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Öğe Anterior uveitis associated with fixed-combination latanoprost and timolol(Canadian Ophthal Soc, 2008) Örnek, Kemal; Onaran, Zaer; Turgut, Yeliz…Öğe Bevacizumab sterility in multiple doses from a single-use vial(Harvey Whitney Books Co, 2008) Örnek, Kemal; Karahan, Zeynep Ceren; Ergin, Ahmet; Tekeli, Alper; Tekeli, OyaBACKGROUND: Recent reports have demonstrated that refrigerated bevacizumab can be stored for up to 3 weeks at 4 degrees C without loss of efficacy. There have been no previous reports addressing bevacizumb's sterility when stored and used as multiple doses from a single-use vial. OBJECTIVE: To evaluate the sterility of bevacizumab when used as multiple doses from a single-use vial. METHODS: Four groups of vials were used to simulate the storage and use conditions for bevacizumab. Each group contained 11 doses of 0.2 mL of bevacizumab. One sample from each group was cultured once each day at 37 degrees C for 10 days; one sample from each group was left for 15 days. MacConkey agar, blood agar, thioglycollate broth, and Sabouraud medium were used to assess bacterial and fungal growth. RESULTS: A total of 44 samples of bevacizumab were included in this study. Each sample was placed on 4 growth media for microbial readings. All samples were found to be negative for microbial growth. No significant differences were observed among the groups. Possible limitations of this study included the number of samples for each group and in vitro design of the study, which might have affected the growth of bacterial organisms. CONCLUSIONS: Storage and multiple use of bevacizumab from single-use vials does not seem to result n microbial contamination.Öğe Bilateral punctum atresia and lacrimal sac fistula in a child with CHARGE syndrome(Wiley-Blackwell Publishing, Inc, 2009) Onaran, Zafer; Yimazbaş, Pelin; Örnek, Kemal…Öğe Bilateral Recurrent Optic Neuropathy with Unilateral Oculomotor Nerve Palsy in Giant Cell Arteritis(Informa Healthcare, 2013) Örnek, Nurgül; Dağ, Ersel; Büyüktortop, Nesrin; Oğurel, Reyhan; Örnek, Kemal…Öğe Burkholderia cepacia keratitis with endophthalmitis(Soc General Microbiology, 2009) Örnek, Kemal; Özdemir, Mehmet; Ergin, AhmetKeratitis with endophthalmitis of the right eye occurred in a 78-year-female following a complicated cataract surgery. Prompt intravitreal vancomycin and ceftazidime with topical fortified tobramycin and cefazolin treatments were started. The corneal, aqueous and vitreous cultures grew a Burkholderia cepacia complex (Bcc) strain on the fourth day. Restriction fragment length polymorphism analysis of the recA amplicon revealed B. cepacia genomovar I. The organism was found to be susceptible to ceftazidime, ciprofloxacin and ofloxacin. Topical ciprofloxacin was given immediately. At day 10, the pain relieved and the clinical condition of the patient improved with resolution of the purulent discharge, severe circumcorneal congestion and chemosis. The size of the corneal abscess and anterior chamber exudation decreased. The Bcc should be included among the bacterial species that may cause keratitis following intraocular surgeries.Öğe Changes in the choroidal thickness in reproductive-aged women with iron-deficiency anemia(Biomed Central Ltd, 2015) Yumuşak, Erhan; Çiftci, Aydın; Yalçın, Selim; Sayan, Cemile Dayangan; Dikel, Nevin Hande; Örnek, KemalBackground: The aim of this study was to investigate the potential significance of the central macular thickness (foveal thickness-FT) and choroidal thickness (CT) in the eyes of patients with iron-deficiency anemia, the most common form of the anemia, via enhanced-depth imaging optical coherence tomography (EDI-OCT). We also investigated whether such changes might serve as an early indicator of underlying hematological disease. Methods: This prospective clinical study compared 96 female patients with iron-deficiency anemia and 60 healthy female control subjects. The macular and choroidal thicknesses in the temporal and nasal subfoveal areas were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) at 500 and 1500 microns and in five different regions (FCT, T-1500, T-500, N-500, and N-1500). Results: The mean ages of the patients and healthy controls were 34.08 +/- 10.39 years and 32.29 +/- 8.28 years, respectively (P = 0.232). There were no significant changes in macular thickness between the groups (225.58 +/- 19.76 vs. 222.45 +/- 13.51, P = 0.2). The choroidal thickness was significantly reduced in the patient group relative to the controls at all measured points (foveal choroidal thickness, P = 0.042; nasal-500 microns, P = 0.033; temporal-500 microns, P = 0.033; and temporal-1500 microns, P = 0.019). At some points, the choroidal thickness findings correlated with the hemoglobin values (temporal-500 microns, r = -0.287, P = 0.001; nasal-500 microns, r = -0.287, P = 0.005; nasal-1500 microns, r = -0.245, P = 0.016; and temporal-1500 microns, r = -0.280, P = 0.06). Conclusions: Patients with iron-deficiency anemia had a significantly reduced choroidal thickness.Öğe Cystoid macular edema following selective laser trabeculoplasty in a patient with ocular hypertension(Springer, 2019) Örnek, Nurgül; Örnek, Kemal; Oğurel, Tevfik; Gökçinar, Nesrin BüyüktortopPurpose Presentation of a case with ocular hypertension who developed cystoid macular edema (CME) following selective laser trabeculoplasty (SLT). Case report A 62-year-old male patient who had undergone phacoemulsification surgery for traumatic cataract 9 years ago was on ocular hypertension treatment for the last 5 years. Due to uncontrolled intraocular pressure and side effect of medications, a 360 degrees SLT was performed. The patient returned with decrased visual acuity 1 week after the procedure. There was CME in the treated eye. It healed completely after topical prednisolone acetate QID and nepafenac QID for 1 week, and no recurrence was observed during follow-ups. Conclusion Cystoid macular edema may occur following SLT treatment in patients with previous traumatic cataract surgery which responds to topical treatment.Öğe Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi(2016) Yumuşak, Mehmet Erhan; Örnek, KemalAmaç: Diyabetik makula ödemi olan hastalarda katarakt cerrahisi sonrası makula ödemindeki değişikliklerin ve hemoglobin A1C ile ilişkisinin incelenmesi.Gereç ve Yöntemler: Bu retrospektif klinik çalışma diyabetik makula ödemi olan ve komplikasyonsuz fakoemülsifikasyon ameliyatı uygulanan 30 hastanın 30 gözünü kapsamaktadır. Olgulara operasyon öncesi ve sonrası birinci hafta birinci ay ve üçüncü aylarda oftalmolojik muayene yapıldı ve optik koherens tomografi yardımıyla santral foveal kalınlık ölçümü yapıldı.Bulgular: Başlangıç değerlerine göre en iyi düzeltilmiş görme keskinliği bakımından birinci ay ve üçüncü ay değerleri artma gösterdi ve bu farklılık istatistiksel olarak anlamlıydı (P 0,05). Foveal kalınlık bakımından da birinci ay ve üçüncü ay değerleri başlangıca göre istatistiksel olarak anlamlı derecede yüksek bulundu. Ancak bir aydan sonra artma eğilimi azaldı. Hemoglobin A1C ile ilk ay foveal kalınlık arasında anlamlı pozitif bir korelasyon bulundu (P 0,030, r 0,38). Sonuçlar: Diyabetik makula ödemi ve kataraktı olan hastalar fakoemülsifikasyonla katarakt cerrahisinden fayda görmektedir. Katarakt cerrahisi sonrası makula ödemi açısından özellikle ilk altı ay optik koherens tomografi ile düzenli takip yapılmalıdırÖğe Diffusion-weighted magnetic resonance imaging in diabetic retinopathy(2018) Burulday, Veysel; Örnek, Kemal; İnal, Mikail; Güler, Hatice Ayhan; Daphan, Birsen Ünal; Örnek, NurgülDiabetic retinopathy (DR) is a complication of diabetes mellitus (DM) that may causes blindness. The vitreous is an extracellular matrix and it may have changes through liquefaction and syneresis in patients with DM, even in those without apparent DR. Diffusion-weighted imaging (DWI) is a new technique provide tissue contrast relying on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to investigate the vitreous of patients in different stages of DR using diffusion-weighted imaging technique. This prospective study included a group of 100 patients with DR and 100 members of an age- and gender-matched control group. All groups were tested using a head coil in conduction with a Achieva 1.5T magnetic resonans imaging (MRI) system (Philips Medical Systems, Best, The Netherlands). The mean ADC values were calculated and used for statistical comparisons. Mean duration of diabetes was 12.22±10.13 years in patients. Compared to controls, both eyes of the DR group had statistically and significantly lower values of ADC (p=0.025 and p=0.002, respectively). No significant correlations were found among the ADC values and central macular thickness, disease duration and stage of DR (all p>0.05) in patients. Mean ADC values revealed no significant differences among the subgroups of patients at different stages of DR (all p>0.05). Decreased ADCs in the vitreous of diabetes patients seem to be associated with the presence of diabetic retinopathy.Öğe Doğumsal persistan pupiller membranın Nd:Yag lazer ile tedavisi(2011) Onaran, Zafer; Örnek, Kemal; Yılmazbaş, PelinPersistan pupiller membran (PPM) pupiller aralığı örterek görme problemlerine yol açabilen gelişimsel bir ön segment anomalisidir. PPM tedavisinde midriazis ve kapama tedavisini içeren konservatif yaklaşımın yanında cerrahi ve Nd:YAG lazer tedavileri uygulanmaktadır. Bu yazıda 25 yaşında bir hastada Nd:YAG lazer ile tedavi edilen bilateral PPM olgusu sunulmaktadırÖğe Effect of 1% brinzolamide and 0.5% timolol fixed combination on intraocular pressure after cataract surgery with phacoemulsification(Ijo Press, 2013) Örnek, Kemal; Büyüktortop, Nesrin; Örnek, Nurgül; Oğurel, Reyhan; Erbahçeci, İnci Elif; Onaran, ZaferAIM: To evaluate the effect of brinzolamide-timolol fixed combination on intraocular pressure (IOP) after cataract surgery. METHODS: The study included 92 eyes of 87 patients who underwent cataract surgery and intraocular lens implantation. Patients scheduled for phacoemulsification were assigned to 1 of 2 groups. The treatment group received 1 drop of brinzolamide-timolol fixed combination immediately after surgery, and the control group received no treatment. The IOP was measured preoperatively and at 2h and 24h postoperatively. RESULTS: The mean IOP change was lower in the treatment group than in the control group at 2h postoperatively. The difference between the mean IOP values of the two groups at 2h postoperatively was found to be statistically significant. Twenty-four hours after the surgery, the mean IOP change was still higher in the control group when compared to the treatment group. CONCLUSION: The fixed combination brinzolamide timolol can effectively reduce IOP after cataract surgery.Öğe Effect of dexamethasone intravitreal implant (Ozurdex (R)) on corneal endothelium in retinal vein occlusion patients Corneal endothelium after dexamethasone implant injection(Bmc, 2018) Güler, Hatice Ayhan; Örnek, Nurgül; Örnek, Kemal; Gökçınar, Nesrin Büyüktortop; Oğurel, Tevfik; Yumuşak, Mehmet Erhan; Onaran, ZaferBackground: To assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex (R)) injection in patients with macular edema secondary to retinal vein occlusion (RVO). Methods: Twenty-two eyes of 22 patients were assessed prospectively after intravitreal 0.7 mg DEX implant injection. Twenty-two eyes of 22 healthy volunteers served as control group. Corneal endothelial cell parameters including endothelial cell density (ECD), coefficient of variation of cell size (CV), percentage of hexagonality (Hex) and central corneal thickness (CCT) were analyzed before and 1 and 3 months after injection by specular microscopy. The results of the study were compared statistically. Results: There were 17 (77.3%) patients with branch RVO and 5 (22.7%) patients with central RVO. Mean intraocular pressure (IOP) was 14.73 mmHg before injection, 17.05 mmHg at 1 month and 17.15 mmHg at 3 months after injection. Mean IOP at 1 and 3 months were significantly higher than pre-injection value (p = 0.002 and p = 0.003, respectively). There was a statistically significant reduction in mean ECD at 3 months after injection compared to pre-injection and 1 month (p = 0.013, p = 0.009, respectively) in the injected eyes. Mean ECD showed no significant difference in the uninjected fellow eyes during the follow up (p>0.05). Mean CV and Hex did not reveal a statistically significant difference in injected and uninjected fellow eyes (p > 0.05). No significant change was observed in mean CCT values during the follow up (p = 0.8). Conclusion: Intravitreal dexamethasone implant may cause a transient reduction in corneal endothelial cell density in short term without changing cell morphology.Öğe Effect of intravitreal bevacizumab on macular and peripapillary choroidal thickness in injected and fellow eyes of patients with diabetic macular oedema(Wiley-Blackwell, 2015) Örnek, Nurgul; Örnek, Kemal; Oğurel, Tevfik; Timur, Inci Elif…Öğe Effect of intravitreal bevacizumab on retrobulbar blood flow of patients with diabetic macular edema(Wichtig Publ, 2015) Örnek, Nurgül; İnal, Mikail; Erbahceci, Inci Elif; Oğurel, Tevfik; Örnek, KemalPurpose: To determine the effect of intravitreal bevacizumab on retrobulbar blood flow of patients with diabetic macular edema. Methods: Peak systolic velocity, end-diastolic velocity, resistance, and pulsatility indices of central retinal artery (CRA), nasal posterior ciliary artery (NPCA), temporal posterior ciliary artery (TPCA), and ophthalmic artery (OA) were assessed by color Doppler ultrasonography in injected and uninjected eyes of 37 patients at baseline and at day 1 and day 7 after the injection. Results: At day 1 after the injection, peak systolic and end diastolic velocities of the CRA and NPCA in the injected eyes and peak systolic velocity of NPCA in the uninjected eyes decreased significantly (p<0.05, p = 0.025, respectively). Peak systolic and end diastolic velocities were not significantly different in the injected and uninjected eyes at day 7 after the injection (p>0.05). In the injected eyes, there was no significant change in resistance and pulsatility indices (p>0.05), but a decrease in resistance index of NPCA and resistance and pulsatility indices of TPCA occurred in uninjected eyes at day 7 after the injection (p = 0.016, p = 0.023, and p = 0.025, respectively). Conclusions: Intravitreal bevacizumab affects retrobulbar blood flow in injected and uninjected eyes of patients with diabetic macular edema.Öğe Effects of Timolol and Latanoprost on Respiratory and Cardiovascular Status in Elderly Patients With Glaucoma(Mary Ann Liebert, Inc, 2009) Ergin, Ahmet; Örnek, Kemal; Güllü, Reyhan; Bulcun, Emel; Ekici, Mehmet; Ekici, AydanurPurpose: To investigate the respiratory and cardiovascular effects of switching therapy from topical timolol 0.5% to latanoprost 0.005% in elderly patients with glaucoma. Methods: Twenty-five patients with primary open-angle glaucoma (POAG) who were treated with topical timolol 0.5% were included in the study. The beta-blocker treatment was ended due to insufficient intraocular pressure (IOP) and systemic or local side effects. The treatment then switched to latanoprost in these patients. All recruited patients underwent a full ocular, cardiovascular, and respiratory examination including spirometry, pulse rate, and blood pressure. All measurements were made 1 day before the beta-blocker treatment was ended and 30 days after the latanoprost treatment was started. Results: Timolol treatment was associated with numerically but not statistically significant lowered pulse rates, systemic blood pressure, diastolic blood pressure, and reductions in the spirometry measurements. The change to latanoprost treatment was associated with numerical improvement in mean values of spirometric test results. There were no significant differences in changes in mean values of spirometry, pulse rate, or blood pressure. Histamine challenge test was determined to be positive in 16 of 25 patients for timolol, of whom 10 were positive for latanoprost. This was statistically significant (P < 0.05). Conclusions: Although all the results presented were statistically insignificant, switching to latanoprost treatment may offer some advantages in respiratory and cardiovascular function for elderly people with glaucoma over beta-blocker drugs. Spirometry and the measurement of pulse rate and blood pressure are advised in all patients receiving topical beta-blocker therapy.Öğe Endophthalmitis after tooth extraction in a patient with previous perforating eye injury(African Field Epidemiology Network-Afenet, 2015) Oğurel, Tevfik; Onaran, Zafer; Oğurel, Reyhan; Örnek, KemalThe aim of this stuty is to describe a case of endophthalmitis after tooth extraction in a patient with previous perforating eye injury. 50 years old male patient attempted to our clinic with complaints of sudden severe pain, reduced vision, light sensitivity and redness in the right eye. The patient stated that severe pain in his eye began approximately 12 hours following tooth extraction. The patient's ocular examination revealed a visual acuity of hand motion in the right eye. Anterior segment examination of the right eye showed intense conjunctival hyperemia, chemosis, a fine keraticprespitat and corneal edema. Dental procedures of the patients who had recently underwent ocular surgery or trauma should be done in a more controlled manner under anti -infective therapy or should be postponed in elective procedures.Öğe Giant eyelid molluscum contagiosum presenting as preseptal cellulitis(Wiley-Blackwell, 2014) Örnek, Kemal; Onaran, Zafer; Koçak, Mukadder…Öğe Glokomu olmayan hipertansif bireylerde dipper ve non-dipper kan basıncı paterninin retina sinir lifi kalınlığı üzerine etkisi(2014) Onaran, Zafer; Oğurel, Reyhan; Ebinç, Haksun; Usta, Gülşah; Şahin, Ömer; Örnek, KemalAmaç: Yirmi dört saat ayaktan kan basıncı izlemi sonucu kan basıncı seyri dipper ve non-dipper olarak saptanan hipertansif hasta- larda retina sinir lifi tabakası (RSLT) kalınlığının ölçülmesi ve farklı kan basıncı paternlerinin RSLT üzerine etkisinin araştırılması. Gereç ve Yöntem: Çalışmaya hipertansiyon tanısı almış 25 hasta ile 22 sağlıklı birey dahil edildi. Hipertansif hastalar 24 saatlik ayaktan kan basıncı ölçümü yapılarak 2 gruba ayrıldı. Arteriyel kan basınçlarının gece ortalaması gündüz ortalamasından %10 ve daha fazla düşük olanlar dipper hipertansiyon grubu (n13), düşüş olmayanlar ise non-dipper hipertansiyon grubu (n12) olarak belirlendi. Takiben çalışmaya katılan tüm bireylerin RSLT kalınlığı NFAII-GDx cihazı ile ölçüldü. Bulgular: Dipper ve non-dipper gruplarında gündüz ve gece ölçülen ortalama kan basıncı değerlerinin kontrol grubundan anlamlı derecede yüksek olduğu tespit edildi (p0.05). RSLT kalınlığının değerlendirilmesinde kullanılan GDx parametrelerinden TSNIT, superior average ve inferior average değerlerinin non-dipper grubunda hem kontrol grubundan hem de dipper grubundan daha düşük olduğu görüldü. En belirgin ve istatistiksel olarak anlamlı olan farkın da kontrol grubu ile non-dipper grubu arasındaki inferior average değerinde olduğu gözlendi (67.03 ?9.15 ve 59.31?6.38, p0.01). Sonuç: Gece boyunca çoğu kişide gözlenen kan basıncı düşüşünün olmadığı (non-dipper) hipertansif kişilerde hedef son organ hasarı- nın daha ciddi boyutlarda olduğu gösterilmiştir. Çalışmanın sonucunda saptanmış olan non-dipper paternde hipertansiyonun RSLT’da oluşturduğu incelme nedeniyle glokomatöz hasar için ek bir risk faktörü olarak geniş kapsamlı çalışmalarda incelenmesi faydalı olabilir.Öğe Göz Kapağı ve Perioküler Bölge Tümörlerinin Histopatolojik Dağılımı(2016) Yumuşak, Mehmet Erhan; Onaran, Zafer; Örnek, Kemal; Oğurel, Tevfik; Balcı, MahiAmaç: Kırıkkale ili ve çevresinde biyopsi alınarak histopatolojik değerlendirmesi yapılan göz kapağı ve perioküler bölge tümörlerinin epidemiyolojisinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: 2008-2016 yılları arasında 217 hastaya ait 239 lezyonun histopatolojik tanısı, yerleşim yeri ve lateralizasyonu geriye dönük olarak taranmış ve sınıflandırılmıştır. Hastalara ait demografik bilgiler derlenmiştir. Bulgular: 217 hastanın 104' ü erkek (%47.9), 113'ü kadın (%52.1) idi. Hastaların Yaş ortalaması 46.0±2.04 olarak bulundu.Lezyonların 117'si sağ (%48.9) 122'si (%51.1) sol tarafta yerleşmiş idi. Olguların 99'u alt kapaktan (%41.4), 120'si üst kapaktan (%50.2), 17'si (%7.1) medial kantus 3'ü (%1.3) ise dış kantusta idi. 239 olgunun %36.8'i epitelyal tümör (n=88), %5.8'i adneksiyal (n=14), % 3.8'i vasküler (n=9), %5'i ksantomatöz (n=12), %15.8 pigmente - melanositik (n=38), %21.3 inflamatuvar veya enfeksiyöz (n=51) , %11.2 u ise malign (n=27) olarak dağılım göstermekteydi. Sonuç: Yaklaşık olarak yapılan her 10 biyopsiden birinin malignite tanısı aldığı görülmektedir. Bir kısım literatür ile uyumlu olan sonuçlarımızın bazıları ile ise farklılık göstermesinin çevresel faktörlerden kaynaklanabileceği düşünülmüştürÖğe Herpes zosterin neden olduğu skatrisyel ektropiyon ve kornea erimesi(2007) Onaran, Zafer; Yılmazbaş, Pelin; Örnek, KemalHerpes zoster oftalmikus, göz yapılarının tümünü etkileyebilen ciddi ve sık rastlanan hir enjeksiyondur. Kornea tutulumu, sıklıkla virüsün direkt invazyonunun rol açlığı keratitler şeklinde izlenmekle birlikle, kapak patolojilerine ikincil olarak da gelişebilir. Bu yazıda 75 yaşında herpes zostere bağlı kapak tutulumu olan bir hastada geç dönemde gelişen skatrisyel üst kapak ektropiyonu ve buna bağlı kornea erimesi sunulmaktadır.
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