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ABSTRACT: To investigate the association of age-related macular degeneration (AMD) with plasma antiphospholipid antibody levels.
This prospective study included 19 patients diagnosed as having dry-type AMD, 23 patients with exudative-type AMD, and 25 control subjects. Venous blood samples of the participants were obtained. Anticardiolipin antibodies (aCL) isotypes IgG and IgM were measured by means of an enzyme-linked immunosorbent assay. Lupus anticoagulant (LA) antibodies were measured by the dilute Russell viper venom time screen test.
The mean aCL IgG concentration in patients with exudative-type AMD was significantly higher than in patients with dry-type AMD and control subjects. The mean ± SE of aCL IgG levels in patients with exudative-type AMD and dry-type AMD and control subjects was 5.46 ± 1.26; 2.55 ± 0.78; and 0.32 ± 0.1, respectively. The mean aCL IgM levels and LA levels in the 3 groups were not statistically different.
Our findings suggest that elevated levels of serum aCL, a risk factor for cardiovascular and cerebrovascular diseases, may be associated with exudative-type AMD.
Canadian Journal of Ophthalmology 06/2012; 47(3):264-8. · 1.47 Impact Factor
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ABSTRACT: To evaluate the 6- month daytime efficacy of a fixed combination of timolol and brimonidine (BTFC) versus a timolol and dorzolamide fixed combination (DTFC) as a first choice therapy in patients with pseudoexfoliation glaucoma (PXG).
This study was a randomized, prospective, investigator-masked, 6-month comparison of twice-daily administration of BTFC versus DTFC in 60 newly diagnosed PXG patients.
Mean baseline untreated IOPs were 25.5 ± 2.6 mmHg and 26.2 ± 2.1 mmHg in the DTFC and BTFC groups, respectively. Mean intraocular pressure (IOP) reductions ranged from -7.3 ± 1.9 to -8.1 ± 2.0 mmHg for the DTFC group and from -7.5 ± 2.0 to -8.6 ± 2.6 mmHg for the BTFC group. No significant differences between the two treatment groups could be found. At month 6, the mean diurnal IOP was 17.5 ± 2.5 mmHg (31.3%) for the DTFC group and 18.0 ± 2.8 mm Hg (31.7%) for BTFC. As compared with baseline, mean diurnal IOP decreased by 7.9 ± 1.9 mmHg in the DTFC and 8.2 ± 1.5 mmHg in the BTFC, the difference between the groups was not statistically significant (p = 0.6). No statistical difference in terms of adverse events was found either.
Both fixed combinations were effective at lowering IOP in PXG. This study suggests that the daytime diurnal IOP is not statistically different when DTFC or BTFC is used as a first choice therapy in patients with PXG.
Current eye research 09/2011; 36(9):804-8. · 1.51 Impact Factor
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ABSTRACT: We aimed to review the epidemiology and visual outcome of patients with open globe injuries in the northwest part of Turkey.
All patients admitted to the Department of Ophthalmology, Kocaeli University Faculty of Medicine with open globe injuries between 2004-2008 were reviewed retrospectively.
Ninety-five eyes of 95 patients, aged between 3 and 79 years, were reviewed. The type of open eye injury was laceration in 76 eyes (80%) and rupture in 19 eyes (20%). In all age groups, projectile objects were the most common cause of injury. In patients 18 years and older, sharp objects (11.1%) were the least prevalent cause of open globe injuries; however, traumas with sharp objects were common in patients younger than 18 years (38.1%) (p=0.01). In patients younger than 18 years, most injuries occurred at home (68.3%), while in patients 18 years and older, the majority of ocular traumas occurred at work (59.2%) (p=0.000). Isolated Zone I lesions showed more improvement in visual acuity than other zones (p=0.043).
Open globe injury in northwest Turkey varied with age and gender. Education and safety precautions are essential to prevent open eye injuries.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 07/2011; 17(4):334-9. · 0.33 Impact Factor
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ABSTRACT: A prospective, non-randomized, comparative study was carried out to investigate aqueous humor and serum erythropoietin (EPO) levels in patients with pseudoexfoliation syndrome (PXS), pseudoexfoliative glaucoma (PXG), and, as controls, senile cataract without glaucoma. Aqueous humor was aspirated at the beginning of cataract or combined glaucoma-cataract surgery from 24 patients with PXS, 24 patients with PXG, and 24 patients with cataract only. Venous blood samples were obtained from all patients at the same time. Levels of EPO were measured in aqueous humor and venous blood using a sandwich enzyme-linked immunosorbent assay (ELISA) kit. There was no statistically significant difference between the mean aqueous humor EPO concentrations in eyes with PXS (10.70 ± 7.18 mU/ml), PXG (10.18 ± 7.20 mU/ml) and controls (9.75 ± 5.04 mU/ml) (P = 0.732). There was no statistically significant difference between the mean serum EPO concentrations in eyes with PXS (6.32 ± 2.86 mU/ml), PXG (7.06 ± 4.35 mU/ml) and controls (7.30 ± 4.15 mU/ml) (P = 0.672). Contrary to predictions based on the relation with ischemic processes, no difference was revealed between levels of EPO in aqueous humor and serum in patients with PXS and PXG.
International Ophthalmology 12/2010; 30(6):669-74.
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ABSTRACT: The aim of the study was to evaluate the variation in retinal nerve fibre layer (RNFL), optic nerve head (ONH) and macular measurements in healthy Turkish subjects using Stratus optical coherence tomography (OCT). The design is a cross-sectional study of 398 eyes in 199 normal subjects aged between 5 and 70 years. The participants underwent a detailed ophthalmologic examination including imaging with Stratus OCT. RNFL, optic disc and macula fast scan methods were used to obtain the peripapillary RNFL thickness, ONH and macular parameters. The effects on the findings of age, gender and laterality of the eye tested were assessed. The average RNFL thickness and the thickness measured in the superior and temporal quadrants were statistically significantly negatively correlated with age. Similar results were found for mean macular thickness, macular RNFL thickness and for total macular volume. There was no effect of age on ONH measurements. The RNFL thickness in the temporal quadrant was significantly greater in females than in males (p<0.05). The mean macular thickness in 1–3 mm was greater in males than in females (p<0.05). The nasal RNFL thickness was significantly thicker in the right eyes than in the left eyes (p<0.05). We conclude that, in healthy subjects, as age increases there is a significant reduction in peripapillary and macular RNFL thickness and in macular thickness and volume. The hypothesis that RNFL and macular measurements are not symmetrical between the two eyes merits further study.
01/2010; 34(1):36-44.
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ABSTRACT: To evaluate the systemic high sensitivity C-reactive protein (hsCRP) levels in patients with pseudoexfoliation syndrome (XFS) and pseudoexfoliation glaucoma (XFG).
We prospectively examined 31 patients with XFS, 26 with XFG, and 25 controls. To the study patients with the exclusion of serious hypertension that do not have any cardiovascular and cerebrovascular disease and that diagnosed as XFS and XFG have been included. Each patient passed through a detailed blood sampling including hsCRP, biochemistry, and lipid profile. Plasma C-reactive protein (CRP) levels were measured with nephelometric method by using Beckman IMMAGE hsCRP reagent.
Each group had similar demographic parameters including age, sex, body mass index, heart rate, and blood pressure. When we compared with controls, there was no statistically significant difference in the hsCRP and biochemistry results between the 3 groups. When all patients with pseudoexfoliation (PEX) compared with controls there was no difference.
Our findings indicated no difference in the hsCRP level between XFS, XFG, and controls. This study suggests that CRP is not a predictive marker of inflammation and peripheral endothelial dysfunction in XFS, which is accepted as a systemic disorder.
Journal of glaucoma 10/2009; 19(6):373-6. · 1.74 Impact Factor
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ABSTRACT: To use optical coherence tomography (OCT) to assess changes in foveal thickness after uneventful phacoemulsification in eyes with pseudoexfoliation syndrome (PXF), pseudoexfoliation glaucoma (PXG), or primary open-angle glaucoma (POAG).
Department of Ophthalmology, University of Kocaeli, Kocaeli, Turkey.
This prospective observational case series comprised 87 eyes (87 patients) that had phacoemulsification. Thirty-three were control eyes with cataract and no ocular disease, 15 eyes had POAG, 22 eyes had PXF, and 17 eyes had PXG. Foveal thickness was measured by OCT preoperatively and 1, 2, 4, and 8 weeks postoperatively. Intraocular pressure was recorded preoperatively and 8 weeks postoperatively.
In all groups, the mean foveal thickness was statistically significantly greater at all postoperative visits than preoperatively. The mean change in foveal thickness was higher in the POAG group than in the PXF and control groups at 2 and 8 weeks. The mean increase in foveal thickness was greater in the PXG group than in the control group and the PXF group at 2 and 4 weeks. Three patients (1 patient in each group except PXF) developed clinically significant cystoid macular edema (CME); the incidence of CME was not statistically significant.
Foveal thickness measured by OCT increased in patients with POAG and PXG and was higher than in the control group and the PXF group after uneventful phacoemulsification.
Journal of Cataract [?] Refractive Surgery 12/2008; 34(11):1953-7. · 2.26 Impact Factor
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ABSTRACT: To investigate the acute effect of caffeine on intraocular pressure and retrobulbar blood flow velocity.
In this randomized, double-masked, placebo-controlled, prospective study, we examined the effects of single 300-mg oral administration of caffeine on retrobulbar arteries' hemodynamics by using color Doppler ultrasonography imaging in healthy human volunteers. The subjects were divided into two groups; group 1 received a 300-mg caffeine tablet and group 2 received placebo. Measurements were obtained in two eyes at baseline, and 1 hr after acute ingestion of caffeine. Blood pressure, pulse rate, and intraocular pressure were monitored.
When compared with placebo, no significant change in mean blood pressure or intraocular pressure was observed after administration of caffeine. No significant differences were detected in the peak systolic and end diastolic velocities of retrobulbar arteries, compared with baseline values. Resistive index of ophthalmic, central retinal, and short posterior nasal ciliary artery were significantly increased after oral application of caffeine in group 1 (p<0.05).
The vascular resistance of the retrobulbar vessels appears to be altered by caffeine consumption. Further studies are needed to investigate the effects of caffeine on hemodynamics in patients with glaucoma.
Current eye research 10/2008; 33(9):804-9. · 1.51 Impact Factor
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ABSTRACT: A 67-year-old woman referred to our clinic complaining of decrease in vision and metamorphopsia for 1 month after initiating latanoprost therapy. Fundus examination and optical coherence tomography (OCT) revealed serous detachment in the macula. The macular thickness measured by OCT was 532 microm. Latanoprost was discontinued. At follow-up, a progressive decrease in macular thickness and increase in visual acuity was observed. Four months later, serous detachment was completely resolved, and macular thickness measured by OCT was 186 mum. Latanoprost may lead a serous retinal detachment in the posterior pole. Clinicians should keep in mind that decreased visual acuity in patients using latanoprost might be related with this complication.
International Ophthalmology 10/2007; 28(5):363-5.
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American Journal of Ophthalmology 03/2007; 143(2):373; author reply 373. · 4.22 Impact Factor
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ABSTRACT: To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with unilateral pseudoexfoliation syndrome (PXS) without glaucoma by using optical coherence tomography (OCT).
22 patients with unilateral PXS were evaluated. Group 1 included the eyes with the pseudoexfoliation, group 2 included the fellow eyes; 18 age-matched normal control eyes were assessed in group 3. The mean and segmental RNFL thickness in eyes with pseudoexfoliation and their fellow eyes in patients with unilateral PXS was compared to age-matched control subject eyes.
The RNFL in patients with PXS were significantly thinner than controls in all quadrants except the nasal quadrant with regard to segmental analysis (p < 0.05). This RNFL loss was apparent at 7, 10 and 11 o'clock of the PXS eyes with regard to clock hour position (p < 0.05). In the fellow eyes, no significant difference in RNFL measurement was found except the temporal quadrant when compared with the controls. In the analysis with regard to clock hour position, no significant reduction in RNFL thickness was found except in the 11-o'clock segment. In PXS eyes, RNFL thicknesses at the inferior quadrant and the 1-, 2- and 5-o'clock segments were significantly lower than in non-PXS eyes (p < 0.05).
This study suggests that PXS without glaucoma may be associated with a thinner RNFL compared with those of age-matched control subjects and non-PXS fellow eyes. Further studies are needed to clarify the relationship between the decrease in RNFL thickness and the development of glaucomatous damage in eyes with pseudoexfoliation.
Ophthalmologica 01/2007; 221(5):299-304. · 1.42 Impact Factor
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Albrecht von Graæes Archiv für Ophthalmologie 04/2006; 244(3):316-21. · 2.17 Impact Factor
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ABSTRACT: There is conflicting evidence as to whether Alzheimer disease (AD) is accompanied by loss of retinal ganglion cells. To evaluate this issue, we have used optical coherence tomography (OCT) to assess the thickness and volume of the retina. We have also sought to correlate our findings with visual function and cognitive impairment.
We evaluated 28 eyes of 14 patients with AD and 30 eyes of 15 age-matched control subjects. In these two groups, we measured retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume with OCT, visual function through latency of the pattern visual evoked potential (VEP) signal, and cognitive impairment through the Mini-Mental State Examination (MMSE).
The parapapillary and macular RNFL thickness in all quadrants and positions of AD patients were thinner than in control subjects. The mean total macular volume of AD patients was significantly reduced as compared with control subjects (P < 0.05). Total macular volume and MMSE scores were significantly correlated. No significant difference was found in the latency of the VEP P100 of AD patients and control subjects.
Our study confirms some other studies in showing that in AD patients there is a reduction of parapapillary and macular RNFL thickness and macular volume as measured by OCT. The reduction in macular volume was related to the severity of cognitive impairment.
Journal of Neuro-Ophthalmology 03/2006; 26(1):18-24. · 1.45 Impact Factor
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ABSTRACT: To evaluate ischemic changes in brain magnetic resonance images in patients with pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG) and compare them with age- and sex-matched control subjects.
This case-control study involved 16 consecutive patients with PXS, 21 patients with PXG and 18 healthy age- and sex-matched control subjects. Each subject underwent a comprehensive ophthalmological examination. In all participants, an axial T(1)-, T(2)- and proton-density-weighted and coronal cerebral 1.5-tesla magnetic resonance imaging (MRI) scan was made. White matter hyperintensities (WMH) were considered present if these were hyperintense on both proton-density- and T(2)-weighted images and not hypointense on T(1)-weighted images. White matter lesions were classified into two parts as the subcortical and periventricular regions. We used a validated rating scale of subcortical WMH: 0 = absent, 1 = punctuate foci, 2 = beginning confluence of foci and 3 = large confluent areas. Periventricular white matter lesions were classified on a scale of 0 (no white matter lesions), 1 (pencil-thin periventricular lining), 2 (thick lining) or 3 (large confluent white matter lesions).
The proportions of persons with WMH were 93.7% for patients with PXS, 95.2% for patients with PXG and 55.5% for control subjects. The numbers of white matter lesions in patients with PXS and PXG were significantly greater than in the control subjects (p < 0.05). White matter lesions at subcortical locations in patients with PXG were significantly more frequent than in the control subjects (80.9 vs. 33.3%; p < 0.05). The proportion of patients with subcortical WMH was 56.2% in PXS; no significant difference was found in subcortical WMH between PXS and controls. The proportions of patients with periventricular WMH were 93% in PXS, 90.4% in PXG and 44.4% in controls. White matter lesions at periventricular locations in patients with PXG and PXS were significantly more frequent than in the control subjects (p < 0.05). The difference between the pseudoexfoliation groups and controls with regard to the size of periventricular and subcortical white matter lesions was statically significant (p < 0.05). When patients with PXS were compared with PXG patients, there was no statistically significant difference in the number, size and scale of white matter lesions.
We found a significantly higher prevalence of MRI-defined WMH in patients with a clinical diagnosis of pseudoexfoliation with or without glaucoma versus control subjects. We think that the findings in this study may shed light on a possible link between ischemic brain lesions and pseudoexfoliation, which is not related with the presence of glaucomatous optic neuropathy. Further investigations are required to resolve the underlying associations.
Ophthalmologica 01/2006; 220(2):125-30. · 1.42 Impact Factor
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ABSTRACT: To evaluate plasma total homocysteine (tHcy) and nitric oxide (NO) marker levels in patients with pseudoexfoliation syndrome (PXS), pseudoexfoliation glaucoma (PXG), primary open-angle glaucoma (POAG), and normal controls.
This cross-sectional, prospective study involved 19 patients with POAG, 18 with PXS, 22 with PXG, and 20 control subjects. Fasting tHcy levels of all study participants were determined using a fluorescence polarization immunoassay method. Quantitation of total nitrate was based on the Griess reaction, in which a chromophore with a strong absorbance at 545 nm is formed by reaction of nitrite with a mixture of naphthylethylenediamine and sulphanilamide.
The mean plasma homocysteine level was statistically significantly elevated in the PXS (p=0.033) and the PXG (p=0.023) groups but not in the POAG group (p=0.996) when compared with the control group. Multiple logistic regression analyses comparing the various patient groups with the single control group indicated that elevation in plasma homocysteine concentration was a significant risk factor for PXS (odds ratio per 1 micromol/l increase in homocysteine concentration=2.05, 95% CI=1.19-3.52) and PXG (odds ratio per 1 micromol/l increase in homocysteine concentration=1.36, 95% CI=1.00-1.85) but was not a significant risk factor for POAG (odds ratio per 1 micromol/l increase in homocysteine concentration=0.99, 95% CI=0.78-1.26). NO markers levels were found to be slightly higher in PXS and PXG patients than control and POAG patients but the differences were not statistically significant (p=0.151). Multiple logistic regression analyses comparing the various patient groups with the single control group indicated that elevation in NO marker concentration was not a significant risk factor for PXS (odds ratio per 1 micromol/l increase in NO concentration=1.00, 95% CI=0.99-1.01), PXG (odds ratio per 1 micromol/l increase in NO concentration=1.00, 95% CI=0.99-1.00) and POAG (odds ratio per 1 micromol/l increase in NO concentration=0.99, 95% CI=0.99-1.00). No statistically significant correlations were observed between plasma tHcy and NO markers in study groups (p>0.05).
Elevated levels of homocysteine in pseudoexfoliation patients with and without glaucoma may partly explain the increased risk of vascular disease among patients with pseudoexfoliation. No significant difference was found in plasma NO markers among the POAG, PXS, PXG, and the control subjects.
Albrecht von Graæes Archiv für Ophthalmologie 08/2005; 243(7):677-83. · 2.17 Impact Factor
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ABSTRACT: To evaluate the effects of menopause and hormone replacement therapy (HRT) on the quality and amount of tear, intraocular pressure (IOP) and retrobulbar blood flow velocities.
Twenty women aged between 40 and 50 years, free of ocular and systemic diseases and planning to receive HRT were recruited as the study group. Twenty-four healthy, age-matched but still menstruating women were enrolled as controls. On the first day of study basal and reflex Schirmer test, tear break-up time and IOP measurements (at 08.00, 12.00 and 16.00 h) were performed for all groups. On the second day of the study, the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI) of the ophthalmic (OA), central retinal (CRA), nasal (NSPCA) and temporal short posterior ciliary (TSPCA) arteries were determined by color Doppler imaging. The menopausal group received HRT for 2 months, when all measurements were repeated for the 15 women who had received HRT on a daily basis.
The quality and amount of tear decreased (p < 0.01), IOP (p < 0.01) and RI of the CRA, TPCA and NPCA (p < 0.05) increased in postmenopausal women compared with the control group. After 2 months of HRT, the quality and amount of tear had increased (p < 0.001) and the IOP had decreased (p < 0.001). The PSV of the CRA and TSPCA had decreased (p < 0.05), as had the RI in the CRA (p < 0.001), NSPCA and TSPCA (p < 0.05).
We conclude that age-induced changes on quality and amount of tear, IOP and retrobulbar blood flow are intensified by the menopause and that it may be possible to decrease the menopausal effects on these parameters by HRT.
Ophthalmologica 218(2):120-9. · 1.42 Impact Factor
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ABSTRACT: To compare the short-term ocular hypotensive efficacy and side effects of 0.2% brimonidine and 0.5% apraclonidine in patients with elevated intraocular pressure (IOP).
We performed a double-masked, placebo-controlled study to compare the efficacy of the application of 0.2% brimonidine and 0.5% apraclonidine for the effect of IOP, systemic blood pressure and heart rate in 20 newly diagnosed ocular hypertensive patients. Effects on the untreated fellow eye and ocular side effects were also determined. All measurements were performed 1, 2, 4, 6 and 8 h after the instillation of one drop.
Brimonidine and apraclonidine significantly reduced IOP from baseline at all observation times. No significant difference was observed between the treatment groups. IOP decreased significantly in the untreated fellow eye in the brimonidine group at 4-, 6- and 8-hour checks and at 6-hour checks in the apraclonidine group when compared with placebo. Blood pressure and heart rate decreased significantly in the brimonidine group compared with placebo. Apraclonidine did not affect blood pressure or heart rate any differently than placebo. The pupil diameter and the interpalpebral fissure width significantly increased in the apraclonidine group, but not in the brimonidine group. There were no significant differences in the overall incidence of foreign body sensation, burning and stinging and dry mouth in the treatment groups.
In the short-term, brimonidine was effective in reducing IOP in patients with elevated IOP and was equivalent in efficacy to apraclonidine. On the other hand, a significant change in blood pressure and heart rate was observed with brimonidine; there was no change at all in the apraclonidine group.
Ophthalmologica 216(1):45-9. · 1.42 Impact Factor
