Oya Tekeli

Results of endoscopic endonasal non-laser dacryocystorhinostomy

Endoscopic dacryocystorhinostomy (EN-DCR) is a procedure that presents itself as an alternative choice to the conventional external approach. This study describes the results of endoscopic endonasal non-laser lacrimal surgery. We reported the data of 64 procedures of 63 patients with epiphora or chronic dacryocystitis who underwent primary EN-DCR by means of a microdrill or revision EN-DCR. One of these cases had bilateral surgery. There were 42 women and 21 men. Thirty-four cases had primary EN-DCR and 30 cases had revision EN-DCR secondary to previously failed external DCR. Mean follow up time was 11.34 months. The procedure was successful in 79.4% of primary EN-DCR cases and in 80% of revision EN-DCR cases. The overall success rate was 79.6%. Postoperative complications included periorbital edema, eyelid ecchymosis, punctal granuloma, cyst of the punctum, adhesion between the superior and inferior punctum. Tube dislocation occurred in 3 patients. Premature loss of silicone tube was determined in 5 patients and granulation tissue occurred at the internal osteum in 11 cases. EN-DCR, when compared with external dacryocystorhinostomy (EX-DCR), has lower success rate, but provides the potential advantages of better intraoperative hemostasis, and lack of cutaneous scar.

Pattern electroretinography and visual evoked potentials in optic nerve diseases

BACKGROUND To evaluate transient pattern electroretinography (PERG) and pattern visual evoked potential (VEP) for the diagnosis, differential diagnosis and follow-up of optic nerve diseases. METHODS Twenty-nine consecutive patients (14 female, 15 male) with the diagnosis of ischaemic optic neuropathy (n=14) and optic neuritis (n=15) were included in this study. Mean age of the patients with ischaemic optic neuropathy was 63.3+/-3.3 (60-78) years and the mean age of the patients with optic neuritis was 28.3+/-8.4 (19-43) years. In each patient ophthalmological examination and systemic evaluation were done and VEP and PERG were recorded. As a control group, VEP recordings of 35 healthy subjects were included. RESULTS In the ischaemic optic neuropathy group (group 1), mean VEP amplitude (+/-SD) (1.96+/-0.95 microV) was found to be decreased significantly in the affected eyes in comparison to the control group and the unaffected eyes. The delay in latency (116.3+/-20.14 msec in the affected eyes compared with 101.31+/-6.19 msec in unaffected eyes) was statistically significant when compared with the healthy subjects. In the optic neuritis group (group 2), VEP amplitude was decreased (4.13+/-4.04 microV vs 6.97+/-3.35 microV and 6.97+/-4.43 microV) and latency was increased (122.59+/-20.09 msec vs 101.31+/-6.19 msec and 108.76+/-13.57 msec) in affected eyes significantly in comparison to the unaffected eyes and control group, respectively. Even though there were no significant differences for P50 latency and N95/P50 ratios between affected and unaffected eyes in both groups, N95 amplitude decreased significantly in the affected eyes of the ischaemic optic neuropathy patients and N95 latency was found to be decreased in optic neuritis patients. There was no correlation between VEP and PERG findings in both groups. CONCLUSION VEP amplitude decreased significantly in ischaemic optic neuropathies while latency delay was more significant in patients with optic neuritis. PERG findings showed decreased N95 amplitude in ischemic optic neuropathy without associated latency changes.

Methylenetetrahydrofolate reductase 677 C-T and homocysteine levels in Turkish patients with pseudoexfoliation.

Purpose:  The 677 C‐T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene is associated with hyperhomocysteinaemia. This study aimed to investigate the frequency of MTHFR 677 C‐T polymorphism and homocysteine (Hcy) levels in Turkish patients with pseudoexfoliation (PEX).

SLITRK6 mutations cause myopia and deafness in humans and mice

Myopia is by far the most common human eye disorder that is known to have a clear, albeit poorly defined, heritable component. In this study, we describe an autosomal-recessive syndrome characterized by high myopia and sensorineural deafness. Our molecular investigation in 3 families led to the identification of 3 homozygous nonsense mutations (p.R181X, p.S297X, and p.Q414X) in SLIT and NTRK-like family, member 6 (SLITRK6), a leucine-rich repeat domain transmembrane protein. All 3 mutant SLITRK6 proteins displayed defective cell surface localization. High-resolution MRI of WT and Slitrk6-deficient mouse eyes revealed axial length increase in the mutant (the endophenotype of myopia). Additionally, mutant mice exhibited auditory function deficits that mirrored the human phenotype. Histological investigation of WT and Slitrk6-deficient mouse retinas in postnatal development indicated a delay in synaptogenesis in Slitrk6-deficient animals. Taken together, our results showed that SLITRK6 plays a crucial role in the development of normal hearing as well as vision in humans and in mice and that its disruption leads to a syndrome characterized by severe myopia and deafness.

Bevacizumab Sterility in Multiple Doses from a Single-Use Vial

Background: Recent reports have demonstrated that refrigerated bevacizumab can be stored for up to 3 weeks at 4 °C without loss of efficacy. There have been no previous reports addressing bevacizumabs sterility when stored and used as multiple doses from a single-use vial. Objective: To evaluate the sterility of bevacizumab when used as multiple doses from a single-use vial. Methods: Four groups of vials were used to simulate the storage and use conditions for bevacizumab. Each group contained 11 doses of 0.2 mL of bevacizumab. One sample from each group was cultured once each day at 37 °C for 10 days; one sample from each group was left for 15 days. MacConkey agar, blood agar, thioglycollate broth, and Sabouraud medium were used to assess bacterial and fungal growth. Results: A total of 44 samples of bevacizumab were included in this study. Each sample was placed on 4 growth media for microbial readings. All samples were found to be negative for microbial growth. No significant differences were observed among the groups. Possible limitations of this study included the number of samples for each group and in vitro design of the study, which might have affected the growth of bacterial organisms. Conclusions: Storage and multiple use of bevacizumab from single-use vials does not seem to result in microbial contamination.

Effects of intracameral lidocaine on ocular tissues

Purpose: To investigate the ultrastructural changes in iris and corneal tissue induced by intracameral 1% lidocaine infusion applied during lens extraction in a rabbit model.

Evaluation of the Optic Nerve Head with the Heidelberg Retina Tomograph in Diabetes Mellitus

Background: To evaluate the optic nerve head by means of the Heidelberg retina tomograph (HRT) in patients with diabetes mellitus (DM). Methods: The study group consisted of 47 patients with DM [group 1; 29 patients without diabetic retinopathy (DR) and 18 patients with non-proliferative DR] and 50 normal subjects (group 2). All patients and controls underwent a complete ophthalmological examination, and the optic nerve head topography of both eyes was evaluated by using HRT-I. One eye of these cases was randomly selected for statistical analysis. Glycosylated haemoglobin (HbA1c) levels of all the study participants were measured. Results: The HRT parameters were similar between diabetic and control groups (p > 0.05). In group 1, in the patients with duration of diabetes ≤10 years, when compared with the patients with duration of diabetes >10 years, we did not detect any statistically significant difference between the HRT parameters (p > 0.05). There was no statistically significant correlation between HBA1c levels and rim volume (r = –0.078, p = 0.601), and mean retinal nerve fibre layer thickness (r = 0.058, p = 0.700) in DM patients. Conclusion: These results suggest that non-glaucomatous diabetic patients had no decreased neuroretinal rim when compared with non-diabetic patients.

Identification of an IGSF3 mutation in a family with congenital nasolacrimal duct obstruction.

To the Editor : Congenital dacryocystocele is a subclass of nasolacrimal duct obstruction (NLDO) characterized by focal dilation of the lacrimal sac. Typical onset initiates prenatally, resulting in either unilateral or bilateral postnatal presentation (1). Here, we present an Indian family with four children having isolated NLDO born to unaffected parents (Fig. 1a,b and Table 1). This study was approved by the local Institutional Review Board (IRB). After written consent forms were obtained from each participant, blood samples were collected. DNA was extracted using standard methods. We sequenced the whole exome in affected children II:1, II:2, and II:3 using the SureSelect Human All Exon 50 Mb kit v4 (Agilent, Santa Clara, CA) and an Illumina, SanDiego, CA; HiSeq 2000 instrument as published previously (2). All missense,

Anterior megalophthalmos with pigmentary glaucoma

PurposeTo describe the ocular findings and clinical characteristics of two sisters having anterior megalophthalmos with megalocornea and pigmentary glaucoma.Material and methodsA complete ophthalmological examination was performed.ResultsMegalocornea and transillumination defects of the irides were observed associated with deep anterior chambers in both cases. In these cases, a diagnosis of anterior megalophthalmos with pigmentary glaucoma was made.ConclusionAnterior megalophthalmos is a rare hereditary condition. The ophthalmologist should be made aware of the many ocular findings that may be associated with megalophthalmos.

Invitro Candidacidal effect of polymorphonuclear neutrophils of Behçet's patients with or without ocular involvementNote

In this study our objective was to evaluate the in vitro candidacidal effect of polymorphonuclear neutrophils of Behçets patients with or without ocular involvement (inactive phase). Fifteen patients with ocular involvement and 15 patients without ocular involvement were studied. Candidacidal assay was performed to assess the in vitro killing of Candida species by the polymorphonuclear neutrophils of both the study and control groups. In brief, peripheral venous polymorphonuclear neutrophils of healthy volunteers and patients with Behçets disease were obtained by density gradient centrifugation. These cells were incubated with Candida spp. (Candida albicans, Candida tropicalis, Candida glabrata) for 3 h. Samples were seeded onto yeast extract peptone dextrose agar, incubated at 25 °C in a 5% humidified incubator for another 48 h, and formed colonies were counted. There was no significant difference between the candidacidal activity of polymorphonuclear neutrophils of healthy volunteers and of Behçets patients with or without ocular involvement. Although various immunological abnormalities are reported in Behçets disease, in vitro killing of Candida spp., which is one of the parameters for the phagocytic function of polymorphonuclear neutrophils, was not affected.