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Öğe Behçet hastalığı'nda oküler tutulumun konjonktival myeloperoksidaz aktivitesi ile değerlendirilmesi(Kırıkkale Üniversitesi, 2008) Güllü, Reyhan; Ergin, AhmetAMAÇ: Behçet hastalığı, etiyolojisi tam olarak bilinmeyen sistemik bir vaskülittir. Farklı serilerde hastaların yaklaşık %50-80'inde göz tutulumu bildirilirken, %20'inde başlangıç bulgusu olarak gözlenmektedir. Hastalığın etiyolojisine yönelik genetik, immünolojik ve infektif birçok neden öne sürülmüş ve son yıllarda özellikle immünolojik nedenlerin araştırıldığı çok sayıda çalışma ile immün sistemin hastalığın başlangıcında ya da seyrinde önemli bir rol üstlendiği gösterilmiştir. Bu nedenle çalışmamızda etiyopatogeneze ışık tutabilecek imflamatuvar markerların belirlenmesini amaçladık.METOD: Çalışmaya klinik olarak Behçet ve rekürren aftöz stomatit tanısı konulan 71 hastanın 142 gözü ile kontrol grubundaki 22 hastanın 44 gözü dahil edildi. Hasta ve sağlıklı bireylerin her iki göz üst temporal konjonktivalarından yaklaşık 1x1 mm'lik insizyonel biyopsi örneği histopatolojik tanı için alınarak %10'luk formol içinde saklandı. Konjonktiva epiteli ve nötrofil hücrelerinde myeloperoksidaz aktivitesi immünohistokimyasal yöntemlerle değerlendirildi.BULGULAR: Hasta ve kontrol grupları arasında yaş ve cinsiyet dağılımı bakımından fark yoktu (p=0.633, p=0.119). Hasta ve kontrol grubu ile grupların kendi aralarında ikili karşılaştırmalarında epitel ve nötrofil MPO aktivitesi açısından bir farklılık izlenmedi (P=0.140, P=0.237) ancak konjonktiva dokusunu infiltre eden mastosit, plazmosit ve lenfosit hücre infiltrasyonu açısından istatistiksel olarak anlamlı farklılık vardı. Hasta grubunda mastosit, plazmosit ve lenfosit infiltrasyonu sağlıklı kontrol grubuna göre daha yüksekti (p=0.000 p= 0.001, p=0.027). Nötrofil infiltrasyonu açısından bakıldığında ise gruplar arasında herhangi bir farklılık yoktu (p=0.385).SONUÇLAR: Sonuç olarak, çalışmamızda hasta ve kontrol grubu arasında konjonktiva dokusunda mastosit, plazmosit ve lenfosit hücre infiltrasyonu açısından istatistiksel olarak tespit edilen anlamlı farklılık; hastalığın kronik inflamatuar proçese dayalı patogenezini destekler bir bulgudur. Ek olarak nötrofil infiltrasyonu ve MPO aktivitesi bakımından gruplar arasında ki anlamlı bir farklılık saptanamamış olması; nötrofillerin daha çok enfeksiyöz inflamasyonlarda etkin rol alması ve MPO'un da nötrofil fonksiyonlarını yansıtan bir parametre olması nedeniyle olabilir.Öğe Central corneal and retinal nerve fiber layer thickness in patients with diabetes mellitus(Gulhane Medical School, University of Health Sciences, 2007) Ergin, Ahmet; Güllü, Reyhan; Çakmak, Yasin; Durukan, A. HakanIt has been shown that diabetes mellitus and systemic hypertension each are the risk factors for high intraocular pressure. The aim of this study was to assess the correlation between glaucoma, and central corneal thickness and retinal nerve fiber layer thickness in patients with diabetes mellitus. Patients diagnosed to have diabetes mellitus type 2 (fasting glucose level ? 126 ml/dL) without systemic hypertension and glaucoma were enrolled in the study. The patients were divided into three groups according to their diabetes duration (0-5, 6-10 and 11-15 years). Central corneal thickness measurements were made with Pacline Opticone Ultrasonic Pacimetry. Retinal nerve fiber layer thickness measurements were made with NFA II, GDx VCC. Data of the patients were compared with the findings of a control group consisting of healthy subjects. There were no significant differences between the control and other groups with respect to age and gender. Central corneal thickness was 544.17±37.95 in the control group, 543.89±33.37 in Group 1, 548.55±37.48 in Group 2, 552.11±32.53 in Group 3, and there were no significant differences between the control and other groups (p>0.05). There were also no significant differences between the control and other groups with respect to parameters such as TSNIT, SA, IA and NFI in the measurement of retinal nerve fiber layer thickness. There were not statistically significant differences between the diabetic patients and the control group on the basis of measurements of central corneal thickness and retinal nerve fiber layer thickness. © Gülhane Askeri Tip Akademisi 2007.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 Glaucomatous risk factors in patients with ischemic heart disease(Gulhane Medical School, University of Health Sciences, 2007) Ergin, Ahmet; Ebinç, Haksun; Güllü, Reyhan; Durukan, A. HakanIt has been demonstrated that ischemia and systemic hypertension each are the risk factors for elevated intraocular pressure. In this study some of the risk factors important for glaucoma in patients with ischemic heart disease were evaluated. Otherwise healthy patients with age of >35 years and diagnosed to have ischemic heart disease by the Department of Cardiology were included in the study. Central corneal thickness measurements of the patients were made with Pacline Opticone Ultrasonic Pacimetry, and intraocular pressures were measured with Goldmann applanation tonometry. Retinal nerve fiber layer thickness measurements were made with NFA II (GDx VCC). A total of 90 eyes of 51 patients (39 male and 12 female) in the patient group and a total of 100 eyes of 50 cases (35 male and 15 female) in the control group were enrolled in the study. There were no significant differences between the control and study groups with respect to age and gender. Intraocular pressure was 16.58±2.92 mmHg in the patient group and 16.86±2.92 mmHg in the control group, and there was no statistically significant difference between the groups. Central corneal thickness was 538.97±36.23 in the patient group and 542.13±38.45 in the control group, and there was no significant difference between the groups. There were also no significant differences between the study and control groups with respect to parameters such as TSNIT, SA, IA and NFI in the measurement of retinal nerve fiber layer thickness. Intraocular pressure, central corneal thickness and retinal nerve fiber layer thickness measurements were not found as high enough to be risk factors for glaucoma in patients with ischemic heart disease. © Gülhane Askeri Tip Akademisi 2007.Öğe Retinal nerve fiber layer thickness is unaffected in migraine patients(Wiley, 2005) Tan, Funda Uysal; Akarsu, Cengiz; Güllü, ReyhanObjectives - To search for possible Structural effects of migraine on the retina. Materials and methods - The study group included 39 consecutive migraine patients, 15 with visual aura and 24 without aura, and 25 healthy subjects as the control group. Scanning laser polarimetry was used to measure and compare retinal nerve fiber layer (RNFL) thickness between migraine and control groups. Results - The mean age of the patients and the control group were 35.64 +/- 8.3 and 35.96 +/- 9.14 years. respectively (P = 0.92) and the mean duration of migraine in patients with aura and without aura as 4.4 +/- 2.9 and 5.3 +/- 4.3 years, respectively (P = 0.68). Parameters related to RNFL thickness were found to be similar (P > 0.001) in migraine and control subjects. After examining the whole patient group migraine patients with and without aura were compared to each other and the control group Individually for a - RNFL thickness parameters. Briefly no statistical difference was found for any of the test parameters between migraine patients with aura. without aura and controls (P > 0.001). Conclusion - Retinal nerve fiber layer thickness was found to be unaffected in migraine patients.Öğe Sistemik Lupus Eritematosuslu Bir Olguda Optik Sinir ve Kiyazma Tutulumu(2009) Örnek, Kemal; Güllü, Reyhan; Onaran, Zafer; Yılmazbaş, Pelin; Ergin, AhmetSistemik lupus eritematosus (SLE) kronik, otoimmün, nekrotizan bir vaskülittir. Retina damar tıkanıklıkları SLE'de en sık izlenen göz bulgularıdır. Sistemik lupus eritematosus tanısıalan hastalarda optik sinir ve kiyazmanın birlikte etkilenmesi oldukça nadirdir. Bu yazıda,böyle bir olguda klinik seyir ile intravenöz steroid ve siklofosfamid tedavilerine alınan cevapsunulmaktadır.
