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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 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 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 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 The Injection of Air/Oxygen Bubble into the Anterior Chamber of Rabbits as a Treatment for Hyphema in Patients with Sickle Cell Disease(Hindawi Ltd, 2014) Ayintap, Emre; Keskin, Ugurcan; Sadigov, Fariz; Coskun, Mesut; Ilhan, Nilufer; Motor, Sedat; Semiz, HilalPurpose. To investigate the changes of partial oxygen pressure (PaO2) in aqueous humour after injecting air or oxygen bubble into the anterior chamber in sickle cell hyphema. Methods. Blood samples were taken from the same patient with sickle cell disease. Thirty-two rabbits were divided into 4 groups. In group 1 (n = 8), there was no injection. Only blood injection constituted group 2 (n = 8), both blood and air bubble injection constituted group 3 (n = 8), and both blood and oxygen bubble injection constituted group 4 (n = 8). Results. The PaO2 in the aqueous humour after 10 hours from the injections was 78.45 +/- 9.9 mmHg (Mean +/- SD) for group 1, 73.97 +/- 8.86 mmHg for group 2, 123.35 +/- 13.6 mmHg for group 3, and 306.47 +/- 16.5 mmHg for group 4. Therewas statistically significant difference between group 1 and group 2, when compared with group 3 and group 4. Conclusions. PaO2 in aqueous humour was increased after injecting air or oxygen bubble into the anterior chamber. We offer to leave an air bubble in the anterior chamber of patients with sickle cell hemoglobinopathies and hyphema undergoing an anterior chamber washout.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 Protective effects of N-acetylcysteine on triamcinolone acetonide-induced lens damage in rats(Taylor & Francis Ltd, 2014) Tuzcu, Esra Ayhan; Tuzcu, Kasim; Basarslan, Fatmagul; Motor, Sedat; Coskun, Mesut; Keskin, Ugurcan; Ayintap, EmreObjective: To examine the relationship of cataract forming effect of intravitreal triamcinolone acetonide (IVTA) injection with oxidative status and the effect of N-acetylcysteine (NAC) on these alterations. Materials and methods: Twenty-six Wistar-Albino rats were included in the study. Rats were assigned into four groups as follows: intravitreal saline injection group (controls); IVTA injection group; IVTA + intraperitoneal NAC injection group (IVTA + NAC); and intraperitoneal NAC injection group (NAC). Triamcinolone acetonide was intravitreally injected at a dose of 1 mg. NAC was intraperitoneally injected at a dose of 150 mg/g body weight. Animals were sacrificed and lens specimens were analyzed for levels of malondialdehyde (MDA) and protein carbonyl (PC) and activities of glutathione (GSH) and glutathione peroxidase (GSH-Px). Results: We found that the MDA and PC levels of lenses were increased in the IVTA group (p < 0.01). It was seen that GSH and GSH-Px in lenses were decreased in the IVTA group (p < 0.01). NAC administration significantly ameliorated these changes in the IVTA + NAC group (p<0.05). Conclusion: These results indicate that the NAC produces a protective mechanism against IVTA-induced cataract and suggest a role of oxidative stress in pathogenesis.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]Öğe Terson Syndrome (A case Report)(Turkish Ophthalmological Soc, 2012) Ilhan, Ozgur; Ilhan, Nilufer; Coskun, Mesut; Ayintap, Emre; Keskin, Ugurcan; Semiz, Hilal; Oksuz, HuseyinTerson syndrome is a vitreous hemorrhage that occurs after intracranial hemorrhages (subarachnoid or subdural) and generally visual deficit or low vision is observed. In this paper, the case of a patient who had undergone pars plana vitrectomy due to Terson syndrome is presented. Visual acuity of the patient was 0.1 prior to the operation, but 1 month postoperatively, it reached 0.7. There was no complication during the surgery and at postoperative follow-up.
