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    Effect of topical antibiotic prophylaxis on conjunctival flora and antibiotic resistance following intravitreal injections in patients with type 2 diabetes
    (Korean Ophthalmological Society (KOS), 2020) Kaldirim H.; Yazgan S.; Kirgiz A.; Ozdemir B.; Yilmaz A.
    Purpose: We sought to determine changes in the conjunctival bacterial flora and antibiotic resistance after topical antibiotic drops for infection prophylaxis were administered following intravitreal injections in patients with type 2 diabetes. Methods: This prospective and nonrandomized cohort study included 116 eyes of 116 treatment-naive patients with type 2 diabetes who received six serial intravitreal anti-vascular endothelial growth factor injections for macular edema. Three conjunctival cultures were obtained from each eye over the course of the study (Culture 1, baseline; Culture 2, 1 month after the third injection; and Culture 3, 1 month after the sixth injection). The study subjects were given topical moxifloxacin hydrochloride for 4 days after each monthly intravitreal injection. The growth patterns of conjunctival bacterial flora and the antibiotic resistance to several commonly used antibiotics were examined. Results: The rate of culture positivity increased significantly during the observation period (Culture 1, n = 47, 40.5%; Culture 2, n = 58, 50%; Culture 3, n = 76, 65.5%, p < 0.001). The bacterium with the highest baseline culture positivity was Staphylococcus epidermidis (n = 45, 38.8%), which increased significantly during the observation period (p < 0.001). No significant increase was noted in the culture positivity of the other bacteria with baseline culture positivity (p > 0.05). Regarding antibiotic susceptibility, significant increases in resistance to the fluoroquinolone group of drugs were noted (p < 0.001). No significant changes in sensitivity were detected in the other 11 investigated antibiotics that are commonly used in clinical practice (p > 0.05). Conclusions: The use of topical moxifloxacin after each intravitreal injection significantly increases the fluoroquinolone resistance of the ocular surface flora and the culture-positivity rate of S. epidermidis in patients with type 2 diabetes. © 2020 The Korean Ophthalmological Society
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    Efficacy of hyperbaric oxygen therapy on central corneal thickness, intraocular pressure, and nerve fiber layer in patients with type 2 diabetes: A prospective cohort study
    (Korean Ophthalmological Society (KOS), 2021) Kaldirim H.; Atalay K.; Ceylan B.; Yazgan S.
    Purpose: To evaluate the effect of hyperbaric oxygen therapy (HBOT) on central corneal thickness (CCT), intraocular pressure (IOP), and the retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus. Methods: This prospective non-randomized cohort study consisted of type 2 diabetes mellitus patients who received 30 sessions of HBOT for diabetic foot ulcer. The CCT, IOP, and RNFL measured at baseline, after the 10th session of HBOT, after the 20th session of HBOT, after the 30th session of HBOT, and after the 3 months of the last session of HBOT. We gained the superior-nasal, superior-temporal, inferior-nasal, inferior-temporal, nasal and temporal quadrant RNFL values with a spectral-domain optical coharence tomography. Results: Forty-six eyes of 46 patients included in the study. During the study period, a statistically significant increase in mean IOP values compared to baseline was observed (p < 0.001). We found no significant changes at CCT and all quadrants of RNFL values during HBOT and after 3 months of the treatment (p > 0.05). During the study period, the IOP levels increased over 21 mmHg (between 22 and 28 mmHg) in seven eyes (15.2%). The mean hemoglobin A1c values of these patients with IOP >21 mmHg were 8.2 ± 0.9 mg/dL, and there was significant differences compared with those of patients with IOP values ?21 mmHg (7.4 ± 2.8 mg/dL) (p = 0.001). Conclusions: HBOT increase IOP in type 2 diabetic patients especially in ones with impaired blood glucose regulation. However, it does not cause any changes in CCT and RNFL. As diabetic retinopathy and diabetic foot ulcer are in common pathologies, thus this brief report concludes a need for further studies with longer follow-up periods to explore the potential interaction of HBOT on CCT, IOP, and RNFL. © 2021 The Korean Ophthalmological Society.
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    Evaluation of Eyelid, Angle, and Anterior Segment Parameters Using Scheimpflug Camera and Topography System in Obstructive Sleep Apnea Syndrome
    (Kare Publishing, 2023) Isik I.; Yazgan S.; Erboy F.; Dogan M.
    Objectives: The purpose of the study was to investigate the eyelid hyperlaxity, anterior segment, and corneal topographic parameters in patients with obstructive sleep apnea syndrome (OSAS) using Scheimpflug camera and topography system. Methods: In this prospective and cross-sectional clinical study, 32 eyes of 32 patients with OSAS and thirty-two eyes of 32 healthy subjects were evaluated. The participants with OSAS were selected from those with an apnea-hypopnea index ? 15. The minimum corneal thickness (ThkMin), apical corneal thickness (ACT), central corneal thickness (CCT), pupillary diameter (PD), aqueous depth (AD), aqueous volume (AV), anterior chamber angle (ACA), horizontal anterior chamber diameter (HACD), corneal volume (CV), simulated K readings (sim-K), front and back corneal keratometric values at 3 mm, RMS/A values, highest point of ectasia on the anterior and posterior corneal surface (KVf, KVb), symmetry indices and keratoconus measurements were taken by combined Scheimpflug-Placido corneal topography and compared with healthy subjects. Upper eyelid hyperlaxity (UEH) and floppy eyelid syndrome were also evaluated. Results: There were no statistically significant difference between groups in terms of age, gender, PD, ACT, CV, HACD, simK readings, front and back keratometric values, RMS/A-KVf and KVb values, symmetry indices, and keratoconus measurements (p>0.05). ThkMin, CCT, AD, AV, and ACA values were significantly higher in OSAS group compared to the control (p<0.05). UEH was detected in two cases in the control group (6.3%) and in 13 cases in the OSAS group (40.6%) and the difference was significant (p<0.001). Conclusion: The anterior chamber depth, ACA, AV, CCT, and UEH increase in OSAS. These ocular morphological changes occurring in OSAS may explain why these patients prones to normotensive glaucoma. © Issues in Information Systems.All rights reserved
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    Intravitreal dexamethasone implant in the treatment of pseudophakic cystoid macular edema or irvine-gass syndrome
    (Gazi Eye Foundation, 2020) Kaldirim H.; Yazgan S.; Kirgiz A.; Kürşat A.; Nacaroğlu Ş.A.
    Purpose: To evaluate the effectiveness of intravitreal injections of dexamethasone (DEX) implant in patients with pseudophakic cystoid macular edema (PCME) or Irvine-Gass Syndrome (IGS). Material and Methods: Patients with ME secondary to uncomplicated cataract surgery who underwent single intravitreal injections of DEX implant from January 2015 to January 2017 were retrospectively reviewed. The patients were examined at base-line and day 1, week 1, month 1, 3, 6 and 12 after intravitreal injection. All patients underwent a complete ophthalmic evaluation, including biomicroscopy, best-corrected visual acuity (BCVA), intraocular pressure by applanation tonometry, and central macular thickness (CMT) measurement with a spectral-domain optical coherence tomography (SD-OCT). Results: Nineteen eyes of 18 patients were evaluated. The alteration of mean BCVA and CMT were statistically significantly better than baseline values at first, third, sixth and twelfth months (p< 0.001). At 1st week, 1st month and 3rd month intraocular pressure (IOP) values significantly higher than baseline (p=0.001, p=0.006, p=0.001, respectively). At 6th month and 12th month IOP values not significantly different at baseline (p=0.506, p=0.650). Conclusion: Both BCVA and mean CMT had significantly improved from baseline values after treatment with single doz intravitreal DEX implant in patients with IGS. © 2020 Gazi Eye Foundation. All rights reserved.