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Biomedical subjects

Sunay Duman

Publications and source records attributed to Sunay Duman.

At least 19 recordsLinked to original sources
PubMed2006

The accommodative element in accommodative esotropia.

PURPOSE: To evaluate the effect of reducing the hyperopic correction on the state of binocular accommodative response in fully accommodative esotropia and to determine the "comfortable" amount of reduction in hyperopic correction. DESIGN: A cohort study. METHODS: Hyperopic corrections of children with a baseline refractive error of +1.50 to +5.0 diopters were gradually reduced in 0.50-diopter increments. Binocular accommodative ability was assessed by dynamic retinoscopy (monocular estimate method). Similar binocular accommodative responses were ascertained among patients with a baseline hyperopic correction of < or =3.0 of hyperopia and >3.0 of hyperopia, and patients were divided into two groups, group 1 (13 patients) and group 2 (18 patients), accordingly. RESULTS: After a reduction of 2.0 diopters in group 1 and 1.0 diopter in group 2, there was a decrease in accommodative response initially in the nondominant eye, accompanied by the dominant eye with a further reduction of 0.50 diopter. To overcome the bilateral accommodative lag, a reinstatement of a 0.50-diopter stronger hyperopic correction was required. Patients in group 1 tolerated a mean undercorrection of 2.37 diopters, and 77% were weaned from their spectacles. All of the children in group 2 were dependent upon spectacles at the completion of the study period. The final spectacle worn was a median of -1.67 diopters less than their full cycloplegic refraction. CONCLUSIONS: A complete binocular accommodative ability seems to be a prerequisite for the establishment of "comfortable" hyperopic undercorrections. It does not seem to be a reasonable approach to consider further reductions in hyperopic correction in the presence of a bilateral decreased accommodative performance.

Accommodation, Ocular↗
PubMed2006

Oxidative stress and protein oxidation in pseudoexfoliation syndrome.

PURPOSE: To investigate the oxidant/antioxidant status and protein oxidation in pseudoexfoliation syndrome. METHODS: The activity of serum superoxide dismutase (SOD) and the levels of serum malondialdehyde (MDA) and protein carbonyl (PC) were measured in 50 patients with pseudoexfoliation (PEX) and in 55 healthy controls. RESULTS: There was significant difference in the SOD activity in PEX group compared with the control group (p < 0.001). In addition, MDA and PC levels were significantly higher in patients than in the controls (p < 0.001). CONCLUSIONS: Decrease in SOD activity and the higher levels of MDA and PC indicate increased oxidative stress. Our results suggest a possible role of oxidative stress in pathology of PEX syndrome.

Aged↗
PubMed2005

Macular edema and iridocorneal endothelial syndrome: a case report.

PURPOSE: To report a case of cystoid macular edema (CME) in iridocorneal endothelial syndrome. METHODS: Case report. RESULTS: The authors describe the clinical history and ocular examination of a 38-year-old woman with iridocorneal endothelial syndrome and CME. This association has never been reported before. The mechanism of CME is unknown. CONCLUSION: CME may cause visual deterioration in iridocorneal endothelial syndrome. We emphasize the importance of posterior segment examination in these cases.

Adult↗
PubMed2004

Decompression retinopathy after Ahmed glaucoma valve implantation in a patient with congenital aniridia and pseudophakia.

We present the case of a 16-year-old adolescent boy with congenital aniridia and pseudophakia who developed decompression retinopathy in a glaucomatous eye after Ahmed glaucoma valve implantation combined with anterior vitrectomy. On the first postoperative day, dot and blot-shaped hemorrhages scattered in the posterior pole were observed. The hemorrhages resolved over 6 months, and the visual acuity returned to the preoperative level. Severe deterioration of the visual field was not observed in the late postoperative period. Despite the sudden visual acuity decrease postoperatively, decompression retinopathy is a benign condition and resolution of hemorrhages without sequelae is the natural course.

Adolescent↗
PubMed2004

Primary viscocanalostomy versus trabeculectomy for primary open-angle glaucoma: three-year prospective randomized clinical trial.

PURPOSE: To compare the efficacy and safety of viscocanalostomy and trabeculectomy in patients with primary open-angle glaucoma (POAG). SETTING: Department of Ophthalmology, Ankara Education and Research Hospital, Ankara, Turkey. METHODS: In this prospective randomized trial, 50 eyes of 50 patients with medically uncontrolled POAG were randomized to have a trabeculectomy (25 eyes) or a viscocanalostomy (25 eyes). Visual acuity, intraocular pressure (IOP), and slitlamp examinations were performed before surgery and 1 day, 1 week, 1, 3, and 6 months, and 1, 2, and 3 years postoperatively. RESULTS: At 3 years, the mean IOP was 16.0 mmHg +/- 7.07 (SD) in the trabeculectomy group and 17.8 +/- 4.6 mmHg in the viscocanalostomy group (P=.694). Complete success (IOP 6 to 21 mm Hg without medication) was achieved in 66.2% of eyes at 6 months and 55.1% at 3 years in the trabeculectomy group and in 52.9% and 35.3%, respectively, in the viscocanalostomy group (P>.05). Qualified success (IOP 6 to 21 mmHg with medication) was achieved in 95.8% of eyes at 6 months and 79.2% at 3 years in the trabeculectomy group and in 90.7% and 73.9%, respectively, in the viscocanalostomy group (P>.05). Postoperative hypotony and cataract formation occurred more frequently in the trabeculectomy group than in the viscocanalostomy group (P=.002). CONCLUSIONS: Primary trabeculectomy lowered IOP more than viscocanalostomy in POAG patients. However, the complication rate was lower in the viscocanalostomy group.

Adult↗
PubMed2004

Outcome of complex retinal detachment surgery after silicone oil removal.

BACKGROUND AND OBJECTIVE: To evaluate anatomical prognosis after silicone oil removal. PATIENT AND METHODS: Sixty-eight eyes which underwent silicone oil removal were enrolled into the study. The underlying ocular pathology for pars plana vitrectomy, surgical methods, and time of silicone oil removal were analysed. RESULTS: Sixteen of 68 eyes (23.5%) redetached following the removal of silicone oil. According to etiology redetachment rates: PVR C 9.5% (2/21), PVR D 25% (4/16), trauma without intraocular foreign body 27.3% (3/11), with intraocular foreign body 33.3% (2/6), giant retinal tear 37.5% (3/8), and proliferative diabetic retinopathy with tractional retinal detachment 33.3% (2/6). The rate of redetachment was 22% in patients with encircling band and 27.8% without encircling band. Retina was redetached in the first 10 days in 81.3% of patients after silicone oil removal. CONCLUSION: The residual vitreoretinal traction especially at the vitreous base is the most likely reason for retinal redetachment after silicone oil removal, which is most commonly seen during the first 10 days.

Adolescent↗
PubMed2004

Trabeculectomy with mitomycin-C in uveitic glaucoma associated with Behçet disease.

PURPOSE: To determine the effect of intraoperative application of Mitomycin-C (MMC) with trabeculectomy in uveitic glaucoma associated with Behçet disease. MATERIALS AND METHODS: Twenty-six eyes of 26 patients with uveitic glaucoma associated with Behçet disease who underwent trabeculectomy with MMC between 1996 and 2001 were reviewed in this retrospective, noncomparative study. Trabeculectomy + MMC in concentration of 0.4 mg/mL for 3 minutes was performed to all patients. Main outcome measures were control of IOP, the number of antiglaucoma medications required to achieve the desired IOP, visual acuity and complications. The surgical success was defined as IOP less than 22 mm Hg and greater than 5 mm Hg without additional further glaucoma surgery or loss of light perception. RESULTS: The cumulative probability of success was 83.3% at 1 year, 76.2% at 2 years, 70% at 3 years, 66.7% at 4 years and 62.5% at 5 years after surgery. The mean follow-up was 40.0+/-18.0 months. At last follow-up 23% of the patients required no antiglaucoma medications. Best-corrected visual acuity improved or remained within two lines of preoperative visual acuity in 19 eyes (73.1%). Glaucomatous (1 eye 3.8%) and nonglaucomatous optic atrophy (3 eyes 11.5%) was the most frequent reason for visual decrease (total 4 eyes 15.2%). The most common complications were cataract formation in 6 eyes (23.1%), bleb leakage in 4 eyes (15.3%) and choroidal effusion in 3 eyes (11.5%). Phthisis bulbi was found in one (3.8%) patient. CONCLUSION: Trabeculectomy and intraoperative application of MMC appears to provide long term safety and effectiveness in uveitic glaucoma associated with Behçet disease.

Adolescent↗
PubMed2003

Penetration of topically applied ciprofloxacin and ofloxacin into the aqueous humor and vitreous.

PURPOSE: To determine the intraocular penetration of topical drops of 2 antibiotics, ciprofloxacin 0.3% and ofloxacin 0.3%, into the aqueous humor and vitreous and to relate these levels to the miminum inhibitory concentration (MIC(90)) for organisms associated with ocular bacterial infections. SETTING: Department of Ophthalmology, Ankara Hospital, and Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. METHODS: This prospective randomized clinical trial comprised 18 patients having cataract surgery, all with an intact corneal epithelium. The patients were randomly assigned to receive topical ciprofloxacin 0.3% (n = 10) or topical ofloxacin 0.3% (n = 8) 1 drop every 15 minutes 5 times and every 30 minutes 3 times before surgery. Aqueous and vitreous samples (if vitreous loss occurred during the cataract surgery) were collected 30 minutes after the administration of the last dose. Drug concentrations were determined by high-performance liquid chromatography (HPLC) fluorescence. RESULTS: All patients had detectable drug concentrations in the aqueous humor and vitreous measurable by HPLC. The mean aqueous humor concentration of ciprofloxacin was 1.13 microg/mL +/- 1.90 (SD) and the mean vitreous concentration, 0.23 +/- 0.06 microg/mL. Topical administration of ciprofloxacin yielded 4.9 times more drug concentration in the anterior chamber than in the vitreous. The mean aqueous concentration of ofloxacin was 2.06 +/- 1.06 microg/mL and the mean vitreous concentration, 0.46 +/- 0.10 microg/mL. Topical administration of ofloxacin yielded 4.7 times more drug concentration in the anterior chamber than in the vitreous. Aqueous humor concentrations of ofloxacin and ciprofloxacin were not statistically significantly different (P =.353). Intravitreal concentrations of ofloxacin were statistically significantly higher than those of ciprofloxacin (P =.001). CONCLUSIONS: Topical ofloxacin 0.3% penetrated better than topical ciprofloxacin 0.3% into the anterior chamber and vitreous in noninflamed eyes. Both drugs were above the MIC(90) for most ocular pathogens in the anterior chamber. The mean concentration in the vitreous of topically applied ofloxacin 0.3% was statistically significantly higher than that of ciprofloxacin 0.3%, but it was not sufficiently above the MIC(90) for most ocular pathogens in terms of empirical endopthalmitis therapy.

Administration, Topical↗
PubMed2003

Hemorrhagic Descemet's membrane detachment after viscocanalostomy.

We report a case of hemorrhagic detachment of Descemet's membrane after viscocanalostomy. A 60-year-old man with pseudoexfoliative glaucoma had an uneventful viscocanalostomy in the right eye. On the first postoperative day, a 5.0 mm x 5.0 mm Descemet's membrane detachment was present in the superior nasal quadrant. The space between Descemet's membrane and the stroma was filled with a hemorrhage. The hemorrhage resorbed by 6 months postoperatively, and Descemet's membrane completely reattached without surgical manipulation. The final visual acuity dropped from 20/40 to 20/100, final intraocular pressure was 20 mm Hg with 1 medication, and a paracentral fibrinoid scar persisted 18 months after surgery. Hemorrhagic detachment of Descemet's membrane can cause visual acuity deterioration and should be recognized as a rare complication of viscocanalostomy.

Corneal Diseases↗
PubMed2003

Squamous cell carcinoma of the lacrimal sac.

The clinical and histopathological findings in a 40-year-old man with a lacrimal sac tumor are reported. Although the clinical history indicated a lacrimal sac obstruction and recurrent dacryocystitis, the lesion was diagnosed by light microscopy as a squamous cell carcinoma.

Adult↗
PubMed2002

Against-the-rule (ATR) astigmatism as a predicting factor for the outcome of amblyopia treatment.

PURPOSE: To evaluate whether with-the-rule (WTR) or against-the-rule (ATR) astigmatism influences the treatment outcome of anisometropic amblyopia. DESIGN: A cohort study. METHODS: Retrospective study of patients with unilateral amblyopia due to anisometropia without strabismus. Ninety-eight patients with simple, compound, mixed, oblique myopic, and hyperopic astigmatism were divided into seven groups based on the type of astigmatism. The groups were reviewed as to the amount of anisometropia, duration of occlusion, and best-corrected visual acuity (BCVA) before and after treatment. RESULTS: There was statistically significant longer duration of occlusion and less lines gain of BCVA among patients with hyperopic ATR astigmatism compared with patients with hyperopic WTR astigmatism (P =.0143 and P =.0000, respectively) and myopic ATR patients compared with myopic WTR patients (P =.0392 and P =.0192, respectively). For the same parameters, group differences were also statistically significant when all hyperopic or myopic simple/compound/mixed ATR patients were compared with all hyperopic or myopic simple/compound/mixed WTR patients (P =.0015 and P =.0000, respectively). CONCLUSION: The outcome of amblyopia treatment seems to be less favorable in patients with either hyperopic or myopic ATR astigmatism. Near vision impairment may be more amblyogenic than distance vision impairment during visual development.

Amblyopia↗
PubMed2002

Management of rhegmatogenous retinal detachment without detectable breaks.

PURPOSE: To evaluate the causes of failure to find retinal breaks, the anatomical and functional outcomes of patients with rhegmatogenous retinal detachment (RD) without detectable breaks (Group I), to compare the results with detectable breaks (Group II). METHODS: Forty-five out of 258 eyes that had RD without detectable breaks were analysed retrospectively. RESULTS: The causes of failure to find retinal breaks were aphakia/pseudophakia in 22 eyes, small pupil without any eye disease in four eyes, corneal opacity in two eyes, cataract in two eyes, vitreous haze in two eyes, choroidal detachment in one eye, and unknown cause in 12 eyes. After a single scleral buckling procedure, anatomical re-attachment of the retina successfully occurred in 62.2% of group I and 78.9% of group II patients. After repeated surgery, final anatomical success rates were 87.2% and 90.2%, respectively. The best corrected visual acuity was 6/60 or better in 53.9% in Group I and 52.5% in Group II. CONCLUSION: The main cause of failure to find the retinal break was aphakia or pseudophakia. Although the rates of retinal reattachment in eyes without detectable breaks in primary buckling surgery was lower than detectable breaks and reoperations were required more frequently, final success rates were satisfactory and similar in both groups.

Adolescent↗
PubMed2002

Aqueous humor nitric oxide levels in patients with Behçet disease.

PURPOSE: The purpose of this study was to quantify aqueous humor nitric oxide levels in patients with Behçet uveitis and age-matched controls to assess how nitric oxide is involved in this ocular condition. METHODS: Samples of aqueous humor were collected from 11 patients with Behçet uveitis who were undergoing cataract surgery. Sampling was done by paracentesis at the beginning of the operation. Similar samples were collected from 20 age-matched normal patients (controls). For each sample, we used the spectrophotometric method based on the Griess reaction to determine the amount of nitrite, which is the stable metabolite of nitric oxide. RESULTS: The amount of nitrite in aqueous humor samples from patients with Behçet disease was above the detection limit in 8 of 11 cases; the mean level +/- SEM was 2.13 +/- 0.621 micromol/L. Levels in the control group were below the detection limit in all cases (<0.08 micromol/L). There was a statistically significant difference between the aqueous humor nitrite levels in patients with Behçet disease and those in controls (P = 0.00002). CONCLUSIONS: Aqueous humor nitric oxide levels are elevated in patients with a history of Behçet disease.

Adult↗
PubMed1999

Evaluation of findings in Crouzon's syndrome.

PURPOSE. The purpose of this study was to investigate the ocular, facial and radiological signs of Crouzon's syndrome in a group of older patients who had not undergone previous craniofacial surgery. METHODS. Six cases of Crouzon's syndrome, four of whom belonged to a three-generation family, were examined systemically, ophthalmologically and roentgenographically; five of these cases were additionally evaluated with computed tomography and compared with Apert syndrome. RESULTS. On radiologic evaluation, all cases had synostosis of all cranial sutures and fontanelles and brachycephalic skulls, crowding of the upper teeth due to maxillary hypoplasia, and serious nasal septum deviation. Bilateral ethmoidal, maxillary and sphenoidal chronic sinusitis was found in 50% of cases. Three patients had hypertelorism and two others had a tendency toward hypertelorism. The typical facial appearance with shallow orbits, globe protrusion and exorbitism was present in all cases. Two of them had V-pattern exotropia while the other four were orthophoric. The single case with mental retardation had bilateral cataract. CONCLUSION. Crouzon's syndrome can present with different findings and must be evaluated multidisciplinarly.

Journal Article↗
PubMedDate not supplied

Results of therapeutic penetrating keratoplasty.

PURPOSE: By a retrospective study of patients in the Ankara Hospital Eye Clinic, to determine the anatomical and visual results of therapeutic penetrating keratoplasty (PK) and its role in the management of corneal disease. METHODS: Therapeutic PK was performed in 36 patients (37 eyes) who had corneal perforation due to corneal disease (23 eyes) or eyes in which perforation was imminent (14 eyes). Initial indications for grafting were nonperforated descemetocele without inflammation (six eyes, 16.2%); nonperforated bacterial corneal ulcer (five eyes, 13.5%); nonperforated herpetic keratitis with active stromal inflammation (two eyes, 5.4%); acanthamoeba keratitis (one eye, 2.7%); perforation due to herpetic keratitis (13 eyes, 35.2%); perforation due to persistent epithelial defect (8 eyes, 21.6%); or perforation due to bacterial corneal ulcer (two eyes; 5.4%). The results were evaluated for each of the following criteria: anatomical integrity of the eye, cure of the disease, complications, graft clarity, and visual acuity. RESULTS: Anatomical integrity was achieved in 21 of the 23 eyes (91.3%) perforated from corneal disease. Therapeutic PK cured the disease in all bacterial keratitis cases. The proportion of clear grafts was 60.9% in the 23 eyes perforated from corneal disease, and 57.1% in the 14 eyes in which perforation was imminent. Fifteen eyes (40.5%) obtained a final visual acuity of 20/100 or better; five of these eyes were not yet perforated before the PK. CONCLUSIONS: Therapeutic PK is effective in the management of the eye with active uncontrolled infection or perforation from corneal disease. Approximately half of our patients maintained a clear graft at the last visit. Without therapeutic surgery, these eyes would have been lost.

Adolescent↗
PubMedDate not supplied

Colour Doppler imaging of superior ophthalmic vein in thyroid-associated eye disease.

PURPOSE: One of the possible etiologies of proptosis in patients with thyroid-associated eye disease is stated to be passive orbital venous congestion caused by the occlusive and constrictive changes of the superior ophthalmic vein (SOV). In an attempt to clarify the validity of this claim, quantitative information on the flow velocity of the SOV was obtained by colour Doppler imaging in 24 patients with thyroid-associated eye disease and compared with data from the control group. METHODS: On clinical examination, ocular motility, proptosis, soft tissue involvement, and the presence of optic neuropathy were evaluated. The interaction of these signs with the flow velocity of the SOV was investigated in conjunction with computed tomographic (CT) findings such as extraocular muscle enlargement, dilatation of the SOV, and apical crowding of the orbit. RESULTS: The mean blood flow velocity was significantly decreased in patients compared to the control group (P <.05). The CT measures that contributed to significant decreases in SOV blood flow velocity were apical crowding (P <.05) and the coexistence of horizontal and vertical extraocular muscle involvement (P <.05). Among the clinical measures, significant decreases could be attributed to soft tissue findings (P <.01) and to optic neuropathy (P <.05). CONCLUSIONS: External compression of the SOV may contribute to the SOV blood flow decrease in orbits afflicted with thyroid eye disease, but proptosis is not relevant to the SOV blood flow decrease.

Adult↗
PubMedDate not supplied

Amniotic membrane transplantation to reconstruct the conjunctival surface in cases of chemical burn.

PURPOSE: To evaluate the efficiency of preserved human amniotic membrane transplantation for conjunctival surface reconstruction in cases of chemical burn. METHODS: Preserved amniotic membrane transplantation was performed in 6 patients (6 eyes) having symblepharon and fornix insufficiency due to chemical burn. Amniotic membrane was sutured to the intact conjunctiva after the fibrotic tissue was excised. The fornix was reconstructed in cases having fornix insufficiency. These cases were followed up for 4-24 months. RESULTS: During the mean follow-up period (10+/-7.37 months) adequate bulbar conjunctiva and fornix depth was achieved in 5 patients without recurrence and with mild fibrosis. In 1 patient who did not have a healthy conjunctiva preoperatively, conjunctival fibrosis and symblepharon recurred. CONCLUSIONS: Preserved human amniotic membrane transplantation is a good alternative treatment method for conjunctival surface reconstruction in those cases with some healthy peripheral conjunctival tissue.

Adolescent↗