Kadri Cemil Apaydin

Is Smoking a Risk Factor in Ocular Behçet Disease

Abstract Purpose: To investigate the association between smoking and prognosis of ocular Behçet disease. Material/Methods: Medical records of 202 patients with Behçet uveitis were collected retrospectively. Patients were assigned to two groups according to smoking habits. In group I, 72 patients were current smokers. In group II, 130 were nonsmokers. The localization of uveitis, time to resolution of uveitis, time to recurrences, visual acuities, and presence of cystoid macular edema were compared between groups. Results: The demographic characteristics were similar in both groups. Smoking was not associated with types of uveitis with OR of 1.01 (95% CI, 0.99–1.04; p = 0.21) for anterior uveitis, 0.96 (95%CI, 0.90–1.02; p = 0.18) for posterior uveitis, and 1.80 (95% CI, 0.75–2.77; p = 0.24) for panuveitis. The average times to inflammation resolution were 48 ± 10.1 days in group I and 51 ± 14 days in group II (p = 0.82). The average times to recurrence were 8.6 ± 5 months for smokers and 9.1 ± 7 months for nonsmokers (p = 0.43). Patients with CME in groups were 18 (25%) and 42 (32.3%), respectively (p = 0.08). Conclusions: Our findings suggest that smoking does not have a negative effect on the clinical findings and prognosis of uveitis in Behçet disease.

An uncommon ocular manifestation of Sweet syndrome: peripheral ulcerative keratitis and nodular scleritis

Sweet syndrome (acute febrile neutrophilic dermatosis) is characterized by fever, neutrophilic leukocytosis, and abrupt appearance of painful erythematous nodules and plaques, particularly on the face, neck, and limbs. In this study, we report a very rare case of Sweet syndrome in which the patient presented nodular scleritis and peripheral ulcerative keratitis during the dermatologically inactive period of the disease.

A case report of bilateral choroidal metastases of epithelial carcinoma of pancreas

A 49-year-old woman with acute loss of vision in her left eye was examined in our clinic. Two months before arriving at out clinic, she was diagnosed with pancreatic endothelial carcinoma. Her visual acuities were 20/20 for the right and 20/200 for the left eye. Fundus examination and fundus fluorescein angiography showed bilateral subretinal solitary mass. Multiple metastases to lung, pleura, liver, spleen, and abdominal lymph nodes were detected during the initial diagnosis. The patient underwent chemotherapy during the period when the visual symptoms were observed. No additional treatment was offered because of the extent of the disease and poor general health. Although pancreatic endothelial carcinoma usually spreads to the abdominal visceral organs and lungs, choroidal metastases are rarely observed.

Comparison of Efficacy and Safety of Loteprednol Etabonate 0.5% and Topical Dexamethasone 1% in Post-Vitrectomy Inflammation

ABSTRACT Purpose: To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV). Methods: A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups. Results: The mean IOP was higher in the patients treated with DEX (p > 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p < 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005). Conclusions: Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.

The Expression of GDF-15 in the Human Vitreous in the Presence of Retinal Pathologies with an Inflammatory Component.

Abstract Purpose: The presence of growth differentiation factor-15 (GDF-15), a protein implicated in the regulation of the inflammatory response, was investigated in the vitreous of patients with vitreoretinal disorders. Methods: Vitreous and plasma samples were collected from patients with idiopathic epiretinal membrane (IERM), macular hole (MH), rhegmatogenous retinal detachment (RRD), nucleus drop (ND), or proliferative diabetic retinopathy (PDR). GDF-15 concentrations were measured using ELISA. Results: The vitreous levels of GDF-15 were higher in ND (5) and PDR (14) patients (1494 ± 243 and 904 ± 138 pg/mL, respectively) than RRD (3), MH (3), and IERM (8) patients (302 ± 160, 288 ± 24, and 254 ± 91 pg/mL, respectively). The vitreous levels of GDF-15 were significantly higher in patients with inflammatory vitreoretinal disorders (p < 0.0001). Conclusions: This is the first report showing that GDF-15 appears to be expressed in the vitreous, and that its expression is significantly higher in the presence of a vitreoretinal disorder in which there is an inflammatory component.

Nonarteritic anterior ischemic optic neuropathy in young patients

PURPOSE To determine and report the demographic and clinical features of patients younger than 50 years with nonarteritic anterior ischemic optic neuropathy (NAION). MATERIAL AND METHODS In this comparative study, we retrospectively reviewed the medical records of 120 patients with NAION. Patients were divided into two groups according to their age; in group I, 44 patients were younger than 50 years, and in group II, 76 patients were older than 50 years. RESULTS The gender distribution was similar in both main groups. Involvement was bilateral in 50% and 26.3% of patients, respectively (P<0.0001). Diabetes mellitus was present in 63.6% of patients in group I and 47.3% of patients in group II (P=0.009). We found hypertension as a frequent risk factor in group II (P=0.019). There was no significant difference in the initial and final visual acuities of patients between the two groups. Both groups had a significantly thinner peripapillary nerve fiber layer (RNFL) in every quadrant. The relative loss was greatest in the superior quadrant in both groups. We generally observed inferior altitudinal defect and superior RNFL thinning in two groups. In group I, 30 eyes (68.1%) demonstrated angiographically diffuse optic disc filling delay of ≥5seconds after choroidal filling confirming ischemia, and 14 (31.8%) eyes with segmental optic disc filling delay. In group II, diffuse optic disc filling delay was seen in 56 of 76 (73.6%) eyes. Segmental optic disc filling delay was present in 20 eyes (26.3%). There was no significant difference in angiographic findings between the two groups (P=0.67). CONCLUSION We observed that age did not play a significant role in prognosis of NAION. Diabetes is an increased risk for NAION in the young age group, and HT for NAION in the older group. Fellow eye involvement is more frequent in young patients. These patients should be followed closely.