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Öğe Atypical Herpetic Corneal Endotheliitis: A Case Report(2016) Karalezli, Aylin; Kucukoduk, Ali; Bozkurt, BanuKorneal endotelit, sıklıkla viral orijinli olan ve primer olarak kornea endotelinin iflamasyonunun gözlendiği bir hastalıktır. Bu olgu sunumunda ön kamara reaksiyonunun gözlenmediği sadece tek taraflı yaygın korneal ödem ile giden atipik herpetik korneal endotelitli bir olguyu sunuyoruz.Öğe Atypical Herpetic Corneal Endothelitis(DERMAN MEDICAL PUBL, 2016) Karalezli, Aylin; Kucukoduk, Ali; Bozkurt, BanuCorneal endotheliitis; frequently caused by viruses, is a disorder in which corneal endothelium is the primary site of the inflammation. We discuss a case of atypical herpetic endotheliitis presented with unilateral diffuse corneal edema with no signs of anterior chamber reaction.Öğe The clinical value and histopathological correlation of lacrimal scintigraphy in patients with primary Sjogren's syndrome(LIPPINCOTT WILLIAMS & WILKINS, 2012) Erhamamcı, Seval; Karalezli, Aylin; Yılmaz, Sema; Aktaş, AyşePurpose To evaluate the lacrimal gland function in patients with primary Sjogren's syndrome (SS) using lacrimal scintigraphy (LS) and to determine the relationship between clinicopathological stage of primary SS and LS findings. Methods Seventy eyes from 35 patients with primary SS and 20 eyes from 10 healthy age-matched and sex-matched individuals who served as the control group were included in this study. The patients with primary SS were divided into two groups - early stage and advanced stage - according to the labial biopsy scores (23 patients in early stage and 12 in advanced stage). LS, the Schirmer-1 test, determination of break-up time (BUT), Rose bengal ocular surface vital staining and assessment of functional parameters including ocular surface disease index (OSDI) scores were performed for all cases. LS was used to evaluate tear clearance. Lacrimal scintigrams were evaluated for the presence and severity of delayed tear clearance. Delay in clearance was also subclassified according to the severity of delay (mild, moderate, severe and very severe). LS findings and ophthalmological test results of patients in early stage of disease were compared with the results of those in advanced stage and with those of normal individuals. Result The Schirmer-1 test and BUT values of patients in advanced stage of primary SS decreased significantly, whereas the Rose bengal and OSDI values increased significantly when compared with the values of patients in early stage of primary SS and with those of normal individuals (P<0.05 and P<0.001, respectively). Tear clearance of patients in advanced-stage disease was delayed significantly, compared with the tear delay in patients in early stage of disease and that of normal individuals (P<0.001). An inverse correlation existed between tear clearance and both the Schirmer-1 test and BUT value in all patients (P<0.001). However, there was a positive correlation between both the Rose bengal ocular surface staining values and OSDI scores and tear clearance in all cases (P<0.001). LS findings and ophthalmologic test results were significantly different between early-stage and advanced-stage primary SS. Conclusion The results indicate that LS, which is correlated closely with ophthalmological test results, may be a useful method for the assessment of the lacrimal gland function in patients with primary SS. LS findings and ophthalmological tests may be used for determining disease severity in primary SS. Nucl Med Commun 33:689-694 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.Öğe The clinical value of dacryoscintigraphy in the evaluation of lacrimal gland function in patients with Primary Sjogren's Syndrome and comparison with histopathologic stage(SPRINGER, 2009) Günel, Seval Erhamamcı; Karalezli, Aylin; Yılmaz, Sema Nur; Aktaş, Ayşe; Akova, Y.[Abstract not Available]Öğe Decreased aortic root elasticity-as a novel systemic manifestation of the pseudoexfoliation syndrome:(2012) Alpaslan, Mete; Karalezli, Aylin; Borazan, Mehmet; Ekinci, Bengü Köktekir; Müderrisoğlu, İbrahim HaldunAmaç: Psödoeksfoliyasyon sendromu olan hastalarda aorta kökü fonksiyonlarını değerlendirmek. Yöntemler: Bu gözlemsel, vaka kontrollü çalışmada, psödoeksfoliyasyon sendromu (PES) olan 31 hasta (ortalama yaş: 719 yıl) ve benzer yaştaki 29 kontrol (ortalama yaşSD: 699 yıl) olguda aorta kök fonksiyonu değerlendirmesi için M-mod transtorasik ekokardiyografi yapıldı. Aorta kök fonksiyonu değerlendirmesinde, M-mod ekokardiyografi ile aortanın kesitsel kompliansı (AKK), Peterson elastik modülü (indeks beta), aorta sertlik indeksi (ASİ) ve aort kökü gerilme kapasitesi (AKG) hesaplandı. Bu iki grup hastanın bulguları, Mann-Whitney U testi ile karşılaştırıldı. Bulgular: AKK ve AKG, psödoeksfoliyasyon sendromu olan hastalarda belirgin derecede azalmıştı. AKK, psödoeksfoliyasyonlu hastalarda 12.26.3 cm2/mmHg iken, kontrol grupta17.511.6 cm2/mmHg olarak bulundu (p0.015). AKG, psödoeksfoliyasyon sendromu olan hastalarda 1.560.80 cm2/dyne olarak, kontrol grubunda ise 2.231.48 cm2/dyne olarak bulundu (p0.021). Aorta kök fonksiyonu değerlendirmesinde iki grup arasında hesaplanan diğer iki indeks açısından belirgin fark bulunamadı. Sonuç: Psödoeksfoliyasyon sendromu olan hastalarda aorta kök fonksiyonu azalmıştır. PES, kardiyovasküler ve serebrovasküler olaylar için bir risk faktörü olarak değerlendirilebilir.Öğe Decreased aortic root elasticity-as a novel systemic manifestation of the pseudoexfoliation syndrome: an observational study(TURKISH SOC CARDIOLOGY, 2012) Alpaslan, Mete; Karalezli, Aylin; Borazan, Mehmet; Koktekir, Bengu Ekinci; Muderrisoglu, Ibrahim HaldunObjective: To assess the aortic root function in patients with pseudoexfoliation syndrome (PEXS). Methods: In this case- controlled observational study, aortic root function in 31 PEXS patients (mean age 71 +/- 9 years) and 29 controls of similar ages (mean age 69 9 years) were evaluated by M-mode transthoracic echocardiography. Aortic cross-sectional compliance (CSC), Peterson's elastic modulus (index beta), aortic stiffness index (ASI) and aortic root distensibility (ARD) were calculated by M-mode echocardiography to evaluate the aortic root function. The findings of two groups of patients were compared by Mann-Whitney U test. Results: The CSC and ARD were significantly decreased in patients with PEXS. The CSC was 12.2 +/- 6.3 cm(2)/mmHg in patients with PEXS and 17.5 +/- 11.6 cm(2)/mmHg in the control group (p=0.015). The ARD was 1.56 +/- 0.80 cm(2)/dyne in patients with PEXS and 2.23 +/- 1.48 cm(2)/dyne in the control group (p=0.021). The other two indices of aortic root function were not significantly different between the two groups. Conclusion: Aortic root function decreases in patients with PEXS. PEXS may be regarded as a risk factor for cardiovascular and cerebrovascular events. (Anadolu Kardiyol Derg 2012; 12:483-7)Öğe Does topical bevacizumab prevent postoperative recurrence after pterygium surgery with conjunctival autografting?(IJO PRESS, 2014) Karalezli, Aylin; Kucukerdonmez, Cem; Akova, Yonca A.; Koktekir, Bengu EkinciAIM: To assess the effect of topical bevacizumab use on postoperative pterygium recurrence in eyes who underwent pterygium excision with limbal -conjunctival autograft transplantation (LCAT). METHODS: eighty -eight eyes of 88 patients with primary pterygium were included. Pterygia were graded preoperatively from type 1 to type 3 (type 1 atrophic, type 3 inflamed) according to the inflammatory status. The eyes were preoperatively randomized to receive topical steroid and antibiotic treatment (group 1, 46 eyes) and additional topical bevacizumab (5 mg/mL; group 2, 42 eyes) in the postoperative period. All eyes underwent pterygium excision and LCAT. Medications were tapered and discontinued at one month. Postoperative complications and recurrence rates were recorded. RESULTS: The mean follow -up duration was 29.3 +/- 4.2mo (24-52mo) and 28.5 +/- 3.4 (24-48mo) in group 1 and 2, respectively (P>0.05). There were no statistically significant differences regarding the age or gender between groups (P>0.05). Also, the difference between groups with respect to pterygium type was not significant. During the follow -up period, recurrence developed in 2 eyes (4.3%) in group 1, whereas in one eye (2.4%) in group 2. No statistically significant difference between groups was found in recurrence rates (P>0.05). No re-operation for recurrence was necessary during the follow-up period in both groups. CONCLUSION: Topical bevacizumab seems to have no additonal effect on pterygium recurrence after LCAT.Öğe Dry Eyes and Migraines: Is There Really a Correlation?(LIPPINCOTT WILLIAMS & WILKINS, 2012) Koktekir, Bengu E.; Celik, Guner; Karalezli, Aylin; Kal, AliPurpose: 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.Öğe Evaluation of choroidal thickness using spectral-domain optical coherence tomography in patients with migraine: a comparative study(SAGE PUBLICATIONS LTD, 2015) Karalezli, Aylin; Celik, Guner; Koktekir, Bengu Ekinci; Kucukerdonmez, CemPurpose: To assess choroidal thickness in patients with migraine and compare them with healthy controls, using spectral-domain optical coherence tomography (OCT). Methods: In this prospective case-control study, choroidal thicknesses of 20 newly diagnosed migraine patients and 20 age-and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain (FD) OCT device (lambda = 840 nm, 26.000 A-scans/s, 5 mu m axial resolution). All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (9: 00 AM), in order to minimize the effects of diurnal variation. Results: There was a statistically significant difference in median choroidal thickness between the migraine patients (277.00 [interquartile range (IQR) 85.75] mu m) and controls (301.00 [IQR 90.50] mu m) (p = 0.012). There were significant differences at all measurement points (p<0.05 for all). Conclusions: The decreased choroidal thickness of patients with migraine might be related to the vascular pathology of the disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and migraine.Öğe Intraorbital Epidermoid Cyst: A 5-Year-Old With Exophthalmos and Strabismus(Lippincott Williams & Wilkins, 2012) Ekinci, Bengu; Koktekir, Ender; Kal, Ali; Karalezli, Aylin; Erinanc, HilalA 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.Öğe Proptosis, Congestion, and Secondary Glaucoma Due to Carotid-Cavernous Fistula After Embolization(LIPPINCOTT WILLIAMS & WILKINS, 2011) Ekinci, Bengu; Koktekir, Ender; Kal, Ali; Karalezli, AylinCarotid-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.Öğe Quantitative and Visual Evaluation of Salivary and Thyroid Glands in Patients with Primary Sjogren's Syndrome Using Salivary Gland Scintigraphy: Relationship with Clinicopathological Features of Salivary, Lacrimal and Thyroid Glands(Lippincott Williams & Wilkins, 2010) Erhamamcı Günel, Seval; Yılmaz, Sema; Karalezli, Aylin; Aktaş, AyşePurpose To evaluate quantitative and visual salivary gland scintigraphy in patients with primary Sjogren's syndrome (SS) and to compare the scintigraphic findings with clinicopathological features of the salivary, lacrimal and thyroid glands. Methods Twenty-seven patients with primary SS and 10 healthy age-matched and sex-matched individuals as a control group were included in this study. The diagnosis of SS was made on the basis of the classification criteria of the American-European Consensus Group. The patients with primary SS were divided into two groups as early-stage and advanced-stage according the labial biposy scores (16 early-stage and 11 advanced-stage). After the administration of 370 M Bq Tc-99m pertechnetate, static images were obtained at 20 min and also after lemon stimulation. Functional parameters for the parotid, submandibular, and thyroid glands were calculated. Schirmer-I, tear film break-up time and Rose Bengal tests were evaluated. Result Statistically significant differences existed for the functional parameters of the parotid and submandibular glands between the early-stage and advanced-stage groups. The submandibular glands were more frequently affected than the parotid glands. Asymmetric uptake pattern was more common in the parotid glands during the early-stages of primary SS. When compared with the control group, the thyroid uptake ratio of the early-stage primary SS and advanced-stage group was not significantly different. According to the results of the ophthalmological tests, there was a statistically significant difference between patients with advanced-stage and early-stage disease. There were no significant correlations between functional parameters of salivary gland and any of the ophthalmological tests. Conclusion The results indicate that quantitative salivary gland scintigraphy may be a useful method for evaluating salivary gland dysfunction and also for determining disease severity in primary SS. Asymmetric activity pattern in the parotid glands commonly observed during the early stages of the disease may be a predictor of progression. In addition, the histopathological stage is related not only to the scintigraphic findings of the salivary glands but also to lacrimal gland function in primary SS. However, thyroid uptake seemed to be unaffected in patients with both early-stage and advanced-stage disease.Öğe Strabismus Secondary to Frontal Sinus Mucocele Associated with Nasal Polyposis(LIPPINCOTT WILLIAMS & WILKINS, 2012) Ekinci Köktekir, Bengü; Karalezli, Aylin; Topal, Özgül; Erbek, SelimParanasal mucoceles are regarded as slow-growing and benign lesions. They are usually recognized by otorhinolaryngologists, but a clinically relevant mucocele with orbital complications may present to an ophthalmologist. We report a 15-year-old's case with unilateral reduced ocular motility due to bilateral frontal mucocele associated with grade II nasal polyposis.Öğe Topiramate-Induced Changes in Anterior Chamber Angle and Choroidal Thickness(LIPPINCOTT WILLIAMS & WILKINS, 2016) Karalezli, Aylin; Koktekir, Bengu Ekinci; Celik, GunerPurpose: To investigate the acute effects of topiramate on the anterior chamber angle (ACA) and choroidal thickness in patients with migraine. Methods: This prospective study included 15 eyes of 15 patients with migraine who have been scheduled to start topiramate therapy. All patients underwent complete ophthalmic examination including measurement of the ACA and choroidal thickness using a spectral domain optical coherence tomography device (Optovue Inc.) and refractive status evaluation with an autorefractokeratometer (KR-8100; Topcon) at the baseline and 1 week after starting therapy. The patients were asked to report any pain or discomfort in their eyes during therapy at the follow-up visit. Results: None of the patients experienced pain or discomfort in their eyes. The mean ACA significantly decreased at the first week of the therapy compared with the baseline levels (40.34 +/- 7.06 degrees and 36.89 +/- 6.87 degrees, respectively) (P=0.001). However, the mean choroidal thickness increased from 277.33 +/- 95.60 mu m at the baseline to 323.40 +/- 84.50 mu m at the first week (P=0.01). There was a nonsignificant increase in the mean refractive error (from -0.25 +/- 0.54 diopter [D] at the baseline to -0.38 +/- 0.49 D after 1 week) (P=0.06). Conclusions: Topiramate can acutely decrease the ACA and increase the choroidal thickness. Because these effects may be asymptomatic, patients with migraine who start this therapy should be warned to be closely followed up by an ophthalmologist.
