Cengiz Akarsu

Color Doppler imaging in ocular hypertension and open-angle glaucoma

PurposeTo quantify the retrobulbar hemodynamics of patients with ocular hypertension and open-angle glaucoma and to compare it with that of normal subjects.MethodsNineteen eyes of 19 ocular hypertensive patients, 19 eyes of 19 open-angle glaucoma patients and 19 eyes of 19 normal subjects were recruited from our clinic and underwent color Doppler imaging evaluation of the ophthalmic, posterior ciliary, and central retinal arteries. The peak systolic and end-diastolic blood flow velocities and resistivity indices of all retrobulbar vessels were measured.ResultsThe retrobulbar blood flow velocities were lower and resistivity indices were higher in all retrobulbar vessels in ocular hypertensive patients than in normal subjects. The differences, however, did not reach statistical significance (P>0.05). Glaucoma patients had lower end-diastolic velocities and higher resistivity indices than did normal subjects in the ophthalmic (P=0.003 and P=0.003, respectively), posterior ciliary (P=0.001 and P<0.001, respectively), and central retinal arteries (P=0.03 and P=0.04, respectively). Glaucoma patients had significantly lower end-diastolic velocity and higher resistivity index than did patients with ocular hypertension in the posterior ciliary artery (P=0.04 and P=0.001, respectively).ConclusionsThis study suggests that ocular hypertensive patients have more normal blood flow than do glaucoma patients, because all retrobulbar homodynamic measurements in ocular hypertension range between glaucoma and normal subjects. On the other hand, glaucoma is associated with blood-flow velocity reduction and resistivity index elevation in all retrobulbar arteries.

Postoperative 5‐fluorouracil versus intraoperative mitomycin C in high‐risk glaucoma filtering surgery: extended follow up

Purpose: To compare the long‐term efficacy and safety of postoperative subconjunctival 5‐fluorouracil (5‐FU) injections with that of intraoperative mitomycin C (MMC) in eyes at high risk for failure of trabeculectomy.

Color Doppler imaging in optic neuritis with multiple sclerosis

PurposeTo evaluate the retrobulbar hemodynamics in eyes with optic neuritis with multiple sclerosis and to compare these values with those of the unaffected fellow eyes and healthy control eyes.MethodsThirty-four eyes of 17 patients with unilateral optic neuritis and multiple sclerosis and 16 eyes of 16 normal healthy subjects were recruited from the Departments of Ophthalmology and Neurology. The peak systolic and end-diastolic blood flow velocities and resistivity indices of the ophthalmic artery, posterior ciliary arteries and central retinal artery were measured in each eye with optic neuritis, using color Doppler imaging. Then, they were compared with those of the unaffected fellow eyes and healthy control eyes using paired and unpaired Student’s t-tests, respectively.ResultsThe mean retrobulbar blood flow velocities and mean resistivity index in the ophthalmic artery in the eyes with optic neuritis were not significantly different from the unaffected fellow eyes and healthy control eyes, as well (P>0.05). The mean end-diastolic blood flow velocity in the central retinal artery (P=0.04) was lower and mean resistivity indices in the central retinal (P=0.02) and posterior ciliary arteries (P=0.009) were higher in the eyes with optic neuritis than in the control eyes. In patients with multiple sclerosis, the eyes with optic neuritis had higher resistivity indices in the posterior ciliary (P=0.02) and central retinal arteries (P=0.04) than did the unaffected fellow eyes. The retrobulbar blood flow velocities and resistivity indices of all vessels in the unaffected fellow eyes did not significantly differ from the control eyes (P>0.05).ConclusionsThis study suggests that optic neuritis with multiple sclerosis is associated with impaired retrobulbar hemodynamics, especially in the posterior ciliary and central retinal arteries when compared with the contralateral unaffected eyes as well as healthy control eyes.

Short‐term effect of latanoprost on ocular circulation in ocular hypertension

Purpose: To determine the short‐term effects of latanoprost on retrobulbar circulation in ocular hypertension.

Bilateral Optic Neuritis After Influenza Vaccination

Optic neuritis is a rare complication of vaccination. We report a 55-year-old woman who presented with bilateral optic neuritis following influenza vaccination. The patient has typical features of acute optic neuritis with acute visual loss, periocular pain, visual defects, full recovery of vision after 6 months, and the absence of deterioration after withdrawal of corticosteroids. Considering the absence of oligoclonal bands in the cerebrospinal fluid analysis and the nonexistence of lesions resembling multiple sclerosis (MS) in cranial magnetic resonance imaging, the case at present does not appear to be associated with MS.

Effect of oxymetazoline nasal spray on intraocular pressure and retrobulbar hemodynamics

OBJECTIVES To determine the effect of oxymetazoline nasal spray on intraocular pressure and retrobulbar hemodynamics in patients with open-angle glaucoma and to compare the results with those measured in healthy control participants. STUDY DESIGN Controlled, prospective clinical trial. SETTING University hospital. METHODS Thirty patients with open-angle glaucoma and 30 healthy volunteers as controls were topically self-administered oxymetazoline nasal spray three times a day (one spray in each nostril of 0.05% concentration) for 5 days continuously. MAIN OUTCOME MEASURES Intraocular pressure and retrobulbar hemodynamics were measured in glaucomatous and normal eyes at baseline and at the end of oxymetazoline application . RESULTS Oxymetazoline nasal spray lowered intraocular pressure significantly in both the glaucoma group (p = .02) and the control group (p = .001) after 5 days of treatment. The systemic parameters in the glaucoma and control groups (systolic blood pressure, p = .14 and p = .17; diastolic blood pressure, p = .18 and p = .49; and pulse rate, p = .06 and p = .50, respectively) did not show statistically significant differences during the study period. Additionally, except with a significant decrease in the resistivity index of the central retinal artery in the glaucoma patients (p = .001), oxymetazoline nasal spray did not result in any significant changes in the retrobulbar hemodynamics in both the glaucoma and control groups. CONCLUSIONS This study showed that a 5-day treatment with oxymetazoline nasal spray reduced intraocular pressure in both healthy controls and patients with glaucoma under treatment. In addition, it had no significant adverse effects on the retrobulbar hemodynamics.