Nurettin Akyol

Karadeniz Technical University, Trabzon, Trabzon, Turkey

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Publications (27)50.82 Total impact

  • 12/2014; 44(6):496-498. DOI:10.4274/tjo.51422
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    ABSTRACT: To prospectively assess the effects of panretinal photocoagulation (PRP) treatment on pulsatile ocular blood flow (POBF) in patients with proliferative diabetic retinopathy (PDRP). The study included 40 eyes with PDRP in 27 patients. The PRP treatments were completed in 3 sessions with 3-week intervals. The intraocular pressure (IOP), pulse amplitude (PA), pulse volume (PV), and POBF changes that arose during the sessions were recorded using a blood flow analyzer. The average age of the patients was 57.37 ± 11.14 years. The pre-PRP basal IOP, PA, PV, and POBF values were 20.44 ± 4.13 mmHg, 4.23 ± 1.73 mmHg, 6.89 ± 2.28 μL, and 21.86 ± 5.83 μL/s, respectively. One month after the completion of the PRP sessions, the values were 18.49 ± 4.44 mmHg, 2.78 ± 1.13 mmHg, 5.27 ± 2.08 μL, and 15.89 ± 5.05 μL/s, respectively, and the differences were significant (P = 0.001, P < 0.0001, P < 0.0001, and P < 0.0001, respectively). PRP treatment reduces the choroidal blood flow and consequently causes significant decreases in IOP, PA, PV, and POBE .
    Turkish Journal of Medical Sciences 01/2014; 44(3):524-9. DOI:10.3906/sag-1303-87 · 0.84 Impact Factor
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    ABSTRACT: Abstract Purpose: To study the existence of anti-carbonic anhydrase antibodies (anti-CA-I&II) in acute anterior uveitis (AAU) patients and to analyze the relationship between the levels of these antibodies and the total antioxidant capacity (TAC), total oxidant capacity (TOC), oxidative stress index (OSI), and malondialdehyde (MDA) level. Methods: Forty-five AAU cases and 43 healthy controls were enrolled in this prospective study. Results: The average anti-CA I and II antibody levels were 0.433 ± 0.306 and 0.358 ± 0.261 IU/mL, respectively, in the AAU group and 0.275 ± 0.147 and 0.268 ± 0.108 IU/mL, respectively, in the control group (p = 0.004 and p = 0.036, respectively). In addition, it was found that the TOC, OSI, and MDA levels in the AAU subjects were statistically significantly higher than those of the control subjects. Conclusions: These results suggest that autoimmune responses against CA I and CA II and an altered serum oxidant-antioxidant balance may be involved in the pathogenesis of AAU.
    Ocular immunology and inflammation 09/2013; 22(2). DOI:10.3109/09273948.2013.830753 · 1.44 Impact Factor
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    ABSTRACT: To evaluate the possible effects of phacoemulsification cataract surgery on ocular hemodynamics. In this prospective study, intraocular pressure (IOP), pulsatile ocular blood flow (POBF), and ocular pulse amplitude (OPA) were measured pre-operatively (baseline) and at 1 week and 3 weeks postoperation in 52 eyes of 26 patients (mean age 63.15±10.25 years) scheduled for unilateral phacoemulsification cataract surgery with intraocular lens implantation. In all of the eyes, a blood flow analyzer (Paradigm DICON; Paradigm Medical Industries Inc.; USA) was used to obtain measurements of IOP, POBF, and OPA. The data obtained from operated eyes were compared statistically to untreated fellow phakic eyes of the patients. For operated eyes, the mean baseline IOP, POBF, and OPA values were 15.9±4.64mmHg, 17.41±4.84µL/s, and 2.91±1.12mmHg, respectively. The IOP, POBF, and OPA values were 17.19±4.34mmHg, 17.56±6.46µL/s, and 3.12±1.1mmHg, respectively, in the nonoperated control eyes. Statistically significant differences from baseline measurements were not observed 1 week and 3 weeks postoperation for the operated or nonoperated eyes. There were also no statistically significant differences in any measurements between the operated and nonoperated eyes in all the examination periods (P>0.05 for all). Uncomplicated phacoemulsification surgery does not affect ocular hemodynamics in normotensive eyes with cataracts.
    International Journal of Ophthalmology 01/2013; 6(4):537-41. DOI:10.3980/j.issn.2222-3959.2013.04.24 · 0.50 Impact Factor
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    ABSTRACT: Mucosa associated lymphoid tissue (MALT) lymphoma (marginal zone B-cell lymphoma of MALT according to the World Health Organization classification) is one of the low-grade non-Hodgkin's lymphomas. The majority of nonHodgkin's lymphomas of the ocular adnexa are extranodal marginal zone B-cell lymphomas of the mucosa associated lymphoid tissue, also known as MALT lymphoma. In 8% of cases, it arises from the conjunctiva. Lymphoid tumors of the conjunctiva may appear as isolated neoplasms or a part of a systemic disease. In this study, we presented a case of primary conjunctival lymphoma and discussed the etiology, diagnosis and treatment with reference to previous studies and reviews.
    Turkiye Klinikleri Journal of Medical Sciences 10/2012; 32(5):1440-1444. DOI:10.5336/medsci.2010-22352 · 0.10 Impact Factor
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    ABSTRACT: We report the case of a 35-year-old man who developed blindness and ophthalmoplegia during local anesthetic infiltration of the nasal septum. The complications were temporary, and the patient had full recovery without treatment. The vascular anatomy of the area and possible pathogenic mechanisms are discussed, with some suggestions on the prevention of this complication.
    Ear, nose, & throat journal 06/2012; 91(6):E1-3. · 0.88 Impact Factor
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    ABSTRACT: To evaluate the surgical outcome in patients diagnosed as having rhinogenic contact point headaches (RCPH). Thirty-six patients (aged 17-58 years) with RCPH underwent mini functional endoscopic sinus surgery procedures. Patients' pain complaints were evaluated with a visual analog scale (VAS) both pre- and postoperatively. All patients reported a decrease in the intensity of pain postoperatively. Nineteen patients (52.7%) reported complete relief. The difference between the preoperative (mean 8.62) and postoperative VAS pain scores (mean 2.11) was statistically very significant (p = 0.0000). No major complications were encountered. The removal of contact points in patients with RCPH is very effective in carefully selected patients.
    Medical Principles and Practice 01/2011; 20(1):29-33. DOI:10.1159/000322076 · 1.11 Impact Factor
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    Retina (Philadelphia, Pa.) 10/2010; 30(9):1557. DOI:10.1097/IAE.0b013e3181f36cdb · 3.18 Impact Factor
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    ABSTRACT: In this study we present the structural vitreoretinal changes observed during the clinical follow-up of a 35-year-old female patient presenting with serous macular detachment complicated with active ocular toxoplasmosis. The patient applied to the ophthalmology outpatient clinic with the complaint of impaired vision in the left eye; during her clinical follow-up her active toxoplasma chorioretinitis and accompanying serous macular detachment (SMD) in the macula of the same eye were evaluated with optical coherence tomography (OCT). In the OCT sections encompassing the active lesion, there was increased reflectance and thickening in posterior hyaloid membrane and retinal layers as well as local fluid collection in the subretinal space. Secondary to increased retinal reflectance, retinal pigment epithelium-choriocapillaris junction demonstrated focal shadowing. The clinical findings of the patient improved with treatment. During her control OCT examination, it was seen that posterior hyaloid membrane at the site of the lesion was detached, collected fluid underneath the retina was resolved, retinal tissue became thinner with irregular layers and the suppressed reflectance of the retinal pigment epithelium-choriocapillaris junction was partially improved. OCT sections at the level of macula demonstrated total disappearance of SMD.
    Turkiye Klinikleri Journal of Medical Sciences 08/2010; 30(4):1409-1412. DOI:10.5336/medsci.2008-9216 · 0.10 Impact Factor
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    ABSTRACT: Objective: Measurement of central corneal thickness (CCT) plays an important role in the assessment of various ocular diseases. In this study we aimed to compare the measurements of the central corneal thickness by Stratus optical coherence tomography with ultrasound biomicroscopy in the healthy corneas. Material and Methods: A total of 54 eyes of 42 (19 females, 23 males) cases aged between 35 and 83 years underwent CCT measurements with Stratus OCT and UBM. All eyes were examined first with Stratus OCT and then by UBM. Pearson's correlation analysis and paired t-test were used to evaluate the relationship between the device results. Measurements were also compared by Bland-Altman analysis. Results: The mean CCT measured by Stratus OCT and UBM were 521.31 +/- 29.98 and 525.56 +/- 30.3 mu m, respectively. While the mean difference between two devices were 4.24 +/- 7.05 mu m, the measurements of two devices were significantly correlated (Pearson's coefficient = 0.973, p<0.0005). In Bland-Altman analysis, there was a high level of agreement between Stratus OCT and UBM. Conclusion: Corneal thickness measurements are influenced by the device of measurement. Generally, Stratus OCT underestimates corneal thickness compared to that measured with UBM. However the differences between two devices are not clinically significant. For this reason, measurement of the CCT can be performed by a standard retinal OCT device which is an accurate, noninvasive, and repeatable technique.
    Turkiye Klinikleri Journal of Medical Sciences 06/2010; 30(3):962-969. DOI:10.5336/medsci.2008-9526 · 0.10 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the effectiveness of intravitreal bevacizumab on persistent retinal neovascularizations in proliferative diabetic retinopathy. Thirty-three eyes of 24 patients (mean age, 52.75 +/- 8.2 years) with proliferative diabetic retinopathy showing recurrences or no regressions in neovascularizations were evaluated in this study. After the intravitreal injection of 1.25 mg/0.05 mL of bevacizumab, the first examination was performed within 3 days and repeated at 1 week, 1 month, 3 months, and 6 months. In these examinations, localization and dimensions of neovascularizations were evaluated with red-free photographs and/or fluorescein angiography. All patients had type II diabetes for a period of 12 +/- 4.4 years (range, 2-20 years). After a single dose of bevacizumab, complete resolution rate of neovascularizations was 78.8% at 1 month, 63.6% at 3 months, and 45.4% at 6 months. When evaluated together with 9 eyes that had a second injection at 3 months, the complete resolution rate was 60.6% at 6 months. Mean best-corrected visual acuity and macular volume were 1.06 logarithm of the minimum angle of resolution (20/225 in Snellen) and 11.65 mm3 before treatment. Six months after treatment, these were 0.73 logarithm of the minimum angle of resolution (20/108 in Snellen) and 8.92 mm3 (P = 0.048 and 0.003, respectively). Bevacizumab can be used safely and successfully in patients with proliferative diabetic retinopathy who do not experience any resolution or experience recurrences after panretinal photocoagulation.
    Retina (Philadelphia, Pa.) 03/2010; 30(4):570-7. DOI:10.1097/IAE.0b013e3181bf5ff0 · 3.18 Impact Factor
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    ABSTRACT: Endonasal dacrocystorhinostomy (DCR) has gained interest in the last decade. Especially when a novice surgeon is performing the surgery, difficulty in identification of the lacrimal apparatus may complicate the procedure. We investigated the efficacy of methylene blue (MB) solution as a marker for lacrimal sac (LS) in endoscopic DCR. A total of 24 endoscopic DCR cases were performed (16 primary and 8 revision cases). During surgery, LS was irrigated with MB solution. Following lacrimal bone removal, medial wall of the LS is seen with a bluish hue. When the sac is dissected, the epithelium of the LS, which is heavily stained with MB contrasts with the surrounding nasal mucosa and therefore tailoring of the extent of the LS mucosa removal is facilitated. The follow-up period of the patients was 23 +/- 7.5 months. Of the 24 cases operated, only one case needed a re-operation. Use of MB solution is effective in both identifying LS and distinguishing it from surrounding nasal mucosa in DCR.
    Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 03/2008; 265(9):1071-4. DOI:10.1007/s00405-008-0612-1 · 1.61 Impact Factor
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    ABSTRACT: The aim of this report was to provide a detailed description of the clinical features of Vogt-Koyanagi-Harada (VKH) disease in Turkish patients. We retrospectively analyzed 45 patients diagnosed with VKH disease at seven referral centers in Turkey. A standard data acquisition form was used for the analysis of demographic and clinical features. The study cohort consisted of 45 patients (32 female, 13 male) who had a mean age at presentation of 31 years. Seven patients (15%) were aged 16 years or younger. Nineteen (42%) patients presented in the acute or subacute stage and 26 (58%) in the chronic stage. According to the revised diagnostic criteria, nine (20%) patients had the complete form of the disease, 23 (51%) had the incomplete form, and 13 (29%) had probable VKH disease. All patients had bilateral ocular involvement. Sunset-glow fundus was observed in 89% of the patients, pigment clumping in 73%, nummular depigmented scars in 71%, cataract in 53%, optic atrophy in 31%, glaucoma in 29%, subretinal fibrosis in 22%, choroidal neovascular membranes in 7%, and phthisis in 4%. All patients who presented at the acute uveitic stage received systemic corticosteroid therapy. Immunosuppressive treatment was employed in 30 (66%) patients, which was initiated at the acute uveitic stage in ten (22%) patients. Final visual acuity was better than 0.5 in 59% of the patients' eyes, between 0.1 and 0.5 in 21%, and less than 0.1 in 20%. VKH disease is rare in Turkey. We conclude that the majority of patients with VKH in Turkey do not have the complete form of the disease. Based on our results, most patients with VKH seem to be late referrals. Ocular complications were common among these patients.
    International Ophthalmology 01/2007; 27(2-3):117-23. DOI:10.1007/s10792-006-9001-1 · 0.55 Impact Factor
  • Engin Sozen, Avni Murat Avunduk, Nurettin Akyol
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    ABSTRACT: Thirty eyes of 28 patients with herpetic disease were included in the study. Group 1 patients (15 eyes of 15 subjects) received topical acyclovir (ACV) ointment. Oral valacyclovir (VACV) was prescribed to group 2 (15 eyes of 13 patients). The anterior segment of each eye was carefully examined by slit lamp and scored. Each patient was also instructed to grade his/her subjective symptoms. The corneal lesion healed significantly faster in the group 2 eyes compared to the group 1 eyes. Photophobia score on day 3 and slit-lamp score on day 10 were at significantly lower levels in group 2 compared to group 1. In herpetic keratitis, oral VACV can be a good alternative to ACV ointment therapy.
    Chemotherapy 02/2006; 52(1):29-31. DOI:10.1159/000090239 · 1.55 Impact Factor
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    ABSTRACT: Topical antiallergic agents, such as antihistamines and mast-cell stabilizers, are the main therapeutic options for seasonal allergic conjunctivitis (SAC). Ketotifen fumarate and olopatadine HCl have dual action that offers a combination of these 2 mechanisms. Although clinical studies comparing the efficacy of these 2 drugs have shown that both were effective in the treatment of SAC, the results were contradictory and did not include the effects of these drugs on inflammatory markers. The aims of this study were to compare the clinical efficacy of topical ketotifen and olopatadine eye drops and to determine the effects of these 2 drugs on the expression of cell adhesion molecules (CAMs) and inflammatory markers in conjunctival surface cells in patients with SAC. This 30-day, randomized, double-masked, artificial tear substitute (ATS)-controlled clinical trial was conducted at the Department of Ophthalmology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey. Patients with SAC were included in the study and randomly assigned to 1 of 3 groups: topical ketotifen fumarate 0.025% ophthalmic solution, topical olopatadine HCl 0.1% ophthalmic solution, or ATS (control group). All drugs were administered 2 drops per eye BID for 30 days. At the beginning of the study (day 0; baseline), on day 15, and on day 30, clinical scores (itching, tearing, redness, eyelid, swelling, and chemosis) and conjunctival impression cytology specimens were obtained. The percentages of cells expressing intercellular adhesion molecule 1, vascular CAM-1, human leukocyte antigen-DR, and beta1-integrin (CD29) from conjunctival impression cytology specimens were determined using flow cytometry. Patients were questioned about adverse events (AEs) at each visit. Ocular discomfort on installation of the drugs was recorded as an AE. Thirty-nine patients (20 men, 19 women; age range, 18-61 years) with SAC were included. Twelve patients received ketotifen; 13, olopatadine; and 14, ATS. In both active-treatment groups, the improvements of clinical scores (tearing and itching) were more pronounced compared with those in the ATS group, although the day-30 difference in tearing score between the olopatadine and ATS groups was not statistically significant. No significant within-group or between-group differences in mean scores for redness, chemosis, or eyelid swelling were found. The expression rates of CAMs and inflammatory markers in conjunctival surface cells were significantly more reduced with ketotifen and olopatadine compared with ATS. However, clinical and flow cytometric parameters were improved with ATS at 15 and 30 days compared with baseline. No AEs were observed during the study period. In this short-term study in a selected, small study population with SAC, ketotifen and olopatadine diminished the expression of CAMs and inflammatory markers on the conjunctival surface cells effectively. Both active treatments were more efficacious compared with ATS and were well tolerated.
    Clinical Therapeutics 10/2005; 27(9):1392-402. DOI:10.1016/j.clinthera.2005.09.013 · 2.59 Impact Factor
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    ABSTRACT: A Turkish woman aged 44 years who presented with a 1 month history of abdominal pain, fatigue and weight loss of 10 kg was diagnosed as having acute tubulointerstitial nephritis. Opthalmological evaluation revealed unilateral uveitis and contralateral chorioretinal scarring. X-ray films of the pelvis revealed unilateral sacroileitis. An elevated erythrocyte sedimentation rate, C-reactive protein, tubular proteinuria and renal glucosuria returned to normal 2 weeks after treatment was started. It is important to be aware of tubulointerstitial nephritis and uveitis syndrome in order to achieve a quick diagnosis in patients with renal impairment and tubular dysfunction with minor symptoms so that appropriate management can be started early.
    Nephrology 09/2005; 10(4):418-20. DOI:10.1111/j.1440-1797.2005.00400.x · 1.86 Impact Factor
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    ABSTRACT: To evaluate the long-term follow-up results of external dacryocystorhinostomy (Ex-DCR) and to assess the role of some factors in its success. Between January 1990 and November 2002, 437 nasolacrimal systems of 387 patients were operated on and included in the study. The success rates were determined on the basis of the last examinations of the patients, and the correlations between success rates and factors such as age, gender, the duration of obstruction, history of acute dacryocystitis, the side of obstruction, and the postoperative follow-up period were calculated. The mean follow-up period was 5.9 +/- 2.5 years. Fifty cases (12.9%) were operated bilaterally. The initial success rate was 91.5% and the last success rate was 98.4% after reoperations. We found meaningful correlations between success and duration of obstruction, age of the patient, and the duration of postoperative follow-up (r = 0.18, 0.17 and -0.14, p = 0.036, 0.001 and 0.002, respectively). In comparison to newly developed surgical techniques for the treatment of nasolacrimal duct obstruction, Ex-DCR still appears to offer higher success rates, even after long-term follow-up. In addition to being a cost-effective procedure, it requires no sophisticated instruments. In our opinion, the high success rates may be explained by the nature of the operation, which creates a fistula between the sac and the nasal mucosa.
    Orbit 07/2005; 24(2):99-102. DOI:10.1080/01676830590926693
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    ABSTRACT: To assess the effect of pericardial effusion on intraocular pressure (IOP). Twenty-two patients with pericardial effusion were enrolled into the study. The average pericardial effusion was 2245 +/- 257 cc, and the mean IOP was 26.1 +/- 2.1 mm Hg in the initial examination. Pericardial effusion was aspirated via canula under topical anaesthesia at two or three-day intervals. IOP was measured after every aspiration of pericardial fluid. We statistically compared the changes in the mean IOP after every aspiration (one-way ANOVA), and calculated the correlation (regression analysis) between the amount of fluid and the changes in IOP. An average of 400 ml of fluid was aspirated at two or three-day intervals. The mean IOP decreased to 23.3, 21.2, 19.1 and 16.3 mm Hg after aspirations, respectively. These decreases in the mean IOP were statistically significant (p < 0.01). In regression analysis, we observed a meaningful relationship between the changes in IOP and the amount of pericardial effusion (p < 0.001). We found that pericardial effusion affected IOP due to increased episcleral venous pressure. Therefore, patients with pericardial effusion should be referred for an ophthalmological examination with IOP measurement. IOP-lowering medication can eventually be started or adjusted by the ophthalmologist.
    Acta cardiologica 10/2003; 58(5):385-8. DOI:10.2143/AC.58.5.2005301 · 0.56 Impact Factor
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    ABSTRACT: This double-masked, prospective and randomized clinical trial was planned to investigate with color Doppler imaging the 1-month vascular effects of betaxolol, dorzolamide and apraclonidine treatment on patients with newly diagnosed primary open-angle glaucoma (POAG). 22 consecutive patients with newly diagnosed POAG between the ages of 46 and 72 years were enrolled in this study. All patients were newly diagnosed cases and had not received any antiglaucoma medication before. Patients who had a systemic vascular disease (including systemic hypertension) or were taking beta-blockers, nitrates or calcium channel blockers were excluded from the study. The patients were randomly divided into three groups. Groups A and B contained 7 patients, group C contained 8 patients. Group A patients were treated with topical betaxolol, group B patients received topical dorzolamide eye drops, and group C patients were treated with topical apraclonidine eye drops. Peak systolic velocities (PSV), end-diastolic velocities (EDV) and resistive indices (RI) in the right ophthalmic arteries (OA), central retinal arteries (CRA) and posterior ciliary arteries (PCA) were measured at baseline by using color Doppler imaging on a masked basis. On days 15 and 30 of treatment, the same measurements were repeated. The inter- and intragroup results were compared statistically. Compared to pretreatment measurements, topical betaxolol therapy significantly decreased PSV only in the PCA and only on day 30 of treatment (p = 0.011). On days 15 and 30, dorzolamide decreased RI measurements in the PCA compared to pretreatment measurement (p = 0.013 and p = 0.011, respectively). Apraclonidine also decreased PSV in the OA on days 15 and 30 of treatment when compared to pretreatment values (p = 0.013 and p = 0.012, respectively). When 15-day measurements were compared between the groups, PSV in the OA were significantly higher in dorzolamide-treated patients compared to other groups (p = 0.01 and p = 0.011). On day 30 of treatment, PSV in the OA was also higher in the dorzolamide-treated group than the other groups (p = 0.012 and p = 0.01). Additionally, apraclonidine-treated patients had a significantly lower EDV in the OA than the other groups (p = 0.013 and p = 0.01). The RI in the OA was also significantly lower in the apraclonidine-treated group compared to the other groups (p = 0.01 and p = 0.011). Our study suggests that dorzolamide has the most advantageous 1-month effects on blood flow velocity in the retrobulbar arterial circulation of POAG patients. Betaxolol seems superior to apraclonidine in this regard. Our data may help the clinician when treating patients with POAG medically. Further studies using a larger population size may clarify our results.
    Ophthalmologica 01/2001; 215(5):361-5. DOI:10.1159/000050886 · 1.87 Impact Factor
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    ABSTRACT: To investigate the possible effects of topical cyclosporine eye drops 2% (CsA) on conjunctival immune cells obtained by impression cytology technique and to determine the clinical relevance of this effect if present. Ten consecutive patients with severe, resistant, and active vernal keratoconjunctivitis (VKC) were included in this study. All of them were treated with 2% of topical CsA drops. Symptom and clinical scores and conjunctival impression cytology specimens were obtained both before and following treatment. Impression cytology specimens were stained with anti-CD8+, CD4+, CD45RA+, and CD23+ antibodies and the percentages of positive cells were counted. The results were compared and correlation analyses were performed between clinical and laboratory data. Significant reductions were observed with respect to the percentages of CD4+ and CD23+ cells in the conjunctival impression cytology specimens and clinical and symptom scores following treatment with topical CsA, while no change occurred in the percentages of CD8+ and CD45RA+ cells. The percentages of CD4+ and CD23+ cells showed good correlations with symptom and clinical scores. Topical CsA treatment is a very effective alternative in severe VKC cases in clinical ground and clinical efficacy of topical CsA treatment in severe, resistant VKC cases can be (at least partly) related to reduction of the CD23+ and CD4+ cell populations on the conjunctival surface.
    Ophthalmologica 01/2001; 215(4):290-3. DOI:10.1159/000050876 · 1.87 Impact Factor

Publication Stats

201 Citations
50.82 Total Impact Points

Institutions

  • 1990–2013
    • Karadeniz Technical University
      • • Department of Opthalmology
      • • Department of Histology and Embryology
      • • Faculty of Medicine
      Trabzon, Trabzon, Turkey