Reşat Duman

Investigation of effect of 1,8-cineole on antimicrobial activity of chlorhexidine gluconate

Background: Chlorhexidine belongs to a group of medicines called antiseptic antibacterial agents. Chlorhexidine is commonly used for the care and clean off the skin, hands, and wounds. In recent years, medicinal and aromatic plants have been used for prevention of disease, maintaining health, and improving disease in traditional and modern medicine as a medicament. According to recent research, cineole is the isolated active agent of eucalyptus oil and possesses antimicrobial activity. It was demonstrated that cineole could enhance the antimicrobial effects of the other antiseptics. Objective: The aim of this study was to investigate the efficacy of 1,8-cineole on the antimicrobial effect of chlorhexidine against some microorganisms. Materials and Methods: The effect of 1,8-cineole on antimicrobial activity of chlorhexidine gluconate (CHG) was tested using seven different microorganisms. In this study, CHG (128–0.125 mg/l) and cineole (512–2 g/l) were analyzed together and separately using checkerboard assay. Interactions between CHG and 1,8-cineole have been identified as synergistic, indifferent, or antagonistic. Results: Synergistic activity was demonstrated between CHG and 1,8-cineole against Staphylococcus aureus, methicillin-resistant S. aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Candida albicans. Indifferent interactions for these compounds were demonstrated against Pseudomonas aeruginosa. Conclusion: CHG antiseptic properties were found to be increased when CHG was used in combination with 1,8-cineole. In this way, CHG will reveal stronger effect against microorganisms.

Corneal endothelial cell density in healthy Caucasian population

Aim To reveal the changes of corneal endothelial characteristics with aging among Caucasian population. Methods Non-contact specular microscopy was performed in 564 eyes of 282 healthy Caucasian Turkish patients. Endothelial cell density (MCD), mean cell area (MCA), coefficient of variation (CV) in cell size, percentage of hexagonal cells, and central corneal thickness (CCT) were measured. Results The mean age was 42 ± 17.1 (6–85) years. The MCD of the population was 2732 ± 305 cell/mm2 (range, 1904–3802 cell/mm2). The MCA was 368 ± 41 m2 (range, 263–522 m2). The mean CV in cell size was 34 ± 7 (range, 25–68), the mean percentage of hexagonal cells was 46 ± 8% (range, 25–76%), and CCT was 513 ± 39 (range, 407–623). There was statistically significantly negative correlation (p < 0.05) between age and cell density, hexagonality, and pachymetry. There was statistically significant correlation (p < 0.05) between age and MCA. Conclusion We report the normal values of corneal endothelial characteristics in Caucasian Turkish eyes. Over the age of 20, the MCD of Caucasian eyes is more than the Indian and Iranian eyes and less than the Chinese eyes. Caucasian population’s cell density in under the age of 20 is 3101 ± 268 cell/mm2.

Effect of smoking on the thickness of retinal layers in healthy smokers

Abstract Purpose: To compare the thicknesses of the retinal layers in smokers with those of nonsmoking healthy subjects using spectral-domain optical coherence tomography (SD-OCT). Methods: One hundred and eight subjects were included in the study. Two groups were separated as smokers and nonsmokers. Both groups were chosen to be similar in terms of age and gender. SD-OCT images were generated with Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany). An automated algorithm was developed to segment the macular retina into eight layers and quantitate the thickness of each layer for the fovea, parafovea and perifovea. Results: The mean smoking history was 18.33 ± 8.45 years (range: 10–40). The mean number of pack-years was 22.22 ± 15.51 (range: 10–80). No significant difference was observed regarding retinal layer measurements between the smoker and nonsmoker groups. Also, no significant difference was observed for central macular thicknesses at 1000, 3000, and 6000 μm between two groups. Conclusion: The thickness of retinal layers in healthy smokers was similar to those of healthy individuals.

Diplopia due to Dacryops

Dacryops is a lacrimal ductal cyst. It is known that it can cause globe displacement, motility restriction, and proptosis because of the mass effect. Diplopia due to dacryops has not been reported previously. Here, we present a 57-year-old man with binocular horizontal diplopia that occurred during left direction gaze due to dacryops.

Characteristics of Anisometropic Patients with and without Strabismus

Objectives: To evaluate the risk factors for strabismus in patients with anisometropia by comparing degree of anisometropia, depth of amblyopia, and binocular visual function in anisometropic patients with and without strabismus. Materials and Methods: Sixty-five anisometropic patients older than 5 years with amblyopia in one eye who were followed in the Ankara University Faculty of Medicine, Department of Ophthalmology, Pediatric Ophthalmology and Strabismus Unit between May 2009 and April 2010 were included in this study. There were 27 cases of strabismus. The depth of amblyopia, degree of anisometropia, and binocular visual function were assessed in anisometropic cases with and without strabismus. Results: The 65 patients with anisometropia were divided into two groups: 27 patients with strabismus (group 1) and 38 patients without (group 2). Depth of amblyopia was greater in patients with strabismus compared to those without (p=0.006). In patients with strabismus, there was no correlation between angle of deviation and depth of amblyopia (p=0.453). In anisometropic amblyopia patients without strabismus, there was a positive correlation between depth of anisometropia and depth of amblyopia (p=0.35, Pearson’s correlation coefficient=0.343). Comparison in terms of anisometropia showed that patients with strabismus had significantly larger spherical difference between the two eyes than in patients without strabismus (p=0.000, Mann-Whitney U test). There was no significant difference in terms of cylindrical values (p=0.146, Mann-Whitney U test). There was no statistically significant difference in the presence of fusion between anisometropic patients with and without strabismus. Conclusion: The risk of developing strabismus increased as degree of anisometropia increased in anisometropic cases. In addition, depth of amblyopia was greater in anisometropic patients with strabismus.

Keratokonus Progresyonunun Önlenmesinde Korneal Kollajen Çapraz Bağlama Tedavisinin Etkinliği

Amac: Ilerleyici keratokonusu bulunan hastalarda korneal kollajen capraz baglama tedavisinin etkinliginin arastirilmasi amaclanmistir.Bulgular: 6 aylik takip suresinin sonunda, korneal topografide, tum hastalarin Sim K max degeri ortalama 0,95±0,22 D azalma gostermistir. Sim K min degeri ise 8 gozde (%80) azalirken (ortalama 0,39 D) 2 gozde (%20) degisiklik olmamistir. Santral kornea kalinliklari ise ortalama 10,1±1,37μm azalma gostermistir. En iyi duzeltilmis gorme keskinlikleri tedavi oncesi ve sonrasina gore incelendiginde 6 hastada (%20) tedavi oncesine gore artis gosterdigi, 4 hastada (%40) ise gorme keskinliklerinin sabit kaldigi tespit edilmistir.Sonuc: Apollon cihazi ile klinigimizin ilk uygulamalarinin sonuclarina gore korneal kollajen capraz baglama tedavisi keratokonus progresyonunu durdurmada etkili bir yontem olarak gorunmektedir. Tedavinin kaliciliginin degerlendirilebilmesi icin uzun donemli genis serili, prospektif calismalara ihtiyac duyulmaktadir.

Analysis of corneal astigmatism with NIDEK axial length scan in caucasian cataract surgery candidates

Aims and Objectives: The aim of the study was to analyze and quantify the pattern of corneal astigmatism in Caucasian cataract surgery patients using a new optical biometer (axial length [AL] Scan, NIDEK Co., Gamagori, Japan). Patients and Methods: The datasets of cataract surgery patients acquired between March 1, 2014, and April 15, 2016, were collected and analyzed. The corneal power (flat keratometry, steep keratometry, and mean keratometry), negative cylinder power, and axis of astigmatism were recorded. Keratometry values were optically measured by optical low coherence interferometry (AL-Scan, NIDEK Co., Ltd.,) before cataract extraction. Results: The study comprised 1233 eyes of 838 consecutive cataract candidates with a mean age of 66.8 ± 10.7 years (range 40–97 years). The mean keratometry value and corneal astigmatism were 43.69 ± 1.61 D and 0.84 ± 0.70 D, respectively. Corneal astigmatism of 1.00 D or greater was found in 344 eyes (27.9%), and 548 eyes (44.4%) had against-the-rule astigmatism. A trend toward decreasing J0 and J45 with age was found by linear regression models. The per-year increase in age was associated with a J0 and J45 decrease of 0.002 D and 0.001D, respectively. Conclusion: This study provides the distribution of astigmatism axis and power for cataract patients in age subsets from Turkey.

Structural changes of macula and optic disk of the fellow eye in patients with nonarteritic anterior ischemic optic neuropathy

PurposeThe aim was to assess the ganglion cell complex (GCC) thickness, retinal nerve fiber layer (RNFL) thickness and optic disk features in the affected eyes (AE) and unaffected fellow eyes (FE) of subjects with unilateral nonarteritic anterior ischemic optic neuropathy (NAION) and to compare with healthy control eyes (CE) using spectral domain-optical coherence tomography (SD-OCT).MethodsThis study included 28 patients and age, sex and refraction-matched 28 control subjects. Mean GCC thickness and peripapillary RNFL thickness in four quadrants measured by cirrus SD-OCT were evaluated in both AE and FE of patients and CE. In addition, optic disk measurements obtained with OCT were evaluated.ResultsMean GCC thickness was significantly lower in AE compared with both FE and CE (P < 0.001), and mean GCC thickness in FE was significantly lower than CE (P = 0.022). In addition, mean RNFL thickness in superior and nasal quadrants significantly decreased in FE compared with CE (P = 0.020 and 0.010, respectively). Furthermore, AE had significantly greater optic disk cupping compared with both FE and CE (P < 0.001).ConclusionsGCC and RNFL thickness decreased significantly at late stages of NAION, in both AE and FE compared with CE, suggesting that some subclinical structural changes may occur in FE despite lack of obvious visual symptoms. In addition, there was no significant difference in optic disk features between the CE and FE. And significantly greater optic disk cupping in the AE compared with both FE and CE supports the acquired enlargement of cupping after the onset of NAION.

Role of innate immunity and oxidative stress in steroid-induced cataracts in developing chick embryos

Abstract Purpose: The exact etiopathogenesis of steroid-induced cataracts (SIC) is not known. Although oxidative stress is one of the most acceptable hypotheses, the exact molecular events in steroid-induced oxidative events in the lens need to be clarified. In addition, to the best of our knowledge, the innate immune system components in SIC formation have not been studied previously. The aim of the present study was to study the oxidative system and the innate immune system components in the cataractous lenses of a developing chick embryo SIC model. Materials and methods: The study included 20 specific pathogen-free (SPF) fertilized eggs divided into two groups, with one hydrocortisone (HC)-treated group (G1) and one non-HC-treated control group (G2). On the 15th day of incubation, the SPF eggs in the two groups were removed from the incubator; HC was injected into G1, and phosphate-buffered saline (PBS) was injected into G2 using insulin injectors into the chorioallantoic membrane. On day 17, all of the chick embryos were removed from the eggs, and all lens and liver tissues were dissected from the embryos. Cataract formation was evaluated in all lenses, and total antioxidant status (TAS), total oxidant status (TOS), reduced glutathione (GSH), oxidized glutathione (GSSG), interleukin-6 (IL-6), and interleukin-1β (IL-1β) levels were measured in all lens and liver tissues. Results: The lenses in the SIC group had lower levels of GSH, GSSG, TAS, and IL-6 (p = 0.016, 0.022, 0.000, 0.000, respectively), and higher levels of TOS (p = 0.000) than the control group. Furthermore, the liver tissues in the SIC group had decreased levels of TAS and IL-6, and increased levels of TOS compared to the control tissues (p = 0.000). Although the IL-1β levels in the lens and liver tissues in the HC-induced cataract group were lower than in the control group, these differences were not statistically significant. In addition, the GSH levels in the liver tissues did not statistically differ between the two groups despite the significant GSH difference in the lens tissues. Conclusions: Steroid therapy causes a decrease in GSH, GSSG, and TAS levels and an increase in TOS levels in lens tissues, which means there is increased oxidative stress and decreased antioxidant defence. Furthermore, lenses with SIC have lower IL-6 levels compared to non-cataractous lenses. The interaction between lenticular IL-6 and antioxidant defence needs to be further studied.

Topical folinic acid enhances wound healing in rat model

PURPOSE Folic acid is an essential vitamin participating in DNA synthesis and repair. Recently folic acid has been shown to stimulate DNA-repair capacity in dermal fibroblasts in response to injury. Thus, the present study aimed to investigate the effects of topical folinic acid, a 5-formyl derivative of tetrahydrofolic acid, on wound healing using rat wound model. MATERIALS AND METHODS A rat wound model was established, and the wound healing was evaluated by macroscopic and histological analyses among vehicle control, 2.5% folinic acid, 1% folinic acid, and dexpanthenol treatment groups. While an image-analysis program was used to evaluate macroscopic wound closure, connective tissue properties, mast cell numbers, and the expressions of matrix metalloproteinase 1 (MMP-1) and 9 (MMP-9) were evaluated by microscopy. RESULTS The 2.5% folinic acid-treated group exhibited enhanced wound healing by increased reepithelialization, neo-vessel formation, inflammatory cell migration, collagen deposition and progressive mast cell increase. Furthermore, 2.5% folinic acid induced higher expressions of MMP-1 and MMP-9. CONCLUSIONS Folinic acid enhances both macroscopic and microscopic wound healing in rat wound model.