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Öğe Comparison of Visual Field Parameters in Early and Advanced Stages of Multiple Sclerosis Patients Without a History of Optic Neuritis(Taylor & Francis As, 2013) Guler, Mete; Turkcuoglu, Peykan; Yilmaz, Turgut; Yoldas, Tahir Kurtulus; Channa, RoomasaThis study compared the visual field parameters of multiple sclerosis patients without optic neuritis in early versus advanced stage of the disease. Patients were divided into two groups: group 1 (early stage, n = 14) constituted of patients with Expanded Disability Status Scale scores <3 and group 2 (advanced stage, n = 13) constituted of patients with Expanded Disability Status Scale scores >= 3. Mean visual acuities in both groups were similar (p = 0.674). Mean sensitivity, mean defect, loss of variance, reliability factor parameters (Octopus 101 perimeter) of groups 1 and 2 were 24.17 +/- 3.62, 21.81 +/- 3.04; 4.14 +/- 3.05, 6.49 +/- 2.58; 21.61 +/- 22.17, 33.31 +/- 18.67; and 1.57 +/- 2.79, 2.59 +/- 3.09, respectively. Compared with group 1, mean sensitivity was significantly lower in group 2 (p = 0.013). Mean defect (p = 0.004) and loss of variance (p = 0.042) parameters in group 2 were significantly higher than in group 1. Mean reliability factor was similar between two groups (p = 0.211). Multiple scleorisis may alter visual field parameters without severe loss of visual acuity by possibly involving optic pathways other than optic nerve.Öğe Detection of the regression on hydroxychloroquine retinopathy in optical coherence tomography(Springer, 2009) Turgut, Burak; Turkcuoglu, Peykan; Koca, Suleyman Serdar; Aydemir, OrhanHydroxychloroquine (HCQ) that is widely used in the treatment of the connective tissue disorders can cause retinopathy. The fundus examination of a patient with systemic lupus erythematosus receiving HCQ revealed left incomplete bull's eye and pigmentary changes in macula in the right eye. Repeated visual field tests showed the paracentral and peripheral defects in the right eye and the pericentral ring scotoma in the left eye. Optical coherence tomography (OCT) scans revealed the photoreceptor loss, retina pigment epithelium (RPE) irregularities, and a cyst-like hypo reflective space over RPE layer on the nasal perifoveal region in the left eye. On the ophthalmoscopic examination, the perifoveal pigmentation was not altered after the discontinuation of HCQ. However, the bilateral visual field defects were improved and the photoreceptor destruction and cyst-like hyporeflective space disappeared in the left eye. Mild RPE irregularities remained in both eyes as revealed by OCT scans. Even if OCT is used to evaluate the regression of HCQ retinopathy, it only shows advanced stage of retinopathy.Öğe Diagnosis of Anomalous Lacrimal Ductule With the Aid of Salivary Gland Scintigraphy(Lippincott Williams & Wilkins, 2009) Turkcuoglu, Peykan; Kekili, Ersoy; Duz, Cem; Tasbent, IlkerA 4-year-old boy presented with the complaint of fluid discharge from a 0.5-mm diameter opening at the lateral side of the right outer canthus during crying. The need for general anesthesia for contrast radiography prompted the authors to conducted salivary gland scintigraphy, which demonstrated radioactivity of the collected fluid. Salivary gland scintigraphy can be used as a diagnostic tool in cases with anomalous lacrimal ductule without the use of general anesthesia.Öğe Factors That Cause Delay of Surgical Treatment in Strabismus(Turkish Ophthalmological Soc, 2008) Turkcuoglu, Peykan; Aydemir, Orhan; Kaya, Murat; Turgut, BurakPurpose: To determine the factors that delayed the diagnosis and surgical intervention in patients who underwent strabismus surgery. Method: Between January-December 2006 patients who underwent strabismus surgery or their parents were given a questionnaire about the causes of delay of diagnosis or surgical intervention. Results: The ages of 38 male and 39 female patients ranged between 9 months and 60 years. 45 patients were under the age of 10 (strabismus was recognized under the age of 6 months in 18; above the age of 6 months in 27 of them). The duration from the first recognition to admition to a doctor was ranged between 1 month and 43 year (86 +/- 108), 1 and 60 months (11 +/- 17), 1 and 42 months (6 +/- 11) in groups above age of ten years, under the age of 6 months, above the age of 6 months, respectively. 17 (94%), 21 (78%) and 29 (91%) patients first admitted to an ophthalmologist in the group above age 10 years, in the group under age 6 months and in the group above age 6 months, respectively. In two of the seventy-seven patients diagnosis of strabismus was delayed because of ophthalmologists. The mean time periods that the patients accepted the surgical intervention were 6 +/- 12 months in the group under the age 6 months; 3 +/- 10 months in the group above the age 6 months; 25 +/- 48 months in the group above ten years of age. % 62 of the patients accepted the surgical intervention promptly, however % 38 of the patients rejected surgery due to affair of being worser, fear of unknown cause, distrust to the doctor, anesthesia risks, inattention, familial problems and belief to improve spontaneously. Conclusion: More attention must be given to the education of the ophthalmologists and public in order not to lose important time in strabismus surgery.Öğe Importance of proper diagnosis for management: multifocal choroiditis mimicking ocular histoplasmosis syndrome(Springer Heidelberg, 2011) Hatef, Elham; Turkcuoglu, Peykan; Ibrahim, Mohamed; Sepah, Yasir; Shulman, Matthew; Heo, Jangwon; Lee, Jeong HeePurpose The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC). Methods Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes. Results Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized or improved in three patients with no recurrence of CNVor lesion activities over the follow-up period. Conclusions MFC may initially masquerade as OHS. Clinical characteristics of recurrent MFC and absence of histoplasma titer may lead to consideration of IMT and other proper treatments for MFC.Öğe Intercellular Adhesion Molecule Inhibitors as Potential Therapy for Refractory Uveitic Macular Edema(Taylor & Francis Inc, 2010) Wang, Jianmin; Ibrahim, Mohamed; Turkcuoglu, Peykan; Hatef, Elham; Khwaja, Afsheen; Channa, Roomasa; Do, Diana V.Purpose: To describe the bioactivity of an intercellular adhesion molecule inhibitor (efalizumab) in a patient with refractory uveitic macular edema. Methods: A 55-year-old man presented with idiopathic autoimmune uveitis and associated macular edema, which could not be controlled by regional and systemic corticosteroid and selected immunomodulatory therapy. Efalizumab was administered as subcutaneous injections. Results: After 37 weekly injections of efalizumab, the uveitic macular edema was successfully eliminated. Six months following discontinuation of efalizumab, there were no signs of recurrent inflammation. Conclusion: Further investigation of the role of intercellular adhesion molecule inhibitors in the management of uveitic macular edema is indicated.Öğe Investigation of human papillomavirus and Epstein-Barr virus DNAs in pterygium tissue(Sage Publications Ltd, 2009) Otlu, Baris; Emre, Sinan; Turkcuoglu, Peykan; Doganay, Selim; Durmaz, RizaPURPOSE. Recent studies postulated the presence of a probable relationship between pterygium and neoplasia. This study aimed to investigate the role of two oncogenic viruses, human papillomavirus (HPV) and Epstein-Barr virus (EBV), in the development of conjunctival pterygia. METHODS. Polymerase chain reaction was used to identify the presence of HPV and EBV in 30 primary and 10 recurrent pterygia samples. Twenty conjunctival samples obtained from patients undergoing cataract surgeries were used as the control group. Patient groups had similar sex, race, and age distribution to eliminate bias. For exploration of HPV in groups, two different PCR methods (in-house PCR with two different primer sets and one real-time PCR method) were studied. The presence of EBV was shown by real-time PCR method. RESULTS. HPV was identified in none of the pterygia and control group patients. However, EBV was detected in 3 out of 30 (10%) primary pterygia patients and in none of the recurrent pterygia and control patients. CONCLUSIONS. Up to now, HPV has been blamed as the major viral pathogen in the etiopathogenesis of pterygium. The current results suggest that EBV may also be involved in the pathogenesis of pterygium, but further larger studies with larger cohorts are required to confirm this hypothesis. (Eur J Ophthalmol 2009; 19: 175-9)Öğe Mycophenolate Mofetil and Fundus Autofluorescence in the Management of Recurrent Punctate Inner Choroidopathy(Informa Healthcare, 2011) Turkcuoglu, Peykan; Chang, Peter Y.; Rentiya, Zubir S.; Channa, Roomasa; Ibrahim, Mohamed; Hatef, Elham; Sophie, RaafayMethods: Eight patients who had at least two recurrent episodes of increased activity before MMF and 12 months of documented clinical course before and after MMF were included. The frequencies of attacks before and after MMF were compared. FAF images evaluated. Results: Before MMF, the 8 patients experienced 19 attacks of recurrent disease activity; during MMF therapy, 3 (38%) patients experienced 6 recurrent episodes. The attack frequencies were 1.09 +/-+/- 0.75 before and 0.23 +/-+/- 0.32 during treatment (p == .036). Among the 6 patients who had FAF, surrounding hyperautofluorescent halo was detected in 4 and recurrence occurred in 2 who did not show any changes on the intensity during treatment. Conclusion: In the index study, the employment of MMF has decreased frequency of attacks in recurrent PIC. FAF may be employed to monitor and predict the response to treatment.Öğe Optical coherence tomography in the detection of an intraocular foreign body(Wiley, 2009) Turkcuoglu, Peykan; Turgut, Burak[Abstract Not Available]Öğe The Origin of Subretinal Fluid in Optic Disc Pit Maculopathy(Slack Inc, 2016) Turkcuoglu, Peykan; Taskapan, CagtayA surgical approach for the drainage of fluid leaking over the pit in optic disc pit maculopathy is described, and a theory of the origin of fluid is discussed. In two cases, complete fluid-air exchange was performed. The air infusion pressure was decreased to 5 mm Hg, and the collected fluid was drained by raising the infusion pressure to 25 mm Hg. The fluid inside the back-flush needle was routed via a microcentrifuge tube. Biochemical analyses of the fluids were conducted in order to find their origin. Results of the first and second case were comparable to normal cerebrospinal fluid (CSF) levels (chloride: 125 mmol/L, 122 mmol/L; sodium: 146 mmol/L, 147 mmol/L; potassium: 2.8 mmol/L, 3.0 mmol/L; protein: 29 mg/dL, 18.4 mg/dL; and glucose: 60 mg/dL, 57 mg/dL, respectively). These findings suggest that the origin of subretinal fluid found in the submacular space in optic disc pit maculopathy is CSF.Öğe Presumed nasolacrimal endometriosis(Lippincott Williams & Wilkins, 2008) Turkcuoglu, Ilgin; Turkcuoglu, Peykan; Kurt, Julide; Yildrim, HanefiA 13-year-old girl was admitted with a complaint of cyclic bleeding from the left inferior punctum with menstruation. Crusted hemorrhage was noticed in the tear meniscus of the left eye and just inferior to the left caruncle. With gradient-echo magnetic resonance imaging, the hemorrhagic tissue in the nasolacrimal canal was demonstrated and the diagnosis of nasolacrimal endometriosis was made. Nasolacrimal endometriosis is a rare ocular condition. Its management and histologic diagnosis remain challenging.Öğe Reply re: Presumed Nasolacrimal Endometriosis(Lippincott Williams & Wilkins, 2009) Turkcuoglu, Ilgin; Turkcuoglu, Peykan; Kurt, Julide; Yildirim, Haneti[Abstract Not Available]Öğe Retinal nitric oxide and malonyldialdehyde levels following photodynamic therapy(Medknow Publications & Media Pvt Ltd, 2011) Turkcuoglu, Peykan; Ozturkmen, Cem; Ilhan, Nevin; Kurt, Julide; Aydemir, Orhan; Celiker, Ulku; Ibrahim, Mohamed A.Background:To determine the retinal nitric oxide (NO) and malonyldialdehyde (MDA) levels following photodynamic therapy (PDT). Materials and Methods:Seven Dutch-belted rabbits received dextrose, while seven others received 2 mg/kg verteporfin infusion over a period of 15 minutes in a dim-lit room. Irradiation to a 1.5 mm diameter intact chorioretinal area in the right eye of verteporfin-infused rabbits, was started 5 minutes after the end of infusion. Three groups were control (dextrose infusion), infusion with verteporfin (left eyes were not irradiated), and irradiation after verteporfin injection (right eyes were irradiated). On the fifth day of the experiment, the eyes were enucleated. The retinas were subsequently frozen and homogenized. Nitrite, a stable end-product of NO and MDA, was measured using the spectrophotometer. Protein concentrations were measured by the Lowry method. Tissue NO and MDA levels were expressed as mu mol/gprt and nmol/mgprt, respectively. Results:The mean retinal NO and MDA levels of the control, infusion, and irradiation groups were 24.67 +/- 6.66, 0.11 +/- 0.02; 45.90 +/- 15.52, 0.21 +/- 0.09; and 84.43 +/- 14.96 mu mol/gprt, 0.58 +/- 0.14 nmol/mgprt, respectively. The mean retinal NO levels were significantly elevated in the infusion and irradiation groups compared with the control group (P:0.004; P:0.001). The mean retinal MDA levels were significantly elevated in the infusion and irradiation groups compared to the control one (P:0.026; P:0.001). Also the mean retinal NO and MDA levels in the irradiation group were found to be significantly higher than the infusion group (P:0.018; P:0.018). Conclusion:Not only PDT, but also verteporfin infusion alone resulted in NO and MDA level increments in the retina, which might be toxic.Öğe Spontaneous corneal perforation in a patient with lamellar ichthyosis and dry eye(Dove Medical Press Ltd, 2009) Turgut, Burak; Aydemir, Orhan; Kaya, Murat; Turkcuoglu, Peykan; Demir, Tamer; Celiker, UlkuWe report spontaneous corneal perforation in a patient with lamellar ichthyosis. The patient presented with complaints of pain, redness, diminished vision, and discharge in her right eye for 15 days. Visual acuities were light perception in the right and 20/400 in the left eye. Cicatricial ectropion in both lower eyelids and 2 mm perforation site in the center of the right cornea were observed. Lamellar ichthyosis was suspected because of scaling and excessive dryness of entire body skin and was confirmed by skin biopsy. Amniotic membrane transplantation and transient tarsorraphy was performed and systemic anti-ichthyosis therapy was started. The follow-up visits were not possible because of patient inconsistency. In patients with cicatricial ectropion secondary to ichthyosis, corneal health should be closely monitored because of the perforation risk.Öğe Vitreous vascular endothelial growth factor level during gestation(Springer Heidelberg, 2010) Turkcuoglu, Ilgin; Turkcuoglu, Peykan; Karabulut, Aysun Bay; Tasar, AhmetTo evaluate the vitreous VEGF level alterations and its correlation with its plasma level if any, in gestation. The blood and vitreous sampling procedures were performed before, during (20-23 days of gestation), and after gestation (2 months after birth) from seven White New Zealand rabbits. Blood samples were centrifuged then supernatants and vitreous samples were stored at -80A degrees C until assay. Measurements of serum and vitreous VEGF(165) were done by ELISA. The median plasma and vitreous VEGF(165) concentrations were 36.61 pg/ml (range 19.17-40.30), 14.92 pg/ml (range 8.95-15.20); 58.30 pg/ml (range 32.60-11.53), 20.51 pg/ml (range 11.94-21.26); and 35.30 pg/ml (range 27.30-39.60), 13.05 pg/ml (range 9.33-16.04) before, during and after gestation, respectively. Both the plasma and the vitreous VEGF(165) concentration during gestational period were significantly higher than pre-gestational period (P = 0.028, P = 0.018) and post-gestational period (P = 0.043, P = 0.028). The intravitreal VEGF(165) concentrations appeared to correlate with plasma VEGF(165) levels (r = 0.940, P = 0.002) only in the gestational period. Vitreous VEGF levels increase in positive correlation with plasma VEGF during pregnancy. Further prospective studies are needed to support this finding.
