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    Dry Eyes and Migraines: Is There Really a Correlation?
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Koktekir, Bengu E.; Celik, Guner; Karalezli, Aylin; Kal, Ali
    Purpose: The purpose of this study was to evaluate the tear film functions and clinical symptoms of patients with migraines. Methods: This observational comparative study consisted of 33 migraine (26 women and 7 men) patients referred from neurology clinics and 33 (22 women and 11 men) control subjects referred from ophthalmology outpatient clinics. The control subjects had neither systemic nor ocular disease nor any type of headache. All 66 patients underwent a complete ophthalmic examination and diagnostic tests for dry eye, including tear break-up time, Schirmer test with topical anesthesia, lissamine green staining, and an ocular surface disease score. Patients with migraine were classified as migraine with an aura, migraine without an aura, and basilar migraine; a pain score from 1 to 4 was determined for each patient, based on the American Headache Society's Migraine Disability Assessment Test. Results: Of the 33 patients who participated in the migraine group, 17 (51%) suffered from migraine with aura, 11 (33%) suffered from migraine without aura, and 5 (15%) suffered from basilar migraine. Significant differences in dry eye scores were found between the patients with migraine and the control subjects. In the migraine group, the mean tear break-up time was 7.75 +/- 2.37 seconds, whereas in the control group it was 9.15 +/- 1.93 seconds. For the Schirmer test, the migraine group had a mean value of 12.09 +/- 4.95 mm/5 minutes, whereas the control group had a mean value of 14.90 +/- 4.26 mm/5 minutes. Testing with lissamine green staining resulted in a mean value of 1.00 +/- 0.16 in the migraine group and 0.30 +/- 0.46 in the control group. In the migraine group, the mean for the ocular surface disease index scoring was 36.27 +/- 17.54. In the control group, it was 28.42 +/- 9.0. A significant difference (P < 0.05) was found in the dry eye syndrome testing results between the 2 groups in this study. Conclusions: An increased frequency of dry eye disease was found to occur in patients with migraine, which might suggest that migraine headaches are related to dry eye disease. Some migraine attacks may be aggravated in the presence of dry eye syndrome.
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    Endocanalicular Diode Laser Dacryocystorhinostomy for Nasolacrimal Duct Obstruction: Short-Term Results of a New Minimally Invasive Surgical Technique
    (Lippincott Williams & Wilkins, 2010) Özçimen, Muammer; Uysal, İsmail Önder; Eryılmaz, Mehmet Akif; Kal, Ali
    Aim: To evaluate the results, complications, effectiveness, and operative results of the endocanalicular laser dacryocystorhinostomy (ECL DCR) in the distal obstructions of the lacrimal drainage system. Methods: Sixty eyes of 57 patients who had a diagnosis of distal obstruction of the lacrimal drainage system were evaluated retrospectively in this study. All patients underwent ECL DCR by diode laser between October 2008 and July 2009. Forty-nine patients (86%) were females, 8 patients (14%) were males, and age distribution was between 3 and 84 years old (median, 40 y). The canaliculi were intubated by a silicone tube. The patency of the nasolacrimal system was controlled by lacrimal lavage, loss of epiphora, and endoscopic evaluation of the endonasal rhinostomy site with routine follow-up scheduled at first day and 1-week, 1-month, and 3-month postoperative intervals. Results: After the 60 ECL DCRs, 10 patients underwent revision ECL DCR because of the persistent epiphora. The patency of the nasolacrimal duct or the decrease of the symptoms was assigned as success. There were no symptoms at all in 83.3% of the patients. Conclusions: The ECL DCR in the treatment of the distal obstructions of the lacrimal drainage system was easily tolerated by the patients, cosmetically preferred because there was no incision and scar formation with high success rates, and a minimally invasive alternative technique.
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    Intraorbital Epidermoid Cyst: A 5-Year-Old With Exophthalmos and Strabismus
    (Lippincott Williams & Wilkins, 2012) Ekinci, Bengu; Koktekir, Ender; Kal, Ali; Karalezli, Aylin; Erinanc, Hilal
    A 5-year-old girl with right exophthalmos and esotropia presented to ophthalmology outpatient clinics. Orbital computed tomography revealed a 20-to 30-mm oval soft tissue mass lying superolateral to the right lateral rectus muscle in the orbit. The patient was operated on by a neurosurgical team, the csyt was removed totally, and examination of the pathologic specimen, which reveals the epidermoid cyst, was performed. After the operation, exophthalmos and esotropia were improved, and visual acuity was increased. Although itis seen as a rare entity in the orbit, epidermoid cyst must be considered during the investigation of exophthalmos.
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    Prophylactic ozone administration reduces renal ischemia-reperfusion injury in the rat
    (E-CENTURY PUBLISHING CORP, 2016) Kal, Öznur; Akıllıoğlu, İshak; Kal, Ali; Çelik, Esin; Yılmaz, Mustafa; Önal, Merih; Önal, Özkan
    Background: The objective of this study was to examine the role of ozone oxidative preconditioning after renal IR (ischemia reperfusion) injury. Methods: Twenty-eight Wistar rats were randomized into four groups: sham operated (S), IR, ozone (O), and O+IR. The S group was administered physiological saline (PS) intraperitoneally (i.p.) for seven days. The IR group was subjected to renal ischemia for 1 h by occlusion of the left renal artery and vein, followed by reperfusion for 2 h. The O group was administered ozone i.p. for seven days. In the O+IR group, ozone was administered i.p. for seven days before the IR procedure. IR injury (as in the IR group) was induced on the eight day. Laboratory analyses of renal tissue samples for superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were performed. Results: The total oxidant score (TOS) and total antioxidant capacity (TAC) of the blood samples were also analyzed. The degree of renal injury was highest in the IR group. In the O+IR group, renal injury was decreased. The antioxidant parameters were increased in the O group. The oxidant parameters were highest in the IR group. Conclusion: Ozone preconditioning ameliorated renal IR injury, with a significant decrease observed in the renal IR injury score.
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    Proptosis, Congestion, and Secondary Glaucoma Due to Carotid-Cavernous Fistula After Embolization
    (LIPPINCOTT WILLIAMS & WILKINS, 2011) Ekinci, Bengu; Koktekir, Ender; Kal, Ali; Karalezli, Aylin
    Carotid-cavernous fistulas (CCFs) are traumatic or spontaneously occurring communications between the carotid artery and the cavernous sinus. Carotid-cavernous fistulas can be due to a direct connection or indirect connections between the carotid artery system and the cavernous sinus. According to the etiologic classification, they may be of traumatic or spontaneous origin, and according to the angiography classification, they may be of direct or dural. Most CCFs are of spontaneous origin, and these are reported as frequently self-healing lesions. Spontaneous CCFs are mostly secondary to arteriosclerotic changes, which explains the increased ratio of elderly patients. Traumatic CCFs are usually of high-flow type and need intervention. The symptoms are various usually correlated to the size and type of venous drainage. The most frequent symptoms on presentation are proptosis, conjunctivitis, and chemosis; however, this picture may be complicated by optic nerve edema, cranial nerve palsies, and intracranial hemorrhage. We report a case with right low-flow dural CCF, which has worsened after angiography and recovered totally soon after endovascular embolization process.
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    The protective effect of prophylactic ozone administration against retinal ischemia-reperfusion injury
    (TAYLOR & FRANCIS LTD, 2017) Kal, Ali; Kal, Öznur; Akıllıoğlu, İshak; Çelik, Esin; Yılmaz, Mustafa; Gönül, Şaban; Solmaz, Merve
    Introduction: Retinal ischemia-reperfusion (IR) injury is associated with many ocular diseases. Retinal IR injury leads to the death of retinal ganglion cells (RGCs), loss of retinal function and ultimately vision loss. The aim of this study was to show the protective effects of prophylactic ozone administration against retinal IR injury.Materials and methods: A sham group (S) (n=7) was administered physiological saline (PS) intraperitoneally (i.p.) for 7 d. An ischemia reperfusion (IR) group (n=7) was subjected to retinal ischemia followed by reperfusion for 2h. An ozone group (O) (n=7) was administered 1mg/kg of ozone i.p. for 7 d. In the ozone+IR (O+IR) group (n=7), 1mg/kg of ozone was administered i.p. for 7 d before the IR procedure and at 8 d, the IR injury was created (as in IR group). The rats were anesthetized after second hour of reperfusion and their intracardiac blood was drawn completely and they were sacrificed. Blood samples were sent to a laboratory for analysis of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), total oxidant score (TOS) and total antioxidant capacity (TAC). The degree of retinal injury was evaluated according to changes in retinal cells and necrotic and apoptotic cells using the TUNEL method. Data were evaluated statistically with the Kruskal-Wallis test.Results: The number of RGCs and the inner retinal thickness were significantly decreased after ischemia, and treatment with ozone significantly inhibited retinal ischemic injury. In the IR group, the degree of retinal injury was found to be the highest. In the O+IR group, retinal injury was found to be decreased in comparison to the IR group. In the ozone group without retinal IR injury, the retinal injury score was the lowest. The differences in the antioxidant parameters SOD, GSH-Px and TAC were increased in the ozone group and the lowest in the IR group. The oxidant parameters MDA and TOS were found to be the highest in the IR group and decreased in the ozone group.Discussion: IR injury is also positively correlated with the degree of early apoptosis. This study demonstrated that ozone can attenuate subsequent ischemic damage in the rat retina through triggering the increase of the antioxidant capacity.