Gürkan Zorlu

Effect of Pregnancy on Intraobserver and Intertechnique Agreement in Intraocular Pressure Measurements

Aim: To evaluate the effect of pregnancy on intraobserver and intertechnique agreement for intraocular pressure (IOP) measurements. Material and Methods: Right eyes of 88 healthy women who were likely to become pregnant and of 94 healthy age-matched females were included in the study. Complete ocular examinations were performed on each eye. IOP measurements were obtained by Goldmann, Schiötz and non-contact tonometers (NCT) during 3-week exam periods before (within 6 weeks of conception) and during pregnancy (first, second and third trimesters) for pregnant cases, and in similar time intervals for control subjects. In each exam period, three readings with each of three separate tonometers were obtained, at least 1 day apart. Intraobserver and intertechnique agreements for IOP measurements were assessed. Results: The mean visual acuity, keratometry and refractive error of both control and pregnant subjects did not change significantly during the study (all p values >0.01). In late pregnancy, pregnant cases demonstrated significant decreases in IOP measurements obtained with each of the three tonometers, and in intraobserver agreement with Goldmann and Schiötz tonometers (all p values <0.01). Intertechnique agreement of both Goldmann and Schiötz tonometers with NCT decreased significantly in the third trimester. Both intraobserver and intertechnique agreement in IOP measurements of control subjects were not found to change significantly during the study (all p values >0.01). Conclusion: IOP significantly decreased in the third trimester of pregnancy. Perfect intraobserver agreement in IOP readings of pregnant subjects was obtained with NCT. This may suggest that NCT is a viable option for IOP measurements during the follow-up of pregnant patients at risk for glaucoma.

Polycystic ovaries in association with müllerian anomalies

The polycystic ovary syndrome, whose etiopathogenesis is not clearly understood, has a wide spectrum of clinical presentations, and may co-exist with other pathologic conditions. In this study, we evaluated the prevalence of ultrasound-defined polycystic ovaries (PCO) in patients with müllerian anomalies (n = 167), and those without müllerian anomalies (n = 3165) from 1990 to 1994, in a population markedly composed of infertility patients. PCO were found in 50 (29.9%) patients in the study group, compared to 637 (20.1%) patients in controls (P < 0.01). Müllerian anomalies were further grouped according to the American Fertility Society (AFS) classification and it was found that patients with the septate uteri and bicornuate uteri malformations had a higher prevalence of PCO than the controls (P < 0.001, P < 0.05, respectively). Although a difference existed in the percentage of PCO in patients with unicornuate uteri and didelphic uteri compared to controls, this difference did not reach statistical significance (P > 0.05). We conclude that, as PCO are more prevalent in certain müllerian anomalies, an embryogenetic defect may also be involved in the etiopathogenesis of PCO.

Endocrinological and Clinical Analysis of Hyperprolactinemic Patients with and without Ultrasonically Diagnosed Polycystic Ovarian Changes

In the present study we aimed to identify the relationship of hyperprolactinemia and polycystic ovarian changes. We retrospectively analyzed the endocrinological and clinical features of 79 hyperprolactinemic patients detected during a 3-year period ending in March 1995. Patients who had hypothyroidism, macroprolactinoma and drug-induced hyperprolactinemia were excluded from the study. Among 61 hyperprolactinemic patients, 41 (67.2%) had ultrasonographically diagnosed polycystic ovaries (PCO). Prolactin levels in the PCO and non-PCO groups were 32.8 +/- 5.8 and 36.7 +/- 5.1 ng/dl, respectively, which was a significant difference (p < 0.05). Hirsutism was associated with hyperprolactinemia in 55.7% of the patients and was found to be more frequent in the PCO (58.8%) than the non-PCO group (41.2%). The mean Ferriman Gallwey scores and both total and free testosterone levels were significantly higher in the PCO group in comparison to the non-PCO group. In addition, a significantly higher body mass index was detected in patients with PCO. We documented a frequent association between hyperprolactinemia and polycystic ovarian changes and suggested that hyperprolactinemia in PCO is most likely related to a pathologic-endocrinologic milieu.

Menstrual cycle dependent changes in blue‐on‐yellow visual field analysis of young diabetic women with severe non‐proliferative diabetic retinopathy

Purpose: To evaluate menstrual cycle dependent changes on blue‐on‐yellow visual fields of diabetic women, and to compare the results with those of healthy women.