Pelin Taner

5-Fluorouracil as chemoadjuvant for primary pterygium surgery: preliminary report.

Purpose. To investigate the safety and efficacy of intraoperative application of 5-fluorouracil as an adjuvant in primary pterygium surgery and to evaluate the effect of postoperative subconjunctival 5-fluorouracil injections on the recurrent pterygium. Methods. Of 25 consecutive white patients, 28 eyes with primary pterygium underwent pterygium excision with intraoperative application of 5-fluorouracil (25 mg/mL for 3 minutes). The superior and inferior conjunctiva was approximated to cover the scleral bed within 1 mm of the limbus. Recurrence of pterygium was defined as postoperative fibrovascular growth more than 1 mm onto the cornea. Eyes with recurrence less than 2 mm were treated with subconjunctival 5-fluorouracil injections. Results. After a mean follow-up of 14.1 ± 3.9 months (mean ± standard deviation), 7 recurrences (25%) were observed. All recurrences were detected within 12 months. In 4 of 7 recurrences, the fibrovascular growths were less than 2 mm. We, therefore, performed subconjunctival 5-fluorouracil injections. In 3 (75%) of 4 recurrences, the fibrovascular growths became atrophic. No serious complications were observed during and after the surgery. However, superficial punctate keratitis, pain, and hyperemia were detected in all patients in the early postoperative period. As a result, of 28 eyes, 4 (14%) had unacceptable cosmetic results and growing recurrences. Conclusions. This study suggests that intraoperative applications of 5-fluorouracil is both efficient and safe in the treatment of primary pterygium. Additionally, postoperative subconjunctival 5-fluorouracil injections may prevent the progression of fibrovascular tissue.

The Effects of Hormone Replacement Therapy on Ocular Surface and Tear Function Tests in Postmenopausal Women

Purpose: To prospectively investigate the impact of various hormone replacement therapies (HRT) on ocular surface and tear function tests. Methods: A total of 70 women in the postmenopausal period were enrolled in the study. The groups consisted of 16 women who were not on HRT (group 1), 29 women who were on HRT with tibolone (group 2) and 25 women who received estradiol plus medroxyprogesterone acetate treatment (group 3). All patients underwent tear film break-up time (TFBUT), Schirmer’s test and conjunctiva cytology at the time of enrollment and at 6 months’ follow-up. Results: Patients in group 2 showed improved Schirmer’s test and TFBUT results (p < 0.001); however, no significant changes occurred in group 1 and group 3 patients (p > 0.05). Conjunctival cytology scores did not differ at the time of enrollment and at 6 months’ follow-up in all groups. Conclusions: This is the first comparative clinical study on the effects of tibolone and estradiol plus medroxyprogesterone acetate on ocular surface and tear function tests. HRT with tibolone seems to improve tear function tests in postmenopausal women.

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.

The effects of cyclopentolate on intraocular pressure and retrobulbar hemodynamics in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma

Purpose To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Methods Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. Results Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudoexfoliation syndrome (p=0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p=0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p<0.05) and RI of the posterior ciliary artery increased significantly (p=0.01) after cyclopentolate instillation. Conclusions On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells.

Sildenafil Does Not Alter Retrobulbar Hemodynamics in Postural Variations

Objectives: In the present study, we aimed to investigate the postural changes of systemic blood pressure, retrobulbar blood flow velocities, and intraocular pressure as a response to sildenafil. Material and methods: A total of 28 healthy volunteers with an average age of 51.4 ± 0.5 years (range: 46–53 years) were divided into two groups: study group (Group 1) and control group (Group 2). After baseline measurements of retrobulbar blood velocity in the ophthalmic, central retinal, and posterior ciliary arteries using color Doppler imaging and intraocular pressure were noted in both groups, sildenafil citrate (50 mg) was given to the participants in Group 1. All parameters were then re-measured in the sitting and supine positions. Mann-Whitney U test, Friedman variant analysis, and Wilcoxon two-related sample test were used to evaluate changes of these parameters with regard to position in both groups. Results: Changing from a sitting to a supine position decreased the systolic and diastolic blood pressures in both groups. These changes were not statistically significant between groups (p > 0.05). Intraocular pressure showed statistically insignificant increases in the supine position in both groups (p > 0.05). There were no statistically significant differences between the two groups with regard to the retrobulbar hemodynamic parameters in two (sitting and supine) positions (p > 0.05). Conclusion: This is the first clinical study on the effects of sildenafil on retrobulbar and systemic hemodynamics in postural variations. Retrobulbar hemodynamics, intraocular pressure, and systemic blood pressure are the same in patients who use recommended doses of sildenafil as in physiological conditions.

The effects of darkness on retrobulbar hemodynamics in patients with early stages retinitis pigmentosa.

Purpose: To investigate the retrobulbar hemodynamic changes occurring in light and darkness in patients with early stages retinitis pigmentosa (RP). Methods: Eleven early stages RP patients were enrolled in the study. The peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistivity index (RI) of the ophthalmic artery (OA) and central retinal artery (CRA) were measured by color Doppler imaging in light and darkness. The results were compared with that of 10 age-matched normal subjects. Results: PSV and EDV of the OA did not show significant differences in both groups. However, PSV and EDV of the CRA in RP patients decreased significantly in darkness (p = 0.001, p < 0.001, respectively). In addition, we found a significant increase in RI of the CRA in RP patients in darkness (p = 0.003). On the contrary, PSV and EDV of the CRA in control subjects showed a significant increase (p = 0.002, p < 0.001, respectively) and RI showed a significant decrease in darkness (p = 0.004). Conclusions: Darkness causes a decreased blood flow in the CRA in early stages of RP.