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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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    Comparison of Different Methods for Measurement of Intraocular Pressure and Evaluation of Effect of Central Corneal Thickness on Measurement Results
    (Turkish Ophthalmological Soc, 2010) Sakalar, Yildirim Bayezit; Keklikci, Ugur; Balsak, Selahattin; Dogan, Eyyup; Unlu, Kaan
    Purpose: To compare measurements of intraocular pressure (IOP) by Goldmann applanation tonometer ( GAT), tonopen and non-contact tonometer (NCT) in normal eyes, and determine the relationship between the results of IOP measurement and central corneal thickness (CCT). Material and Method: Seventy-nine eyes of 41 patients, whose ophthalmologic examination and visual field test revealed no glaucoma, were included into the study. IOP was measured by GAT, NCT and tonopen. CCT was measured with an ultrasonic pachymeter. Results: The mean IOP measured by GAT was 12.63 +/- 2.94 mmHg, by tonopen - 8.51 +/- 2.66 mmHg and by NCT - 13.34 +/- 3.88 mmHg. In terms of measurement results, there was a statistically significant difference between the three methods (p<0.05). Although the correlation between tonopen and CCT was insignificant (p>0.05), there was a significant correlation between GAT and CCT, as well as between NCT and CCT (p<0.05). Discussion: There was a significant difference between measurements of IOP by GAT, NCT and tonopen in normal eyes. Tonopen may not be affected by CCT in normal eyes, while a significant correlation existed between CCT and GAT or NCT in normal eyes.
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    Comparison of Vertical C/D Ratio Obtained by Assistant of Ophthalmology with Results of Optical Cohorence Tomography
    (Turkish Ophthalmological Soc, 2008) Sakalar, Yildirim Bayezit; Unlu, Kaan; Keklikci, Selahattin Ugur; Caca, Ihsan; Ari, Seyhmus; Balsak, Selahattin; Akkus, Zeki
    Purpose: To compare vertical C/D ratio that measured with ophthalmoscopic examination of second, third and fourth year assistant of ophthalmology with vertical C/D ratio obtained by optical cohorence tomography. Materials and Methods: One hundred and ten eyes of 72 glaucoma patients which are followed in glaucoma unit were included to study. Each assistant examined vertical C/D ratio by Goldman tree mirror lens and results were recorded independently from results of the other assistants. The measurements of vertical C/D ratio were obtained by optic nerve head analyses of Stratus Optical Cohorence Tomography after pupillary dilatation and vertical C/D ratio were enlisted. All measurements of vertical C/D ratio were compared each other. Results: Thirty patients were male and 42 patients were female, mean age was 51.43 +/- 19.2. Mean vertical C/D ratio measured by second year asisstant was 0.556 +/- 0.246, mean vertical C/D ratio measured by third year assistant was 0.534 +/- 0.251, mean vertical C/D ratio measured by fourth year assistant was 0.529 +/- 0.250. Mean vertical C/D ratio obtained by optical cohorence tomography was 0.651 +/- 0.223. There was no statistically signicant differences among vertical C/D ratio measured by assistants (p>0.05). The mean vertical C/D ratio that measured by each assistant was statistically lower than obtained by optical cohorence tomography (p<0.05). Conclusions: The vertical C/D ratio that measured with ophthalmoscopic examination by assistant of ophthalmology will be different from vertical C/D ratio obtained by optic nerve head analyses of optical cohorence tomography.
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    Congenital isolate and total optic disc coloboma -: Case report and review of the literature
    (Humana Press Inc, 2007) Ari, Seyhmus; Keklikci, Ugur; Caca, Ihsan; Unlu, Kaan; Alakus, Fuat
    Isolated and total optic disc coloboma is a markedly rare congenital anomaly of the eye. Congenital eye colobomas frequently present with eye anomalies and systemic signal findings. We present a case of isolated total optic disc coloboma without systemic involvement, which has been rarely reported in the literature.
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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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    The effect of extremely low frequency magnetic field on the conjunctiva and goblet cells
    (Taylor & Francis Inc, 2008) Keklikci, Ugur; Akpolat, Veysi; Ozekinci, Selver; Unlu, Kaan; Celik, M. Salih
    Purpose: The aim of this study was to examine the effects of extremely low frequency magnetic field (ELF MF) on the conjunctiva and goblet cells density. Methods: Thirty adult female Spraque Dawley rats were assigned to one of two groups, each containing 15 rats. The experimental group received magnetic field 4 hr/day for 7 days. The second group received standard laboratory care and served as a control. The specimens were evaluated by light microscopy for goblet cell density, conjunctival edema, inflammation, and fibroblast proliferation. Results: In ELF MF exposure group rats, the number of goblet cells was less than the control group. We also observed a significant difference between ELF MF exposure group and control group in terms of goblet cell density (p = 0.010). The ELF MF exposure group manifested conjunctival edema and inflammation compared to the control group (p < 0.001 and p = 0.003). There was no statistical difference between the groups for fibroblast proliferation (p = 0.422). Conclusion: This study suggests that ELF MF exposure leads to morphological alterations of the conjunctiva and reductions in the number of goblet cells. We believe that ELF MF may cause dry eye symptoms.
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    The Effect of Mitomycin-C on Trabeculectomy in Primary Glaucoma Cases
    (Turkish Ophthalmological Soc, 2005) Caca, Ihsan; Unlu, Kaan; Sakalar, Yildirim Bayezit; Ari, Seyhmus
    Purpose: The aim of this study was to determine the effect of mitomycin-C (MMC) treatment on the accomplishments and complications of trabeculectomy. Materials and Methods: 75 eyes of 59 (group 1) primary glaucoma cases that were treated with trabeculectomy operation together with 0.2 mg/ml 2 minutes intraoperative MMC and 22 eyes of 16 (group 2) glaucoma cases to whom only trabeculectomy operation were evaluated. Results: Cases in the group 1 were followed up 10.87 +/- 2.88 months meanly and cases in the group 2 were followed up 9.55 +/- 2.56 months meanly. In all of group 1 and 82% of group 2, intraocular pressure was found postoperatively to . be below 21mmHg. In the postoperative short-term, the most common complications for groupl were anterior chamber shallowness in 22 cases (30%), temporary ocular hypotonia in 21 cases (28%), conjunctival leakage in 8 cases (11 %), while for group 2 the most complications were intraocular pressure rise in 5 cases (23%), anterior chamber shallowness in 3 cases (14%) and temporary ocularhypotonia in 2 cases (9%). The complications appeared in the postoperative long-term for group 1 were endophthalmitis in 1 case (1.3%) and cataract formation in 7 cases (9%) whereas for group 2 were steady high intraocular pressure in 4 cases (18%) and cataract formation in 2 cases (9%). Conclusion: 0.2 mg/ml 2 minutes intraoperative MMC increases considerably the success rate of trabeculectomy in primary glaucoma cases. Nevertheless, postoperative short-term complications should be followed at close range and treated.
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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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    Effects of trypan blue on corneal endothelium and anterior lens capsule in albino Wistar rats
    (Elsevier Science Inc, 2006) Ari, Seyhmus; Caca, Ihsan; Unlu, Kaan; Nergiz, Yusuf; Aksit, Ihsan
    Background: The development of continuous curvilinear capsulorrhexis (CCC) has contributed significantly to the tolerability and effectiveness of cataract extraction and intraocular lens implantation. Staining of the anterior capsule has become a popular method of increasing visibility when performing CCC. Objective: The aim of this study was to determine, using scanning electron microscopy (SEM) and transmission electron microscopy (TEM), the highest concentrations of trypan blue dye that would not cause long-term toxicity after injection into the anterior chamber of rat eyes. Methods: The eyes of healthy female albino Wistar rats were used in this investigator-masked, controlled, 2-period, experimental study conducted over 12 weeks at the Dicle University Experimental Animal Laboratory, Diyarbakir, Turkey. The rats were randomly divided into 5 groups of 4 using a random-number table. Each rat was administered a 0.05-mL injection of trypan blue into the right eye in 1 of the following concentrations: 0.4%, 0.2%, 0.1%, 0.05%, or 0.025%. A 0.05-mL pH-balanced saline solution was injected into the left eye of each rat to act as a control. At 1 day after injection and 4 weeks after injection (early period), 1 rat from each concentration group was euthanized and their eyes were enucleated. At 12 weeks after injection (late period) the remaining 2 rats from each group were euthanized and their eyes were enucleated. Corneal endothelial cells and the anterior lens capsule of the enucleated eyes were analyzed using SEM and TEM, and the results were compared with those of the control group. In the TEM analysis, the primary end point was the histopathologic changes in the cellular organelles when compared with those in the control group. In the SEM analysis, the primary end point was changes in cell shape, intracellular junctions, and density of the microvilli when compared with those in the control group. Results: Forty eyes from 20 albino Wistar rats (mean [SD] age, 8.2 [1.6] weeks; mean [SD] weight, 175.6 [16.5] g) were used in the study. Each group of rats received a different concentration of trypan blue in the right eye. In the early period, both the 0.4% and 0.2% concentrations were associated with the impairment of the hexagonal structure of corneal endothelial cells and intercellular junctions. Those concentrations were also associated with an increased occurrence of cellular vacuolation, cytoplasmic edema, extensive granulation of the endoplasmic reticulum, pyknotic nuclei, and mitochondrial degeneration. In the late period, these changes were observed as persisting in a decreasing manner. With the 0.1% and 0.05% concentrations, the density of microvilli decreased, nuclei appeared normal, granulation of the endoplasmic reticulum and Golgi apparatus was active, and minimal levels of mitochondrial degeneration were observed. Conclusions: In this small experimental study in rat eyes, trypan blue at concentrations > 0.025% was associated with impaired morphology and structure of corneal endothelial cells after short-term exposure. This effect continued in a decreasing fashion after long-term exposure. No significant changes were noted in the control group or the group administered the 0.025% concentration.
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    Efficacy of topical cyclosporin A 0.05% in conjunctival impression cytology specimens and clinical findings of severe vernal keratoconjunctivitis in children
    (Springer Tokyo, 2008) Keklikci, Ugur; Soker, Sevda I.; Sakalar, Yildirim B.; Unlu, Kaan; Ozekinci, Selver; Tunik, Selcuk
    To evaluate the efficacy of topical cyclosporin A 0.05% in managing the symptoms of severe vernal keratoconjunctivitis (VKC). Fifty-four children with severe VKC were included in this study. All 54 patients were treated with topical cyclosporin A (CsA) 0.05% for 3 months. Ocular signs and symptoms were scored in all patients at entry and after 3 months. Conjunctival impression cytology specimens were examined on the day of enrollment and at the end of the treatment period. The mean scores for severity of signs and symptoms significantly decreased after 3 months compared with those at entry (P < 0.001). The density of inflammatory cells in the conjunctival impression cytology specimens decreased significantly. No side effects of the treatment with CsA 0.05% eyedrops were observed. Topical CsA 0.05% eyedrops were found to be safe and effective in the treatment of patients with VKC. Consistent with these results, topical CsA may efficiently reduce conjunctival inflammation in severe VKC.
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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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    Incidence, clinical findings and management of intraoperative floppy iris syndrome associated with tamsulosin
    (Wiley-Blackwell Publishing, Inc, 2009) Keklikci, Ugur; Isen, Kenan; Unlu, Kaan; Celik, Yusuf; Karahan, Mine
    To determine the risk ratios and incidence of intraoperative floppy iris syndrome (IFIS) during cataract surgery in patients using tamsulosin, and to assess management strategies for IFIS. We performed a non-randomized, observational, prospective study, in which 594 eyes of 579 patients undergoing cataract surgery were enrolled. Surgeons were masked to the patients' drug history. Usage or non-usage of tamsulosin, duration of tamsulosin use, presence or absence of IFIS, management of IFIS and intraoperative complications were recorded in the patients' theatre notes. Twelve of 15 (80%) IFIS patients were taking systemic tamsulosin. Twelve of 23 (52%) patients using tamsulosin showed features of IFIS. The odds ratios (ORs) and relative risk (RR) ratios show strong positive correlations between tamsulosin use and IFIS. The ORs and RR ratios and the 95% confidence intervals (CIs) are as follows: OR 206.5 (95% CI 50.9-836.5); RR 99.3 (95% CI 30.0-327.8). There were no statistically significant differences between patients with or without IFIS, who were using tamsulosin, in terms of age or duration of tamsulosin use (p > 0.05). Seven eyes (46.6%) with IFIS were successfully managed with epinephrine. Eight eyes (53.4%) with IFIS needed iris hooks. Patients using tamsulosin appear to be at high risk of IFIS during cataract surgery. The occurrence of IFIS may not be affected by duration of tamsulosin use or age. Epinephrine may be effective in approximately 50% of eyes with IFIS. The iris hook procedure represents an effective management strategy in IFIS.
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    Intravitreal bevacizumab combined with panretinal photocoagulation in the treatment of open angle neovascular glaucoma
    (Sage Publications Ltd, 2009) Ciftci, Suleyman; Sakalar, Yildirim Bayezit; Unlu, Kaan; Keklikci, Ugur; Caca, Ihsan; Dogan, Eyup
    PURPOSE. To evaluate the clinical efficacy of intravitreal bevacizumab (IVB) combined with panretinal photocoagulation in patients with open angle neovascular glaucoma (NVG). METHODS. Nine patients (9 eyes) with NVG participated in this study. Patients received IVB (1.25 mg) as the initial treatment for NVG and were followed up for at least 4 months. IVB was offered as the first treatment of choice to patients with NVG. Panretinal photocoagulation was performed as soon as feasible after the second week and completed in all patients the fourth week after IVB. The main outcome measures are resolution of INV, inhibition of peripheral anterior synechia (PAS), and controllability of intraocular pressure (IOP). RESULTS. The mean follow-up period was 5.6 +/- 1.4 months (range, 4-9 months). The mean IOP before treatment was 35.1 +/- 9.7 mmHg (range, 24-56) under medication before IVB treatment. After IVB and after combined treatment, the mean IOP was reduced to 22.8 +/- 8.1 mmHg (range, 9-33) and 13.0 +/- 4.0 mmHg (range, 7-20), respectively. The mean referral INV was 3.6 +/- 0.4 grade (range, 3-4) and reduced to 1.6 +/- 0.4 (range 1-2) grade after IVB and 0.6 +/- 0.8 (range 0-2) grade after combined therapy. By IVB, combined panretinal photocoagulation recurrence of INV was not observed. CONCLUSIONS. In NVG, IVB treatment can reduce iris and angle neovascularization and inhibits further PAS formation temporarily. Panretinal photocoagulation inhibits neovascularization constantly. Therefore, management of open angle NVG is more feasible with bevacizumab combined with panretinal photocoagulation. (Eur J Ophthalmol 2009; 1028-33)
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    Melkersson-Rosenthal syndrome with partial oculomotor nerve palsy
    (K Faisal Spec Hosp Res Centre, 2008) Aluclu, Mehmet Ufuk; Keklikci, Ugur; Guzel, Aslan; Unlu, Kaan; Tatli, Mehmet
    [Abstract Not Available]
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    Persistent Triamcinolone Acetonide Particles on the Posterior Lens Capsule After Intravitreal Injection
    (Amer Soc Contemporary Medicine Surgery & Ophthalmology, 2008) Sakalar, Yildirim Bayezit; Unlu, Kaan; Keklikci, Ugur; Caca, Ihsan; Senol, Berivan Bozarslan
    We report a rare case in which triamcinolone acetonide particles gathered on posterior lens capsule after injection of intravitreal triamcinolone acetonide. Intravitreal injection of triamcinolone acetonide is useful in the treatment of macular edema; however, accumulation of triamcinolone acetonide particles on the posterior lens capsule may decrease visual acuity and requires surgical treatment.
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    Phthiriasis Palpebrarum in an Infant
    (Slack Inc, 2009) Keklikci, Ugur; Cakmak, Alpay; Akpolat, Nezahat; Unlu, Kaan; Ozkul, Sedat
    The authors describe a case of phthiriasis palpebrarum embedded in the right upper eyelid of a 9-month-old male infant. The patient was successfully treated with mechanical removal of all lice and nits from the eyelashes. in children, phthiriasis palpebrarum should be considered in the differential diagnosis of blepharoconjunctivitis that is resistant to treatment. [J Pediatr Ophthalmol Strabismus 2009;46:173-174.]
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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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    Retinal Nerve Fiber Layer Thickness and Features of the Optic Disc in Patients with Nonocular Behcet's Disease
    (Turkish Ophthalmological Soc, 2010) Sakalar, Yildirim Bayezit; Keklikci, Ugur; Cakmak, Sevin Soker; An, Seyhmus; Erdem, Seyfettin; Unlu, Kaan
    Purpose: To evaluate the retinal nerve fiber layer (RNFL) thickness and optic disc measurements in patients with nonocular Behcet's disease. Material and Method: Forty-six eyes of 23 patients with nonocular Beh double dagger et's disease (Group 1) and 30 eyes of 15 healthy subjects (Group 2) were included in the study. A detailed ophthalmologic examination was performed, and the RNFL thickness and optic disc measurements were made by optical coherence tomography (OCT) in all cases. Thinning was considered when the RNFL thickness values were below 5%. Results: The mean RNFL thickness was 104.08 +/- 8.27 mm and 106.98 +/- 9.14 mm in group 1 and group 2, respectively. No significant difference was found between the two groups in terms of mean RNFL thickness (p>0.05). In group 1, the thinning of RNFL was detected in: one segment-13 eyes (28%), two segments-10 eyes (22%), three segments-2 eyes (4.3%), one quadrant - 8 eyes (17.4%), and two quadrants - 1 eye (2.2%). In group 2, the thinning of RNFL was observed in one segment - 7 eyes (25%) and in three segments - 2 eyes (7%). No thinning was detected in any quadrants in group 2. The thinning of RNFL in both segments and quadrants between the two groups was found to be significantly different (p<0.05). No significant difference existed between the two groups for optic disc measurements (p>0.05). Discussion: Thinning of RNFL may be seen in patients with nonocular Behcet's disease. The OCT can be used as an ancillary examination method in these patients.
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    Tick infestation of the eyelid: a case report in a child
    (Turkish J Pediatrics, 2009) Keklikci, Ugur; Unlu, Kaan; Cakmak, Alpay; Akdeniz, Sedat; Akpolat, Nezehat
    A three-year-old girl presented with a small brown lesion on the right upper eyelid margin. Close examination revealed an insect body attached to the eyelid margin. Microscopic examination of the specimen identified the species of the organism as Ixodes ricinus. The tick was completely removed with blunt forceps. She was treated with lid toilet, irrigation, and application of topical 0.3% ciprofloxacin four times daily to the affected eye. The lesion healed without scarring after one week. No systemic symptoms were observed. Mechanical removal with blunt forceps may be a quick, easy, safe and effective treatment for ticks located on the eyelids.