (r=0.24, p=0.03; r=0.41, p=0.01, r=0.27, p=0.01). Conclusion: No significant diurnal change was detected in the flare measurements of our study subjects but positive correlation with age was observed. Hence, all flare measurements within a day are reliable and have high repeatability in healthy subjects.Öğe Evaluation of Retinal Nerve Fiber Layer Thickness in Patients With Anisometropic and Strabismic Amblyopia Using Optical Coherence Tomography(Slack Inc, 2013) Ersan, Ismail; Zengin, Nazmi; Bozkurt, Banu; Ozkagnici, AhmetPurpose: To evaluate the retinal nerve fiber layer (RNFL) thickness of eyes with amblyopia using optical coherence tomography (OCT). Methods: RNFL thickness measurements obtained by time-domain OCT of amblyopic eyes of patients with strabismus (35 patients) and patients with anisometropia (30 patients) were compared with their fellow eyes and age-and gender-matched healthy eyes (40 participants). RNFL thickness values of the groups were also compared and the correlation between RNFL thickness and refraction was evaluated. Results: In the strabismic and anisometropic groups, there were no statistically significant differences in average RNFL thickness between amblyopic eyes and their fellow eyes (P > .05). Temporal RNFL quadrant in the hypermetropic anisometropic group, and superior RNFL quadrant in the myopic anisometropic group were significantly thinner in amblyopic eyes compared to their fellow eyes (P < .05). RNFL thickness did not differ between strabismic amblyopic, anisometropic amblyopic, and control eyes (P > .05). In the anisometropic group, a significant correlation was found between mean RNFL thickness and refraction (P < .05). Conclusion: Amblyopia is not associated with a decrease in RNFL thickness in strabismic or anisometropic amblyopia. In the anisometropic group, the inter-eye differences in RNFL thickness parameters seemed to be related to the refraction differences between the amblyopic eyes and their fellow eyes. [J Pediatr Ophthalmol Strabismus 2013;50:113-117.]Öğe The Evaluation of Retinal Nerve Fiber Layer Thickness in Patients with Obstructive Sleep Apnea Syndrome(Hindawi Ltd, 2013) Adam, Mehmet; Okka, Mehmet; Yosunkaya, Sebnem; Bozkurt, Banu; Kerimoglu, Hurkan; Turan, MeydanAim. To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with obstructive sleep apnea syndrome (OSAS) by optical coherence tomography (OCT). Materials and Method. We studied 43 new diagnosed OSAS patients and 40 healthy volunteers. Patients underwent an overnight sleep study in an effort to diagnose and determine the severity of OSAS. RNFL analyses were performed using Stratus OCT. The average and the four-quadrant RNFL thickness were evaluated. Results. There was no difference between the average and the four-quadrant RNFL thickness in OSAS and control groups. There was no correlation between apnea-hypopnea index and intraocular pressure. Body mass index of patients with moderate and severe OSAS was significantly higher in patients with mild OSAS. Conclusion. Mean RNFL thickness did not differ between the healthy and the OSAS subjects, however, the parameters were more variable, with a larger range in OSAS patients compared to controls.Öğe GAPO syndrome: Four new patients with congenital glaucoma and myelinated retinal nerve fiber layer(Wiley, 2013) Bozkurt, Banu; Yildirim, Mahmut Selman; Okka, Mehmet; Bitirgen, GulfidanThis article reports on the ophthalmological features of four Turkish children with GAPO syndrome, a very rare autosomal recessive condition characterized by growth retardation (G), alopecia (A), pseudoanodontia (P) (failure of tooth eruption), and optic atrophy (O). The children were from two unrelated families born to consanguineous parents. They had the characteristic facial appearance of alopecia, rarefaction of eyebrows and eyelashes, frontal bossing, high forehead, midfacial hypoplasia, hypertelorism, and thickened eyelids and lips. Two children had severe end-stage glaucoma in both eyes and unilateral corneal opacity, whereas other two children had myelinated retinal nerve fiber layer; one with bilateral optic atrophy and the other one with persistent pupillary membrane in the left eye. (c) 2013 Wiley Periodicals, Inc.Öğe Granulomatous Anterior Uveitis, Internal Ophthalmoplegia, and Retinal Vasculitis During Chickenpox Disease in A Child(Turkish Ophthalmological Soc, 2013) Donbaloglu, Meryem; Bozkurt, Banu; Kerimoglu, Hurkan; Ozturk, Banu TurgutHerein, we report the case of a patient who had granulomatous anterior uveitis, internal ophthalmoplegia, and retinal vasculitis during chickenpox disease. A 9-year-old girl was admitted to our clinic with blurred vision and hyperemia in the right eye. Corrected visual acuity was 20/20 in both eyes. Direct/indirect pupillary reactions were negative in the right eye and pupil was dilated. Biomicroscopic examination revealed middle-sized granulomatous keratic precipitates and a severe anterior chamber reaction. Fundus examination was normal. As there were red papules all over the body she was diagnosed as anterior uveitis secondary to chickenpox and systemic/topical acyclovir, topical steroid, antihistaminic suspension, isolation, and follow-up were recommended. On day 6, anterior chamber inflammation decreased remarkably, whereas a salt-pepper appearance was observed in the retina. On day 10, a perivascular sheathing was observed, which regressed after 1 month, and her medications were slowly tapered and discontinued. Although anterior uveitis is a common finding after chickenpox, the occurrence of three different involvements is very rare.Öğe In vivo corneal confocal microscopic analysis in patients with keratoconus(Ijo Press, 2015) Bitirgen, Gulfidan; Ozkagnici, Ahmet; Bozkurt, Banu; Malik, Rayaz A.AIM: To quantify corneal ultrastructure using laser scanning in vivo confocal microscopy (IVCM) in patients with keratoconus and control subjects. METHODS: Unscarred corneas of 78 keratoconic subjects without a history of contact lens use and 36 age-matched control subjects were evaluated with slit-lamp examination (SLE), corneal topography and laser scanning IVCM. One eye was randomly chosen for analysis. Anterior and posterior stromal keratocyte, endothelial cell and basal epithelial cell densities and sub-basal nerve structure were evaluated. RESULTS: IVCM qualitatively demonstrated enlarged basal epithelial cells, structural changes in sub -basal and stromal nerve fibers, abnormal stromal keratocytes and keratocyte nuclei, and pleomorphism and enlargement of endothelial cells. Compared with control subjects, significant reductions in basal epithelial cell density (5817 +/- 306 cells/mm(2) vs 4802 +/- 508 cells/mm(2), P<0.001), anterior stromal keratocyte density (800 +/- 111 cells/mm(2) vs 555 +/- 115 cells/mm(2), P<0.001), posterior stromal keratocyte density (333 +/- 34 cells/mm(2) vs 270 +/- 47 cells/mm(2), P<0.001), endothelial cell density (2875 +/- 223 cells/mm(2) vs 2686 +/- 265 cells/mm(2), P<0.001), sub-basal nerve fiber density (31.2 +/- 8.4 nerves/mm(2) vs 18.1 +/- 19.2 nerves/mm(2), P<0.001), sub -basal nerve fiber length (21.4 +/- 3.4 mm/mm(2) vs16.1 +/- 5.1 mm/mm(2), P<0.001), and sub-basal nerve branch density (median 50.0 (first quartile 31.2 - third quartile 68.7) nerve branches/mm(2) vs median 25.0 (first quartile 6.2 - third quartile 45.3) nerve branches/mm(2), P<0.001) were observed in patients with keratocon us. CONCLUSION: Significant microstructural abnormalities were identified in all corneal layers in the eyes of subjects with keratoconus using IVCM. This non invasive in vivo technique provides an important means to define and follow progress of microstructural changes in patients with keratoconus.Öğe OCULAR FINDINGS IN 22Q11.2 DELETION SYNDROME(Springer/Plenum Publishers, 2014) Gokturk, Bahar; Bozkurt, Banu; Yildirim, Mahmut Selman; Reisli, Ismail[Abstract Not Availabe]Öğe Ocular Findings in Children With 22q11.2 Deletion Syndrome(Slack Inc, 2016) Gokturk, Bahar; Topcu-Yilmaz, Pinar; Bozkurt, Banu; Yildirim, Mahmut Selman; Guner, Sukru Nail; Sayar, Esra Hazar; Reisli, IsmailPurpose: To identify the ocular features of children diagnosed as having 22q11.2 deletion syndrome in a Turkish population, which is the most common microdeletion syndrome with a wide range of facial and ocular abnormalities. Methods: Sixteen children aged between 4 months and 18 years with a microdeletion in chromosome 22q11.2 underwent a detailed ophthalmological examination including uncorrected and best corrected visual acuity testing, stereoscopic vision examination, biomicroscopic and indirect fundus examination, and ocular motility testing. Results: All patients had at least one ocular abnormality. The major abnormalities were eyelid abnormalities (eye hooding, narrow palpebral fissure, telecanthus, hypertelorism, sparse and thin eyebrows and eyelashes, blepharitis, and distichiasis), posterior embryotoxon, and tortuous retinal vessels in at least half of the patients. Other ophthalmological disorders were refractive errors, iris remnants, and strabismus. Conclusions: The chromosome 22q11.2 deletion syndrome is associated with a wide range of ocular disorders, which necessitates a comprehensive eye examination for appropriate treatment and follow-up. Ocular findings sometimes can provide a clue to the diagnosis of 22q11.2 deletion.Öğe Ocular Surface Disorders in Intensive Care Unit Patients(Hindawi Publishing Corporation, 2013) Saritas, Tuba Berra; Bozkurt, Banu; Simsek, Baris; Cakmak, Zeynep; Ozdemir, Mehmet; Yosunkaya, AlperPatients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 +/- 18.15 years (range 17-74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 +/- 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 +/- 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.Öğe Ön Kamara Bulanıklığının Gün İçi Değişimi(2015) Adam, Mehmet; Okka, Mehmet; Kerimoğlu, Hürkan; Pekel, Hamiyet; Turgut Öztürk, Banu; Bozkurt, Banu; Okudan, SüleymanAmaç: Laser flaremetre cihazı ile yapılan ön kamara bulanıklık ölçümlerin ideal zamanı ve tekrarlanabilirliğinin araştırılması. Gereç ve Yöntem: Kırk beş gönüllünün sabah saat 8.00da laser flaremetre cihazı ile ön kamara bulanıklık ölçümleri yapılmış ve bu ölçümler aynı gün saat 12.00 ve saat 16.00da tekrarlanmıştır. Bulgular: Gönüllülerin 25i (55,5) kadın ve 20si (44,5) erkekti ve ortalama yaşları 28,677,40 yıldı. Olguların oftalmolojik muayenelerini takiben alınan ortalama ön kamara bulanıklık ölçümleri sabah saat 8:00da 5,941,41 foton msn, saat 12de 5,651,45 foton/msn, saat 16.00da 5,791,20 foton/msn idi. Ölçümler arasında anlamlı bir farklılık saptanmadı (p0,08). Katılımcıların göz rengine göre yapılan alt grup analizinde de kahverengi, ela ve yeşil göz renkler arasında anlamlı bir farklılık bulunmamıştır. Korelasyon analizinde gün içinde alınan üç ölçümün de yaşla korele olduğu görülmüştür. Sonuç: Ön kamara bulanıklık ölçümlerinde sağlıklı bireylerde gün içerisinde anlamlı bir değişiklik saptanmamıştır ancak yaşla pozitif korelasyon göstermektedir. Bu nedenle gün içindeki tüm ölçümler güvenilirdir ve tekrarlanabilirliği yüksektir.Öğe Suçiçeği Geçiren Bir Çocukta Granülomatöz Ön Üveit, İnternal Oftalmopleji ve Retinal Vaskülit(2013) Donbaloğlu, Meryem; Kerimoğlu, Hürkan; Bozkurt, Banu; Turgut Öztürk, BanuBu olgu sunumunda suçiçeği esnasında granülomatöz ön üveit, internal oftalmopleji ve retinal vaskülit gelişen bir olgu tartışıldı.Dokuz yaşında bir kız çocuğu sağ gözde bulanık görme ve kızarıklık şikayetiyle tarafımıza başvurdu. Her iki göz düzeltilmiş görme keskinlikleri 20/20 düzeyindeydi. Sağ göz direkt ve indirekt ışık reaksiyonları negatifti ve pupil dilate idi. Biyomikroskopik muayenede sağ göz korneada orta büyüklükte granülomatöz keratik presipitatlar ve ön kamarada yoğun hücre reaksiyonu mevcuttu. Fundus muayenesi normaldi. Hastanın tüm vücudunda kırmızı renkte papüller lezyonları görülmesi üzerine suçiçeğine sekonder granülomatoz ön üveit tanısıyla sistemik ve topikal asiklovir ve steroid, antihistaminik süspansiyon, izolasyon ve günlük takip önerildi. Altıncı günde keratik presipitat ve hücre reaksiyonu azalırken, retinada tuzbiber manzarası izlendi. Onuncu günde retinanın nazal ve temporaperifer kadranlarında görülen perivasküler kılıflanma 4. haftada tamamen geriledi ve ilaçlar azaltılarak kesildi. Suçiçeğinde ön üveit sık görülmesine rağmen, 3 farklı tutulumun görülmesi son derece nadirdir.Öğe Systemic Atopy and Immunoglobulin Deficiency in Turkish Patients with Vernal Keratoconjunctivitis(Taylor & Francis Inc, 2013) Bozkurt, Banu; Artac, Hasibe; Arslan, Nasha; Gokturk, Bahar; Bozkurt, Mete Kaan; Reisli, Ismail; Irkec, MuratPurpose: To determine the prevalence of systemic atopy and immunoglobulin (Ig) deficiencies in vernal keratoconjunctivitis (VKC). Methods: Sixty-seven VKC subjects (79.1% boys) with a mean age of 11.3 +/- 4.3 years were included. Serum Ig levels and specific IgE levels were measured using the nephelometric method and reversed enzyme immunoassay with sandwich ELISA technique, respectively. The patients underwent epidermal skin tests with commercial extracts. Results: Family history of atopy and associated systemic allergies were detected in 32.8 and 40.3% of the subjects, respectively. Blood eosinophilia, elevated total, and specific IgE and positive skin tests were detected in 33.8, 42.2, 50, and 35% of the subjects, respectively. Out of 62 subjects, low levels of IgA, IgG, IgM, and IgG3 were detected in 12.9, 8, 6.5, and 1.6% of the patients, respectively. Conclusion: IgE-mediated mechanisms are involved in approximately 40% of VKC patients. A new finding was the higher incidence of Ig deficiency.Öğe Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma(Turkish Ophthalmological Soc, 2012) Bitirgen, Gulfidan; Okka, Mehmet; Bozkurt, Banu; Dogru, Ismail; Kerimoglu, Hurkan; Ozturk, Banu Turgut; Kamis, UmitPurpose: To evaluate the safety and efficacy of transscleral diode laser cyclophotocoagulation (TSDLC) in advanced glaucoma refractory to medical or surgical treatment. Material and Method: The data of subjects who were treated with TSDLC between 2009 and 2011 were retrospectively reviewed. Intraocular pressure before and after treatment, visual acuity, the number of medications and complications were analysed. Success was defined as final IOP of 6-22 mmHg with or without antiglaucomatous medications. Results: Thirty seven eyes of 37 patients were included in the study. Mean age of patients and mean follow-up time were 61.73 +/- 17.13 years (range: 19-80 years) and 8.06 +/- 5.81 months (range: 3-22 months), respectively. Mean pretreatment IOP was 38.68 +/- 8.94 mmHg and IOP was 26.46 +/- 11.34 mmHg (p<0.01) at the second week, whereas it was 24.97 +/- 10.84 mmHg (p<0.01) at the last visit. IOP of less than 22 mmHg was achieved in 40.5% of eyes at the last visit. Mean treatment number per eye was 1.48 +/- 0.73, and more than one treatment was required in 13 (35.1%) eyes. Preoperative and postoperative mean total antiglaucomatous medications were 3.14 +/- 1.18 and 2.76 +/- 1.23, respectively. No phthisis bulbi or persistent hypotonia developed during the follow-up period. Discussion: TSDLC is an effective and safe method for the treatment of refractory glaucoma. It also served to reduce the number of antiglaucoma medications, thus improving both the quality of life of the patients and their compliance to therapy.
