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    Central Retinal Vein Occlusion Associated with Hyperhomocysteinemia in a Patient with Heterozygous for the Methylenetetrahydrofolate Reductase C677T Mutation: Case Report
    (Ortadogu Ad Pres & Publ Co, 2012) Sakalar, Y. Bayezit; Keklikci, Ugur; Unlu, Kaan; Caca, Ihsan; Alakus, Mehmet Fuat
    A 19-year-old male patient presented with blurring of vision in his left eye. Central retinal vein occlusion was detected on ophthalmic examination. Clinical examination and laboratory analysis were performed for risk factors predisposing him to retinal vein occlusion. His plasma homocysteine concentration was 14.30 U/mL. No other abnormalities were found in other hematologic tests. C677T heterozygous mutation in the methylenetetrahydrofolate reductase (MTHFR) gene was detected by real-time polymerase chain reaction. A heterozygous mutation was detected in the same gene in the patient's mother, father and one of his sisters, also a homozygous mutation was detected in the other sister. Retinal vein occlusion in young patients may be related to mild hyperhomocysteinemia and a C677T mutation in the MTHFR gene.
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    Distribution of Central Corneal Thickness and Intraocular Pressure in a Large Population of Turkish School Children
    (Informa Healthcare, 2012) Sakalar, Yildirim Bayezit; Keklikci, Ugur; Unlu, Kaan; Alakus, Mehmet Fuat; Yildirim, Mine; Dag, Umut
    Purpose: To determine the distribution of central corneal thickness (CCT) and intraocular pressure (IOP) in a population of Turkish school children and to evaluate the relationships between these values and both age and gender. Methods: A total of 30,320 eyes from 15,160 healthy school children aged 5-18 years were examined. CCT and IOP were measured using an ultrasonic pachymeter and a non-contact tonometer, respectively. Measurements were compared with age, gender, and parental consanguinity of subjects. Results: The mean age of the school children was 10.43 +/- 2.54 years. For right eyes, mean CCT was 557.91 +/- 34.26 mu m and mean IOP was 14.15 +/- 2.87 mmHg. Mean CCT was significantly thicker in males compared to females (P < 0.0001). Mean IOP was significantly higher in females compared to males (P < 0.0001). CCT in children aged 14 years and older was significantly thinner than that in the younger age groups (P < 0.0001). There was a significant difference among the age groups for IOP (P < 0.05). No significant differences were observed in CCT or IOP related to parental consanguinity (P = 0.538, P = 0.319, respectively). Conclusion: Mean CCT in Turkish school children is of comparable thickness to that in Western school children. CCT reached adult values around 14 years of age in our children. Furthermore, males had thicker CCT than females. IOP was lower in males than females, and increased with age.
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    Effects of Photodynamic Therapy With Verteporfin for the Treatment of Chronic Central Serous Chorioretinopathy: An Uncontrolled, Open-Label, Observational Study
    (Elsevier, 2010) Sakalar, Yildirim Bayezit; Keklikci, Ugur; Unlu, Kaan; Alakus, Mehmet Fuat; Kara, Ismail Hamdi
    BACKGROUND: Central serous chorioretinopathy is an idiopathic disorder that leads to serous neurosensory retinal detachment. The disorder is usually self-limited and resolves spontaneously; however, sometimes neurosensory retinal detachment persists. This form of the disorder is called chronic central serous chorioretinopathy (CCSC). OBJECTIVE: The aim of this study was to assess the effects of photodynamic therapy (PDT) on visual acuity with full-dose verteporfin for CCSC. METHODS: The eyes of patients with CCSC were included in the study. Ophthalmic examination including best-corrected visual acuity (BCVA), fundus examination, fluorescein angiography, and optical coherence tomography was performed before treatment and at 1, 3, 6, 9, and 12 months. PDT with full-dose verteporfin (6 mg/m(2) of body surface area) was applied only to areas of active leakage. BCVA was converted to a log of the minimum angle of resolution (logMAR) equivalent for statistical analysis. Central foveal thickness and BCVA between baseline and follow-up were compared. RESULTS: Seventeen eyes of 16 patients (13 males, 3 females; mean [SD] age, 39.75 [7.51] years; mean duration of follow-up, 13.06 [1.82] months) were used in the study. The mean (SEM) logMAR BCVA was 0.26 (0.07) at baseline and 0.04 (0.02) at 12 months. Mean logMAR BCVA values at baseline (0.259) and after treatment (0.112, 0.053, 0.047, 0.041, and 0.041 at 1, 3, 6, 9, and 12 months, respectively) differed significantly (P = 0.006, P = 0.005, P = 0.005, P = 0.005, and P = 0.005). There was a significant difference in the mean central foveal thickness at the final visit (169 pm) compared with the baseline value (383 pm; P < 0.001). BCVA decreased in one eye (20/20 vs 20/25) and persisted during follow-up; in the other 16 eyes, BCVA either increased (n = 10) or remained stable (n = 6). CONCLUSIONS: In this small, open-label study, patients with CCSC treated with a single course of PDT with full-dose verteporfin had significant improvement from baseline in BCVA and resolution of subretinal fluid accumulation and active leakage. Treatment was generally well tolerated, but one patient had worsening in BCVA. (Curr Thor Res Clin Exp. 2010;71:173-185) (C) 2010 Excerpta Medica Inc.
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    Preseptal Cellulitis Related to Tick Infestation
    (Turkish Ophthalmological Soc, 2010) Sakalar, Yildirm Bayezit; Arserim, Neval Berrin; Keklikci, Ugur; Balsak, Selahattin; Alakus, Mehmet Fuat; Unlu, Kaan
    A 4-year-old girl presented with complaint of tick bite on the left upper eyelid and head. The tick bites were noticed by her parents one day ago. On her examination, tick infestation was found in the lash margin of the right upper eyelid. Bilateral eyelid edema and mild hyperemia of the left upper yelid were observed. The tick in the eyelid was removed with a proper technique using a blunt-ended forceps and prophylactic systemic antibiotic therapy was started. Signs such as high fever or prolongation of clotting time were not observed in the patient. The species of tick was identified as Ixodes species on microscopic examination. The edema of both eyelids resolved 3 days later and no systemic complications were observed. The Crimean Congo hemorrhagic fever was not detected on serological investigations.
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    Retinal Detachment, Presumably Due to Electrical Injury: A Case Report
    (Turkish Ophthalmological Soc, 2010) Sakalar, Yildirirn Bayezit; Alakus, Mehmet Fuat; Keklikci, Ugur; Unlu, Kaan
    A 57-year-old female patient applied with loss of vision in her left eye one day after electrical injury. Systemic examination did not reveal any other pathological findings. On ophthalmic examination, visual acuity was 20/20 in the right eye and hand movements in the left eye. Two retinal holes and a shallow retinal detachment were found in superotemporal peripheral retina of the right eye. In the left eye, subtotal retinal detachment, involving the macula, and two retinal holes in supero-temporal quardrant were observed. In the first month after scleral buckling surgery in the left eye, visual acuity improved to 20/200 and did not change during the follow-up period. Electrical injury may lead to retinal hole and retinal detachment as a result of traction at the site of a vitreoretinal adhesion. For this reason, the risk of ocular complications should be kept in mind after electrical injury.
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    Two Different Cases with Melanocytoma of the Optic Disc
    (Ortadogu Ad Pres & Publ Co, 2010) Sakalar, Yildirim Bayezit; Keklikci, Ugur; Unlu, Kaan; Caca, Ihsan; Alakus, Mehmet Fuat
    A 45-year-old woman (Case 1) applied for control examination to learn whether there was any growth or not on tumoral lesion in her left eye. Melanocytoma of the optic disc involving the adjacent choroid in the left eye was seen on ophthalmoscopic examination. The appearence of the patient was consistent with achondroplasia. Case 2, a 29-year-old woman, applied with headache complaint. Bilateral optic disc hypoplasia and melanocytoma of the optic disc in the right eye was found on the fundus examination and magnetic resonance imaging revealed an arachnoid cyst in the left temporal fossa. Although melanocytoma of the optic disc has not been proven to have any systemic associations, it is likely to be associated with some of the systemic diseases and other ocular pathologies. Optic disc hypoplasia associated with melanocytoma of the optic disc has been reported previously, however, associations of achondroplasia or arachnoid cyst with melanocytoma of the optic disc have nor yet been reported.