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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 Serous Detachment Associated with Latanoprost/Timolol Fixed Combination Use: A Report of One Phakic Case(Hindawi Ltd, 2012) Tuzcu, Esra Ayhan; Keskin, Ugurcan; Coskun, Mesut; Ilhan, Ozgur; Daglioglu, Mutlu; Oksuz, HuseyinWe present a case of bilateral diffuse serous detachment associated with latanoprost/timolol fixed combination treatment which was recovered after changing treatment.Öğe A Case of Multipl Cranial Nerve Involvement Caused by Skull Base and Orbital Wall Fractures(Elsevier Science Bv, 2013) Ilhan, Nilufer; Ilhan, Ozgur; Parlakfikirer, Nihan; Coskun, Mesut; Tuzcu, Esra AyhanPost-traumatic skull base fractures can cause cranial nerve paralysis. Mortality and morbidity rates are high in skull base fractures. Treatment modalities should be determined by a multidisciplinary evaluation. Here a case of crushing head injury with right abducens, facial and left optic nerve palsies caused by skull base and orbital fracture is presented.Öğe Central retinal artery occlusion secondary to orbital cellulitis and abscess following dacryocystitis(Sage Publications Ltd, 2011) Coskun, Mesut; Ilhan, Ozgur; Keskin, Ugurcan; Ayintap, Emre; Tuzcu, Esra; Semiz, Hilal; Oksuz, HuseyinPurpose. To report a case of dacryocystitis that progressed to orbital abscess resulting in the rare complication of central retinal artery occlusion. Methods. A patient without any other known health problems presented with dacryocystitis complicated by orbital cellulitis, orbital abscess, and finally central retinal artery occlusion despite medical treatment. Results. After 48 hours of medical treatment, there was no recovery, and there was loss of light perception; because of this, surgery indication was determined. Fundus fluorescein angiogram demonstrated findings of central retinal artery occlusion. There was no recovery of light perception after surgical intervention. Conclusions. We report a case of orbital abscess following dacryocystitis in a healthy middle-aged woman resulting in the rare complication of central retinal artery occlusion. To our knowledge, this is the first report of central retinal artery occlusion secondary to orbital abscess following dacryocystitis.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 Compatibility of Spectacles with their Prescriptions in Central Anatolia(Taylor & Francis Inc, 2015) Ilhan, Nilufer; Dogan, Hakki; Ilhan, Ozgur; Coskun, Mesut; Bulut, Betul Tasar; Ersekerci, Tulay KaracanPurpose: To investigate compatibility of spectacles with their prescriptions. Methods: This study was conducted prospectively between October 2007 and March 2009. A total of 1002 spectacles of 1002 individuals were included in the study. First right and then left lenses of the spectacles were measured with a Topcon CL-200 digital lensmeter. Interpupillary distance (PD) of the subjects was measured. Spherical, cylindrical, and axial differences between the prescription and the spectacles were separately calculated for the left and right lenses. Prismatic effect (PE) of the lenses, with decentralized focus according to the pupil, its base direction, and amount of decentralization, were measured. Results: A total of 505 (50.4%) of the subjects were female and 497 (49.6%) were male. The mean age was 37.0 (range 3-81). The mean PD of the subjects was 59.9 +/- 4.09 mm, and mean optical center distance (OCD) of the lenses was 65.6 +/- 4.07 mm. The difference between PD and OCD was significant (p < 0.001). While the right spherical, cylindrical, and axial differences and left spherical, cylindrical, and axial differences between the prescription and the spectacles were not significant, the left axial difference was statistically significant (p < 0.001). The decentralization direction was towards the lower temporal with a percentage of 76.8% on the right and 80.3% on the left lenses. The mean amount of the decentralization was 4.37 +/- 2.39 mm on the right and 4.63 +/- 2.36 mm on the left. Conclusion: Dioptric error in the spectacles was quite low. However, there may be a small amount of axis deviation at the time of mounting the lens to the frame. We conclude that asthenopic complaints due to PE caused by the decentralization of the optic center of the lenses are quite important. Examination of the spectacles after they are prepared can be deemed as a solution to reduce asthenopic complaints due to improper spectacles.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 Remifentanil and Esmolol on Increase in Intraocular Pressure Due to Laryngoscopy and Tracheal Intubation: A Double-Blind, Randomized Clinical Trial(Lippincott Williams & Wilkins, 2015) Tuzcu, Kasim; Tuzcu, Esra A.; Karcioglu, Murat; Davarci, Isil; Coskun, Mesut; Ilhan, Ozgur; Daglioglu, Mutlu C.Purpose:This study aimed to compare the effects of remifentanil and esmolol on the elevation of intraocular pressure (IOP) and hemodynamic response.Methods:After approval of the institutional Ethics Committee and obtaining informed consent, 60 adult patients with American Society of Anesthesiologists I-II status undergoing elective, nonophthalmic surgery were included in the study. Exclusion criteria were preexisting eye disease, neuromuscular disease, esophageal reflux, hiatus hernia, allergy to any of the study drugs, and the use of -blockers, diuretics, or other antihypertensive agents. The patients were randomized into 2 groups by using the sealed-envelope method, as follows: group E (esmolol) and group R (remifentanil). A single intravenous dose of esmolol (0.5 mg/kg) or remifentanil (1 g/kg) just before induction agents were given to patients in groups E and R, respectively. IOP, heart rate (HR), and mean arterial pressure (MAP) values were recorded before intubation and at 1, 3, 5, and 10 minutes after intubation.Results:The IOP decrease in group R was statistically significant compared with group E (P<0.01). HR values at 10 minutes after intubation were significantly decreased in group E compared with group R (P<0.05). There was no significant difference in MAP values between the groups.Conclusions:It was concluded that remifentanil is more effective than esmolol in preventing IOP elevation related to laryngoscopy and tracheal intubation, while there is no significant difference between the 2 agents in terms of HR and MAP.Öğe Effects of Smoking on Central Corneal Thickness and the Corneal Endothelial Cell Layer in Otherwise Healthy Subjects(Lippincott Williams & Wilkins, 2016) Ilhan, Nilufer; Ilhan, Ozgur; Coskun, Mesut; Daglioglu, Mutlu C.; Tuzcu, Esra Ayhan; Kahraman, Hilal; Keskin, UgurcanObjectives:The effects of smoking on central corneal thickness (CCT), corneal endothelial cell density (ECD), and morphology were evaluated in otherwise healthy subjects.Methods:The study included 103 current smokers and 106 healthy nonsmoking subjects without any eye disease apart from refractive errors. Endothelial cell density, percentage of hexagonality, and coefficient of variation (CV) in cell size were measured using noncontact specular microscopy. Central corneal thickness was measured by ultrasound pachymetry.Results:The mean age of participants in the nonsmoker group was 31.4 5.1 years (18-60) and 33.0 +/- 9.1 years (18-58) in the current smoker group. The mean CCT value was 523.7 +/- 34 m in the nonsmoker group and 518.5 +/- 37 m in the smoker group. The mean ECD, CV, and percentage of hexagonality values were 2,881 +/- 293.7 cells per square millimeter, 32.5 +/- 6%, and 56.6 +/- 11% in the nonsmoker group, and 2,681 +/- 323.9 cells per square millimeter, 33.4 +/- 5%, and 55.5 +/- 10% in the smoker group, respectively. Although there was no difference between the groups in terms of CCT, CV, and percentage of hexagonality values, a significant difference was determined in the case of ECD values (P<0.001). The smoker group comprised 67 light smokers (65.0%) and 36 (35.0%) heavy smokers. Between these groups, there was no statistically significant difference in the mean values of CCT, ECD, CV, and the percentage of hexagonality.Conclusions:Although cigarette smoking has no effect on cell polymorphism and polymegethism, the results suggest that smoking reduces endothelial cell count.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 Topical Phenylephrine HCI 2.5% used before Cataract Surgery on Systemic Blood Pressure(Turkish Ophthalmological Soc, 2011) Ayintap, Emre; Keskin, Ugurcan; Coskun, Mesut; Ilhan, Ozgur; Semiz, Hilal; Oksuz, HuseyinPurpose: To evaluate the effect of topical phenylephrine HCI 2.5% (Mydfrin), used as a fast and effective mydriatic before cataract surgery, on systemic blood pressure. Material and Method: Topical phenylephrine HCI 2.5% was administered 3 times with 5-minute intervals before cataract surgery to 44 eyes of 44 patients. The systemic blood pressure was measured preoperatively and at 15 and 30 minutes. Results: The mean systolic blood pressure before the topical administration of phenylephrine HCI 2.5% was 119.7mmHg, while 15 and 30 minutes later, it was 125.3 mmHg and 121.2 mmHg, respectively. The mean diastolic blood pressure before the topical administration of phenylephrine HCI 2.5% was 75.9 mmHg; 15 and 30 minutes later, it was 76.9 mmHg and 75.3 mmHg, respectively. The increase in systolic blood pressure at 15 and 30 minutes was statistically significant (p=0.003 and p=0.042). The change in diastolic blood pressure was not statistically significant. Discussion: Phenylephrine HCI 2.5%, which is used preoperatively as a fast and effective mydriatic for cataract surgery, can increase the systolic blood pressure. This effect is most significant at 15 minutes and lasts at least 30 minutes. This agent should be used with care in hypertensive patients.Öğe The factors affecting the development of phthisis bulbi after penetrating eye injuries(Turkish Assoc Trauma Emergency Surgery, 2012) Coskun, Mesut; Atas, Mustafa; Akal, Ali; Ilhan, Ozgur; Keskin, Ugurcan; Tuzcu, Esra AyhanBACKGROUND We aimed to investigate the factors affecting the development of phthisis bulbi after penetrating eye injuries. METHODS The medical records of 132 patients admitted to our clinic between 2000-2006 with the diagnosis of penetrating eye injury were collected. The records of the eight patients who developed phthisis bulbi were evaluated retrospectively. The aspects of anatomic localization, type of trauma, associated events, and development of phthisis bulbi were also investigated. RESULTS The mean age of the eight patients (5 males, 3 females) was 7.12 +/- 4.70 years (range: 2-16 years) and the mean follow-up time was 2.06 +/- 1.47 years (range: 6 months-5 years). Three of eight patients developed post-perforation endo-phthalmitis. Three patients had zone 2-3 scleral perforation and associated retinal detachment and the remaining two patients had proliferative vitreoretinopathy according to the trauma; all eight patients eventually developed phthisis bulbi. The mean time for the development of phthisis bulbi was 5.5 +/- 2.13 months (range: 3-10 months). CONCLUSION After penetrating eye injuries, visual prognosis and development of phthisis bulbi were affected significantly by the factors including anatomic localization, size of the injury, associated anterior or posterior segment pathologies, and endophthalmitis secondary to the trauma.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 Mean platelet volume is influenced by many inflammatory and cardiovascular disorders and cardiovascular risk factors(Springer, 2013) Tuzcu, Esra Ayhan; Arica, Secil; Ilhan, Nilufer; Daglioglu, Mutlu; Coskun, Mesut; Ilhan, Ozgur; Ustun, Ihsan[Abstract Not Available]Öğe Mean platelet volume measurement protocol should be standardized for diabetic retinopathy(Springer, 2013) Tuzcu, Esra Ayhan; Arica, Secil; Ilhan, Nilufer; Daglioglu, Mutlu; Coskun, Mesut; Ilhan, Ozgur; Ustun, Ihsan[Abstract Not Available]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.
