Ayhan Dursun

Miltefosine and polyhexamethylene biguanide: a new drug combination for the treatment of Acanthamoeba keratitis

In this study, a series of compounds – miltefosine, polyhexamethylene biguanide, chlorhexidine and propamidine isethionate – and combinations of the latter three agents with miltefosine were prepared and used in a rat model for the topical treatment of Acanthamoeba keratitis.

Comparison of the effects of bevacizumab and ranibizumab injection on corneal angiogenesis in an alkali burn induced model.

AIM To investigate the effects of bevacizumab and ranibizumab on corneal neovascularization in an alkali burn-induced model of corneal angiogenesis. METHODS Fifteen Wistar albino rats were divided randomly into 3 groups after chemical cauterization of the cornea. The first group received a single dose of 0.1mL saline solution as a control group whereas second and third groups received a single dose of 2.5mg bevacizumab or 1mg ranibizumab by subconjunctival injection, respectively. After three weeks, the rat corneas were evaluated by biomicroscopy and corneal photographs were taken. The percentage of neovascularization area, length of the longest new vessel, corneal edema and corneal opacity scores were assessed. RESULTS The analysis of digital photographs showed that the percentage of neovascularization area to the total corneal area, the length of the longest new vessel, corneal edema and opacity scores were significantly lower in both study groups compared to the control group (P<0.05). Additionally, the percentage of corneal neovascularization area, the length of the longest new vessel and corneal opacity score were less with bevacizumab than ranibizumab. CONCLUSION Subconjunctival bevacizumab and ranibizumab treatments may be effective methods in reducing corneal neovascularization. Furthermore, bevacizumab is more effective than ranibizumab in the inhibition of corneal neovascularization.

Total oxidative stress, paraoxonase and arylesterase levels at patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma

AIM To investigate the oxidative stress status of the aqueous humor and serum of patients with pseudoexfoliation (PEX) syndrome and pseudoexfoliative glaucoma (PEG) and to measure paraoxonase (PON) and arylesterase (ARE) levels. METHODS A total of 78 patients were enrolled in the study, with 26 patients in each separate group. The patients were divided into three groups: the first group entailed PEX syndrome patients, while the second group consisted of patients with PEG and the third group involved patients with no additional systemic diseases, other than the diagnosis of cataract as control. Total oxidative stress (TOS), total antioxidant capacity (TAC), PON, and ARE levels in aqueous humor and serum were measured. RESULTS TAC, PON and arylesterase levels in aqueous humor and serum of the PEX syndrome and PEG patients were significantly decreased compared with control group (P<0.05). TOS values were higher in patients with PEX syndrome and PEG than controls (P<0.05). TAC, PON and ARE levels of aqueous humor did not differ significantly between the PEX syndrome and PEG groups. CONCLUSION These findings are potentially of significance and add to the growing body of evidence for oxidative stress in PEX syndrome and PEG. Decreased antioxidant defense and increased oxidative stress system may play an important role in the pathogenesis of PEX syndrome and PEG.

The Association between Diabetic Retinopathy and Levels of Ischemia-Modified Albumin, Total Thiol, Total Antioxidant Capacity, and Total Oxidative Stress in Serum and Aqueous Humor.

Purpose. To investigate the oxidant and antioxidant status of patients with type 2 diabetes mellitus and nonproliferative diabetic retinopathy (DRP). Methods. Forty-four patients who had cataract surgery were enrolled in the study. We included 22 patients with DRP in one group and 22 patients in the control group. Samples of aqueous humor and serum were taken from all patients. Serum and aqueous ischemia-modified albumin (IMA), total thiol, total antioxidant capacity (TAC), and total oxidative stress (TOS) levels were compared in two groups. Results. Median serum IMA levels were 44.80 absorbance units in the DRP group and 40.15 absorbance units in the control group (P = 0.031). Median serum total thiol levels in the DRP group were significantly less than those in the control group (3051.13 and 3910.12, resp., P = 0.004). Mean TOS levels in the serum were 2.93 ± 0.19 in the DRP group and 2.61 ± 0.26 in the control group (P = 0.039). The differences in mean total thiol, TAC, and TOS levels in the aqueous humor and mean TAC levels in the serum were not statistically significant. Conclusion. IMA, total thiol, and TOS levels in the serum might be useful markers in monitoring the risk of DRP development.

The prevalence of exfoliation syndrome in Turkey

To investigate the prevalence of the exfoliation syndrome and its relationship with ocular and cardiovascular diseases in the Central Anatolia region of Turkey.

Association of neutrophil/lymphocyte ratio and retinal vein occlusion

Purpose To evaluate the association between neutrophil/lymphocyte ratio (NLR) and the development of retinal vein occlusion (RVO). Methods Forty patients were included in the study. Forty age- and sex-matched healthy volunteers were recruited as the control group. The RVO diagnosis was made clinically, based on the findings of fundus examination. The NLR and file records of the patients and the control group were compared. Results The mean age of patients was 64 ± 12 years. Neutrophil levels were higher in RVO patients compared to the control subjects (5.1 ± 1.9 vs 3.6 ± 1.0, p<0.001). Lymphocyte levels were lower in RVO patients compared with the control subjects (2.0 ± 0.7 vs 2.6 ± 0.9, p = 0.005). The NLR was significantly higher in RVO patients compared with the control subjects (3.0 ± 2.7 vs 1.5 ± 0.3, p<0.001). According to the receiver operator characteristics curve analysis, the optimal cutoff value of NLR to predict RVO was >1.89, with 72.5% sensitivity and 100% specificity. Conclusions The current study demonstrated that higher NLR was associated with the development of RVO. The NLR may be used as a predictive tool for identifying risk for RVO.

Apoptotic effects of topical antiglaucoma medications on conjunctival epithelium in glaucoma patients.

Purpose In this study, we aimed to investigate the apoptotic effects of topical antiglaucoma medications on the conjunctival epithelium. Methods A total of 65 patients were included in the study. Thirty patients were included in the first group who had received antiglaucomatous therapy before trabeculectomy. In the second group, 20 patients who had received no drugs before trabeculectomy were included, while the third group underwent only cataract surgery as control. During the surgery, 2 × 4 mm conjunctival samples were harvested from the upper bulbar conjunctiva. The mean apoptosis rate was calculated by determining apoptosis at conjunctival epithelium using the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) method. Results The mean apoptosis rate was 0.537 ± 0.369 (0.026 ± 0.962) in group 1, 0.139 ± 0.162 (0.005 ± 0.676) in group 2, and 0.078 ± 0.035 (0.035 ± 0.142) in the control group (group 3). The mean apoptosis rate was significantly higher in the first group than the other 2 groups (p = 0.0001). Conclusions Apoptotic effects of topical antiglaucoma drugs on the conjunctival epithelial cells were found. However, our results revealed that the number of medications, duration of medication, and type of glaucoma had no effect on the apoptotic effect.

Evaluation of Choroidal Thickness in Patients with Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

Purpose. To compare the macular and peripapillary choroidal thickness in eyes with pseudoexfoliation (PEX) syndrome and PEX glaucoma with the normal eyes of healthy controls. Materials and Methods. In this prospective study, 30 eyes of 30 patients with PEX syndrome, 28 eyes of 28 patients with PEX glaucoma, and 30 eyes of 30 age-matched healthy subjects were enrolled. Choroidal thicknesses in the macular and peripapillary areas were measured by using spectral domain optical coherence tomography. Results. Gender, age, and axial length did not significantly differ between the groups (all, p > 0.05). The mean values of choroidal thickness in the macular and peripapillary areas (except the superior quadrant) in the patients with PEX syndrome and PEX glaucoma were lower compared with controls (all p < 0.05). The mean values of the macular and peripapillary choroidal thickness in the PEX glaucoma group were lower compared with PEX syndrome group; however this difference was not significant. Conclusions. The findings of this study revealed that macular and peripapillary choroidal thicknesses were decreased in PEX syndrome and PEX glaucoma cases. The role of choroid in the development of glaucomatous damage in patients with PEX syndrome remains unclear.

Evaluation of inner and outer retinal thickness in patients receiving intravitreal ranibizumab injections for diabetic macular edema.

Purpose To measure inner and outer retinal thickness with optical coherence tomography (OCT) in patients in whom intravitreal ranibizumab was administered due to diabetic macular edema (DME) and to investigate its relation to the visual prognosis. Methods In this retrospective case series, there were 60 consecutive eyes with DME in which intravitreal ranibizumab injection was performed for 3 times in 1-month intervals. All patients underwent full ophthalmic examination and spectral-domain OCT (SD-OCT). The total retinal thickness, the inner thickness, and the outer thickness in 4 parafoveal subfields were measured. The correlation between the retinal thickness and logMAR best-corrected visual acuity (BCVA) was investigated. Results No significant correlation was found between the total retinal thickness in the central and other subfields and either the baseline or final visit logMAR BCVA values (p>0.05). There was a significant positive correlation between the final visit logMAR BCVA values and pretreatment inner retinal thickness in the nasal and inferior subfields (r = 0.270, p = 0.037, and r = 0.410, p = 0.001, respectively). There was significant negative correlation between the final visit logMAR BCVA values and pretreatment outer retinal thickness in nasal and temporal parafoveal subfields (r = −0.297, p = 0.021, and r = −0.268, p = 0.038, respectively). Conclusions It could be beneficial to use inner and outer retinal thickness instead of total retinal thickness in determination of short-term prognosis in patients who had intravitreal ranibizumab injection for DME.

Safety of Polyacrylamide 1.5% Left in Anterior Chamber in Combined Phacoemulsification and Pars Plana Vitrectomy Surgery.

ABSTRACT Purpose: To evaluate safety, efficacy and postoperative characteristics of polyacrylamide 1.5% ophthalmic viscosurgical device (OVD) left in anterior chamber during and at the end of combined phacoemulsification and pars plana vitrectomy surgery. Materials and Methods: This prospective study comprised 20 eyes that received combined phacoemulsification and pars plana vitrectomy performed by the same surgeon. Polyacrylamide 1.5% was left in anterior chamber at the end of the surgery. Preoperative and postoperative examinations (4, 12 and 24 hours; 14 days; 1 and 3 months) included measurement of intraocular pressure (IOP), central corneal thickness (CCT), endothelial cell density and assessment of any ocular adverse reactions. Results: Four of the 20 patients (20%) showed increased IOP at hours postoperatively and needed medical treatment for IOP control. There was no significant difference in IOP between the preoperative visit and postoperative 3 months (p > 0.05). CCT measurements were similar between preoperative and postoperative visits (p > 0.05). A mean endothelial cell density loss of 6.7% was observed at postoperative day 14, however there was no change after this visit. Conclusion: Polyacrylamide 1.5% is safe, well-tolerated and protective in eyes undergoing combined phacoemulsification and pars plana vitrectomy.