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Biomedical subjects

L S Atmaca

Publications and source records attributed to L S Atmaca.

At least 19 recordsLinked to original sources
PubMed1999

Indocyanine green videoangiography and color Doppler imaging in Behçet's disease.

PURPOSE: The purpose of this study was to examine the status of the retina and the choroid, and to evaluate blood flow velocity in the central retinal (CRA) and ophthalmic artery in Behçet's disease. METHODS: Digital fluorescein and indocyanine green (ICG) videoangiography were performed in 53 eyes and color Doppler ultrasonography in 61 eyes of 31 Behçet patients, between December 1993-January 1996. RESULTS: Fluorescein angiography revealed no vascular leakage in 7, and diffuse retinal and/or disc leakage due to vasculitis in 46 eyes. ICG angiography was normal in 14 eyes while it revealed hypo or hyperfluorescence in the remaining. For the CRA, peak systolic and end diastolic velocities were significantly lower in Behçet patients than in control cases. In the Behçet group, Doppler indices did not differ significantly in eyes which had choroidal abnormalities and those that did not, according to ICG angiography. CONCLUSION: In Behçet's disease, some abnormalities in the choroid may be seen. The disease appears to be associated with decreased mean flow velocities in CRA.

Adolescent↗
PubMed1997

ICG videoangiography of occult choroidal neovascularization in age-related macular degeneration.

Digital indocyanine green videoangiography has recently been reported to improve the imaging of occult choroidal neovascularization. In this study, 44 eyes with occult choroidal neovascularization in age-related macular degeneration were studied with fluorescein and indocyanine green videoangiography. On indocyanine green videoangiographic examination, 6 of the 44 eyes (13.6%) with occult choroidal neovascularization had vascularized pigment epithelial detachment and 27 (61.4%) had vascularized retinal pigment epithelium. In the remaining 11 (25%) eyes which had previous laser photocoagulation, indocyanine green videoangiography confirmed the presence of recurrence while fluorescein revealed no demonstrable neovascularization. The findings in our study indicate that patients with occult choroidal neovascularization have manifestations that are more clearly demonstrated with indocyanine green videoangiography and improved imaging of these abnormal vessels could potentially increase the number of patients eligible for photocoagulation treatment.

Adult↗
PubMed1997

Indocyanine green videoangiography of angioid streaks.

PURPOSE: This study was performed to define the indocyanine green angiographic features of angioid streaks and associated posterior pole lesions and to compare them with fluorescein angiography. METHODS: Digital fluorescein and indocyanine green videoangiography was performed on 16 eyes of 8 patients with angioid streaks. RESULTS: Streaks were hyperfluorescent in 15, hypo- and hyperfluorescent in 1 of the 16 eyes with fluorescein angiography. Indocyanine green angiography showed hyperfluorescent streaks in 10 and hypofluorescent streaks in 6 eyes. Of the hyperfluorescent streaks, 6 had a hypofluorescent line between fluorescent edges and 4 were made up of numerous hyperfluorescent spots. Peau d'orange appearance was more evident in indocyanine green angiography as dark, round spots throughout the posterior pole. Fluorescein angiography confirmed the presence of well-defined choroidal neovascularization in 5 eyes. In one eye, occult choroidal neovascularization which was not evident on fluorescein angiography, became well-demarcated on indocyanine green angiography. CONCLUSION: Indocyanine green angiographic features of angioid streaks are different from fluorescein angiography. Angioid streaks and peau d'orange are more evident with indocyanine green angiography.

Adolescent↗
PubMed1996

Retinal and disc neovascularization in Behçet's disease and efficacy of laser photocoagulation.

BACKGROUND: The vaso-occlusive episodes resulting from Behçet's disease can cause capillary dropout and vascular remodeling. Retinal and disc neovascularizations, which occur as a result of occlusive vasculitis, can cause recurrent vitreal hemorrhages and neovascular glaucoma leading to severe visual impairment. METHODS: 1080 eyes of 540 patients with Behçet's disease were examined between 1973 and 1993. Of the 912 eyes with posterior segment involvement, laser photocoagulation could be performed in 13 of 25 eyes with disc neovascularization (NVD), 12 of 22 eyes with retinal neovascularization (NVE), and 4 of 6 eyes with NVD and NVE. Laser was directed at areas of NVE and retinal capillary nonperfusion. In cases of NVD, panretinal photocoagulation was performed. RESULTS: The rate of regression of NVD was significantly greater in laser-treated eyes than in the untreated group. The results were similar in cases of NVD with NVE. In eyes with NVE which underwent laser photocoagulation, the NVE regressed. None of the treated eyes developed neovascular glaucoma during the follow-up period. Vitreous hemorrhage occurred in two laser-treated eyes. CONCLUSION: Laser photocoagulation is successful in preventing complications of retinal and disc neovascularizations. Thus, in cases of occlusive vasculitis associated with Behçet's disease, laser photocoagulation should be considered for prevention of complications such as vitreous hemorrhage and neovascular glaucoma.

Adult↗
PubMed1996

A descriptive study on Behçet's disease.

This study was performed in order to evaluate the age, sex, geographical distribution, ocular involvement, age of onset, and attacks in Behçet's disease. We examined 540 Behçet patients between 1973-1993. Of the patients, 453 were male and 87 female (m/f: 5.2/1). The average age was 30.7 +/- 0.35. The disease mostly appeared in the third decade and it was statistically significant that sex affected the age at onset of the initial symptoms. The onset of symptoms was more frequent among males in the 25-29-year age group, and among females below 19 and above 35 years of age. The duration of the disease was 28.7 +/- 3.1 months. The state of ocular attacks were evaluated in 598 eyes of 303 patients who were followed regularly during the first year. The risk and frequency of attacks were greater in the eyes with poorer visual acuity, and in such eyes, the number of attacks was greater < or = 24 while smaller > or = 35 years of age.

Adolescent↗
PubMed1996

Evaluation of choroidal neovascularization in age-related macular degeneration with fluorescein and indocyanine green videoangiography.

This study is performed to evaluate the fluorescein and indocyanine green (ICG) characteristics of choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). 200 eyes of 101 patients were examined with digital ICG videoangiography (ICGV). 190 of the 200 eyes had macular lesions of ARMD, and CNVs were detected in 84 (44.2%) of them. Angiographies confirmed the presence of well-defined CNV in 40 (47.6%) eyes and occult CNV in 44 (52.4%) eyes. On ICG-videoangiographic examination, 6 (13.6%) of the 44 eyes with occult CNV had vascularized pigment epithelial detachment. 27 (61.4%) had a vascularized retinal pigment epithelium. Laser photocoagulation had been performed on the remaining 11 (25%) eyes. The results of this study suggest that ICGV is a valuable technique in the diagnosis and evaluation of occult CNVs and may be suggested as an additional diagnostic tool in cases with choroidal neovascular membranes.

Adult↗
PubMed1995

Early and late visual prognosis in solar retinopathy.

BACKGROUND: Solar retinopathy was observed in a total of 86 eyes of 58 patients following the solar eclipse over Turkey in April 1976. The visual prognosis and the presence of late complications were evaluated at the early and late periods. METHODS: Of the 58 patients, 34 (51 eyes) presented during the first week and came for follow-up examination in the succeeding week, also after 1, 3, 12, and 18 months. After that they were examined at yearly intervals (mean 4.2 years). Twenty-four patients (35 eyes) presented during the period between 1 and 11 years post-eclipse and were followed up for a mean period of 3.4 years. After a period of 15 years, all of the patients were invited for re-examination and nine patients (14 eyes) attended. RESULTS: The improvement in visual acuity was observed to have taken place mostly during the first 2 weeks to 1 month after the eclipse. Further improvement in visual acuity was not observed in any of the eyes after the 18-month examination. The improvement in visual acuity was more prominent and earlier in the eyes that had visual acuity of 0.2 or better initially. Only the eyes with initial visual acuity equal to or better than 0.4 had a chance to improve their acuity to 10/10. Having observed the 51 eyes for mean period of 4.2 years and the 35 eyes for 3.4 years, no change in visual acuity was observed. Among the total of 86 eyes, 9 were found to have pseudolamellar macular holes. CONCLUSION: Correlation was found between initial visual acuity and the funduscopic appearance after the 2nd week. Fluorescein angiography was not found to be a conclusive test in solar retinopathy. No late complications were observed.

Adolescent↗
PubMed1995

Genetic features of retinitis pigmentosa in Turkey.

Sixty-two cases with retinitis pigmentosa from 42 index families were investigated to reveal the genetic features of the disease in Turkey. There were 42 propositi of whom 5 had a systemic syndrome associated with retinitis pigmentosa. Of the remaining 37 cases the condition was autosomal recessive in 21 (56.8%), sporadic in 12 (32.4%), autosomal dominant in 3 (8.1%) and X-linked recessive in one (2.7%). Sporadic cases may be more frequent as many hereditary cases are not brought to medical attention in rural families. Male preponderance among sporadic cases may indicate that there may be more X-linked cases. Nine out of 21 cases initially classified as sporadic displayed parental consanguinity and they were included as having autosomal recessive trait. Large families with autosomal recessive inheritance may prove valuable in linkage analysis and in defining future gene abnormalities.

Adolescent↗
PubMed1995

Dye laser treatment in proliferative diabetic retinopathy and maculopathy.

The aim of this study was to compare the efficacy of various dye laser wavelengths in different forms of retinopathies. The study material consisted of 292 eyes of 210 diabetic retinopathy patients treated with dye laser photocoagulation between 1990 and 1992. All the patients were followed for at least 6 months after photocoagulation. Non-proliferative changes (maculopathy and/or preproliferative retinopathy) were present in 135 (46.3%) and proliferative retinopathy in 157 (53.7%) of the eyes undergoing photocoagulation. Of the 157 eyes with proliferative retinopathy, 60 (20.5%) had disc neovascularization, 71 (24.3%) had retinal neovascularization and 26 (8.9%) had retinitis proliferans. Yellow dye laser (580 nm) was applied in 92 (31.5%) eyes, red dye laser (630 nm) in 120 (41.1%) eyes and both yellow and red dye lasers in 80 (27.4%) eyes. There was no significant difference between the different wavelength groups with regard to visual acuity changes before and after treatment (p < 0.01). Overall, the visual acuity was maintained in 56.2% and improved in 25.0% of the eyes. After panretinal photocoagulation, disc neovascularization regressed partially or completely in 47 (78.3%) of the eyes. There was no significant difference among the various laser wavelengths with regard to treatment efficacy judged by the disappearance or regression of disc neovascularization (p < 0.01). All retinal neovascularizations regressed completely with laser treatment, but in 7 eyes (9.9%) new retinal neovascularizations in previously untreated areas developed. Dye laser has not resulted in any complications. It requires lower power settings compared to argon laser and thus facilitates photocoagulation. Another advantage of dye laser is the ability to use yellow and red wavelengths sequentially.

Adult↗
PubMed1994

The efficacy of cyclosporin-a in the treatment of Behçet's disease.

We used cyclosporin A (CA) to treat 14 patients (25 eyes) with Behçet's disease characterized by severe retinal vasculitis and active intraocular inflammation. All of the patients had been treated previously with corticosteroids, colchicine, and immunosuppressives, without satisfactory results. The patients were given an initial oral dose of 5 mg/kg/day. All medication was tapered and eventually completely stopped after 12 months. The number and severity of ocular attacks (anterior and/or posterior uveitis with vitreous haze) were significantly reduced below pretreatment levels during therapy (Kolmogorov Smirnov two-pair test: P < .05). Visual acuity improved in 32% and remained unchanged in 44%. No ocular attacks recurred in 11 eyes; they recurred 1 time in 8 eyes; 2 times in 3 eyes; and 3 times in 3 eyes during CA therapy. There were no significant changes in the level of retinal vasculitis. In two cases with vaso-obstructive changes, treatment with CA was not effective and laser photocoagulation was performed. Based on our study, we recommend that an initial dose of 5 mg/kg/day CA be used in the systemic medical treatment of ocular Behçet's disease. The CA can be continued at this low dosage for an unspecified time. If intraocular inflammation does not totally resolve at this dosage or the inflammatory process recurs, combining the CA with low doses of a steroid should be considered.

Administration, Oral↗
PubMed1993

Antibodies to endothelial cells in patients with Behçet's disease.

Autoantibodies that bind to endothelial cells have been identified in patients with several forms of vasculitis. Behçet's disease--a multisystem inflammatory disorder of unknown etiology--is associated with thrombosis in addition to systemic manifestations resulting from small and large vessel vasculitis. We studied 72 Turkish patients (33 female, 39 male) with Behçet's disease in order to investigate the prevalence of antiendothelial cell antibodies (AECA) and to examine their possible relationship with clinical and laboratory features of the illness. Sera from 30 healthy Turkish people were used as controls. Human umbilical vein endothelial cells were cultured and used unfixed in a cellular ELISA to detect AECA. IgG and/or IgM AECA were found in 13 (18.1%) patients but not in healthy controls. Antiendothelial cell antibodies did not induce complement-mediated cytotoxicity as assessed by 51Cr release assay and the binding was not due to immune complexes. The prevalences of acute thrombotic events and retinal vasculitis at the time of the AECA assay among patients with AECA were significantly higher than those in patients without AECA. Laboratory parameters of active disease were higher in patients with AECA. There was no correlation between other clinical and laboratory features of Behçet's disease and AECA. Anticardiolipin and antineutrophil cytoplasmic antibodies were negative in our series, excluding a possibility of cross-reaction with AECA. Our results suggest a possible role of AECA in association with thrombosis and vasculitis in patients with Behçet's disease.

Adolescent↗
PubMed1993

Acute frosted retinal periphlebitis.

A 30-year-old woman developed bilateral acute vision loss without any systemic symptoms. There was diffuse retinal edema and thick perivenous sheathing with moderate vitreous inflammation. Fluorescein angiography showed late staining and dye leakage from diseased vessels. Oral corticosteroid treatment stabilized the visual acuity and fundus of the left eye but did not halt the progression to total fibrosis in the right eye.

Acute Disease↗
PubMed1993

Comparisons of photocoagulation treatment in exudative age-related macular degeneration with the blue-green argon, green argon and red krypton laser wavelengths.

Between November 1975 and December 1989, we examined 1,540 patients with age-related macular degeneration (ARMD). 297 eyes of 270 of these patients received photocoagulation treatment (from L.S.A.) for exudative ARMD, including choroidal neovascular membranes (CNVMs) and retinal pigment epithelial detachment. Initially, only the blue-green argon laser was available. From 1983 onwards we could choose between the blue-green argon, green argon and red krypton laser wavelengths. The 270 treated patients were followed for a minimum of 6 and a maximum of 168 months posttreatment (median 16 months). Of the 297 eyes, 138 received treatment with the blue-green argon, 36 with the green argon and 123 with the red krypton laser. Eyes with subfoveal and juxtafoveal NVMs were treated with the krypton laser. Also assigned to krypton photocoagulation were extrafoveal NVMs accompanied by hemorrhage. There was no statistical difference in the results of the three treatment modalities as judged by visual acuity. But, green argon is preferable to blue-green argon since it is absorbed less by the xantophyll pigment. On the other hand, krypton laser appears to be at least as effective as green argon in extrafoveal neovascularization and is certainly the treatment of choice in subfoveal and juxtafoveal NVMs.

Aged↗
PubMed1993

Natural progression of age-related macular degeneration.

We planned to study the natural progression of age-related macular degeneration, not treated by laser photocoagulation, in 3172 eyes of 1642 patients seen by us between 1969 and 1989. The results were available in 1576 eyes of 811 patients followed for six to 180 months (median, 24 months). We came to the following conclusions: nonexudative lesions were more frequent (67%) and the incidence of exudative lesions increased in proportion to patient age and the duration of the disease, influencing the prognosis more adversely than do nonexudative ones.

Aged↗
PubMed1993

Changes in the fundus caused by blunt ocular trauma.

Generally encountered during adolescence, blunt ocular trauma results in a variety of changes in the fundus. Our study investigated the distribution of trauma-induced changes in the fundus on the basis of the incidence and the latent interval between the trauma and the occurrence of the symptoms. In addition, we studied the distribution of the cases in regard to patient age and sex and the cause of the trauma. Included in this study were the 445 eyes, whose fundi could be evaluated, of 435 patients, who applied to the Eye Clinic of the Faculty of Medicine, Ankara University, because of blunt eye trauma and patients from private practice during the period between 1980 and 1991. The following are the changes found in the fundus, either isolated or combined, that were detected in the 445 eyes included in this study: retinal detachment (194), retinal and choroidal atrophy (52), vitreous hemorrhage (50), optic atrophy (43), Berlin's edema (42), choroidal rupture (36), macular hole (18), macular hemorrhage (16), retinal hole (9), papillary-macular membrane (8), arterial occlusion (7), evulsion of the optic nerve (5), and retinal-papillary edema (3). Seventy-nine percent were male patients, and 21% were female. The most frequently encountered age group was 11 to 20 years (32.2% of the cases included in our study).

Adolescent↗
PubMed1992

[Macular involvement in angioid streaks. Gronblad-Strandberg syndrome].

Between 1971 and 1988, we examined 116 eyes of 58 patients with Gronblad-Strandberg syndrome in private practice and in the Retinal Department of the Eye Clinic, Faculty of Medicine, Ankara University. There was initial macular involvement in 79% of cases with angioid streaks. The most frequently encountered lesion, found in 53% of the cases, was choroidal neovascularization. Macular involvement had become bilateral in 80% of the cases after 12.5 months median follow up. Thirteen of the 50 eyes with choroidal neovascularization were treated by argon or red krypton laser photocoagulation. Vision decreased during follow-up in 15% of the 13 eyes treated whereas it decreased in 32% of the 69 eyes unsuitable for laser treatment.

Adult↗
PubMed1992

Farnsworth-Munsell 100-hue test for patients with diabetes mellitus.

We evaluated 164 eyes of 87 patients with diabetes mellitus compared with 50 eyes from 25 healthy subjects as the control group. We compared 87 patients with diabetes mellitus (164 eyes) in relation to their duration of diabetes, fundus findings, visual acuity, and color vision defects. In all patients, color vision defects were determined using the Farnsworth-Munsell 100-hue test, and the total error score was established on the basis of age norms from subjects without diabetes. No color vision defect was detected in the control group. In the diabetic group, fundus degeneration and color vision defects were observed and correlated with the duration of diabetes. The dominant color defect was of the blue-yellow type.

Adolescent↗