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    Amblyopia and Refractive Errors Among School-Aged Children With Low Socioeconomic Status in Southeastern Turkey
    (Slack Inc, 2013) Caca, Ihsan; Cingu, Abdullah Kursat; Sahin, Alparslan; Ari, Seyhmus; Dursun, Mehmet Emin; Dag, Umut; Balsak, Selahattin
    Purpose: To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. Methods: A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. Results: There were 11,118 females and 9,944 males. The average age was 10.56 +/- 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). Conclusion: Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors. [J Pediatr Ophthalmol Strabismus 2013;50:37-43.]
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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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    Effect of Deltamethrin Toxicity on Rat Retina and Examination of FAS and NOS Immunoactivity
    (Sci Printers & Publ Inc, 2021) Dag, Umut; Ermis, Isilay Sezen
    OBJECTIVE: To investigate the changes in the retina due to deltamethrin toxicity and the process in cell inflammation and apoptosis. STUDY DESIGN: Sixteen Wistar albino rats were randomly divided into two groups as control (n=8) and deltamethrin (n=8) groups. Saline was given to the control group, and 0.5 mL of 5 mg/kg deltamethrin was given to the deltamethrin group for 14 days each. Blood was collected for biochemical analysis. Retinal tissue was processed for histological examination. RESULTS: Compared to the control group, MDA levels were high while GSH and CAT levels were low in the deltamethrin group. Histopathological analysis showed spaces between the pigment epithelium, irregularity in the delimiting membrane, degenerated ganglion, cone and bacillus cell, pyknotic nuclei, thinned inner limitation membrane, and thickened vascular wall. The control group showed FAS expression in the pigment layer limiting membranes, in the nuclei of many cone and bacillus cells, and ganglion cells in the control group sections. In the deltamethrin group, FAS expression was observed in the inner and outer limiting membranes of the pigment epithelium, cone and bacillus cells, and ganglion cell nuclei. In the control group, negative NOS expression in the pigment epithelium and outer limiting membranes, internal limitation membrane, and ganglion cells in the cone and bacillus cell nuclei were observed. In the deltamethrin group, NOS expression was positive in the pigment epithelium, cone and bacillus, and ganglion cell nuclei. CONCLUSION: We suggest that deltamethrin toxicity induced apoptotic process due to increased inflammation in the retina and may cause visual impairment as a result of neural damage.
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    Hemorrhagic Retinal Infarction Due to Inadvertent Overdose of Cefuroxi me in Cases of Complicated Cataract Surgery: Retrospective Case Series
    (Elsevier Science Inc, 2014) Ciftci, Suleyman; Ciftci, Leyla; Dag, Umut
    PURPOSE: To present 4 patients that developed hemorrhagic retinal infarction attributable to inadvertent overdose of cefuroxime after cataract surgery. DESIGN: Case series. SUBJECTS AND METHODS: Surgery in 4 patients was complicated-the posterior capsule was absent or torn-and anterior vitrectomy was performed. Cefufoxime was inadvertently injected at a dose higher than recommended in all 4 cases. RESULTS: Case 1 had hemorrhage in the central and inferior retinal regions, as well as optic atrophy. Case 2 had hemorrhage in the peripapillary and macular regions, as well as optic atrophy. Case 3 had hemorrhage in the peripapillary and inferior retinal regions, as well as macular pucker attributable to fibrovascular formation in the central retinal region. Case 4 had hemorrhage in the peripapillary, macular, and inferior retinal regions. The cefuroxime doses administered to the presented patients were much higher than reported in other cases and resulted in a higher concentration in the vitreous. Consequently, the severity of toxicity was much higher than in other reported cases of cefuroxime-induced toxicity. CONCLUSION: In cases of intracameral cefuroxime overdose, hemorrhagic retinal infarction can develop after cataract surgery. (C) 2014 by Elsevier Inc. All rights reserved.
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    The Importance of the Family Factory in Perforating Eye Injuries
    (Turkish Ophthalmological Soc, 2007) Keklikci, Ugur; Sakalar, Yildirim Bayezit; Unlu, Kaan; Bozarslan, Berivan Senol; Dag, Umut
    Background: To evaluate epidemiologic properties of infants applying to our clinic due to perforating eye injury, as well as the educational level of their parents, and socioeconomic status of their families. Methods: A total of 172 patients aged between 0-15 years and applying to our clinic due to perforating eye injury between March 2005 - March 2007, were included into the study. The cases were prospectively evaluated in terms of age, sex, material causing injury, cause of injury and social environtment where it occured, education levels and professions of parents, the number of siblings, socioeconomic and environmental conditions. Results: Of the cases, 117 (68%) were male, and 55 (32%) were female: the mean age of the patients was 7.8 +/- 5.6 (1-15 years old). The mothers of 118 cases (68.6%) and fathers of 52 cases (30.2%) were determined to be illiterate. Eye injuries occured mostly (53.5%) during playing activites. In 79.6% of the cases, the montly income per capita was less than 150 Yeni Turk Lirasi (YTL.), and 65% of the families had five or more siblings. In addition, 102 (59.3%) of our cases were living in rural areas. Conclusion: There was a significant relationship between perforating eye injuries and parents'educational level and socioeconomic status. It was concluded that this kind of injuries could be prevented through education of parents and improvent of socioeconomic conditions of families.
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    Protective Effect of Losartan, an Angiotensin Type 1 Receptor Blocker, on Retinal Damage Caused by Traumatic Brain Injury
    (Sci Printers & Publ Inc, 2021) Dag, Umut; Deveci, Engin
    OBJECTIVE: To observe the changes in retina after traumatic brain injury (TBI), and the effect of Losartan, an angiotensin II receptor antagonist, which inhibits the vasoconstrictor and platelet aggregation. STUDY DESIGN: Male Sprague Dawley rats (n=30) were divided into 3 groups of 10: Control (isotonic sa-line solution given intragastrically for 7 days), Trauma (craniectomy under anesthesia, saline solution administered intragastrically, sacrificed after 7 days), and Trauma+ Losartan (after craniotomy, 30 mg/kg losartan administered for 7 days, sacrificed at the end of the 7th day). Retina and blood samples were taken. MDA, GSH-Px, and MPO were used as biochemical markers. Tissues were fixed in a 10% formalin solution and embedded in paraffin blocks for histopathologic examination; 5-mu m-thick sections were obtained and stained with H-E. RESULTS: MPO activity significantly decreased in the Trauma group after TBI as compared with Controls (p< 0.001). The MDA level was low in the Losartan group (p< 0.001). GSH-Px levels in the Trauma group were lower than levels in Controls (p< 0.001). Hypertrophy and intense chromatin were observed in some of the photoreceptors in the Trauma group. Dilation and endothelial hyperplasia were observed in the vessels towards the ganglion layer. In the Trauma+ Losartan group a significant improvement was observed in the nuclei of the photoreceptors, and edema between the membranes disappeared. VEGF expression in the Trauma group was increased in pigment epithelium cells. In the Trauma+ Losartan group VEGF expression was evident in the inner and outer limiting membranes in the pigment epithelium and ganglion cells. In the Control group there was negative expression in the distribution of APAF in the nuclei of the photoreceptors. In the Trauma group APAF-1 positive expression in the limiting membrane with degenerative photoreceptors and an increase in APAF-1 expression was observed. In the Trauma+ Losartan group, APAF-1 expression was negative in ganglion cells. CONCLUSION: Losartan plays a role in the development of mitotic activity and decrease of apoptotic process in preventing cell damage, and as it induces angiogenic development it can be an important prophylactic agent in vascular remodeling.
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    Removal of Tenon fortified by conjunctival-limbal autograft in treatment of pterygium
    (Springer, 2017) Ciftci, Suleyman; Dogan, Eyup; Dag, Umut; Ciftci, Leyla
    To describe a simple and effective technique for the prevention of pterygium recurrence. This is a retrospective consecutive single-center case series with recurrence rate as the main outcome measure. Dissection of the conjunctiva, the Tenon's layer, and the sclera was continued up to the insertion of medial rectus. The exposed Tenon's layer was excised for 2 to 3 mm. The entire free edges of the conjunctiva was tacked firmly to the sclera. The conjunctival-limbal graft was sutured firmly to the sclera, recipient limbus, and to the conjunctiva incorporating the reciprocal edges. We report findings in a total of 36 patients, with 20 (%55.5) males and 16 (%44.4) females. Median age of the patients was 44.5 years (range 16-80). The mean follow-up period was 23.1 +/- 6.5 months. The mean size of pterygium in mm length was 3.8 +/- 0.7. Recurrence did not occur in any patient. Diplopia was not reported by any patients. Conjunctival-limbal autograft combining with selective exicison of Tenon's layer but without damage to any essential tissue such as the semilunar fold or Tenon's capsule pulley is a relatively simple and effective procedure.