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Öğe Audio-vestibular evaluation in patients with Behçet's syndrome(2001) Evereklioglu C.; Cokkeser Y.; Doganay S.; Er H.; Kizilay A.A prospective controlled clinical study was carried out at the Department of Ophthalmology and ENT, Inönü University Medical Faculty, Turgut Ozal Medical Center, Research Hospital, to evaluate the audiovestibular involvement in patients with Behçet's syndrome compared with controls. Twenty-five consecutive patients with Behçet's syndrome (mean age ± SD, 34.96 ± 8.50) and 20 age- and sex-matched healthy volunteers (hospital staff) as control subjects (mean age ± SD, 34.45 ± 9.16) were included in this study. Behçet's patients were divided into two groups according to the number of criteria, complete (all four major criteria) and incomplete (three major criteria without ocular involvement). The groups were compared with each other or controls regarding inner ear involvement. Audiometric pure-tone thresholds at 125 to 8000 Hz were obtained in all subjects in both groups, and pure tone average (PTA) hearing thresholds were calculated for the middle, high and low frequencies. In addition, short increment sensitivity index (SISI), tone decay and BERA examinations were performed in all Behçet's patients. Sensorineural hearing loss (SNHL) was present in six of 25 patients with Behçet's syndrome. Two Behçet's patients had unilateral total SNHL, two had bilateral moderate level SNHL, one had bilateral low-frequency SNHL and one bilateral high frequency SNHL. In two, BERA, and in five SISI, examination disclosed inner ear involvement. In control subjects, the past medical history was normal and there was no consistent audio-vestibular complaint. Their PTA thresholds were all in the normal range. Otoscopic examination findings were normal, with intact, mobile tympanic membranes in both groups. The present study showed that audio-vestibular involvement is not infrequent in Behçet's syndrome compared with age- and sex-matched healthy controls, and it is under-estimated. All Behçet's patients should regularly be followed by an otolaryngologists and be given information about the possibility of inner ear involvement. According to our results, hearing loss occurs more often in older patients and also in the complete form of Behçet's syndrome.Öğe Comparison of letters, numbers and E-test for final visual acuity(2001) Evereklioglu C.; Doganay S.; Erten A.; Er H.Objective: To compare E-test, letters and numbers on Snellen chart to obtain the earliest and best visual acuity with less variability in the healthy volunteers. Materials and Methods: A hundred healthy subjects included in the present study. Uncorrected visual acuity was obtained in all subjects bilaterally in the same office and illumination situations from 6 m with Snellen chart (separately for letters, numbers and E-test). Only one eye (right eyes) was evaluated for statistical analysis. Time spent for final visual acuity was recorded for each test separately. Results: In all subjects, the best uncorrected visual acuity was over 0.8 L in each test and had 20/20 visual acuity at least in the one of each three test. The best final visual acuity was obtained with E-test (1.06 L) and the level was significantly higher when compared with letters (0.97 L) (P < .01) and numbers (0.99 L) (P < .01). E-test demonstrated less variability in determining the final visual acuity than the others determine (average standard deviation [SD], E-test = 0.11 L, Letters = 0.17 L, Numbers = 0.17 L; average range, E-test = 0.02 L, Letters = 0.19 L, Numbers = 0.11 L). The time spent in obtaining the best visual acuity was least in E-test and the difference was significant when compared with the other test types (for each, P < .01). Conclusions: We obtained a higher and more stable (less variability with lower SD) visual acuity with E-test. The results of the present study showed that E-test should not only be the choice of routine examination in illiterate children in a particular age group, but also should be used routinely in all age groups as a standard test type. The shortest time spent in obtaining the final visual acuity is also occurred in E-test. E-test is a simple visual acuity test that appeared to be more accurate than letters and numbers with its less variability in Snellen chart in determining the final visual acuity.Öğe Insidious homonymous quadrantic visual field defect revealed after a sudden bilateral loss of vision: Report of two cases(2001) Evereklioglu C.; Ozcan C.; Doganay S.; Er H.Objective: To report two patients with sudden transient complete loss of vision in their both eyes because of cortical blindness and to emphasize the importance of close monitoring with computerized tomography (CT), magnetic resonance imaging (MRI) and perimetry. Materials and Methods: Complete ophthalmologic and neurological examinations were performed in two patients with sudden bilateral loss of vision. Perimetry, CT and MRI were carried out in both patients and the clinical significance was discussed. Results: After recovery from complete visual loss, one patient (40-years old woman) showed congruous right-side superior homonymous quadrantanopsia because of the pre-existed infarction in the left side. The quadrantanopia was accompanied by increased T2-weighted contrast intensity of bilateral regions in the occipital cortex. The second patient (28-years old woman) showed right-side superior homonymous quadrantanopia because of the subacute infarction with increased T2-weighted contrast intensity of the left parahypocampal area reaching parietoccipital sulcus. Not the sudden transient visual loss lasting 2 hours as a consequent of cortical blindness, but interestingly quadrantic right superior visual field defects were the main complaints of the patients on admission. Conclusion: Both cases are of interest because of unrecognized pre-existed quadrantanopia was present and unilateral aforementioned lesions were noticed by physicians only after sudden complete but transient bilateral loss of visions (cortical blindness). We suggest that all patients complaining transient bilateral sudden visual loss should be evaluated more carefully and have perimetry even neurological examination reveals normal results.Öğe Interpupillary index: A new parameter for hypo-hypertelorism(Churchill Livingstone, 2001) Evereklioglu C.; Doganay S.; Er H.; Tercan M.; Gunduz A.; Balat A.; Borazan M.Aim: To establish a new clinical index to evaluate the presence of hypo-hypertelorism with greater accuracy. Material and Methods: After screening a wide range of population, 310 elementary school children (185 boys, 125 girls) aged 7-15 years were included in this study. For this cross-sectional study, a millimetre ruler was used. The anatomical interpupillary distance was measured by a modified Viktorin's method. In addition, inner and outer intercanthal distances were obtained. The data were analyzed by Student's t-test for two independent samples using SPSS for Windows. There were children with clinical hypertelorism (n = 92, group 1), children with large fronto-occipital circumference (FOC) (n = 101, group 2), and age- and sex-matched normal controls (n = 117, group 3). Due to variations in FOC among healthy subjects, we introduced a new practical concept for evaluation of interpupillary distance, namely the interpupillary index, the simple product obtained by dividing the interpupillary distance by the FOC, multiplied by 100. Results: The overall idiopathic benign macrocephalic children (group 2) had significantly (p < 0.001) larger interpupillary distances (6.13 ± 0.36 cm) and FOCs (56.99 ± 1.46 cm) than those of normal controls (5.70 ± 0.26 cm and 52.82 ± 1.22 cm, respectively). But, the difference between the combined product of interpupillary distance and FOC, the interpupillary index, was not significant (10.76 ± 0.50 and 10.79 ± 0.35, respectively) (p > 0.05). On the other hand, the children with hypertelorism had significantly (p < 0.001) larger interpupillary distances (6.47 ± 0.29 cm) and FOCs (54.90 ± 2.18 cm) when compared with the controls. In addition, the interpupillary index was significantly (p < 0.001) higher (11.80 ± 0.45) than both macrocephalic children (10.76 ± 0.50) and controls (10.79 ± 0.35). Intercanthal distances and intercanthal index of hyperteloric children were also significantly (p < 0.001) larger than both macrocephalic children and controls. Conclusion: This new index offers a new concept for more accurate evaluation of the presence of ocular hypo-hypertelorism. © 2001 European Association for Cranio-Maxillofacial Surgery.Öğe Polyurethane stent obstruction as a cause of recurrent epiphora: Case report(Centauro SRL, 2006) Doganay S.; Sarac K.; Miman M.C.; Karadag N.; Cokkeser Y.A Song's nasolacrimal duct stent was placed in a patient with epiphora due to primary nasolacrimal duct obstruction and the stent was kept for 32 months. Mitomycin C 0.02% eye drops four times a day were prescribed for four weeks following polyurethane stent placement procedure. No epiphora-related complaints occurred for thirty months after then the epiphora started. Nasolacrimal stent was removed from nasal cavity endoscopially and the tissues within the extruded stent were examined histopathologically. The patient's complaints were relieved following stent removal. Dacryocystogram revealed normal passage and a filling defect within the lacrimal sac. Macroscopic evaluation of the stent revealed a firm mass in the stent mushroom, causing complete obstruction. Pathological examination of the mass revealed chronic inflammation, increased connective tissue and vascular proliferation. N asolacrimal polyurethane stents can be removed easily by nasal approach. Nasolacrimal passage may be left open temporarily after stent removal. The use of Mitomycin C drop is a novel approach in nasolacrimal stent placement cases. However, when the long-term results of endoscopic and external dacryocystorhinostomy are considered, further research is needed on the biocompatibility of stent material.Öğe Silent sinus syndrome.(2009) Miman M.C.; Akarcay M.; Doganay S.; Erdem T.; Firat Y.We present a case of silent sinus syndrome (SSS) who underwent unilateral surgical endoscopic maxillary meatotomy. Orbital floor reconstruction is delayed after follow up. Enophthalmos recovered 8 months after the surgery and radiologic findings improved. SSS is a clinical entity that should be kept in mind in the differential diagnosis of enophthalmos and can be treated successfully via endoscopic approach.Öğe Surgical excision, cryotherapy, autolimbal transplantation and mitomycin-C in treatment of conjunctival-corneal intraepithelial neoplasia.(2005) Doganay S.; Er H.; Tasar A.; Gürses I.PURPOSE: To report surgical excision, cryotherapy, autologous conjunctival-limbal transplantation and topical mitomycin C (MMC) in the patient with extensive conjunctival-corneal intraepithelial neoplasia. METHODS: Case report and literature review. RESULTS: A 75-year-old woman was referred to our department with the diagnosis of conjunctival-corneal neoplasia. Slit-lamp microscopic examination revealed an extensive papilliform tumoral mass invading the limbus at 360-degrees, and bulbar conjunctiva and cornea. Visual acuity was finger counting from 2 m in the right eye and 20/20 in the left eye. We performed total surgical excision, cryotherapy and autologous conjunctival-limbal transplantation in the right eye. Mitomycin-C 0.02% eye drops four times a day were prescribed for 4 weeks after the surgery. After the treatment, the visual acuity increased to 0.7 in the right eye. Corneal epithelium completely healed within 1 week after the surgery. No corneal epithelium-related problem or neoplasia recurrence were noted during the 2-year follow-up period. CONCLUSIONS: This technique may be useful in reconstruction of eyes with extensive neoplastic involvement of the conjunctiva, limbus, and cornea. In addition, mitomycin C drops may be useful in preventing postoperative recurrence of conjunctival-corneal intraepithelial neoplasia.
