Hayyam Kiratli

Hacettepe Üniversitesi Ana Sayfasi, Engüri, Ankara, Turkey

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Publications (144)188.47 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Renal carcinoid tumor is an exceedingly rare malignancy. A 57-year-old man with a renal carcinoid tumor discovered after metastasizing to intraocular and bilateral orbital structures is described. The patient presented with a blind painful OS and a right superotemporal subconjunctival mass. Imaging studies revealed a large left intraocular tumor, a mass in the left medial rectus muscle, and right lacrimal gland enlargement. The OS was enucleated, and incisional biopsies were performed from the other 2 lesions. Histopathological studies demonstrated metastatic neuroendocrine tumor with chromogranin and synaptophysin positivity. Systemic work up revealed a right renal mass and multiple hepatic metastatic lesions. Radical nephrectomy was performed, and octreotide, capecitabine, and temozolomide were administered. Removal of the primary tumor and the eye that had no prospect for useful vision and further treatment with octreotide, capecitabine, and temozolomide provided a disease progression-free period of 24 months and allowed the patient to function normally.
    Ophthalmic plastic and reconstructive surgery 04/2014; · 0.69 Impact Factor
  • Pinar Topcu-Yilmaz, Burcu Kasim, Hayyam Kiratli
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    ABSTRACT: To compare the optical coherence tomography (OCT) findings of neurofibromatosis-1 (NF-1) patients with/without optic pathway glioma (OPG) with those of healthy controls. Ten patients with NF-1, 17 patients with NF-1-associated OPGs, and 17 control subjects were included in the study. Retinal nerve fiber layer (RNFL) and macular thickness findings measured with Stratus OCT were compared between the groups. The average RNFL thickness was significantly lower in the OPG group (76.72 ± 22.16 μm) than in the controls (108.89 ± 9.92 μm) and NF-1 patients without OPGs (111.17 ± 12.13 μm) (p < 0.001). The macular volume was also found to be lower in NF-1 patients with OPG (6.41 ± 0.66 mm(3)) than in the healthy controls (7.19 ± 0.36 mm(3); p = 0.001) and NF-1 patients without OPGs (7.25 ± 0.26 mm(3); p = 0.005). Following this analysis the OPG group was further subdivided into two categories: OPG patients with normal visual acuity (VA) and OPG patients with decreased VA. The statistical analysis was repeated for these four subgroups, revealing that while the decrement in the average RNFL thickness was significant for both OPG groups that in the macular volume was only significant for OPG patients with decreased VA. The results of our study suggest that RNFL thinning can be a helpful marker for the detection of OPGs in NF-1 patients. Larger studies with longitudinal data are required to confirm the role of OCT in the diagnosis and follow-up of these patients.
    Japanese Journal of Ophthalmology 02/2014; · 1.27 Impact Factor
  • Bercin Tarlan, Hayyam Kiratli
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    ABSTRACT: Choroidal melanoma is the most common primary intraocular malignancy in adults. Alternative treatment modalities have been proposed in recent years including enucleation, local resection, plaque brachytherapy, charged-particle radiotherapy, stereotactic photon beam irradiation therapy, transpupillary thermotherapy and photodynamic therapy. This review aims to focus on all the available therapeutic options in choroidal melanoma and update the reader on the current status of each modality. Treatment of choroidal melanomas should be directed towards reducing the risk of recurrences, as it is known that recurrent tumors are associated with an increased rate of metastatic disease and poor prognosis. Advances in genetics and cytogenetics can enhance the accuracy of patient prognostication.
    Expert Review of Ophthalmology 01/2014; 7(2).
  • Hayyam Kiratli, Salih Uzun, Berçin Tarlan
    Albrecht von Graæes Archiv für Ophthalmologie 12/2013; · 1.93 Impact Factor
  • H Kiratli, B Tarlan, O Tanas, A Uner
    Journal francais d'ophtalmologie 08/2013; · 0.51 Impact Factor
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    ABSTRACT: Abstract We report two patients with previously diagnosed chronic lymphocytic leukemia who developed Richter syndrome in the orbit as the sole extranodal site. The medical history, clinical findings, orbital imaging and histopathological features of the patients were reviewed. Treatment protocols and the outcomes were also assessed. The first patient developed Richter syndrome at the age of 64 years, 3 years after the diagnosis of chronic lymphocytic leukemia. The tumor was located at the inferotemporal quadrant of the orbit. The second patient was 59 years old when Richter syndrome arose in the lacrimal gland, 4 years after the diagnosis of chronic lymphocytic leukemia. Incisional biopsy from the orbital tumors were performed. Histopathological findings included diffuse CD20, CD 23, CD5, bcl2, bcl6 positive lymphocytic infiltration. Both patients were treated with chemotherapy and rituximab. During 3 years of follow-up, there was no orbital or systemic recurrence of the disease. Richter syndrome may develop in the orbital soft tissue and the lacrimal gland, and the orbital disease appears to have a better prognosis compared to patients with systemic involvement.
    Orbit (Amsterdam, Netherlands) 07/2013;
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    ABSTRACT: Abstract Background: A microdeletion in the chromosome 22q11.2 (DiGeorge or velocardiofacial syndrome) is the most common human deletion syndrome. Patients with 22q11.2 deletion may have a wide range of ocular findings but severe ocular involvement is uncommon. Here, we describe a 2-year-old boy who had growth retardation, developmental delay, right renal agenesis, ventricular septal defect and severe bilateral ocular anomalies. Materials and methods: The systemic and ocular findings and cranial magnetic resonance imaging study results were reviewed. Fluorescence in situ hybridization analysis was performed on his peripheral blood. Results: The patient presented with the oculodigital sign. On examination, he had severe right microphthalmia with no light perception and his left eye could not fix and follow. The left eye had anterior segment dysgenesis, mild sclerocornea, corneal staphyloma and congenital aphakia. Systemic findings included growth deficiency, microcephaly, micrognathia, ventricular septal defect, atrial septal defect and right renal agenesis. Fluorescence in situ hybridization analysis of this patient was significant for a heterozygous deletion covering DiGeorge critical region 2 and spanning a 250 kb region in the 22q11.2 locus. Conclusion: The 22q11.2 deletion syndrome may be associated with severe bilateral ocular malformations including microphthalmia, sclerocornea, corneal staphyloma, anterior segment dysgenesis and congenital aphakia. Corneal staphyloma might have resulted from the oculodigital phenomenon or increased intraocular pressure.
    Ophthalmic Genetics 07/2013; · 1.07 Impact Factor
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    ABSTRACT: Here, we present the case of a patient with bilateral choroidal metastases with extraocular extension in one eye. Metastasis of papillary thyroid carcinoma to the uvea is extremely rare, with only 6 patients reported in the literature. A 62-year-old man with a prior history of papillary thyroid carcinoma suffered the rapid loss of vision in his right eye. He had neovascular glaucoma, total retinal detachment, and a solitary choroidal mass. A month later, his left visual acuity also decreased because of a small macular choroidal mass. The right eye was enucleated and a nodular lesion over the sclera representing extraocular extension was observed. This tumor and the intraocular lesion were composed of papillary excrescences and cystic spaces and stained positively for thyroid transcription factor 1 and thyroglobulin, all confirming the diagnosis of metastatic papillary thyroid carcinoma. The tumor in the left eye was successfully treated with diode laser transpupillary thermotherapy. The patient expired within a month as a result of widespread pulmonary metastases. Papillary thyroid carcinoma may metastasize to the uvea bilaterally, cause rapid visual function loss, erode the sclera, and may extend outside the globe similar to choroidal melanoma. This aggressive ocular involvement was associated with a dismal prognosis in our patient.
    Korean Journal of Ophthalmology 06/2013; 27(3):215-8.
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    ABSTRACT: A case of a paraneoplastic vitelliform retinopathy is described in the fellow eye of a 40-year-old woman 4 years after enucleation of her left eye for a ciliochoroidal melanoma. There were multiple yellow subretinal vitelliform-like lesions at the posterior pole, which were hyperautofluorescent and hypofluorescent on fluorescein and indocyanine green angiographies. Spectral-domain optical coherence tomography showed hyperreflective material between the retinal pigment epithelium and the photoreceptor layer. Paraneoplastic vitelliform retinopathy may appear concomitantly with the development of distant metastases years after treatment of a ciliochoroidal melanoma and may present with symptoms resembling melanoma-associated retinopathy and electroretinogram findings. However, unlike with melanoma-associated retinopathy, the retinal lesions are located between the retinal pigment epithelium and the photoreceptor layer.[Ophthalmic Surg Lasers Imaging Retina. 2013;44:290-292.].
    Ophthalmic surgery, lasers & imaging retina. 05/2013; 44(3):290-2.
  • Hayyam Kiratli, Berçin Tarlan, Sevket Ruacan
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    ABSTRACT: ABSTRACT Purpose: To describe a case of an epitheloid hemangioendothelioma which is a tumor of endothelial origin with borderline malignancy between hemangioma and angiosarcoma and which is very rare in the orbit. Methods: Clinical features, results of imaging and histopathological studies and postoperative clinical course of a 22-year-old female patient who presented with a gradual swelling of the left upper eyelid were reviewed. Results: Magnetic resonance imaging studies suggested a solid lesion with moderate contrast enhancement in the palpebral lobe of the lacrimal gland. A short course of systemic corticosteroid therapy failed to resolve the lesion. Excisional biopsy of the tumor yielded the diagnosis of epitheloid hemangioendothelioma of the lacrimal gland. The tumor was composed of nests of epitheloid cells, some forming CD31 positive intracytoplasmic vascular channels containing erythrocytes. CD34 and EMA were also positive and desmin, SMA, p63, S100, Factor VIII and HHV-8 were negative on immunohistochemical studies. During 44 months of follow-up, there has been no recurrence or systemic metastasis. Conclusion: Epitheloid hemangioendothelioma can occur in the palpebral lobe of the lacrimal gland as a hard, painless, immobile mass. Simple excisional biopsy of the tumor, assumed to have an intermediate malignancy grade, without further local or systemic therapy provided a disease-free 3-year survival.
    Orbit (Amsterdam, Netherlands) 03/2013;
  • Hayyam Kiratli, Ozlem Dikmetaş
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    ABSTRACT: This report aims to raise awareness of the potential link between isotretinoin use and the development of lacrimal gland enlargement. A 23-year-old woman who was using isotretinoin 40 mg daily for acne vulgaris for 6 months presented with periocular pain and bilateral swelling of upper eyelids. She did not have any signs of inflammation. Her systemic workup including serological tests for autoimmune disorders were within normal limits. MRI of the orbits revealed bilateral enlargement of the lacrimal glands. Discontinuation of isotretinoin resulted in disappearance of her signs and symptoms and the size of the lacrimal glands reverted to normal after 2 months. Isotretinoin use may be associated with lacrimal gland enlargement, and this adverse effect seems to be transient and reversible on cessation of the drug.
    Ophthalmic plastic and reconstructive surgery 03/2013; · 0.69 Impact Factor
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    ABSTRACT: Purpose: The management of Langerhans cell histiocytosis is controversial. This study evaluated our clinical experience and therapeutic results in orbital Langerhans cell histiocytosis. Methods: This is a retrospective, noncomparative interventional case series involving 17 consecutive patients with biopsy-proven orbital Langerhans cell histiocytosis. Response to surgery and chemotherapy and development of diabetes insipidus were the main outcome measures. Results: Thirteen (76.5%) of the patients were male and the mean age at diagnosis was 10.7 years (range 2-39 years). The most frequent presenting sign was proptosis (8 patients) and upper eyelid edema (4 patients). Pain was present in 5 cases and periocular redness in 6. No patient reported a history of trauma. The frontal bone was involved in 16 patients followed by the zygomatic in 9 cases. Five patients also had lesions in the calvarium, femur, facial, temporal, and parietal bones. No patients had systemic disease. Ten patients were managed with vinblastine (0.2 mg/kg, 6-12 months) chemotherapy because of major residual tumor burden (5 cases) and multi-bone involvement (5 cases). Four patients were observed following macroscopically complete tumor removal. Three patients with limited anterior orbital soft tissue tumors and single bone involvement received systemic corticosteroids (40 mg/m2/d, 6-10 weeks). No patients developed diabetes insipidus after a median follow-up of 46 months. Conclusions: Macroscopically complete excision of the unifocal tumors may not necessitate any further treatment. Vinblastine chemotherapy following incomplete tumor removal and in patients with multifocal bone disease resulted in recurrence-free survival at 3 years in 90% of patients.
    European journal of ophthalmology 03/2013; · 0.91 Impact Factor
  • H. Kiratli, B. Tarlan
    Journal francais d'ophtalmologie 02/2013; 36(2):184–185. · 0.51 Impact Factor
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    Bercin Tarlan, Hayyam Kiratli
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    ABSTRACT: Subconjunctival hemorrhage is a benign disorder that is a common cause of acute ocular redness. The major risk factors include trauma and contact lens usage in younger patients, whereas among the elderly, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis are more common. In patients in whom subconjunctival hemorrhage is recurrent or persistent, further evaluation, including workup for systemic hypertension, bleeding disorders, systemic and ocular malignancies, and drug side effects, is warranted.
    Clinical ophthalmology (Auckland, N.Z.) 01/2013; 7:1163-1170.
  • H. Kiratli, B. Tarlan, Ö. Tanas, A. Üner
    Journal francais d'ophtalmologie 01/2013; · 0.51 Impact Factor
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    ABSTRACT: Orbital chondrosarcoma arising from paranasal sinuses or from the nasal cavity with orbital extension is highly unusual. The aim of this report is to describe our multidisciplinary experience in the treatment of three patients with extensive sino-orbital chondrosarcomas. The patients were aged 43, 75 and 63 years, and the tumors originated from the maxillary, sphenoidal, and ethmoidal sinuses, respectively. Magnetic resonance imaging studies showed homogeneously hypointense lesions on T1-weighted scans, which were hyperintense on T2-weighted images. Intranasal endoscopic surgery alone or in combination with other conventional surgical approaches was the main therapeutic choice. Two patients had recurrences treated with wider surgical removal. Fractionated stereotactic radiotherapy was used in two cases. Two patients had histopathological grade I tumor and one had grade III chondrosarcoma. No patient had regional spread or distant metastasis. All patients were disease-free at 4, 2, and 3 years, respectively, following their last therapeutic interventions. Endoscopic surgery results in lesser morbidity for chondrosarcomas arising from paranasal sinuses and extending into posterior parts of the orbit. However, because control of surgical margins may not be complete, recurrences may occur justifying more radical approaches.
    International Ophthalmology 11/2012;
  • Hayyam Kiratli, Berçin Tarlan, Pınar Fırat
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    ABSTRACT: Primary sebaceous carcinoma is an exceptionally rare tumor of the lacrimal gland and less than 10 cases have been so far published in the literature. Two adult patients aged 38 and 81 years, respectively, who suffered unilateral painful massive swelling of the lacrimal gland are described. The disease in the first patient initially manifested as ipsilateral parotid gland metastasis and the primary tumor could be detected 3 months later. Both tumors were rock hard and fixed on palpation, caused partial upper eyelid ptosis, displaced the globe anteromedially and impaired ocular motility. Magnetic resonance imaging studies showed mostly homogeneous, well-delineated and moderately contrast-enhancing lacrimal gland fossa tumors without bone destruction. The management consisted of incisional biopsy for the diagnosis, immediately followed by exenteration. The younger patient further underwent radical neck dissection, parotidectomy and orbital and neck radiotherapy, which provided him a 2-year disease-free survival. Histopathological examination showed poorly differentiated sebaceous carcinoma destructing completely the lacrimal gland with predominantly comedo pattern. Despite its rarity and lack of specific clinical and imaging signs, sebaceous carcinoma should be considered in rapidly evolving painful and hard lacrimal gland fossa tumors. Also noteworthy is the early propensity of this tumor to spread to regional draining lymph nodes and the parotid gland in particular.
    Orbit (Amsterdam, Netherlands) 08/2012; 31(5):352-4.
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    ABSTRACT: Over an 11-year period, 59 patients (83 eyes) were treated with four-drug chemotherapy (cisplatin, etoposide, cyclophosphamide, and vincristine) at Hacettepe University, Departments of Ophthalmology and Pediatric Oncology. We evaluated the clinical features, treatment modalities, and outcome of these patients with a median follow-up of 55 months (range 9-130 months). Enucleation was performed as a first-line treatment for 30 eyes due to iris neovascularization and neovascular glaucoma, tumor in the anterior chamber regardless of the tumor stage, and for the patients with the Reese-Ellsworth (RE) group Vb. Chemotherapy was given regardless of tumor stages according to the RE groups in all 59 patients (83 eyes). Fifty-three eyes were treated with chemoreduction (CRD) and focal treatment. The rates of globe preservation were 87% for bilateral tumors and 35% for unilateral tumors in the CRD group. The 5-year overall (OS) and enucleation-free survival (EnFS) was 86.9% and 40%, respectively, for the whole group. At 3rd year, ocular survival rate for the eyes with vitreal or subretinal seeding was 58% and without seeding was 66% (P = .78). Seeding or subretinal collection may not indicate poor prognosis under intensive chemotherapy. The intensive four-drug chemotherapy protocol might have satisfactory results in the retinoblastoma (RBL) patients.
    Pediatric Hematology and Oncology 07/2012; 29(6):529-37. · 0.90 Impact Factor
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    ABSTRACT: To report 3 patients with conjunctival cavernous hemangioma in association with multiple recurrent episodes of subconjunctival hemorrhage. Retrospective clinical case series. We studied 3 patients, 11, 13, and 21 years of age, respectively, each of whom had a small, solitary, and irregular multiloculated vascular mass on the temporal bulbar conjunctiva of the right eye. The tumours were excised for cosmetic reasons. The medical records and histopathologic slides of the 3 patients were reviewed. Histopathologic examination showed that the tumours were composed of large, congested blood vessels separated by thin connective tissue. The patients did not have any recurrence of the tumour or hemorrhage. Cavernous hemangioma had a tendency to develop rapidly in young people on the temporal bulbar conjunctiva of the right eye, causing recurrent subconjunctival hemorrhages.
    Canadian Journal of Ophthalmology 06/2012; 47(3):318-20. · 1.15 Impact Factor
  • H. Kiratli, K. Erkan
    Journal Francais D Ophtalmologie - J FR OPHTALMOL. 01/2012;

Publication Stats

620 Citations
188.47 Total Impact Points

Institutions

  • 2003–2013
    • Hacettepe Üniversitesi Ana Sayfasi
      • • Department of Ophthalmology
      • • Faculty of Medicine
      Engüri, Ankara, Turkey
  • 1997–2013
    • Hacettepe University
      • • Department of Ophthalmology
      • • Department of Radiation Oncology
      • • Department of Medicine
      Ankara, Ankara, Turkey
  • 2008
    • Ankara University
      • Department of Ophthalmology
      Ankara, Ankara, Turkey
  • 2007
    • Eskisehir Osmangazi University
      • Department of Ophthalmology
      Eskişehir, Eskisehir, Turkey
  • 1996
    • Thomas Jefferson University
      • Wills Eye Institute
      Philadelphia, Pennsylvania, United States