Murat Özdemir

Age-related differences in normal corneal topography.

BACKGROUND AND OBJECTIVE The aim of this study was to compare age-related differences in the corneal topography of a normal population using a computerized corneal topography system. PATIENTS AND METHODS The randomized comparative study included 240 eyes of 120 subjects with normal corneas. Subjects were divided into six age groups: 5 to 10 years (group 1), 11 to 20 years (group 2), 21 to 30 years (group 3), 31 to 40 years (group 4), 41 to 50 years (group 5), and 51 years or older (group 6). Average corneal power and corneal astigmatism were examined. An average corneal topography map was constructed and the astigmatism pattern was determined in each age group. RESULTS Average corneal power values were 41.64 +/- 0.85 diopters (D), 42.35 +/- 0.90 D, 42.63 +/- 0.99 D, 42.94 +/- 0.93 D, 43.38 +/- 0.77 D, and 43.53 +/- 0.88 D in groups 1 to 6, respectively (P < .001). Mean astigmatism values were similar in all age groups (P = .225). Younger subjects had with-the-rule astigmatism, but older subjects showed a shift to oblique or against-the-rule astigmatism. The averaged maps of groups 1 to 3 showed a vertical bow-tie pattern, but the central steep area gradually extended horizontally and it became a round configuration in groups 4 to 6. CONCLUSION This study suggests that the normal cornea becomes steeper in the horizontal line and superior vertical quadrant and shifts from with-therule to against-the-rule astigmatism, but the amount of physiological corneal astigmatism does not change with age.

Early and late effects of pterygium surgery on corneal topography.

BACKGROUND AND OBJECTIVE The aim of this study was to compare the corneal topographic changes at the early and late postoperative period after pterygium surgery. PATIENTS AND METHODS Sixteen eyes of 15 patients with primary pterygium were included in the study. All of the pterygia were excised primarily. Computerized corneal topography measurements were taken before surgery and at the second week (postoperative early period) and third month (postoperative late period) after the operation. Keratometric astigmatism, total mean corneal refractive power, and flattened or steepened areas of the cornea were detected at each visit. The topographical changes were evaluated using the analysis of variance. Multiple comparison analyses were made with the Tukey HSD test. RESULTS Keratometric astigmatism was 2.58 +/- 2.33 diopters (D) at the preoperative period, 1.30 +/- 1.24 D at the postoperative early period, and 0.61 +/- 0.38 D at the postoperative late period (P < .001). The surgically induced corneal astigmatism was 3.23 +/- 2.33 D (range, 0.52 to 8.32 D) at the postoperative early period and 2.70 +/- 2.24 D (range, 0.47 to 7.72 D) at the postoperative late period (P = .287). Astigmatism was 81.25% with-the-rule at the preoperative period, 43.75% oblique and 37.50% against-the-rule at the postoperative early period, and 62.50% with-the-rule at the postoperative late period. Total mean corneal refractive power was 42.51 +/- 1.99 D at the preoperative period, 43.95 +/- 1.58 D at the postoperative early period, and 43.89 +/- 1.80 D at the postoperative late period (P = .014). CONCLUSION Corneal topographic changes induced by pterygium greatly improve at the postoperative early period. However, normal corneal topography patterns are formed at the postoperative late period.

Ocular surface disorders and tear function changes in patients with chronic renal failure

BACKGROUND Ocular surface changes, mainly squamous metaplasia of the conjunctival epithelium and corneoconjunctival calcification of unknown etiology, may develop in patients with chronic renal failure undergoing hemodialysis. An association between squamous metaplasia and corneoconjunctival calcification has been suggested. The purpose of this study was to investigate the relation between ocular surface disorders and tear function changes in patients with chronic renal failure undergoing hemodialysis. METHODS In this prospective case-control study, 42 patients with chronic renal failure and 20 age- and sex-matched control subjects underwent full ophthalmologic examination, tear function tests (including Schirmers test, tear film break-up time [BUT] test and rose bengal staining) and impression cytology to determine the degree of conjunctival squamous metaplasia. They also responded to a questionnaire regarding subjective ocular complaints. Corneoconjunctival calcification was graded on a scale of 0 to 5 according to the system proposed by Porter and Crombie. Impression cytology samples were graded on scale of 0 to 3 according to the Nelson classification. The relation between ocular surface disorders and tear function changes was evaluated. RESULTS Of the 42 patients, 12 (28%) had grade 0 calcification, 10 (24%) had grade 1, 14 (33%) had grade 2, and 6 (14%) had grade 3 or higher. Four patients (10%) had grade 0 squamous metaplasia, 22 (52%) had grade 1, 12 (28%) had grade 2, and 4 (10%) had grade 3. The difference between the patient and control subjects in squamous metaplasia grades and corneoconjunctival calcification grades was statistically significant (p < 0.001 and p = 0.022 respectively). Abnormal tear film BUT (p = 0.002) and abnormal rose bengal staining (p = 0.023) were significantly more frequent in the patient group than in the control group. The grade of conjunctival squamous metaplasia was correlated with abnormal rose bengal staining (tau = 0.79, p < 0.001) and with the existence of subjective ocular complaints (tau = 0.32, p = 0.026). There was no correlation between corneoconjunctival calcification and tear function changes. INTERPRETATION Abnormal rose bengal staining and the presence of subjective ocular complaints may be used as follow-up criteria for ocular surface disorders in patients with chronic renal failure regularly undergoing hemodialysis.

Comparison of the Intraocular Pressure Lowering Effect of Latanoprost and Carteolol-pilocarpine Combination in Newly Diagnosed Glaucoma

PURPOSE To evaluate the comparative efficacy of latanoprost monotherapy versus combined carteolol and pilocarpine therapy in patients with newly diagnosed glaucoma. METHODS Masked randomized prospective trial. This study included 51 patients (64 eyes) with newly diagnosed glaucoma or ocular hypertension. The cases were randomly divided into two treatment groups for administration of latanoprost 0.005% once daily, or of carteolol 2% twice daily and pilocarpine 2% twice daily. Mean diurnal intraocular pressure (IOP) was measured at baseline, week 2, week 4, and month 3 after the beginning of treatment. Changes in mean IOP from baseline to the 3-month visit were determined by an analysis of variance. RESULTS Mean diurnal IOP values were 25.1 +/- 3.1 mm Hg and 25.5 +/- 2.5 mm Hg at baseline in the latanoprost monotherapy group and in the carteolol-plus-pilocarpine group, respectively. Diurnal IOP was significantly decreased from baseline to 3 months in both groups (P <.001). At this time point, latanoprost monotherapy had reduced mean diurnal IOP by 7.2 +/- 2.5 mm Hg (28.7%) and carteolol plus pilocarpine had reduced mean diurnal IOP by 7.4 +/- 2.7 mm Hg (29%). There was no difference between the groups in terms of their IOP reduction effect (P =.51). Decreased visual acuity and twilight vision, blurred vision, and headache were more frequent in the carteolol-plus-pilocarpine group than in the latanoprost group (P <.05). CONCLUSIONS We concluded that latanoprost monotherapy was at least as effective as the carteolol-pilocarpine combination therapy in reducing mean diurnal IOP in newly diagnosed glaucoma or ocular hypertension.

A Newborn With Lipemia Retinalis

: Lipemia retinalis is a rare ocular manifestation of certain types of hyperlipidemia. A case of a newborn with lipemia retinalis evaluated by laboratory and dinical findings is described. A creamy white appearance of all retinal blood vessels was demonstrated by color fundus photographs. The patient had elevated levels of triglycerides (29,000 mg/dL) and cholesterol (1,470 mg/dL). Lipid electrophoresis indicated hyperprebetalipoproteinemia. Type IV primary hyperlipoproteinemia was diagnosed.

Yılan ısırığı sonrası ekstraoküler kas felci

On bir yasinda erkek cocuk yilan isirmasi tanisi ile yatirildi Sol el sirtinda isirik izi sislik ve ekimoz vardi Dorduncu gunde cift gorme sikayeti ortaya cikti Sol gozde yukari duz ve yukari saga bakista kisitlilik saptandi Sol gozde inferior oblik kas felci tanisi kondu ve hasta izleme alindi Hastanin cift gormesi zamanla azalarak dorduncu ayda tamamen kayboldu ve goz hareketleri normale dondu Yilan zehirlenmelerinde nadir gorulen ve genellikle kendiliginden iyilesen gozun dis kaslarinin felclerine dikkat cekmek icin bu olgu sunuldu Turk Ped Ars 2012; 47: 134 6

Latanoprost therapy in patients with glaucoma and ocular hypertension inadequately controlled with carteolol.

Long-term use of drugs on a regular basis may be inconvenient in glaucoma patients. Latanoprost has several advantages, including once-a-day dosage, few adverse effects, and high efficiency. In this study, we compare the effects of latanoprost monotherapy with the addition of latanoprost to carteolol in patients with open-angle glaucoma (OAG) or ocular hypertension (OH) inadequately controlled with carteolol.