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Öğe The association of non-arteritic anterior ischemic optic neuropathy and cystoid macular edema [Non-arteritik anterior iskemik optik nöropati ve kistoid maküler ödem birlikteli?i](2013) Ekinci Köktekir B.; Yavuzer K.; Gönül Ş.; Bakbak B.; Gedik Ş.A sixty one years old patient who sufferred from visual loss in the left eye upon awakening, presented with optic atrophy in the right eye and hyperemic optic disc edema combined with flame shaped hemorrhages in the left eye. He was diagnosed as Non-Arteritic Anterior Ischemic Optic Neuropathy (NA-AION) after ophthalmological examination. Optical Coherence Tomography (OCT) revealed cystoid macular edema (CME) in the left eye. NA-AION is a common disease which is associated with optic disc edema and painless visual loss. In this case report, a patient who probably experienced NA-AION in the right eye and sufferred from NA-AION and CME in the left eye is reported, and the combination and pathogenesis of NA-AION and CME have been discussed.Öğe Evaluation of the effect of diabetes mellitus type 1 and its metabolic control on retinal nerve fiber layer thickness [Tip 1 diabetes mellitus ve metabolik kontrolünün retina sinir lifi tabakasi kalinli?ina etkisinin de?erlendirilmesi](2010) Gönül Ş.; Turgut Öztürk B.; Şahin A.; Özka?nici A.; Okudan S.Purpose: To evaluate the retinal nerve fiber layer (RNFL) thickness changes in type 1 Diabetes Mellitus (DM) patients without diabetic retinopathy (DR) and the effect of blood glucose regulation. Materials and Methods: The RNFL thickness measured by optical coherens tomography (OCT) of type 1 DM patients without DR according to ophthalmological examination (n=98) are compared with age-sex matched healthy subjects (n=49). Fasting blood glucose and HbA1c levels measured via analysis of venous blood samples obtained after 12 hours of starvation period are evaluated for the assessment of the metabolic regulation. Results: The mean RNFL thickness was 100.00±11.93 ? in diabetic patients and 103.79±6.45 ? in the control group, however this difference was not statistically significant. The comparison of RNFL thickness in superior, nasal, inferior and temporal quadrants revealed also no statistically significant change. The mean duration of DM was 60.76±50.41 months and analysis according to duration demonstrated no statistically significant difference of RNFL thickness among patients with duration of DM for 1-60 months, 61-120 months and those with duration of DM for >120 months (p>0.05). The mean fasting blood glucose was 237.46±119.22 mg/dl and the mean HbA1c was 8.77±1.94%. The HbA1c levels showed a negative correlation with RNFL thickness (koeff= - 0.49 p<0.001) Conclusion: The RNFL thickness did not show a statistically significant difference between healthy subjects and patients with type 1 DM without DR. However the negative correlation with HbA1c suggests that poor metabolic control may cause a progressive defect in RNFL.Öğe The management of a patient with elevated intraocular pressure resistant to medical treatment: Anterior chamber irrigation [Medikal tedaviye dirençli göziçi basınç yüksekliği bulunan komplike hifemalı olgunun yönetimi: Ön kamara lavajı](Turkish Ophthalmology Society, 2014) Beyoğlu A.; Gönül Ş.; Ekinci Köktekir B.; Gedik Ş.A 7-year-old male patient was medically treated in another center for hyphema which occurred after blunt trauma to his right eye. He was admitted to our clinic when his visual acuity decreased after being discharged. Biomicroscopic examination revealed total hyphema. Intraocular pressure (IOP) was 48 mm Hg in the right eye with Goldmann applanation tonometry. Since IOP could not be managed by medical therapy and there was no regression in hyphema, anterior chamber was irrigated. As in our case, it should not be forgotten that re-hemorrhage may occur in the frst week of hyphema during childhood. Moreover, surgical treatment should be considered when hemorrhage does not regress with medical treatment, increased IOP persists, and when there is a risk of corneal endothelial staining (corneal blood staining). © 2014 Turkish Ophthalmology Society. All rights reserved.Öğe Optical coherence tomography findings in patients with Wolfram syndrome [Wolfram sendromlu hastalarda optik koherans tomografi bulgulari{dotless}](Turkish Ophthalmology Society, 2014) Köktekir B.E.; Bakbak B.; Gönül Ş.; Gedik Ş.Objectives: To report the optical coherence tomography (OCT) fndings in patients with Wolfram syndrome. Materials and Methods: Four patients who fulfilled the criteria for Wolfram syndrome were recruited to the study. In all patients, OCT was performed with Stratus OCT (OCT-3, Carl Zeiss Meditec, Inc. Germany). The fast retinal nerve fiber layer (RNFL) and fast macular thickness protocols were used to measure the RNFL and macular thickness, respectively. The fast optic disc protocol was used to determine the cup-to-disc ratios of the optic disc. All patients were examined with VEP (Retimax, CSO Strumenti Oftalmici, Florence, Italy). Results: In eight eyes of four patients (3 male and 1 female) with a mean age of 18.5±2.08 years (range 16-21 years), RNFL, macular thickness, and cup-to-disc ratios were determined. The mean RNFL was 42.2±5.6 ?m (range 34.1-49.5 ?m), while the mean macular thickness and cup-to-disc ratios were 145±15 ?m (range 125-160 ?m) and 0.79±0.07 (range 0.7-0.92), respectively. There was a moderate negative correlation between VEP latencies and macular and RNFL thicknesses (Spearman correlation coefficient was -0.23 and -0.34, respectively). Conclusions: RNFL loss and secondary optical atrophy are severe complications that may affect the visual acuity in patients with Wolfram syndrome. Retinal changes in these patients may be quantified and can be observed using OCT.
