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Öğe Bir Olgu Sebebiyle Tek Taraflı Optik Atrofi Etiyolojisinde Hipofiz Adenomlarının Yeri: Olgu Sunumu(Selçuk Üniversitesi, 2017 Haziran) Oflaz, Ayşe Bozkurt; Gedik, Şansal; Bozkurt, Banu; Öztürk, Banu Turgut; Okudan, SüleymanHipofiz adenomları gerçek kapsül ihtiva etmeyen adenohipofizyel hücrelerden oluşan metastaz yapmayan neoplazilerdir. Hipofiz adenomları intrakraniyel kitlelerin %10-15'ini oluştururlar. En sık 3-6. dekadlarda görülürken, çocuklarda nadirdir. Hipofiz adenomları boyut olarak 1 cm’den küçük ise mikroadenom, 1 cm’den büyük ise makroadenom olarak sınıflandırılır. Mikroadenomların aksine makroadenomlar görsel semptomlara, görme alanı defektine ve hipofiz yetmezliğine sebep olabilir. Hipofiz makroadenomları, benign tümöral olgular olarak kabul edilseler de nörovasküler bası ve hipopituitarizm yoluyla klinik tabloyu kötüleştirebilirler. Optik sinire bası yapan tümor patofizyolojik olarak desendan optik atrofiye yol açabilir. Optik diskin atrofik görünümü hastanın görme keskinliğini ve görme kalitesini önemli derecede düşüren, bir takım klinik olaylar zincirinin son basamağı olarak karşımıza çıkan bir tablodur. Bu nedenle takip ve tedavide fikir sahibi olabilmek için optik atrofi ile karşılaşıldığında ayırıcı tanı yapmak, hasta için önem arz etmektedir. Biz bu olguda tek taraflı optik disk atrofisinden yola çıkılarak yapılan görüntüleme sayesinde tanı konulan makroadenom hastasını sunmayı amaçladık.Öğe Quantitative assessment of the effect of fasting on macular microcirculation: An optical coherence tomography angiography study(BMJ Publishing Group, 2019) Karaküçük, Yasin; Beyoğlu, Abdullah; Çömez, AyşegülAim: To analyse the effect of fasting on the retinal vascular plexus and choriocapillaris structures in healthy subjects via Optical Coherence Tomography Angiography (OCTA). Methods: In this prospective study, OCTA scans of 98 eyes in 49 healthy subjects were compared in fasting and non-fasting period. All cases had a full ophthalmological examination, with OCTA parameters measured, including superficial flow area (SCP) (mm2), deep flow area (DCP) (mm2), choriocapillaris flow area (CC) (mm2), superficial and deep vascular density (SVD and DVD, respectively) (%), superficial foveal avascular zone area (FAZs) (mm2), deep foveal avascular zone area (FAZd) (mm2), subfoveal choroidal thickness (SFCT) (?m) and central macular thickness (CMT) (?m). Results: The mean SCP, DCP and CC flow area values were induced to be significantly lower in a fasting than a non-fasting period (p<0.001, p<0.001, p=0.049, respectively). The mean VD in a fasting period was statistically significantly lower than in a non-fasting period at the SCP level (p=0.009). No statistically significant difference was found between the two periods in respect to DVD, FAZd and CMT (p=0.068, p=0.653 and p=0.531, respectively); however, FAZs were significantly lower in a non-fasting than fasting period (p=0.038). The SFCT was determined to be statistically significant and thicker during a fasting period (p<0.001). Conclusion: The current study documented several physiological changes in a fasting period, such as changes in SCP, DCP, CC flow, SVD and DVD, via OCTA. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.Öğe Management of ocular allergy(Blackwell Publishing Ltd, 2019) Leonardı, Andrea; Silva, Diana; Perez Formigo, Daniel; Bozkurt, Banu; Sharma, Vibha; Allegri, Pia; Rondon, Carmen; Calder, Virginia; Ryan, Dermot; L. Kowalsk, Marek; Delgado, Luis; Doan, Serge; L. Fauquert, JeanThe treatment and management of ocular allergy (OA) remain a major concern for different specialties, including allergists, ophthalmologists, primary care physicians, rhinologists, pediatricians, dermatologists, clinical immunologists, and pharmacists. We performed a systematic review of all relevant publications in MEDLINE, Scopus, and Web Science including systematic reviews and meta-analysis. Publications were considered relevant if they addressed treatments, or management strategies of OA. A further wider systematic literature search was performed if no evidence or good quality evidence was found. There are effective drugs for the treatment of OA; however, there is a lack an optimal treatment for the perennial and severe forms. Topical antihistamines, mast cell stabilizers, or double-action drugs are the first choice of treatment. All of them are effective in reducing signs and symptoms of OA. The safety and optimal dosing regimen of the most effective topical anti-inflammatory drugs, corticosteroids, are still a major concern. Topical calcineurin inhibitors may be used in steroid-dependent/resistant cases of severe allergic keratoconjunctivitis. Allergen-specific immunotherapy may be considered in cases of failure of first-line treatments or to modify the natural course of OA disease. Based on the current wealth of publications and on the collective experience, recommendations on management of OA have been proposed. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.Öğe The evaluation of intraocular pressure fluctuation in glaucoma subjects during submaximal exercise using an ocular telemetry sensor(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2019) Bozkurt, Banu.; Okudan, Nilsel.; Belviranli, Muaz.; Oflaz, Ayse Bozkurt.Purpose: To evaluate the effect of acute submaximal exercise on intraocular pressure (IOP) fluctuations in open-angle glaucoma (OAG) subjects using an ocular telemetry sensor (OTS, Sensimed TriggerFish (R)). Methods: Twelve OAG subjects aged 45-65 years with no medical limitation for exercise were included in this prospective study. A submaximal exercise test was performed using a cycle ergometer for 20 min during which OTS voltages and metabolic parameters were recorded continuously. IOP voltages taken before, during, and after exercise were compared using the Friedman test and correlations with the metabolic parameters were evaluated using the Spearman analysis. Results: In two subjects, the OTS stopped functioning after a few hours. Median OTS measurements were 37.60 mVeq 10 min before exercise [interquartile range (IQR) 137.27], 51.75 (IQR 121.2), 62.35 (IQR 123.72), 54.6 (IQR 141.3), and 59.7 mVeq (IQR 196.7) during exercise (4 time points, 5 min apart), and 50.7 (IQR 147.35) and 64.2 mVeq (IQR 103.25) 10 and 30 min after exercise and the change was statistically non-significant (P = 0.66). No correlations were found between OTS and metabolic parameters measured at the same time points (P > 0.05). Nocturnal acrophase pattern was detected in five subjects (50%), diurnal acrophase in two patients, and double-hump in two patients. Median IOP voltages in the morning, afternoon/evening, and night were 335.84, 149.15, and 341.38 mVeq, respectively (P < 0.001). Conclusion: Continuous IOP monitoring did not reveal a remarkable voltage change in OAG patients during or immediately after exercise, but nocturnal IOP peaks in half of the patients.Öğe The correlation of optical cohorence tomography findings with serum cytokine levels, TNF-alpha, serum neopterin levels in relapsing and remitting periods of MS(SAGE PUBLICATIONS LTD, 2019) Ekmekci, Hakan.; Eren, Fettah.; Ongun, Gözde.; Gedik, Şansal.; Ünlü, Ali.; Öztürk, Şerefnur.Background: Optical Coherence Tomography (OCT) is an improved technique in the last 20 years that allows quantitative measurement of retinal nerve fiber layer (RNFL) thickness, which provides important information on approach to optic nerve diseases in neurology and ophtalmology area. Therefore, OCT is now being used in various neuro-ophthalmic situations. On the other hand it is known that MS is also involved in a highly complexity of countless biomarkers that are elucitaded an autoimmune disease of the central nervous system. Serum and Cerebrospinal fluid Cytokines, TNF-?, neopterin (a marker of INF-? activity) may play important role in cell swelling, synaptic transmission and neural integration.Öğe Strabismus in hydrocephalus patients(SPRINGER, 2019) Koktekir, Bengu Ekinci; Koktekir, E.; Ozcan, G.; Karabagli, H.Purpose To evaluate the characteristics and outcomes of strabismus in patients with hydrocephalus. Methods A retrospective chart review of patients with strabismus and hydrocephalus is performed in the Department of Pediatric Ophthalmology between 2012 and 2018. Results Seventeen patients between the ages of 6 months and 13 years met the criteria of strabismus and hydrocephalus. Although all had developmental delay, five patients out of 17 were premature (lower than 36 weeks of gestation). All patients had ventriculoperitoneal shunt placement for congenital hydrocephalus. Three patients had exotropia, whereas 14 had esotropia. Glasses were prescribed to 13 patients: hyperopic correction in 12 and myopic correction in one patient. Surgical correction with bimedial recession was performed in five patients. Four of them achieved successful ocular alignment. Conclusions Children with hydrocephalus most likely have esotropia. Although good ocular alignment is achieved with surgical correction in some patients, some patients may benefit from glasses.Öğe Quantitative analysis of retinal microcirculation in optical coherence tomography angiography in cases with Behcet's disease without ocular involvement(SPRINGER, 2019) Comez, Aysegul; Beyoglu, Abdullah; Karakucuk, YalcinPurposeTo evaluate the retinal vascular plexus and choriocapillaris structures in patients with non-ocular Behcet's disease (BD) using optical coherence tomography angiography (OCTA).MethodsThe study included 42 eyes of non-ocular BD patients (study group) and 40 eyes of 20 healthy subjects (control group). Flow area (mm(2)), mean vascular density (VD) (%) and foveal avascular zone (FAZ) (mm(2)) were measured using OCTA (Optovue Inc., Fremont, CA, USA). Subfoveal choroidal thickness (CT) (mu m) and central macular thickness (CMT) (mu m) measurements were also performed.ResultsThe mean superficial capillary plexus, deep capillary plexus and choriocapillaris flow area values were found to be significantly lower in the study group than in the control group (p<0.001, p<0.001, p=0.008, respectively). In respect of mean VD, a statistically significant difference was determined between the study and control groups in both superficial and deep VD (p<0.001). No statistically significant difference was found out between the groups in respect of superficial FAZ, deep FAZ and CMT (p=0.165, p=0.477, p=0.457, respectively). The subfoveal CT was also measured to be significantly thicker in the study group than in the control group (p<0.001).ConclusionThe results obtained with OCTA revealed that there could be both retinal and choroidal involvement in non-ocular BD patients before the emergence of evident clinical findings.Öğe Quantitative assessment of the effect of acute anaerobic exercise on macular perfusion via swept-source optical coherence tomography angiography in young football players(SPRINGER, 2019) Karakucuk, Yalcin; Okudan, Nilsel; Bozkurt, Banu; Belviranli, Muaz; Sezer, Tugba; Gorcuyeva, SonaAim To evaluate the effect of acute anaerobic exercise on macular perfusion measured by swept-source optical coherence tomography angiography (SS-OCTA) in young football players. Materials and methods Football players with ages between 18 and 20 years were included into the study. After a detailed ophthalmological examination, physiological parameters including height (cm), body weight (kg), body fat percentage (%), systemic blood pressure (BP) (mmHg), hematocrit values (%), oxygen saturation pO(2) (%) and heart rate (bpm) were recorded. Intraocular pressure (IOP) (mmHg) and SS-OCTA using DRI OCT Triton (Topcon, Tokyo, Japan) were measured immediately before and after Wingate test. Results Out of 20, 16 participants completed the study. All participants were males with a mean age of 18.12 +/- .34 years. Systolic BP, hematocrit and heart rate increased, while pO(2) and IOP decreased remarkably after Wingate test (p < .01). After anaerobic exercise, there was an increase in mean FAZ area in superficial capillary plexus (FAZs) which was not significant (p = .13), while decrease in FAZ area in deep capillary plexus (FAZd) (mm(2)) was remarkable (p = .04). No changes were observed in mean vessel density (VD) (%) in superficial capillary plexus (VDs), deep capillary plexus (VDd), choriocapillaris (VDcc), central macular thickness (CMT) (mu m) and subfoveal choroidal thickness (SFCT) (mu m) after Wingate test (p > .05). FAZd and some of the VD parameters showed a significant correlation with BP (p < .05). Conclusion Acute anaerobic exercise seems not to alter either mean VD in retina and choroid or CMT and SFCT. Among OCTA parameters, only FAZd decreased remarkably.Öğe Novel application software for the semi-automated analysis of ınfrared meibography ımages(LIPPINCOTT WILLIAMS & WILKINS, 2019) Shehzad, Danish; Gorcuyeva, Sona; Dag, Tamer; Bozkurt, BanuPurpose: To develop semi-automated application software that quickly analyzes infrared meibography images taken with the CSO Sirius Topographer (CSO, Italy) and to compare them to the manual analysis system on the device (Phoenix software platform). Methods: A total of 52 meibography images verified as high quality were used and analyzed through manual and semi-automated meibomian gland (MG) detector software in this study. For the manual method, an experienced researcher circumscribed the MGs by putting dots around grape-like clusters in a predetermined rectangular area, and Phoenix software measured the MG loss area by percentage, which took around 10 to 15 minutes. MG loss was graded from 1 (<25%) to 4 (severe >75%). For the semi-automated method, 2 blind physicians (I and II) determined the area to be masked by putting 5 to 6 dots on the raw images and measured the MG loss area using the newly developed semi-automated MG detector application software in less than 1 minute. Semi-automated measurements were repeated 3 times on different days, and the results were evaluated using paired-sample t test, Bland-Altman, and kappa kappa analysis. Results: The mean MG loss area was 37.24% with the manual analysis and 40.09%, 37.89%, and 40.08% in the first, second, and third runs with the semi-automated analysis (P < 0.05). Manual analysis scores showed a remarkable correlation with the semi-automated analysis performed by 2 operators (r = 0.950 and r = 0.959, respectively) (P < 0.001). According to Bland-Altman analysis, the 95% limits of agreement between manual analysis and semi-automated analysis by operator I were between -10.69% and 5% [concordance correlation coefficient (CCC) = 0.912] and between -9.97% and 4.3% (CCC = 0.923) for operator II. The limit of interoperator agreement in semi-automated analysis was between -4.89% and 4.92% (CCC = 0.973). There was good to very good agreement in grading between manual and semi-automated analysis results (kappa 0.76-0.84) and very good interoperator agreement with semi-automated software (kappa 0.91) (P < 0.001). Conclusions: For the manual analysis of meibography images, around one hundred dots have to be put around grape-like clusters to determine the MGs, which makes the process too long and prone to errors. The newly developed semi-automated software is a highly reproducible, practical, and faster method to analyze infrared meibography images with excellent correlation with the manual analysis.Öğe IgG4 related disease and ligneous conjunctivitis in a girl: A coexistence or a relationship(WILEY, 2019) Emiroglu, M.; Bozkurt, B.; Emiroglu, H. H.[Abstract not Available]Öğe Early effects of selective serotonin reuptake inhibitors (SSRIs) on cornea and lens density in patients with depression(TAYLOR & FRANCIS LTD, 2019) Karaküçük, Yalçın.; Beyoglu, Abdullah.; Çömez, Aysegül.; Orhan, Fatma Özlem.; Demir, Merve.PURPOSE: To investigate the effects of SSRIs on cornea and lens density, intraocular pressure (IOP) and anterior chamber parameters, including anterior chamber volume (ACV), anterior chamber depth (ACD), corneal volume (CV) and central corneal thickness (CCT), in patients with depression during a three-month follow-up period. METHOD: In this prospective study, 31 total patients, who were prescribed SSRIs for depression, were recruited. Sertraline, 50?mg/daily, was given to ten patients; 11 received Escitalopram, 10?mg/daily; and ten were treated with Fluoxetine, 20?mg/daily. The parameters recorded were corneal density (CD), lens density (LD), IOP, ACV, ACD, CV and CCT at the start of treatment, as well as at one-week, one-month, and three-month follow-ups. RESULTS: The study revealed that there was no risk of cataract development from three months of SSRI intake. Significant decrease in ACD was recorded at the one-week follow up; however, after three months, this decrease was insignificant compared to the baseline. ACV, CV, CCT, CD and LD showed no significant alterations in any of the follow up examinations over the three-month period. IOP, however, significantly fell (a P value of 0.004). CONCLUSION: In this study, SSRI use does not seem to be associated with an increased risk of cataract or glaucoma or with changes in CD and LD. Long-term follow-up is necessary to determine the actual risk of cataract or glaucoma with SSRI intake.Öğe Does cataract surgery simulation correlate with real-life experience?(TURKISH OPHTHALMOLOGICAL SOC, 2018) Oflaz, Ayse Bozkurt; Koktekir, Bengu Ekinci; Okudan, SuleymanObjectives: To evaluate the correlation of cataract surgical simulator and real-life surgical experience and its contribution to surgical training. Materials and Methods: Sixteen doctors in our department were divided into three groups based on their surgical experience. After being familiarized with the device, the participants were evaluated while performing the navigation, forceps, bimanual practice, anti-tremor and capsulorhexis stages. The capsulorhexis stage was repeated five times. Participants were also assessed while performing capsulorhexis again with their non-dominant hand. The influence of repetition and surgical experience on the recorded points was evaluated. P values below 0.05 were considered statistically significant. Results: There was correlation between the participants' surgical experience and their scores in the capsulorhexis module. Their dominant hand was more successful than the non-dominant hand in capsulorhexis (p=0.004). Capsulorhexis scores increased with repetition (p=0.001). Conclusion: Results achieved with the cataract surgery simulation device correlate with surgical experience. The increase in performance upon repeated practice indicates that the simulator supports surgical training.Öğe Kristalin lens luksasyonu sanılan spontan lens absorbsiyonu(2018) Gönül, Şaban; Oflaz, Ayşe Bozkurt; Bakbak, Berker; Yavuzer, Kamil; Bozkurt, BanuSpontan lens absorbsiyonu (SLA), hipermatür kataraktların seyrek görülen bir komplikasyonudur. Bu durum travma, yaşlılık, Fuchs üveitsendromu (FÜS) gibi üveitik hastalıklar ve leptospirozis ve kızamıkçık gibi bulaşıcı hastalıklardan kaynaklanan hipermatür kataraktolgularında bildirilmiştir. Bu yazıda FÜS’ye ikincil olarak gelişen hipermatür kataraktın spontan emilime uğradığı bir olgu sunmaktayız.Bildiğimiz kadarıyla SLA’nın bu ilk raporu, kapsüler bakiyelerin vitreusa doğru yönelmesini takiben, muayene sırasında yanıltıcı olarakkristalin lens luksasyonu görünümünde olan ilk olgu sunumudur.Öğe Beta-Talasemi Hastalarında Göz Bulgularının Değerlendirilmesi(2018) Bitirgen, Gülfidan; Tokgöz, Hüseyin; Çalışkan, Ümran; Akkuş, Abdullah; Özkağnıcı, AhmetAmaç: Beta-talasemi majör ve intermedia tanısı ile takip edilen hastalarda göz bulgularının görülme sıklığı ve özellikleri yönünden de-ğerlendirilmesi.Gereç ve Yöntem: Beta-talasemi majör ve intermedia tanıları ile takip edilen 69 hastanın dosya kayıtları retrospektif olarak incelendi. Tümhastaların görme keskinliği ve göz içi basıncı ölçümü, biyomikroskopik ön segment ve fundus muayenesini içeren tam oftalmolojik muayene ka-yıtları mevcuttu. Hastaların demografik özellikleri, tespit edilen göz bulguları, serum ferritin düzeyleri, eritrosit süspansiyonu transfüzyon sa-yıları ve kullanılan demir şelasyon tedavisinin türü ve tedavi süresi değerlendirildi.Bulgular: Hastaların ortalama yaşı 9.7 5.9 yıl idi ve 54 hastada (%78,3) beta-talasemi majör, 15 hastada (%21,7) beta-talasemi inter-media tanısı mevcuttu. Eritrosit süspansiyonu transfüzyon sayısı, tedavi süresi ve serum ferritin düzeylerinin medyan (çeyrekler arası aralık)değerleri sırası ile 67,0 (34,0-115,5), 6.0 yıl (3,3-10,5) ve 1308,6 ng/mL (857,3-2193,1) idi. Anormal göz bulguları 28 hastada (%40,6) izlen-di ve bunların 25’inde (%89,3) beta-talasemi majör tanısı mevcuttu. Başlıca tespit edilen göz bulguları arasında lens opasiteleri (8 hastada[%11,6]), retinal vasküler tortuosite artışı (10 hastada [%14,5]) ve retina pigment epiteli değişiklikleri (9 hastada [%13,0]) yer almakta idi.Anormal göz bulguları olan hastalarda eritrosit süspansiyonu transfüzyonu sayısı (p0,001), tedavi süresi (p0,001) ve serum ferritin düzey-leri (p0,004) göz bulgusu olmayanlara kıyasla daha yüksek bulundu.Sonuç: Beta-talasemi hastalarında hastalığın seyri sırasında çeşitli göz bulguları ortaya çıkabilmektedir. Bu hastalardaki erken değişik-liklerin tespit edilebilmesi için düzenli göz muayenesi gerekmektedir.Öğe Toxic anterior segment syndrome: Is it possible to have corneal dysfunction without changes in corneal morphology(2018) Yassa, Ertuğrul Tan; Bakbak, BerkerToxic anterior segment syndrome (TASS) is a sterile postoperative infl ammatory reaction caused by a noninfectious substance thatenters the anterior segment, resulting in a wide range of toxic damage to intraocular tissues. The process typically begins 12 to 48 hoursafter anterior-segment surgery, but delayed mild cases have been reported. In this paper, a case of mild late-onset TASS that specifi callycaused corneal edema without changes in corneal morphology is described. While, ideally, corneal morphology should be documentedby a corneal confocal microscopy, this case could be documented by a biomicroscopic anterior and posterior segment examination,central corneal thickness (CCT) detection by a corneal B mode ultrasound and a corneal specular microscope without corneal confocalmicroscopy. For this case, mild corneal edema was observed on postoperative day 32 (the CCT was 701 ?m on postoperative day 32,602 ?m on postoperative day 75) without any specular microscopic changes (the preoperative endothelial cell density was 2660 cells/mm 2 , and on postoperative day 75, it was 2660 cells/mm 2 ) and major infl ammation in the anterior and posterior segment of the eye,which responded well and promptly to topical steroid treatment. The aim is to contribute to the identifi cation and proper management ofsimilar patients and to discuss whether TASS causes corneal dysfunction without changes in corneal morphology, as the early detectionof mild cases is important in preventing potentially severe cases.Öğe Persistent subretinal fluid: Wait or treat(2018) Yassa, Ertugrul Tan; Bakbak, BerkerPersistent subretinal fluid (SRF) may occur even after successful surgery for rhegmatogenous retinal detachment (RRD).In most cases, persistent SRF resolves spontaneously within a year, but persistent SRF may cause poor central vision, photoreceptordamage, and the irreversible loss of visual function. Therefore, a variety of interventions have been developedto manage persistent SRF, including the prophylactic use of steroids. As far as we know, an intravitreal steroid injectionhas never been used in the treatment of persistent SR. This report is a description of steroid treatment used in the caseof a 46-year-old male patient with SRF persisting for 15 months after pars plana vitrectomy surgery for the treatmentof macula-off RRD. A single-dose intravitreal triamcinolone acetonide (IVTA) injection (4 mg/0.1 mL) was administered;however, no improvement was seen in the lesions. It was concluded that an IVTA injection should be used in a limitedfashion in patients with persistent SRF.Öğe Pnömokok keratitli bir olguda korneal kolajen çapraz bağlama tedavisi(2017) Oflaz, Ayşe Bozkurt; Bozkurt, Banu; Kamış, Ümit; Köktekir, Bengü EkinciBakteriyel keratit, görmeyi tehdit eden ciddi bir oküler enfeksiyöz hastalıktır. Hastalık genelde hızlı seyreder ve doğru tedavi edilmezsekorneada skar, stromal apse, perforasyon ve komşu dokulara yayılım görülebilir. Son yıllarda yapılan çalışmalarda topikal antibiyotiktedavisine dirençli bazı olgularda ultraviyole-A ve riboflavin kullanılarak yapılan korneal kolajen çapraz bağlama (KKÇB) tedavisininetkili olduğu gösterilmiştir. KKÇB bakterisidal etkinliğinin yanı sıra korneadaki kolajen yapıyı kuvvetlendirerek perforasyon riskini deazaltmaktadır. Bu olgu sunumunda 6 ay önce sağ keratoplasti operasyonu yapılan, daha sonra kornea greftinde merkezi yerleşimli genişkeratit odağı saptanan, kültürde Streptococcus pneumonia üreyen ve yaklaşık bir 1 ay boyunca uygulanan medikal tedaviye cevap vermediğiiçin KKÇB tedavisi uygulanan bir erkek hasta tartışılmıştır. KKÇB tedavisinden sonra hastanın ağrısı azalmış, kornea epitel defektikapanmış ve kornea infiltratında hızlı bir iyileşme görülmüştür. Görme keskinliği el hareketi düzeyinden 20/400 seviyesine çıkmıştır.KKÇB tedavisi medikal tedaviye dirençli bakteriyel keratitli olgularda adjuvan tedavi olarak kullanılabilir.Öğe Topikal proparakain suistimaline bağlı gelişen toksik keratopati(2014) Yavuzer, Kamil; Gönül, Şaban; Köktekir, Bengü Ekinci; Gedik, Şansal; Bozkurt, BanuGözde ağrı, yanma, batma ve yaşarma şikayetleri ile başvuran kırk iki yaşındaki erkek olguda kornea santralinde epitel defekti, stromal ülserasyon ve korneal ödem saptandı. Sanayide kaynak işi yapan ve şikayetlerinin 40 gündür mevcut olduğunu ifade eden olgunun ısrarlı sorgulanması sonucunda proparakainin topikal formunu kullandığı öğrenildi. Özellikle sanayi, inşaat gibi kornea yaralanması oranı yüksek olan meslek gruplarında proparakain suistimali daha sık görülmektedir. Bu nedenle, kornea epitel defekti, epitel iyileşmesinde gecikme, stromal erime, şiddetli ağrı ve görme keskinliğinde azalma görülen özellikle bu meslek gruplarındaki hastalarda propakain suistimali akla getirilmelidirÖğe Tedaviye dirençli blefarit nedeni: pitriyazis palpebrarum(2014) Güzel, Hüseyin; Gönül, Şaban; Gedik, Şansal; Okudan, Süleyman; Dağı, Hatice TürkElli üç yaşında kadın hasta, her iki gözde iki aydır devam eden, kirpik diplerinde kaşıntı şikâyetiyle polikliniğimize başvurdu. Oftal- molojik muayenede her iki kirpik diplerinin hiperemisiyle beraber, kirpiklere yapışık, hareketli, sarı-kahverengi renkte, çok sayıda bit ve yumurtaları tespit edildi. Kirpiklerden alınan örneklerde pitriyazis palpebrarum saptandı. Pitriyazis ve cinsel yolla bulaşan diğer hastalıklar açısından dermatoloji konsültasyonu istendi. Tedavi olarak bir petrolatum bileşiğinin (saf vazelin) günde üç kez kirpik diplerine uygulanması önerildi. Kirpik diplerindeki bit ve yumurtalar 2 hafta sonra tamamen ortadan kayboldu. Olgumuzda da ol- duğu gibi kötü hijyenik şartlarda yaşayan kişilerde, klasik tedaviye yanıt vermeyen blefaritle karşılaşıldığında, ayrıcı tanıda pitriyazis palpebrarum da düşünülmelidirÖğe Cluster Headache with Ptosis Responsive to Intranasal Lidocaine Application: A Case Report(2012) Bakbak, Berker; Gedik, Şansal; Ekinci Köktekir, Bengü; Okka, MehmetIntroduction. The application of lidocaine to the nasal mucosal area corresponding to the sphenopalatine fossa has been shown to be effective at extinguishing pain attacks in patients with a cluster headache. In this report, the effectiveness of local administration of lidocaine on cluster headache attacks as a symptomatic treatment of this disorder is discussed. Cases presentation. A 22-year-old Turkish man presented with a five-year history of severe, repeated, unilateral periorbital pain and headache, diagnosed as a typical cluster headache. He suffered from rhinorrhea, lacrimation and ptosis during headaches. He had tried several unsuccessful daily medications. We applied a cotton tip with lidocaine hydrochloride into his left nostril for 10 minutes. The ptosis responded to the treatment and the intensity of his headache decreased. Conclusion: Intranasal lidocaine is a useful treatment for the acute management of a cluster headache. Intranasal lidocaine blocks the neural transmission of the sphenopalatine ganglion, which contributes to the trigeminal nerve as well as containing both parasympathetic and sympathetic fibers.
