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Öğe Assessment of Neutrophil/Lymphocyte Ratio in Patients with Age-related Macular Degeneration(Taylor & Francis Inc, 2015) Ilhan, Nilufer; Daglioglu, Mutlu Cihan; Ilhan, Ozgur; Coskun, Mesut; Tuzcu, Esra Ayhan; Kahraman, Hilal; Keskin, UgurcanPurpose: To investigate the neutrophil/lymphocyte ratio (NLR) as an indicator of inflammation in patients with age-related macular degeneration (AMD). Methods: Patients were evaluated by a review of records. The study included 81 patients with dry AMD (group 1), 84 patients with wet AMD (group 2), and 80 healthy age-and sex-matched controls (group 3). The NLR of the patients was obtained from the hospital laboratory archive and was measured by dividing the neutrophil count by the lymphocyte count. Results: A significant difference was found in NLR values between groups 1 and 2 (p = 0.017), groups 2 and 3 (p<0.001), and groups 1 and 3 (p<0.001). In correlation analyses, NLR was correlated positively with age (r = 0.22, p<0.001) and disease severity (r = 0.40, p<0.001). Conclusions: Patients with AMD have higher NLR compared with controls, and NLR correlates with disease severity. NLR may be used as a biomarker of inflammation in AMD.Öğe Bilateral Abducens Paralysis Secondary to Compression of Abducens Nerve Roots by Vertebrobasilar Dolichoectasia(Informa Healthcare, 2013) Tuzcu, Esra Ayhan; Bayarogullari, Hanifi; Coskun, Mesut; Yilmaz, Cahide; Ilhan, Nilufer; Daglioglu, Mutlu Cihan; Aras, MustafaVertebrobasilar dolichoectasia is characterized by dilatation, tortuosity, and marked elongation of the vertebral and basilar arteries. Dolichoectatic arteries usually have thin arterial walls secondary to degeneration of the internal elastic lamina, reticular fibre deficiency, and smooth muscle atrophy. This anomaly is relatively uncommon and generally asymptomatic. Clinical manifestations of dolichoectasia result from the compression and displacement of adjacent structures, causing cranial nerve palsy, obstructive hydrocephalus, or ischaemic stroke. The authors present a case in which vertebrobasilar dolichoectasia led to the development of bilateral abducens nerve paralysis in a 9-year-old girl.Öğe Bilateral Smiltaneously central serous Choroidoretinopathy in a physician related to working conditions(Gazi Eye Foundation, 2014) Daglioglu, Mutlu Cihan; Coskun, Mesut; Adibelli, Fatih; Ilhan, Nilöfer; Tuzcu, EsraCentral Serous Chorioretinopathy (CSR) is commonly seen in young men, and self limited retinal disease. There are several treatments for this disease but usually %90 self limitation can be seen in young men in a few months.Emotional Stress is the leading factors of the pathogenesis of this disease. We here represent clinical and OCT features of a bilateral CSR case whose job is family doctor. There is no any other stress factor in his life but his job instability. Medical profession is one of the most stressful vocation, in this case we want to concluse that CSR in a young physician.Öğe Changes in the cornea related to sickle cell disease: a pilot investigation(Wichtig Publ, 2015) Coskun, Mesut; Ilhan, Ozgur; Ilhan, Nilufer; Tuzcu, Esra Ayhan; Daglioglu, Mutlu Cihan; Kahraman, Hilal; Elbeyli, AhmetPurpose: To investigate corneal structural changes (central corneal thickness, endothelial cell count, and cellular morphology) in patients with sickle cell disease (SCD). Methods: This prospective study included 56 patients with SCD and 50 age- and sex-matched healthy subjects without any eye disease aside from refractive errors. Endothelial cell density (ECD), percentage of hexagonality, and the coefficient of variation in cell size (CV) were measured using noncontact specular microscopy, and central corneal thickness (CCT) was measured by pachymetry. Results: The mean CCT value was 509.6 +/- 20.7 mu m in the study group and 520.8 +/- 23.6 mu m in the control group. The mean ECD, CV, and percentage of hexagonality values in the study group were 2712 +/- 335 cells/mm(2), 34.5 +/- 5.3%, and 57.2 +/- 6.6%, respectively, and 3030 +/- 247 cells/mm(2), 31.6 +/- 5.0%, and 60.4 +/- 6.9% in the control group, respectively. Endothelial cell density (p = 0.001), CCT (p = 0.011), CV (p = 0.005), and percentage of hexagonality values (p = 0.018) were significantly different between the study and control groups. Conclusions: The results of the current study indicate that patients with SCD had considerable morphologic changes in the structure of the cornea when compared to healthy subjects.Öğe The Effect of Enoxaparin-Containing Irrigation Fluid Used During Cataract Surgery on Postoperative Inflammation in Patients With Diabetes(Elsevier Science Inc, 2013) Ilhan, Ozgur; Ilhan, Nilufer; Coskun, Mesut; Daglioglu, Mutlu Cihan; Tuzcu, Esra Ayhan; Ayintap, Emre; Keskin, UgurcanPURPOSE: To investigate effects of enoxaparin on postoperative inflammation in patients with moderate nonproliferative diabetic retinopathy (NPDR) and nuclear cataract. DESIGN: Prospective masked controlled trial. METHODS: SETTING: Institutional practice. STUDY POPULATION: The study included 51 eyes of 51 diabetes mellitus (DM) patients with moderate NPDR and grade 2-3 nuclear cataracts. Group 1 included randomly selected patients who received enoxaparin in balanced salt solution (BSS) during cataract surgery, while standard BSS was used in Group 2. OBSERVATION PROCEDURE: Patients were followed up 1 day, 1 week, and 1 and 2 months after the surgery. MAIN OUTCOME MEASURES: Anterior chamber cell and flare. RESULTS: Postoperatively, 20 patients from Group 1 and 4 patients in Group 2 had less than a mean of 10 cells at day 1 (P = .012). At the first week, 20 patients from Group 1 and 10 patients from Group 2 had less than a mean of 10 cells (P = .004). When compared for flare, 20 patients from Group 1 and 8 patients from Group 2 had a flare between 0 and + 1 at postoperative day 1 (P < .001). By the end of postoperative first week, 24 patients from Group land 18 patients from Group. 2 had a flare between 0 and + 1 (P = .012). There was no difference between groups in terms of postoperative inflammation at the first and second months after the surgery. CONCLUSION: The results of the study suggest that enoxaparin added into the infusion fluid may reduce postoperative inflammation in patients with DM, and this result supports the anti-inflammatory effect of enoxaparin. ((C) 2013 by Elsevier Inc. All rights reserved.)Öğe Effect of Intravitreal Injection of Dexamethasone Implant on Corneal Endothelium in Macular Edema Due to Retinal Vein Occlusion(Karger, 2014) Ilhan, Nilufer; Coskun, Mesut; Ilhan, Ozgur; Tuzcu, Esra Ayhan; Daglioglu, Mutlu Cihan; Keskin, Ugurcan[Abstract Not Available]Öğe Effect of intravitreal injection of dexamethasone implant on corneal endothelium in macular edema due to retinal vein occlusion(Taylor & Francis Ltd, 2015) Ilhan, Nilufer; Coskun, Mesut; Ilhan, Ozgur; Tuzcu, Esra Ayhan; Daglioglu, Mutlu Cihan; Elbeyli, Ahmet; Keskin, UgurcanObjective: To evaluate the effects of dexamethasone (DEX) implant (Ozurdex(R)) on corneal endothelium in patients with retinal vein occlusion complicated with macular edema. Materials and methods: Patients (n = 31) received 1-3 intravitreal DEX implants in one eye. Measurements were intraocular pressure (IOP) at baseline and 1, 3, and 6 months after the first intravitreal injection and corneal specular microscopy and central corneal thickness (CCT) at baseline and 1 and 6 months. We analyzed endothelial cell density (ECD), coefficient of variation of cell size (CV), and percentage of hexagonality. Results: Mean follow-up period was 9.7 +/- 3.3 months. Mean number of injections was 1.5 +/- 0.8. Mean IOP values were 15.6 +/- 2.6mm Hg at baseline, 17.7 +/- 3.6mm Hg at one month, 16.4 +/- 4.1mm Hg at three months, and 16.0 +/- 2.7mm Hg at six months. There was a significant difference in mean IOPs at one month and six months (p = 0.008). There were no significant differences in mean ECD (p = 0.375), CV (p = 0.661), percentage of hexagonality (p = 0.287), and CCT (p = 0.331). Conclusion: Although intravitreal injection of 0.7mg DEX causes moderate elevation of IOP, it does not seem to have detrimental effects on corneal endothelium at six months.Öğe The effects of soft contact lens use on cornea and patient's recovery after autograft pterygium surgery(Elsevier Science Bv, 2014) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Nilufer; Tuzcu, Esra Ayhan; Ilhan, Ozgur; Keskin, Ugurcan; Ayintap, EmrePurpose: To investigate usage of soft contact lens (SCL) on post-operative pain relief and daily, activity due to pterygium surgery. Methods: Autograft pterygium surgery was performed to 63 eyes of 63 patients. After surgery in 30, eyes of 30 patients in group-1, SCL was placed on the cornea. In 33 patients of group-2, antibiotic, pomade was applied and tightly covered with bandage. Follow-up visits were performed on 24th and, 48th h after the surgery. Re-epithelization time and pain scores were compared. Results: Patients' 24th h pain score was 2.96 +/- 0.76 in group-1, and 4.15 +/- 0.75 in group-2. The mean, pain score for 48 h was 1.66 +/- 0.66 in group-1, and 2.96 +/- 0.68 in group-2. Patients' pain scores for, both 24th h and 48th h were lower in group-1 (p < 0.01). The mean re-epithelization times in, group 1 and 2 were 48 and 56.7 h, respectively. Corneal re-epithelization is improved in patients, with SCL compared to group 2. Conclusion: SCL seems effective on reducing post-operative pain and eye stinging, and may accelerate, corneal re-epithelization and maintaining daily activities. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of British Contact Lens Association. All rights reserved.Öğe Effects of sub-Tenon's anaesthesia on ocular hemodynamics(Canadian Ophthal Soc, 2014) Coskun, Mesut; Daglioglu, Mutlu Cihan; Davran, Ramazan; Ilhan, Niluefer; Ilhan, Oezguer; Tuzcu, Esra Ayhan; Ayintap, EmreObjective: To research the effects of sub-Tenon's anaesthesia (STA) on ocular hemodynamics in patients with cataract using colour Doppler imaging (CDI). Design: Prospective clinical study. Participants: Thirty-four eyes of 34 patients with age-related cataract. Methods: Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) values of the ophthalmic artery (OA), central retinal artery, and central retinal vein were measured by CDI before and immediately after performing sub-Tenon block using 2 mL of 2% lidocaine with adrenaline (1:200 000). Results: Both PSV and EDV values were significantly decreased after sub-Tenon injection in all the studied vessels of the patients. However, no important changes were observed in the RI values of the vessels. Conclusions: STA markedly reduced ocular blood flow. The reduction may be more acceptable compared with other retrobulbar block methods. Sub-Tenon block should be performed carefully to senile patients with cataract with vascular occlusive disorder.Öğe Investigation of the association between glaucoma and Helicobacter pylori infection using the 14C-urea breath test(Consel Brasil Oftalmologia, 2015) Tuzcu, Esra Ayhan; Aydogan, Fusun; Motor, Vicdan Koksaldi; Ilhan, Ozgur; Daglioglu, Mutlu Cihan; Coskun, Mesut; Ikirer, Nihan ParlakfPurpose: To investigate the association between glaucoma and Helicobacter pylori infection by evaluating for the presence of H. pylori infection in patients with glaucoma using the C-14-urea breath test (14C-UBT). Methods: Using 14C-UBT, H. pylori infection positivity was compared between a group of patients with primary open-angle glaucoma and a control group with normal intraocular pressure and a normal optic disc or normal perimetry. Results: The 14C-UBT was positive in 18 (51.42%) out of 35 patients in the glaucoma group and in 15 (42.85%) out of 35 patients in the control group. H. pylori infection positivity rates were similar between the glaucoma and control groups (p>0.05). Conclusion: According to the 14C-UBT, there is no association between primary open-angle glaucoma and H. pylori infection.Öğe Is There a Relationship Between Pathologic Myopia and Dry Eye Syndrome?(Lippincott Williams & Wilkins, 2014) Ilhan, Nilufer; Ilhan, Ozgur; Tuzcu, Esra Ayhan; Daglioglu, Mutlu Cihan; Coskun, Mesut; Parlakfikirer, Nihan; Keskin, UgurcanPurpose:The aim of this study was to investigate the relationship between pathologic myopia and the dry eye syndrome.Methods:Forty-five patients with a spherical equivalence (SE) greater than -6.0 diopters (D) and an axial length (AL) >26.5 mm were assigned to the pathological myopia group (group 1). Forty-four healthy individuals were selected from subjects with emmetropia whose SE values ranged from -1.0 to +1.0 D (group 2). Ocular surface disease index (OSDI) scores of all the patients were determined. All the participants underwent the following: Schirmer 1 test without anesthesia, corneal staining, tear break-up time (TBUT), Schirmer 1 test with anesthesia, and AL measurement.Results:The mean age of group 1 and group 2 patients was 40.2 12.3 and 38.8 +/- 9.3 years. The mean values of SE, keratometry, and AL were -9.6 +/- 3.8 D, 43.9 +/- 1.1 D, and 27.4 +/- 0.6 mm in group 1 and -0.1 +/- 0.5 D, 42.3 +/- 1.4 D, and 23.0 +/- 0.2 mm in group 2. The mean values of the Schirmer 1 test without and with anesthesia were 14.4 +/- 6.1 and 9.5 +/- 4.5 mm in group 1 and 16.7 +/- 6.2 and 11.4 +/- 6.0 mm in group 2. The mean TBUT in group 1 was 7.2 +/- 3.4 seconds, whereas that in group 2 was 13.6 +/- 3.7 seconds. There was a significant difference between the groups in SE, keratometry, AL, TBUT, and OSDI scores (P < 0.001).Conclusions:Patients with pathologic myopia have lower TBUT scores and higher OSDI scores when compared with healthy individuals.Öğe A Novel Capsulorhexis Technique in White Cataract Surgery(Informa Healthcare, 2015) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Ozgur; Tuzcu, Esra Ayhan; Ilhan, Nilufer; Ayintap, Emre; Taskin, IbrahimPurpose: To investigate the efficacy and safety of novel capsulorhexis technique in white cataract surgery using the irrigation-aspiration system of a phaco device. Materials and Methods: 53 eyes of 50 patients were included in the study. Patients were randomly divided into two groups. To 27 eyes of 27 patients in Group 1, continuous curvilinear capsulorhexis (CCC) was made using an irrigation-aspiration system by a phaco machine. To 26 eyes of 23 patients in Group 2, CCC was made using an ocular visco-elastic device (OVD) and utrata forceps. Surgical results were compared between two groups. Results: No difference in outcome endothelial cell count or central corneal thickness was noted between the two groups. CCC-2 has been completed totally in Group 1 but only 22 eyes in the other group. Conclusions: Capsulorhexis with described technique is safe in white cataracts. This technique may be an alternative in capsulorhexis to the other method, which is made using OVD and forceps.Öğe Orbital compression syndrome complicated by epidural hematoma and wide cephalohematoma in a patient with sickle cell disease(Mosby-Elsevier, 2014) Ilhan, Nilufer; Acipayam, Can; Aydogan, Fusun; Atci, Nesrin; Ilhan, Ozgur; Coskun, Mesut; Daglioglu, Mutlu CihanOrbital wall infarctions resulting in orbital and epidural hematomas are rare manifestations of sickle cell disease (SCD). We report orbital compression syndrome associated with an epidural hematoma and wide cephalohematoma in a 15-year-old boy with SCD. An infarcted orbital bone was observed on magnetic resonance imaging and three-phase bone scintigraphy with Technetium-99m methylene diphosphonate. The patient recovered completely without surgical intervention at the end of the fourth week. Prompt diagnosis and proper management are critical for complete recovery.Öğe Peripapillary Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layers Thickness in Ankylosing Spondylitis(Informa Healthcare, 2014) Tuzcu, Esra Ayhan; Ustun, Nilgul; Ilhan, Nilufer; Yagiz, Erman; Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, OzgurObjective: To assess the thickness of the retinal nerve fibril layer (RNFL) in cases with ankylosing spondylitis (AS). Materials and methods: The study included 40 AS patients who had no history of acute and/or previous uveitis and 50 healthy controls. After detailed ocular examination, the thickness of the peripapillary RNFL, the macula, and the ganglion cell-inner plexiform layers (GCIPL) were measured by spectral domain optic coherence tomography (SD-OCT). The correlation between the duration of the disease and the thickness of the RNFL, the macula, and the GCIPL were analyzed in the patients who had AS. These patients were then placed into 2 groups according to their BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) score: patients with BASDAI score <4 and those with BASDAI score >= 4. The correlations between the BASDAI score and the mean GCIPL and temporal RNFL thickness were evaluated. Results: No significant difference was detected in the RNFL thickness of the AS patients and that of the controls (p = 0.407). Nor was any significant difference detected in the GCIPL thickness of the AS and the control groups (p = 0.091). In addition, no significant difference was found in the macular thickness when the AS group was compared to the control group (p = 0.139). However, a negative correlation was detected between the duration of the disease and the thickness of the temporal quadrant RNFLs (r = -0.334; p = 0.035). The temporal quadrant RNFL thickness and the mean thickness of the GCPIL were significantly thinner in the AS patients with BASDAI score >= 4 (p = 0.034 and p = 0.025, respectively). Also, the BASDAI score were negatively correlated to the temporal quadrant RNFL and GCIPL thickness (r = -0.332; p = 0.036 and r = -0.348; p = 0.028, respectively). Conclusion: RNFL thickness and GCIPL thickness of ankylosing spondylitis may be affected by the severity and duration of the disease.Öğe Posterior Hyaloidotomy by Nd:YAG Laser Application in a Patient with Postpartum Depression Caused by Valsalva Retinopathy(Karger, 2013) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Nilufer; Tuzcu, Esra Ayhan; Ari, Mustafa; Ayintap, Emre; Ilhan, OzgurPurpose: The aim of this report is to present a case of premacular hemorrhage in a 37-week pregnant woman with concurrent presence of postpartum depression secondary to her ocular disease. Methods: A 27-year-old woman in her 37th week of pregnancy presented with Valsalva retinopathy, which occurred in her left eye secondary to severe coughing. Her visual acuity was reduced to perception of hand motions, and she was agitated because of the loss of vision. The patient, who gave birth by cesarean section, was admitted for control examination 2 weeks after birth. No change was observed in premacular hemorrhage in control examination. However, the patient's relatives stated that the patient was very agitated and disinterested in her baby. For this reason, the patient was referred to the psychiatry clinic, and she was diagnosed with postpartum depression. The anatomical location of the premacular hemorrhage was determined by spectral domain optical coherence tomography. Results: Neodymium yttrium aluminum garnet (Nd:YAG) laser hyaloidotomy was performed to her left eye on the same day. Rapid release of premacular hemorrhage into the vitreous cavity was observed immediately after Nd:YAG laser application. Two days after the application, the patient's visual acuity had improved to 20/20. The clinical improvement positively impacted on the patient's mood. Conclusion: In pregnant patients suffering from Valsalva retinopathy during the postpartum period, posterior hyaloidotomy by Nd:YAG laser can be implemented in terms of the patients' own and their babies' physical and mental health.Öğe Repair of Iridodialysis Using 8-0 Polypropylene(Taylor & Francis Inc, 2014) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Nilufer; Ayintap, Emre; Tuzcu, Esra Ayhan; Ilhan, Ozgur; Oksuz, HuseyinPurpose: Investigate the effectiveness of repair of iridodialysis with 8-0 polypropylene. Methods: We present four cases of traumatic iridodialysis that were repaired by 8-0 polypropylene suture. Results: Better iris reposition and stability were achieved with 8-0 polypropylene suture despite wide degree traumatic iridodialysis in all patients. Conclusion: In this study, we used 8-0 polypropylene suture, which is thicker, cheaper, and more durable than 10-0 sutures. We suggest that usage of 8-0 polypropylene sutures may provide better iris repositioning.Öğe The Significance of the Neutrophil/Lymphocyte Ratio as a Simple Indicator of Inflammation in Age-related Macular Degeneration REPLY(Taylor & Francis Inc, 2016) Ilhan, Nilufer; Daglioglu, Mutlu Cihan; Ilhan, Ozgur; Coskun, Mesut; Tuzcu, Esra Ayhan; Kahraman, Hilal; Keskin, Ugurcan[Abstract Not Available]
