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    Assessment of ocular neurotoxicity in patients treated with systemic cancer chemotherapeutics
    (2014) Bakbak B.; Gedik S.; Koktekir B.E.; Yavuzer K.; Tulek B.; Kanat F.; Pancar E.
    Purpose: Cisplatin and Paclitaxel are two chemotherapeutic agents known to produce neurotoxicity when used for cumulative dose regimens. In this study we aim to assess their toxicity in the optic nerve, and to evaluate the retinal nerve fibre layer (RNFL) thickness and visual field changes in lung cancer patients treated with Cisplatin and Paclitaxel. Methods: Fifteen patients who were treated intravenously with 75mg/m2 cisplatin and 175mg/m 2 paclitaxel every 3 weeks, up to a maximum of six courses, were enrolled in this prospective clinical trial. All patients underwent complete ophthalmological assessments before their treatments began, as well as three months after the completion of their treatments. The RNFL thickness measurements were performed using optical coherence tomography (OCT). Functional testing included the use of frequency-doubling technology (FDT) perimetry and the Humphrey visual field analyser (HFA). The main outcome measurements included the average RNFL thicknesses and visual field indices (mean deviation [MD] and pattern standard deviation [PSD]). Results: The median age of the 15 patients (nine male and six female) was 63.49 years old (range: 53-77). The average RNFL thickness measurement during the baseline examination was 103.73?m (range: 97-111). Three months after the cessation of treatment the RNFL thickness declined to 97.4?m (range: 91-102). Statistical analysis showed a significant thinning between the two measurements (p=0.032). The MD and PSD values recorded by the HFA demonstrated no statistically significant changes 3 months after the cessation of treatment (p>0.207 and p>0.186, respectively). There were statistically significant decreases in both the MD (0.48 to-1.13dB) and PSD (2.13 to 0.65dB) indices measured by the FDT perimetry (p=0.041 and p=0.025, respectively). Conclusions: In our study, the systemic administration of Cisplatin and Paclitaxel affected the peripapillary RNFL thicknesses and visual field indices as revealed by FDT perimetry. OCT and FDT perimetry may be adjunctive tools for the screening of ocular toxicity in patients treated with these agents. © 2014 Informa Healthcare USA, Inc.
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    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.
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    Bilateral adie's tonic pupil [Bilateral adie'Nin tonik pupillası]
    (Turkish Ophthalmology Society, 2013) Bakbak B.; Ekinci B.K.; Gedik S.; Yavuzer K.; Öztürk B.T.
    A 37-year-old male patient applied with the complaint of photophobia and having difficulties in reading. Both pupils were found to be dilated and un reactive to light but responsive to accommodation. The case was diagnosed with bilateral tonic pupil following neurological, radiological and laboratory evaluations. Tonic pupil should be kept in mind in eyes with light-near dissociation. In this case report, bilateral tonic pupils and the possible mechanism which may cause this disorder were discussed.