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Öğe 5-fluorouracil as chemoadjuvant for primary pterygium surgery: Preliminary report(Lippincott Williams & Wilkins, 2003) Akarsu, C; Taner, P; Ergin, APurpose. To investigate the safety and efficacy of intraoperative application of 5-fluorouracil as an adjuvant in primary pterygium surgery and to evaluate the effect of postoperative subconjunctival 5-fluorouracil injections on the recurrent pterygium. Methods. Of 25 consecutive white patients, 28 eyes with primary pterygium underwent pterygium excision with intraoperative application of 5-fluorouracil (25 mg/mL for 3 minutes). The superior and inferior conjunctiva was approximated to cover the scleral bed within I mm of the limbus. Recurrence of pterygium was defined as postoperative fibrovascular growth more than 1 mm onto the cornea. Eyes with recurrence less than 2 mm were treated with subconjunctival 5-fluorouracil injections. Results. After a mean follow-up of 14.1 +/- 3.9 months (mean +/- standard deviation), 7 recurrences (25%) were observed. All recurrences were detected within 12 months. In 4 of 7 recurrences, the fibrovascular growths were less than 2 mm. We, therefore, performed subconjunctival 5-fluorouracil injections. In 3 (75%) of 4 recurrences, the fibrovascular growths became atrophic. No serious complications were observed during and after the surgery. However, superficial punctate keratitis,:Pain, and hyperemia were detected in all patients in the early postoperative period. As a result, of 28 eyes, 4 (14%) had unacceptable cosmetic results and growing recurrences. Conclusions. This study suggests that intraoperative applications of 5-fluorouracil is both efficient and safe in the treatment of primary pterygium. Additionally, postoperative subconjunctival 5-fluorouracil injections may prevent the progression of fibrovascular tissue.Öğe Color Doppler imaging in optic neuritis with multiple sclerosis(Springer, 2004) Akarsu, C; Tan, FU; Kendi, TPurpose: To evaluate the retrobulbar hemodynamics in eyes with optic neuritis with multiple sclerosis and to compare these values with those of the unaffected fellow eyes and healthy control eyes. Methods: Thirty-four eyes of 17 patients with unilateral optic neuritis and multiple sclerosis and 16 eyes of 16 normal healthy subjects were recruited from the Departments of Ophthalmology and Neurology. The peak systolic and end-diastolic blood flow velocities and resistivity indices of the ophthalmic artery, posterior ciliary arteries and central retinal artery were measured in each eye with optic neuritis, using color Doppler imaging. Then, they were compared with those of the unaffected fellow eyes and healthy control eyes using paired and unpaired Student's t-tests, respectively. Results: The mean retrobulbar blood flow velocities and mean resistivity index in the ophthalmic artery in the eyes with optic neuritis were not significantly different from the unaffected fellow eyes and healthy control eyes, as well (P>0.05). The mean end-diastolic blood flow velocity in the central retinal artery (P=0.04) was lower and mean resistivity indices in the central retinal (P=0.02) and posterior ciliary arteries (P=0.009) were higher in the eyes with optic neuritis than in the control eyes. In patients with multiple sclerosis, the eyes with optic neuritis had higher resistivity indices in the posterior ciliary (P=0.02) and central retinal arteries (P=0.04) than did the unaffected fellow eyes. The retrobulbar blood flow velocities and resistivity indices of all vessels in the unaffected fellow eyes did not significantly differ from the control eyes (P>0.05). Conclusions: This study suggests that optic neuritis with multiple sclerosis is associated with impaired retrobulbar hemodynamics, especially in the posterior ciliary and central retinal arteries when compared with the contralateral unaffected eyes as well as healthy control eyes.Öğe The effects of hormone replacement therapy on ocular surface and tear function tests in postmenopausal women(Karger, 2004) Taner, P; Akarsu, C; Atasoy, P; Bayram, M; Ergin, APurpose: To prospectively investigate the impact of various hormone replacement therapies (HRT) on ocular surface and tear function tests. Methods: A total of 70 women in the postmenopausal period were enrolled in the study. The groups consisted of 16 women who were not on HRT ( group 1), 29 women who were on HRT with tibolone ( group 2) and 25 women who received estradiol plus medroxyprogesterone acetate treatment ( group 3). All patients underwent tear film break-up time (TF-BUT), Schirmer's test and conjunctiva cytology at the time of enrollment and at 6 months' follow-up. Results: Patients in group 2 showed improved Schirmer's test and TFBUT results (p < 0.001); however, no significant changes occurred in group 1 and group 3 patients (p > 0.05). Conjunctival cytology scores did not differ at the time of enrollment and at 6 months' follow-up in all groups. Conclusions: This is the first comparative clinical study on the effects of tibolone and estradiol plus medroxyprogesterone acetate on ocular surface and tear function tests. HRT with tibolone seems to improve tear function tests in postmenopausal women. Copyright (C) 2004 S. Karger AG, Basel.Öğe Effects of hypertension and antihypertensive treatment on retrobulbar circulation detected on Doppler sonography(Wiley, 2004) Karadeniz-Bilgili, MY; Ekmekci, Y; Koksal, A; Akarsu, C; Ziraman, IObjective. To study the effect of anti hypertensive drugs in essential hypertension and in the central retinal, posterior ciliary and ophthalmic arteries by using Doppler sonography. Methods. Thirty patients with essential hypertension and 32 control subjects were enrolled in the study. The pulsatility and resistive indices were evaluated in the central retinal, posterior ciliary and ophthalmic arteries before and 2 months after treatment with anti hypertensive drugs as well as in the control group. The pulsatility and resistive index values for each artery in each group were compared statistically. Results. There were significant differences in the retrobulbar pulsatility and resistive index values in each artery among the patients with initially diagnosed hypertension and the control group (P < .05). There were significant reductions in the resistive and pulsatility index values of the posterior ciliary and ophthalmic arteries after treatment (P < .05). For the ophthalmic artery posttreatment pulsatility and resistive index values did not reach the level of flow measured in the control subjects. Conclusions. The alteration of Doppler parameters of medication-free patients with hypertension may result from a peripheral vasospasm in the retrobulbar circulation, and the improvement in the Doppler parameters with oral anti hypertensive drugs may indicate the importance of early diagnosis in ameliorating hypertension-induced retrobulbar circulation changes.Öğe Short-term effect of latanoprost on ocular circulation in ocular hypertension(Blackwell Publishing Asia, 2004) Akarsu, C; Bilgili, YK; Taner, P; Unal, B; Ergin, APurpose: To determine the short-term effects of latanoprost on retrobulbar circulation in ocular hypertension. Methods: Forty-six eyes of 23 consecutive bilateral ocular hypertensive patients with an intraocular pressure (IOP) of greater than 22 mmHg were evaluated in a prospective controlled study. All subjects received a single drop of latanoprost 0.005% in one eye and placebo in the fellow control eye. Systemic circulatory parameters, intraocular pressure, blood flow velocities, and resistance indices of the ophthalmic, short posterior ciliary and central retinal arteries were measured using colour Doppler imaging at baseline and 2 h and 8 h after dosing, Results: Latanoprost lowered IOP significantly after 2 h and 8 h (P < 0.01). The mean IOP reduction was 6.7 mmHg 8 h after dosing. At baseline, there were no statistically significant differences in any retrobulbar vessels of eyes that received a single drop of latanoprost when compared with the eyes that received placebo (P > 0.05). Comparisons with baseline and latanoprost conditions revealed that latanoprost did not alter the blood flow velocities and resistance indices in the ophthalmic (P > 0.05), posterior ciliary (P > 0.05) and central retinal (P > 0.05) arteries 2 h and 8 h after dosing. The systolic and diastolic blood pressures (P = 0.74, P = 0.29, respectively) and pulse rate (P = 0.68) remained unchanged over the 8-h period. Conclusions: This study found that a single drop of latanoprost significantly reduces intraocular pressure 8 h after dosing. However, it does not have any short-term effects on the retrobulbar haemodynamics in ocular hypertensive eyes.Öğe Unilateral hyperhydrosis in Pourfour du Petit syndrome(Elsevier Science Bv, 2004) Kara, M; Dikmen, E; Akarsu, C; Birol, AUpper limp hyperhydrosis is an idiopathic disease with bilateral involvement. However, Pourfour du Petit syndrome, the opposite of Horner syndrome, may result in unilateral upper limb hyperhydrosis. It occurs following hyperactivity of the sympathetic cervical chain as a consequence of irritation secondary to trauma. We report herein two cases with Pourfour du Petit syndrome showing unilateral upper limb hyperhydrosis. The patients presented with right-sided mydriasis and ipsilateral hemifacial hyperhydrosis. The onset of disease was followed by a trauma in both patients. They underwent upper thoracic sympathectomy with favorable outcome. A history of an antecedent trauma in patients with unilateral upper limb hyperhydrosis and anisocoria may imply a possible diagnosis of Pourfour du Petit syndrome. (C) 2004 Elsevier B.V. All rights reserved.
