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Acinetobacter baumannii endophthalmitis following ıntravitreal ranibizumab ınjection
(Retina-Vitreus, 2013) Çankaya, Cem; Cumurcu, Tongabay; Doğanay, Selim
Öz: Çalışmamızda, vitreus içi Ranizumab (Lucentis®) uygulaması sonrası Acitenobacter Baumannii endoftalmisi gelişen bir olguyu sunmayı amaçlamaktayız. Yetmişdokuz yaşında erkek hasta, her iki gözünde görme azlığı şikayeti ile kliniğimize başvurdu. Hastanın yapılan Fundus floresein anjiografisinde (FA) sağ gözde kuru tip yaşa bağlı maküla dejenerasyonu (YBMD), sol gözde ise subfoveal klasik tip koroid neovasküler membran ve buna ikincil subretinal hemoraji tespit edildi. Hastanın sol gözüne 3 doz birer ay arayla intravitreal Ranibizumab (Lucentis®) tedavisi planlandı. Olgumuz, 3. doz uygulamayı takiben 3. günde görme kaybı, şiddetli göz ağrısı ve kırmızı göz ile kliniğimize başvurdu. Hastanın görme keskinliği ışık hissi düzeyindeydi. Biyomikroskobik muayenesinde ve B tarama ultrasonografide endoftalmi tablosu izlendi. Hasta acil olarak hospitalize edildi ve medikal tedavisine başlandı. Sol gözden vitreus örneği alınmasını takiben intravitreal Vankomisin ve Seftazidim uygulandı. Topikal sikloplejik ajanlarla birlikte sistemik sefazolin ve gentamisin, topikal fortifiye seftazidim ve vankomisin ve topikal moksifloksasin tedavisine başlandı. Yoğun kornea opasifikasyonu nedeni ile pars plana vitrektomi uygulanamadı. Tedavinin başlangıcından 4 gün sonra vitreus kültüründe Acinetobacter baumannii üremesi olduğu bildirildi. Takip eden günlerde klinik tabloda bir iyileşme izlenmedi ve görme keskinliği ışık hissi kaybına kadar ilerledi. Vitreus içi Ranibizumab uygulamasından sonra akut Acinetobacter baumannii endoftalmisi çok hızlı oluşabilir ve ciddi görme kaybına neden olabilir. Acinetobacter baumannii'ye bağlı endoftalmi tablosu nadir olmasına rağmen, oftalmologlar bu etyolojik ajana karşı daha dikkatli olmalıdırlar. Başlık (İngilizce): İntravitreal ranibizumab enjeksiyonu sonrası gelişen acinetobacter baumannii endoftalmisi Öz (İngilizce): We aimed to report a case who developed Acitenobacter baumannii endophthalmitis after intravitreal Ranibizumab (Lucentis®) injection. A 79-year-old male patient was admitted with vision loss in both eyes. Fluorescein angiography showed dry type age-related macular degeneration (ARMD) in the right eye and subretinal hemorrhage secondary to subfoveal classic type choroidal neovascular membrane in the left eye. Intravitreal injections of 3-dose Ranibizumab (Lucentis®) at monthly intervals were planned for the left eye of the patient. After the injection of the third dose of Ranibizumab, on the third day, the patient returned to the clinic with a complaint of excruciating ocular pain, red eye and vision loss in the left eye. The visual acuity of the patient was at the level of light perception. A slit lamp examination and B-mode ultrasonography revealed endophthalmitis. The patient was promptly hospitalised and medical treatment was started. After the sampling of vitreous from the left eye, vancomycin and ceftazidime were intravitreally administered. Systemic cefazolin and gentamicin, topical fortified vancomycin and ceftazidime, and topical moxifloxacin along with topical cycloplegic drops were started. Pars plana vitrectomy could not be performed due to corneal opacification. Four days after the initialisation of the therapy, the culture of the vitreous sample yielded Acinetobacter baumannii. In the following days, no regression in the clinical picture was determined and the level of the visual acuity worsened to light perception loss. Acute Acinetobacter baumannii endophthalmitis following intravitreal Ranibizumab injection occurs rapidly and can result in severe loss of vision. Although endophthalmitis is rare, ophthalmologists should be alert to the possibility of patients having endophthalmitis caused by A. baumannii.
Aripiprazole-induced transient myopia
(Kare Publ, 2020) Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Yesil, Bahar; Gunduz, Abuzer
This study aims to present a case of transient myopia due to aripiprazole used in the treatment of depression. A 21-year-old female who was being treated for depression with 15 mg/day Aripiprazole during two months. She normally used -3.75 D glasses. She was admitted to our outpatient clinic with sudden onset blurring of vision in both eyes despite using glasses for about three days. Using of aripiprazole was observed in the patient's history. She was found to have myopia of -6.0 diopters in both eyes with measurement of otorefractometer; her visual acuity was 6/10 in both eyes with her glasses. The other eye examination findings of the patient were normal. The drug was discontinued, and the patient was followed. One mount later on examination, the patient's visual acuity increased to 10/10 in both eyes. Following the first day of the Alx values measured were 0.3 mm longer than one month after the measurement; the minimal difference between the other anterior segment findings were recorded. Although the specific mechanisms that cause acute myopia has not been fully revealed, it can be ciliary spasm, ciliary bodies effusion, peripheral uveal effusion and effects of ocular serotonergic intraneural fibers. We believe that it would be important for clinicians. They should keep in mind these conditions when prescribing aripiprazole and need to inform patients about the side effects related to the eye.
Behçet Hastasında Sildenafil Kullanımı Sonrasında Optik Nöropati Gelişimi
(MN Oftalmoloji, 2019) Cumurcu, Tongabay; Fırat, İlknur Tuncer
Öz: Daha önce kliniğimizde Behçet üveiti tanısıyla takibi yapılan kırk dört yaşında erkek hasta sildenafil kullanımı sonrası başlayan ani gör- me azalması ile başvurdu. Sağ gözün görme keskinliği iki hafta önce snellen eşelinde 0,4 iken, son ziyarette 0,15 olarak tespit edildi. Fundus muayenesinde sağ gözde optik disk soluktu. Floresein anjiyografisinde anormal bir bulgu izlenmedi. Posterior iskemik optik nöropati düşünül- dü. Tedavisinde oral steroid verildi ancak görme artışı sağlanamadı. Sonuç olarak Behçet hastalığı ve sildenafil kullanımına bağlı gelişen gör- me azalması birlikteliğinin ilk kez karşılaşılan bir durum olduğunu; bu durumun varlığında olası iskemik optik nöropati açısından dikkatli olun- ması gerektiğini vurgulamak için bu olguyu sunmak istedik. Başlık (İngilizce): Optic Neuropathy Development Following Sildenafil Use in Behçet’s Patient Öz (İngilizce): A 44-year-old male patient who was being followed and treated for Behçet’s disease at our clinic presented with decreased visual acuity that had started following the use of sildenafil. The visual acuity of the right eye had previously been 0.4 on the Snellen chart and had decreased to 0.15. The right optic disc was pale. Fluorescein angiography findings were normal. Posterior ischemic optic neuropathy was considered. Oral steroids were used for treatment but the visual acuity did not increase. In conclusion, an association between Behçet's disease and de- creased vision due to sildenafil use has been encountered for the first time and we wanted to present this case to emphasize the need to be care- ful in terms of ischemic optic neuropathy in the presence of this condition.
Changes in Anterior Chamber Parameters with the Pentacam Rotating Scheimpflug and Axial Length Measurements by Ultrasound in Patients Who Use Isotretinoin
(Informa Healthcare, 2012) Cumurcu, Tongabay; Sener, Serpil; Ozsoy, Ercan; Doganay, Selim
Purpose: Evaluation of changes in anterior chamber parameters with the Pentacam rotating Scheimpflug and axial length measurements (Alx) by ultrasound in patients who use isotretinoin for the treatment of acne vulgaris. Methods: Twenty-nine eyes of 29 patients (15 men, 14 women) were evaluated with the Pentacam before the treatment, and at the 3rd and 6th months of treatment. The axial length was evaluated by ultrasound biometry. The non-parametric paired t-test was used to compare pretreatment and 3rd and 6th month anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA) width, central corneal thickness (CCT), lens thickness (LT), pupil size, axial length measurement (Alx) and mean keratometry values (K). Results: The mean age of the patients was 21.82 +/- 4.14 years. The differences between the pretreatment and 3rd and 6th month ACD, ACV, CCT, Alx, LT and mean K values were statistically significant (p < 0.05). The differences between the pretreatment and 3rd and 6th month pupil size measurements were not statistically significant (p > 0.05). The differences between the pretreatment and 3rd month ACA measurements were statistically significant (p > 0.05), but there was no statistically significant difference with 6th month values (p < 0.05). Conclusions: Isotretinoin treatment causes statistically significant changes in most anterior segment parameters during treatment.
The Changes in Tear Film Parameters and Impression Cytology in Heavily Drinking Men
(Lippincott Williams & Wilkins, 2013) Cumurcu, Tongabay; Gunduz, Abuzer; Cumurcu, Birgul Elbozan; Gul, Isil Gogcegoz; Akpolat, Nusret; Karlidag, Rifat
Purpose: To evaluate the tear film function and ocular surface changes in heavily drinking men. Methods: This prospective case-control study involved 35 male subjects with heavy alcohol consumption (group 1) and 35 age-and sex-matched control subjects (group 2). Best-corrected visual acuity measurement, slit-lamp examination, Schirmer I test, tear film break-up time (BUT) measurement, and conjunctival impression cytology were performed in all subjects. The results were compared between the 2 groups. Results: The mean Schirmer I test results in group 1 and group 2 were 8.31 +/- 3.56 mm and 13.17 +/- 5.71 mm, respectively, and the mean BUT values were 9.22 +/- 3.10 seconds and 13.20 +/- 4.04 seconds, respectively. The mean Schirmer I and BUT results were statistically lower in group 1 than in group 2 (P < 0.0001). The mean impression cytology scores in group 1 and group 2 were 2.08 +/- 0.78 and 1.37 +/- 0.94, respectively. A statistically significant difference was noted between the study and control groups for the grading of cytological changes (P = 0.001). Conclusions: Our data showed that heavily drinking men have decreased tear production, tear film instability, and significant degeneration of the ocular surface epithelium when compared with normal subjects.
Çocuklukta Görülen Bir Konjonktival Yassı Epitel Hücreli Karsinom Olgusu+
(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2005) Cumurcu, Tongabay; Köseoğlu, R. Doğan
Bu çalışmanın amacı olağan olmayan bir yaş ve cinsiyette gözlenen konjonktival yassı epitel hücreli karsinom vakasını ve tedavi yöntemlerini değerlendirip, tartışmaktır. 11 yaşında bir kız çocuğu sol gözünde 5-6 yıldır geçmeyen bir kitle ile polikliniğimize getirildi. Hasta yakınları kitlede herhangi bir büyüme olmadığını, hep aynı büyüklük ve şekilde olduğunu ifade ettiler. Hastanın yapılan muayenesinde sol göz temporalinde limbustan 3 mm lateralde 3×3 mm boyutlarında hafif kabarık, vaskülarize, hareketli, keratinize ve kahverengi kitle mevcuttu. Operasyonda kitle, 3 mm’lik cerrahi sınır dahil edilerek çıkarıldı. Koterizasyon ve bölgeye bir sponç yardımı ile mitomisin C, 0,2 mg/ml 2 dakika süre ile uygulandı. Histopatolojik inceleme sonucu kitlenin konjonktival yassı epitel hücreli karsinom olduğu görüldü. Hasta aylık takibe alındı, 4 aylık takibinde nüks görülmedi. Konjonktival lezyonlarda, olağan dışı bir yaş grubu ve cins olsa dahi yassı hücreli karsinoma akla getirilerek uygun yöntemlerle tedavi edilmelidir.
Contact-lens-related corneal ulcer caused by klebsiella pneumoniae
(Hospital Clinicas, Univ Sao Paulo, 2011) Cumurcu, Tongabay; Firat, Pembegul; Ozsoy, Ercan; Cavdar, Mufide; Yakupogullari, Yusuf
[Abstract Not Available]
Corneal Endothelial Changes in Behcet's Patients with Inactive Ocular Involvement
(Taylor & Francis Inc, 2018) Cankaya, Cem; Cumurcu, Tongabay; Gunduz, Abuzer; Firat, Ilknur
Purpose: The purpose of this article is to evaluate alterations in the corneal endothelial layer in Behcet's disease (BD) with inactive ocular involvement using specular microscopy.Materials and Methods: Thirty-three eyes of 33 BD patients who had at least one anterior segment involvement and no active inflammation in the last 3months were included in the study (group 1). Twenty-seven of the 33 BD patients had an anterior uveitis attack and six of them had a panuveitis (both anterior and posterior involvement) attack. Thirty-three eyes of 33 age- and sex-matched healthy subjects were enrolled in the control group (group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical, Nishinomiya, Japan), and the results were compared between groups.Results: The mean CD was 2739164.18 cells/mm(2) in group 1 and 2922 +/- 107.60 cells/mm(2) in group 2 (p=0.001). The mean CV was 32.9 +/- 4.76 in group 1 and 28.5 +/- 3.06 in group 2 (p=0.001). The mean HEX was 44.7 +/- 6.51 in group 1 and 49.7 +/- 6.10 in group 2 (p=0.019). The mean CCT was 545.75 +/- 40.89 in group 1 and 545.66 +/- 30.09 in group 2 (p>0.05).Conclusions: Ocular attacks in our BD patients may have caused permanent changes in the corneal endothelial layer. However, these changes did not lead to corneal decompensation, but further studies are necessary to confirm these results.
Corneal endothelial changes in behcet's patients with ınactive ocular ınvolvement
(TAYLOR & FRANCIS INC, 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA, 2018) Çankaya, Cem; Cumurcu, Tongabay; Gündüz, Abuzer; Fırat, İlknur
Purpose: The purpose of this article is to evaluate alterations in the corneal endothelial layer in Behcet's disease (BD) with inactive ocular involvement using specular microscopy.Materials and Methods: Thirty-three eyes of 33 BD patients who had at least one anterior segment involvement and no active inflammation in the last 3months were included in the study (group 1). Twenty-seven of the 33 BD patients had an anterior uveitis attack and six of them had a panuveitis (both anterior and posterior involvement) attack. Thirty-three eyes of 33 age- and sex-matched healthy subjects were enrolled in the control group (group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical, Nishinomiya, Japan), and the results were compared between groups.Results: The mean CD was 2739164.18 cells/mm(2) in group 1 and 2922 +/- 107.60 cells/mm(2) in group 2 (p=0.001). The mean CV was 32.9 +/- 4.76 in group 1 and 28.5 +/- 3.06 in group 2 (p=0.001). The mean HEX was 44.7 +/- 6.51 in group 1 and 49.7 +/- 6.10 in group 2 (p=0.019). The mean CCT was 545.75 +/- 40.89 in group 1 and 545.66 +/- 30.09 in group 2 (p>0.05).Conclusions: Ocular attacks in our BD patients may have caused permanent changes in the corneal endothelial layer. However, these changes did not lead to corneal decompensation, but further studies are necessary to confirm these results.
Corneal endothelial changes in long-term cannabinoid users
(Taylor & Francis Ltd, 2018) Polat, Nihat; Cumurcu, Birgul; Cumurcu, Tongabay; Tuncer, Ilknur
Purpose: The aim of this study was at evaluating the effects of long-term cannabis use on the corneal endothelial cells with the specular microscopy.Methods: The study enrolled 28 eyes of 28 patients diagnosed with cannabinoid use disorder. The cannabinoid group was selected among patients who had been using the substance for three days or more per week over the past one year. Thirty-two eyes of 32 age- and sex-matched healthy individuals enrolled as control group in the study. Corneal endothelial cell density (CD), coefficient of variation (CV) and hexagonal cell ratio (HEX) values were analyzed by specular microscopy.Results: The mean CD was 2900211 cells/mm(2) in the cannabinoid group and 3097 +/- 214 cells/mm(2) in the control group (p<0.01). There was a significant decrease in cannabinoid group. The mean CV was 29 +/- 7 and 27 +/- 4 in the cannabinoid and control groups, respectively (p>0.05). No significant difference was present between the cannabinoid and the control groups in terms of mean CV value. The mean HEX was 52 +/- 5% in the cannabinoid group and 53 +/- 10% in the control group (p>0.05). There was not a significant difference between the cannabinoid and the control groups in terms of mean HEX value.Conclusion: A significant decrease in CD was found in cannabinoid users compared the control group.
Corneal endothelial changes in long-term cannabinoid users
(TAYLOR & FRANCIS LTD, 2-4 PARK SQUARE, MILTON PARK, ABINGDON OR14 4RN, OXON, ENGLAND, 2018) Polat, Nihat; Cumurcu, Birgül; Cumurcu, Tongabay; Tuncer, İlknur
Purpose: The aim of this study was at evaluating the effects of long-term cannabis use on the corneal endothelial cells with the specular microscopy.Methods: The study enrolled 28 eyes of 28 patients diagnosed with cannabinoid use disorder. The cannabinoid group was selected among patients who had been using the substance for three days or more per week over the past one year. Thirty-two eyes of 32 age- and sex-matched healthy individuals enrolled as control group in the study. Corneal endothelial cell density (CD), coefficient of variation (CV) and hexagonal cell ratio (HEX) values were analyzed by specular microscopy.Results: The mean CD was 2900211 cells/mm(2) in the cannabinoid group and 3097 +/- 214 cells/mm(2) in the control group (p<0.01). There was a significant decrease in cannabinoid group. The mean CV was 29 +/- 7 and 27 +/- 4 in the cannabinoid and control groups, respectively (p>0.05). No significant difference was present between the cannabinoid and the control groups in terms of mean CV value. The mean HEX was 52 +/- 5% in the cannabinoid group and 53 +/- 10% in the control group (p>0.05). There was not a significant difference between the cannabinoid and the control groups in terms of mean HEX value.Conclusion: A significant decrease in CD was found in cannabinoid users compared the control group.
Corneal endothelial changes in patients with vitamin D deficiency
(Wolters Kluwer Medknow Publications, 2018) Cankaya, Cem; Cumurcu, Tongabay; Gunduz, Abuzer
Purpose: The purpose of this study is to evaluate the effect of vitamin D deficiency on corneal endothelial layer using specular microscopy. Methods: Fifty-eight eyes of 58 patients whose vitamin 13 level was below 15 ng/ml and who had no ocular pathology were included in the study (Group 1). Forty eyes of 40 age-and sex-matched subjects were enrolled as control group (Group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical Inc., Nishinomiya, Japan). The obtained data were compared between the groups. Results: There was no significant difference between the groups in terms of age and gender (P = 0.344, P = 0.399, respectively). The mean CD value was 2772.79 +/- 202.21 cells/mm(2) in Group 1 and 2954.97 +/- 116.89 cells/mm(2) in Group 2 (P = 0.001). The mean CV value was 30.31 +/- 3.65 in Group 1 and 28.20 +/- 2.71 in Group 2 (P = 0.003). The mean HEX value was 46.56 +/- 6.32 in Group 1 and 51.07 +/- 5.28 in Group 2 (P = 0.001). The mean CCT value was 555.87 +/- 36.90 mu in group 1 and 549.0 +/- 37.39 mu in Group 2 (P = 0.96). Conclusion: Vitamin D deficiency may affect the corneal endothelial layer. Patients with vitamin D deficiency should be evaluated for endothelial parameters in particular before an intraocular surgery. Further studies are needed to confirm our results.
Corneal endothelial changes in patients with vitamin D deficiency
(WOLTERS KLUWER MEDKNOW PUBLICATIONS, WOLTERS KLUWER INDIA PVT LTD , A-202, 2ND FLR, QUBE, C T S NO 1498A-2 VILLAGE MAROL, ANDHERI EAST, MUMBAI, 400059, INDIA, 2018) Çankaya, Cem; Cumurcu, Tongabay; Gündüz, Abuzer
Purpose: The purpose of this study is to evaluate the effect of vitamin D deficiency on corneal endothelial layer using specular microscopy. Methods: Fifty-eight eyes of 58 patients whose vitamin 13 level was below 15 ng/ml and who had no ocular pathology were included in the study (Group 1). Forty eyes of 40 age-and sex-matched subjects were enrolled as control group (Group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical Inc., Nishinomiya, Japan). The obtained data were compared between the groups. Results: There was no significant difference between the groups in terms of age and gender (P = 0.344, P = 0.399, respectively). The mean CD value was 2772.79 +/- 202.21 cells/mm(2) in Group 1 and 2954.97 +/- 116.89 cells/mm(2) in Group 2 (P = 0.001). The mean CV value was 30.31 +/- 3.65 in Group 1 and 28.20 +/- 2.71 in Group 2 (P = 0.003). The mean HEX value was 46.56 +/- 6.32 in Group 1 and 51.07 +/- 5.28 in Group 2 (P = 0.001). The mean CCT value was 555.87 +/- 36.90 mu in group 1 and 549.0 +/- 37.39 mu in Group 2 (P = 0.96). Conclusion: Vitamin D deficiency may affect the corneal endothelial layer. Patients with vitamin D deficiency should be evaluated for endothelial parameters in particular before an intraocular surgery. Further studies are needed to confirm our results.
Corneal structure in tilted disc syndrome
(Consel Brasil Oftalmologia, 2016) Gunduz, Abuzer; Polat, Nihat; Cumurcu, Tongabay; Demirel, ErsinErsan; Ozsoy, Ercan
Purpose: To evaluate the central corneal thickness (CCT), corneal volume (CV), and anterior and posterior corneal surfaces using the Scheimpflug imaging system in patients diagnosed with tilted disc syndrome (TDS). Methods: The study group (Group 1) and the control group (Group 2) comprised 35 eyes of 35 age-, sex-, and refraction-matched cases. All cases underwent a full ophthalmic examination that included cycloplegic refraction, axial ocular length measurement, and Scheimpflug imaging. Results: The mean age was 34.68 +/- 15.48 years in Group 1 and 34.11 +/- 12.01 years in Group 2 (p = 0.864). The gender distribution was 18 males and 17 females in Group 1 and 16 males and 19 females in Group 2 (p = 0.618). All subjects were Caucasian. The spherical equivalent was 3.62 +/- 1.75 D in Group 1 and 3.69 +/- 1.51 D in Group 2 (p = 0.850). There was no significant difference in age, sex, race, or spherical equivalent between groups. There was no significant difference in mean keratometric value and CV3 (the CV in the central 3 mm) between groups (p = 0.232 and 0.172, respectively). There were statistically significant differences in CCT, CV5, and CV7 (CV in the central 5 and 7 mm(3), respectively) and total CV between groups (p = 0.008, 0.003, 0.023, and 0.019, respectively). The values of all parameters were lower in the study group than in the control group. There was also a statistically significant difference in the anterior elevation parameters of the cornea between groups (p < 0.05). The mean values of Group 1 were higher than those of Group 2. There were statistically significant differences in the two parameters referring to the posterior elevation of the cornea between the two groups (p < 0.05). Conclusion: The results of this study showed that eyes with TDS have thinner CCT, lower CV, and different anterior corneal curvature than normal eyes.
Does the use of cannabinoids affect the ocular surface?
(2022) Mutlu, Kayhan; Cumurcu, Tongabay; Cumurcu Elbozan, Birgül
Aim: To examine tear functions and ocular surface variables in patients with cannabis addiction. Materials and Methods: This clinical trial was planned as a prospective case-control study. In this study, 51 male patients with cannabis addiction (group 1) and 51 healthy volunteers (group 2) with similar demographic characteristics were included. Visual acuity, spherical equivalent, biomicroscopic examination, Schirmer test, tear break-up time (TBUT), and impression cytology (Nelson scores) results were recorded, and the 2 groups were compared with each other. Results: The mean Schirmer values were 9.68 ± 6.8 mm and 8.39 ± 4.08 mm in group 1 and group 2 (p = 0.97), respectively, whereas the mean TBUT values were 9.96±3.9 and 9.29±4.01s. (p = 0.35) and the mean Nelson scores were 1.49±1 and 1.25±0.97 in group 1 and group 2, respectively (p = 0.26). Conclusion: In this study, the effects of cannabis addiction on the ocular surface were evaluated using Schirmer, TBUT, and impression cytology methods. In the statistical analysis, no significant difference was found compared to the control group. This study showed that tear production, tear film stability, and impression cytology of patients with cannabis addiction were not different from the control group.
Effective management of exposure keratopathy developed in intensive care units: The impact of an evidence based eye care education programme
(Elsevier Sci Ltd, 2014) Demirel, Soner; Cumurcu, Tongabay; Firat, Penpegul; Aydogan, Mustafa Said; Doganay, Selim
Objectives: To assess the impact of eye care education on the incidence of corneal exposure in intensive care units (ICU). Research methodology/design: Approximately 300 ICU personnel were educated about eye care to reduce the incidence of corneal exposure. The patients were divided into two groups: pretraining (Group 1: Between February 1, 2011 and March 31, 2011 [2 months]) and post-training periods (Group 2: Between April 1, 2011 and April 1 2012 [1 year]). We compared the groups for keratopathy incidence to evaluate the efficacy of this education. Results: The number of patients were 762 in Group 1 and 6196 in Group 2 (p=0.335). Medians of patients followed in pre training ICU and post training ICU for each month were found to be 476 (interquartile range, 433-539) and 515 (interquartile range, 490-528). Exposure keratopathy was identified in 8 eyes of 6 patients (3 males and 3 females) in pre training ICU with the mean age of 27.6 +/- 31.8 years and 5 eyes of 3 patients (1 male and 2 females) in post training ICU with the mean age of 41.3 +/- 32.1 years. No significant difference was noticed between two groups in terms of the medians of patients followed in ICUs for each month (p =0.335). The time of hospitalisation in ICU when the patients were consulted for the first ocular assessment in pre training ICU and post training ICU were found to be 13 +/- 8.7 days and 8 +/- 1.7 days, respectively. After the training, the decrease in incidence of exposure keratopathy was found to be highly significant (p<0.001). Conclusion: We observed a highly significant reduction in the incidence of corneal exposure, following the eye-care education programme. (C) 2013 Published by Elsevier Ltd.
Eksternal Dakriyosistorinostomide Mukozal Flep Tekniğinin Cerrahi Başarı Üzerine Etkisi: H Flep mi? U Flep mi?
(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2012) Gündüz, Abuzer; Cumurcu, Tongabay; Demirel, Soner; Özsoy, Ercan
Lakrimal kese ve burun mukozasında oluşturulan “H” ve “U” flep tekniklerinin eksternal dakriyosistorinostominin (DSR) başarısı üzerine etkisini karşılaştırmak. Yöntem: Distal nazolakrimal kanal tıkanıklığı tanısı ile eksternal DSR ameliyatı yapılan 50 olgunun (36 bayan, 14 erkek) 50 gözü çalışmaya alındı. Olgular ameliyat olma sıralarına göre iki gruba ayrıldı. Önce ameliyat olan 25 vaka birinci gruba (H-flep grubu), sonra ameliyat olan 25 vaka ikinci gruba (U-flep grubu) alındı. Birinci gruptaki hastalarda kese ve nazal mukozada “H” şeklinde kesi ile ön ve arka flepler hazırlandı. İkinci gruba ise sadece “U” şeklinde kesi ile ön flepler hazırlandı. Tüm olgulara flep tekniği dışındaki tüm cerrahi basamaklar aynı şekilde yapıldı. Bulgular: Birinci grup yaşları 18-60 (ort. 42.7±14.3) arasında değişen 25 olgu, ikinci grup ise yaşları 22-65 (ort. 44.2±13.4) arasında değişen 25 olgudan oluşturuldu. Birinci gruptaki olgular 7-14 (ort. 10.5±3.6) ay, 2. gruptaki olgular 5-13 (ort. 11.4±4.2) ay takip edildiler. Birinci gruptaki (H-flep) 25 olgunun 21’inde (%84) cerrahi başarı sağlanırken, 4’ünde (%16) başarısızlık saptandı. İkinci gruptaki (U-flep) tüm olguların erken ve geç postoperatif dönemde yapılan tüm kontrollerinde lavajla kanalın açık olduğu ve hastaların preoperatif tüm şikâyetlerinin kaybolduğu saptandı. Sonuç: “U” flep tekniği ile eksternal DSR’nin cerrahi başarı oranının artabileceğini düşünmekteyiz. Bu flep tekniği ile büyük lakrimal keselerde olduğu gibi küçük lakrimal keselerde de yeterli büyüklükte ön fleplerin oluşturulması mümkün olmaktadır.
Endoscopic Transcanalicular Diode Laser Dacryocystorhinostomy: Is It an Alternative Method to Conventional External Dacryocystorhinostomy?
(Lippincott Williams & Wilkins, 2013) Derya, Kutukde; Demirel, Soner; Doganay, Selim; Orman, Gozde; Cumurcu, Tongabay; Gunduz, Abuzer
Purpose: To compare the success rates of endoscopic transcanalicular diode laser dacryocystorhinostomy (EL-DCR) and external DCR. Materials and Methods: Operations were performed on 55 eyes of 54 patients who had distal nasolacrimal canal obstruction. External DCR was performed on 29 of the eyes and EL-DCR on 26 of them. Success was defined based on subjective relief of patients reported at their final examinations. Results: There were 23 women and 6 men in group 1 and 19 women and 6 men in group 2 (p = 0.77). The mean ages of groups were 45.24 +/- 12.08 (range, 15-74) and 43.2 +/- 17.01 (range, 11-72) years, respectively (p = 0.63). The mean follow-up times were 8.82 +/- 5.51 (range, 3-18) and 7.12 +/- 2.96 (range, 2-12) months, respectively in groups (p = 0.58). The success rates based on symptoms were measured at 25 of 29 (86%) and 17 of 25 (68%) for 2 groups. The difference in the success rates was higher but not found to be statistically significant (p = 0.202). The authors found various conditions related to nasal passage in 4 of 8 unsuccessful EL-DCR, including allergic rhinitis, nasal crust, silicone tube reaction, and unsuitable passage for endoscopic surgery. Conclusions: The success rate of EL-DCR was lower than that of the external DCR; however, no statistically significant difference was observed. Endoscopic transcanalicular diode laser DCR may be considered as an alternative method to external DCR with these results. (Ophthal Plast Reconstr Surg 2013;29:15-17)
Evaluation of Anterior Segment's Structures in Tilted Disc Syndrome
(Hindawi Ltd, 2016) Ozsoy, Ercan; Gunduz, Abuzer; Demirel, Ersin Ersan; Cumurcu, Tongabay
Purpose. To evaluate anterior segment's structures by Pentacam in patients with tilted disc syndrome (TDS). Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups. Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (p = 0.625, p = 0.830, p = 0.234, and p = 0.850). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (p = 0.001, p = 0.0001, p = 0.003, and p = 0.001). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (p = 0.130, p = 0.910, and p = 0.057). Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc.
Evaluation of peripapillary retinal nerve fiber layer, macula and ganglion cell thickness in amblyopia using spectral optical coherence tomography
(Ijo Press, 2013) Firat, Penpe Gul; Ozsoy, Ercan; Demirel, Soner; Cumurcu, Tongabay; Gunduz, Abuzer
AIM: To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS: Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS: The mean global thicknesses of the RNFL were 113.22 +/- 121.47, 111.57 +/- 18.25, 109.96 +/- 11.31 mu m in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P=0.13). The mean thicknesses of the macula were 258.25 +/- 18.31, 258.75 +/- 19.54, 248.62 +/- 10.57 mu m in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P=0.06). The GCC was investigated into two parts: superior and inferior. The mean thicknesses of superior GCC were 102.57 +/- 113.32, 103.32 +/- 10.64, 100.52 +/- 15.88 mu m in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 +/- 112.60, 107.82 +/- 12.33, 105.86 +/- 10.79 mu m in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P=0.63, P=0.46). CONCLUSION: The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.

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