Ümit Doğan

Effect of Smoking on Choroidal Thickness in Healthy Smokers

Abstract Purpose: To evaluate the acute and chronic effects of cigarette smoking on the choroidal thickness of young male smokers with smoking histories exceeding 10 years using spectral domain optical coherence tomography (SD OCT). Materials and methods: The right eyes of 40 never-smoking and 30 smoking healthy subjects were included in this study. We measured the choroidal thicknesses of the never-smoking subjects as a control group. The choroidal thicknesses of the smoking subjects were measured before, 5, 30 and 60 min after smoking. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 µm nasal and temporal to the fovea. Results: No significant difference was found for the retinal thickness, choroidal thicknesses, spherical equivalent, intraocular pressure and central corneal thickness of the smokers and non-smokers (p > 0.05 for all). In the measurements that were taken after smoking, a statistically significant increase was found in choroidal thickness that was observed between 0 and 5 min for the central, nasal and temporal segments (p < 0.001 for all). Conclusions: Smoking caused acute, significant increase in choroidal thickness that returned to baseline levels after 1 h. The choroidal and retinal thicknesses did not differ significantly between the healthy young smokers and non-smokers.

Ocular findings in patients with psoriasis

Background  Psoriasis is a chronic inflammatory disease affecting skin, nails, and joints. Although there are not many reports in the literature, ocular findings occur in approximately 10% of patients, in mostly those who have psoriatic arthritis. In this study, we aimed to evaluate eye involvement in psoriasis patients.

Choroidal Thickness Changes During the Menstrual Cycle

Abstract Purpose: To evaluate the effects of the menstrual cycle on the choroidal thickness of healthy women of reproductive age using spectral-domain optical coherence tomography. Materials and methods: A total of 23 right eyes of 23 women with regular natural menstrual cycles of 28–30 d and ages 22–30 years were included in this prospective study. The choroidal thicknesses of the women were measured using high-resolution spectral-domain optical coherence tomography line scans with the activated enhanced depth imaging mode in the early follicular, ovulatory and mid-luteal phases of the menstrual cycle (3rd, 14th and 21st days) using a follow-up scanning protocol of the Spectralis optical coherence tomograph by setting the early follicular phase scan as the reference image. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 µm nasal and temporal to the fovea. The mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses were also measured. All measurements were taken within the same menstrual cycle. Results: The mean ± standard deviation (standard error of the mean) of subfoveal choroidal thicknesses in the early follicular, ovulatory and mid-luteal phases were 383.87 ± 84.38 (17.59), 373.74 ± 82.40 (17.18) and 359.09 ± 79.65 (16.61) µm, respectively. The relative reductions in choroidal thickness between early follicular and ovulatory phases and early follicular and mid-luteal phases were 2.64% and 6.47%, respectively. The subfoveal choroidal thickness was decreased significantly in the mid-luteal phase when compared with both the early follicular (p < 0.001) and ovulatory phases (p = 0.003). However, the measures of subfoveal choroidal thickness in the early follicular phase were non-conclusively greater (p = 0.071) than in the ovulatory phase. Additionally, the mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses did not significantly differ during the menstrual cycle (p > 0.05 for all). Conclusions: The choroidal thickness decreased significantly in the mid-luteal phase of the menstrual cycle in young, healthy women. These findings emphasize the importance of the menstrual phase in the interpretation of choroidal thickness measurements in women of reproductive age.

Investigation of the choroidal thickness in patients with hypothyroidism.

Purpose: The effect of hypothyroidism on the choroidal thickness (CT) was investigated in patients with subclinical hypothyroidism and overt hypothyroidism, and biochemically and clinically euthyroid patients receiving levothyroxine treatment. The patients were compared with healthy subjects. Materials and Methods: One eye of 71 hypothyroid and 22 healthy subjects between 20 and 40 years of age were included in this study. CT measurements were taken at the fovea and at 2 points that were 1500 μm nasal and temporal to the fovea using spectral-domain optical coherence tomography. Independent sample t-tests and was used for statistical analysis of the data. Results: The CT was significantly thicker in hypothyroid patients compared to healthy subjects (P values were 0.013 for subfoveal, 0.015 for temporal and 0.020 for nasal segments). The intraocular pressure (IOP) and body mass index (BMI) were also significantly higher in hypothyroid patients (P values were 0.021 and 0.003, respectively). There was not a statistically significant difference in the BMI and IOP measurements between healthy subjects and euthyroid patients (P > 0.05). However, there was a statistically significant difference in the subfoveal, temporal and nasal CT measurements between healthy subjects and euthyroid patients (P values were 0.006, 0.031 and 0.013, respectively). Conclusions: All subgroups of hypothyroid patients had thicker CT compared to healthy subjects. Euthyroid patients receiving levothyroxine treatment had lower IOP, BMI levels, and serum lipid levels than patients with subclinical hypothyroidism and overt hypothyroidism.

Comparison of the effect of intravitreal bevacizumab and intravitreal fasudil on retinal VEGF, TNFα, and caspase 3 levels in an experimental diabetes model

AIM To evaluate the influence of an intravitreal injection of bevacizumab and fasudil on the retinal vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNFα), and caspase 3 levels in a diabetic rabbit model. METHODS The study included 6 healthy rabbits (Group 1), 6 rabbits with experimentally induced diabetes mellitus (DM) (Group 2), 7 rabbits with experimentally induced DM to which intravitreal bevacizumab was administered (Group 3), and 7 rabbits with experimentally induced DM to which intravitreal fasudil was administered (Group 4). An intravitreal injection of 1.25mg/50µL bevacizumab in the right eye of rabbits in Group 3 and an intravitreal injection of 0.0064mg/50µL fasudil in the right eye of rabbits in Group 4 were administered on day 21 after the induction of DM. The studied eyes of the rabbits were enucleated three days after the intravitreal injection. The TNFα, VEGF, and caspase 3 levels were determined using the ELISA method. RESULTS There was a statistically significant difference in the VEGF and caspase 3 levels between groups (P=0.005 and P =0.013, respectively), but the TNFα level did not differ significantly between groups (P=0.792). It was found that VEGF levels were significantly lower in Group 1 and Group 3 than in Group 2 using the Mann-Whitney U test with the Bonferroni correction (P=0.004 for both comparison). There was no statistically significant difference between other groups with regard to VEGF levels (the P value ranged between 0.015 and 0.886). Although the P values of the caspase 3 levels were 0.015 for Group 1 and Group 4, 0.038 for Group 2 and Group 3, and 0.018 for Group 3 and Group 4, these P values remained above the threshold P value of 0.0083, which was the statistically significant level for post hoc tests. CONCLUSION An intravitreal injection of bevacizumab decreased both the VEGF level, which plays a role in angiogenesis, and the caspase 3 level, which plays a role in apoptosis. Although not as effective as bevacizumab, fasudil had a beneficial effect on the VEGF levels but significantly increased the caspase 3 levels.

Bilateral nevus comedonicus of the eyelids associated with bladder cancer and successful treatment with topical tretinoin.

Mualla Polat*, Bengu Altunay Tuman*, Asli Sahin†, Umit Dogan‡ & Cetin Boran§ *Department of Dermatology, Faculty of Medicine, Abant IzzetBaysal University, Bolu, Turkey, †Department of Dermatology, IzzetBaysal Education and Research Hospital, Bolu, Turkey, ‡Department of Ophthalmology, Faculty of Medicine, Abant IzzetBaysal University, Bolu, Turkey and §Department of Pathology, Faculty of Medicine, Abant IzzetBaysal University, Bolu, Turkey

Evaluation of subjects with a moderate cup to disc ratio using optical coherence tomography and Heidelberg retina tomograph 3: Impact of the disc area

Aim: The aim was to evaluate subjects with a moderate cup to disc ratio using optical coherence tomograph (OCT) and Heidelberg retina tomograph (HRT) 3. Settings and Design: We included 80 patients with early glaucoma and 80 nonglaucomatous subjects with moderate cup/disc ratio (range of 0.5–0.8) to this cross-sectional study. Subjects and Methods: We compared results of color-coded algorithms of HRT 3 (Moorfields regression analysis [MRA] and Glaucoma probability score [GPS]) and OCT. All outputs are classified into three categories: Within normal limits (WNLs), borderline and outside normal limits (ONLs). Diagnostic accuracies of algorithms were determined using the highest sensitivity criteria. Results: The sensitivities of global MRA, GPS and OCT were 0.75, 0.925 and 0.725, respectively, in average disc area group and 0.85, 1.0 and 0.425, respectively, in large disc area group. The specificities of global MRA, GPS and OCT were 0.55, 0.15 and 0.85, respectively, in average disc area group and 0.425, 0.025 and 0.80, respectively, in large disc area group. Area under receiver operating characteristic curve (AUROC) of global MRA, GPS and OCT were 0.667, 0.617 and 0.792, respectively, in average disc area group and 0.746, 0.576 and 0.627, respectively, in large disc area group. AUROC of global MRA and OCT combination in the average and large disc area groups were 0.828 and 0.825, respectively. Conclusions: In contrast to GPS and OCT algorithms, diagnostic performance of MRA algorithm increased in large disc area group. Combining MRA and OCT algorithms produced satisfactory diagnostic performance in subjects with an average and large disc area.

Anterior chamber fixation of a posterior chamber intraocular lens: a novel technique.

We aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL) in the anterior chamber (AC) with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.

Optik Koherens Tomografi ile Arka Kutup Analizi ve Maküla KalınlığıÖlçüm Modu Sonuçlarının Tek Taraflı Anizometropik Ambliyoplarda Karşılaştırılması

Özet Amaç: Optik koherens tomografi (OKT) cihazıyla tek taraflı anizometropik ambliyopisi olan çocuk yaş grubundaki olgularda arka kutup analizi (AKA) ve maküla kalınlığı ölçüm modunda alınan ölçümlerin karşılaştırılması. Ge reç ve Yön tem: Kliniğimizde takip edilen 6-17 yaş arası 37 tek taraflı anizometropik ambliyopi olgusunun 74 gözünün OKT cihazıyla AKA ve maküla kalınlığı ölçüm modu sonuçları değerlendirildi. Tüm ölçümler aynı seansta, pupilla dilate edilmeksizin aynı deneyimli hekim tarafından yapıldı. AKA ve maküla kalınlığı ölçüm modu çekimleri rastgele sırayla yapıldı. AKA ve maküla kalınlığı ölçüm modu sonuçlarının karşılaştırılması için her iki ölçüm modunda da ortak olarak elde edilebilen maküla kalınlık haritası sonuçları değerlendirildi. Sağlam ve ambliyop gözlerde AKA ve maküla kalınlığı ölçüm modu sonuçlarının karşılaştırılması eşleştirilmiş örneklem t-testiyle, ambliyop ve sağlam gözlerin retina kalınlıkları arasındaki farkın araştırılması bağımsız örneklem ttesti ile değerlendirildi. So nuç lar: Ambliyop gözlerde AKA ve maküla kalınlığı ölçüm modunda alınan ölçümler arasında değerlendirilen tüm segmentlerde istatistiksel olarak anlamlı fark saptanmadı (p değerleri tüm segmentler için 0,10’un üzerinde idi). Sağlam gözlerde AKA ve maküla kalınlığı ölçüm modunda alınan ölçümler arasında merkezi, superior, inferior ve nazal segmentlerde istatistiksel fark saptanmazken (p değerleri tüm segmentler için 0,16’nın üzerinde idi), temporal segmentte anlamlı fark saptandı (p=0,04). Sağlam ve ambliyop gözlerin maküla kalınlıkları karşılaştırıldığında her iki ölçüm modunda da maküla kalınlıkları arasında istatistiksel olarak anlamlı fark saptanmadı (p değerleri tüm segmentler için 0,24’ün üzerinde idi). Tar t›fl ma: Tek taraflı anizometropik ambliyopisi olan olgularda, OKT cihazının farklı çekim modlarında alınan maküla kalınlığı ölçümleri anizometropik ambliyop ve sağlam gözlerde benzerlik göstermektedir. Ancak makülanın temporal segment ölçüm değerleri dikkatli değerlendirilmelidir. (Turk J Ophthalmol 2013; 43: 113-7) Anah tar Ke li me ler: Ambliyopi, arka kutup analizi, maküla, optik koherens tomografi