Ahmet Temel

Short-wavelength automated perimetry in patients with migraine

BackgroundThe aim was to investigate short-wavelength sensitivity deficits in patients with migraine.MethodsFifteen migraine and 18 age-matched healthy volunteers with normal ophthalmologic examination participated in this study. Migraine characteristics were graded by the Migraine Disability Assessment Questionnaire (MIDAS). All participants underwent SWAP (short wavelength amplitude perimetry) testing using a Humphrey field analyzer; there was a 30-2 presentation pattern.ResultsShort wavelength amplitude perimetry parameters for mean deviation (MD; p<0.0001) and pattern standard deviation (PSD; p<0.0001) were significantly worse in the migraine group. In the migraine group 53.3%. of eyes had glaucoma hemi-field tests (GHT) outside normal limits and 10 of these had early glaucomatous visual field loss. Statistically significant correlations were found between frequency of migraine attacks and MD (p=0.02; r=0.56) and PSD (p=0.03; r=0.41) and also between the MIDAS score and MD (p=0.03; r=0.49) and PSD (p=0.04; r=0.51). In all migraine cases with early glaucomatous visual field defect a corresponding site of the head was predominantly involved in headache (p=0.03).ConclusionSome patients with severe migraine have earlier defects on SWAP suggesting a common vascular insult of glaucoma and migraine, and all migraine cases with high MIDAS scores should be further evaluated for early glaucomatous visual field defects using SWAP.

Corneal sensitivity changes in long-term wearing of hard polymethylmethacrylate contact lenses.

The effect on corneal sensitivity of years of wearing hard contact lenses was evaluated in 20 subjects who had worn polymethylmethacrylate (PMMA) lenses for up to 20 years. An age- and sex-matched group of 20 eyes was used as the control group. It was found that corneal sensitivity diminished significantly in wearers of PMMA contact lenses. This reduction of corneal sensitivity was found to be most prominent centrally and was markedly related with the duration of PMMA contact lens use. The loss of corneal sensitivity due to wearing contact lenses increases the risk of a silent infection.

Influence of serum levels of sex hormones on intraocular pressure in menopausal women.

PurposeThe purpose of this study was to assess the effect that changes in sex hormone levels have on intraocular pressure (IOP) in menopausal women. Subjects and MethodsThirty menopausal women on hormone replacement therapy and 32 menopausal women who had never received hormone replacement therapy (HRT), matched for age and duration of amenorrhea, participated in this study. Intraocular pressures were measured with Goldmann applanation tonometer. Serum levels were measured for estradiol, free testosterone, and follicle stimulating hormone (FSH). The influence of serum hormone levels on IOP was assessed by correlation analysis. ResultsThe mean IOP of postmenopausal women receiving HRT (13.29 ± 2.28 mm Hg) was not significantly different from that of menopausal women not receiving HRT (13.56 ± 2.5 mm Hg, P = 0.24). Higher testosterone levels were associated with higher IOPs in women receiving HRT (r = 0.48, P = 0.02) and in those not receiving HRT (r =0.42, P = 0.003). No significant correlations were observed between IOP and serum levels of estradiol and FSH in either group. ConclusionOur data provide evidence for a relation between serum testosterone levels and IOP in menopause. Higher testosterone seems to have a tendency to increase IOP in menopausal women.

The choroid and lamina cribrosa is affected in patients with Parkinson's disease: enhanced depth imaging optical coherence tomography study

To compare lamina cribrosa (LC) and choroidal thicknesses using enhanced depth imaging optical coherence tomography (EDI‐OCT) in patients with Parkinsons disease (PD) and healthy controls.

Low vision aids (evaluation of 185 patients).

One hundred and eighty‐five referred patients with various eye pathologies were evaluated retrospectively after they had undergone an examination and issued with a prescription for low vision. The majority of patients (77%) benefited from the prescribing of low vision aids (LVA). Spectacle‐mounted magnifiers, high reading additions and telescopes were used as LVAs. Visual acuity, age and magnification are important factors in the assessment of an LVA.

Hypotonic Maculopathy after Trabeculectomy with Postoperative Use of 5-Fluorouracil

We evaluated two patients who developed hypotonic maculopathy following trabeculectomy and adjunctive 5-fluorouracil injections. Both patients had ocular hypotony and decreased visual acuity following these injections. The first case showed marked choroidal foldings, retinal striae, increased retinal vascular tortuosity, engorgement and optic disc oedema. The second case had radial perifoveal retinal striae, increased retinal vascular tortuosity and engorgement. The first patient regained pre-operative visual acuity while the second case had a visual acuity of 20/25 without any intervention. Fundus changes were less marked 12 months after initial evaluation in both cases. Hypotonic maculopathy is a reversible complication of trabeculectomies with adjunctive use of 5-fluorouracil.

Detection of hepatitis B surface antigen in aqueous humor.

Abstract We detected hepatitis B surface antigen (HBsAg) in tears and aqueous humor of 18 patients who upon preliminary examination were seropositive for HBsAg and were scheduled to undergo cataract extractions. HBsAg remained detectable in the serum of 10 of these patients on the day of operation, and of these, 7 were found to have detectable levels of HBsAg in their tears and aqueous humor. Based on our findings, we caution ophthalmologists to take all the necessary precautions in both surgical and nonsurgical treatment of patients at high risk for hepatitis B infection.

Comparison of Optical Coherence Tomography Findings in Patients With Primary Open-angle Glaucoma and Parkinson Disease.

Purpose:To evaluate the peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex, and macular thickness as well as their correlation with the severity of diseases. Materials and Methods:This is a cross-sectional study and comparing both eyes of 26 patients with primary open-angle glaucoma, 25 patients with Parkinson disease (PD), and 23 healthy subjects. RNFL, ganglion cell complex, and macular thickness were measured and analyzed with optical coherence tomography (OCT) in all cases and correlation with severity of the disease was assessed in PD group. Results:The mean RNFL of PD was significantly thinner compared with controls (P=0.002). In glaucoma group, the mean RNFL was significantly thinner (96.28±12.49 &mgr;m) than PD (105.43±13.45 &mgr;m) and the controls (113.75±8.53 &mgr;m) (P<0.001; P<0.001, respectively). The global loss volume (GLV) rates in the glaucoma and PD group were significantly higher than controls, respectively (P=0.006; P<0.001/P=0.002, P=0.013). However, the GLV rate was significantly lower in PD group compared with glaucoma group (P=0.001). There was no significant correlation between OCT measurements and disease duration or severity in the PD patients. Conclusions:Although RNFL thickness and GLV changes may show the ganglion cell loss in both disease but none of the OCT parameters are correlated with the severity of PD. OCT may help to reveal the ganglion cell damage but may not help in determination of severity during the clinical follow-up of PD patients.

Low-Vision Aids in Stargardt’s Disease

The use of low-vision-aids (LVAs) to improve distance and near visual acuity was evaluated in 27 patients. Most of the patients had a useful distance vision with or without glasses, and 24 patients (89%) were prescribed a near visual aid successfully. The high success rate was attributed to young age, strong motivation and myopic refractive error of these patients. We recommend the trial of LVAs to patients with Stargardts disease who have visual difficulties.

Effect of the application of acetazolamide soaked contact lenses on intraocular pressure of rabbits.

Topical application of acetazolamide has no known effect on intraocular pressure (IOP). We tried to detect the hypotensive effect on IOP of acetazolamide soaked onto soft contact lenses (CL). We applied CLs soaked in either 1%, 3%, or 5% acetazolamide solution onto one eye of 29 rabbits while the contralateral eye served as a control. There was an average 32% reduction of IOP amongst all acetazolamide applied eyes, and an average 19% reduction of IOP amongst all control eyes. Amongst the 1% acetazolamide-CL applied eyes there was a mean 37% reduction of IOP, amongst the 3% acetazolamide-CL applied eyes a mean 36% reduction, amongst the 5% acetazolamide-CL applied a mean 30% reduction, and a mean 19% reduction in control eyes. The longest period of IOP reduction followed the application of 1% acetazolamide-CLs, probably owing to improved drug corneal penetration at this concentration. Our results reveal that the application of acetazolamide soaked soft CLs has a significant hypotensive effect on IOP in both the applied and contralateral control eyes of rabbits.