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Öğe 0.1% Nepafenac reduces pain and increases patient comfort during cataract surgery(Elsevier, 2018) Oğurel, Tevfik; Oğurel, Reyhan; Onaran, Zafer; Ornek, KemalPurpose: To evaluates analgesic effectiveness of 0.1% nepafenac during cataract surgery. Methods: This prospective randomized randomized double-masked, placebo-controlled study comprised 80 eyes of 40 consecutive patients who underwent bilateral cataract surgery and implantation of foldable intraocular lens with topical anesthesia with and without topical nepafenac drops. Each eye of patients was assigned to group 1 and group 2. Topical anesthesia combined with 0.1% nepafenac used three times a day the day before the surgery and once half an hour just before the surgery was group 1, consisting of 40 eyes, and topical anesthesia with using placebo was group 2 consisting of 40 eyes. Patients were asked to score their pain using a visual analog scale (VAS) and verbal pain scale (VPS) immediately following the surgery. When the patient moved or squeeze the eye during surgery, the surgical comfort was evaluated as bad and otherwise, it was evaluated as good. Results: When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild or no pain in group 1 was %825 and in group 2 was %45. Mean VAS pain score and mean VPS pain score in group 1 was significantly lower than that in group 2(p = 0.024, p < 0.001). Surgical comfort in group 1 was %825 and in group 2%65(P = 0.075). Conclusion: 0.1% nepafenac reduces pain of patients who undergone routine clear corneal phacoemulsification with topical anesthesia and may increase patient comfort during the surgery when used preoperatively.Öğe Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis(Karger, 2016) Yumusak, Erhan; Ornek, Kemal; Ozkal, FatmaA 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK) in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360 degrees scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication. (C) 2016 The Author(s) Published by S. Karger AG, BaselÖğe Branch Retinal Artery Occlusion following Dental Extraction(Hindawi Ltd, 2014) Ogurel, Tevfik; Onaran, Zafer; Ogurel, Reyhan; Ornek, Nurgul; Gokcinar, Nesrin Buyuktortop; Ornek, KemalAim. To describe a case of branch retinal artery occlusion following dental extraction and to point out the ophthalmic complications of dental procedures to ophthalmologists and dentists. Case. A 51-year-old woman was referred to our clinic with painless sudden visual loss in her left eye after tooth extraction two days ago. In her left eye the best corrected visual acuity was 6/30 and fundus examination revealed peripapillary flame-shaped hemorrhages and pale retina in the upper temporal arcuate. The right eye examination was unremarkable. Conclusion. Dental procedures can lead to miscellaneous ophthalmic complications possibly due to the close proximity of the anatomic structures. Retinal arterial occlusion is a rare but serious cause of permanent visual loss among these dental procedures where the exact pathologic mechanism is still obscure.Öğe Central corneal thickness in patients with mild to moderate rosacea(Canadian Ophthal Soc, 2012) Onaran, Zater; Karabulut, Ayse Anil; Usta, Gulsah; Ornek, KemalObjective: We aimed to evaluate central corneal thickness (CCT) in patients with rosacea in comparison to a healthy control group and to investigate any correlations by using the Schirmer test, tear break-up time (TBUT), and disease severity. Design: Prospective nonrandomized study. Participants: Patients with mild to moderate rosacea (n = 51) and a group of healthy individuals (n = 51) were included. Method: Patients were evaluated by a dermatologist; disease severity was determined and total rosacea severity score was calculated for each patient. CCT measurements were performed using ultrasonic pachymetry. Tear function tests, including Schirmer and TBUT, were also performed. Results: The mean CCT value was significantly lower in patients with rosacea than in the control group (544.91 +/- 29.41 mu m vs 559.40 +/- 24.18 mu m, p = 0.003). The mean Schirmer test value was significantly lower in patients than in controls (10.54 +/- 6.09 mm vs 19.13 +/- 4.24 mm, p < 0.0001), and the mean TBUT was shorter in the group with rosacea than in the controls (8.32 +/- 3.50 s vs 16.67 +/- 5.76 s, p < 0.0001). CCT values were found to be correlated with the Schirmer test values in the rosacea group (r = 0.33, p = 0.01). Conclusions: Patients with rosacea have thinner corneas, which could be attributed to the observed deteriorated tear function parameters. Candidates for corneal photoablation surgery should be evaluated regarding rosacea disease because the postoperative period could be complicated by decreased ocular wetting and corneal thinning, even in overlooked mild forms.Öğe Central corneal thickness in tilted disc syndrome(Lippincott Williams & Wilkins, 2008) Ornek, Kemal; Ozdemir, MehmetPurpose. Earlier literature reports that abnormal optic disc shape or size seem to be closely associated with the shape or size of the cornea. Here we search for an association between the presence of tilted disc syndrome and the central corneal thickness. Methods. Sixty-one eyes of 61 patients with tilted disc syndrome were included in the study. Sixty-one eyes of 61 subjects were chosen as controls. Corneal thickness was evaluated with ultrasound pachymetry from the central region after instillation of topical proparacaine hydrochloride and before the ophthalmologic examination. Results. The mean central corneal thickness in the tilted disc syndrome group was found to be 547.5 +/- 36.16 mu m (median 546, range 467 to 638). The mean central corneal thickness in the control group was measured as 541.09 +/- 29.52 mu m (median 540, range 500 to 627). There was no statistically significant difference in corneal thickness between the tilted disc syndrome group and control group (p = 0.218). Conclusion. There seems to be no correlation between the central corneal thickness and the presence of tilted disc syndrome.Öğe Choroidal thickness changes in non-treated acute and ranibizumab-treated chronic central serous chorioretinopathy(Lippincott Williams & Wilkins, 2018) Yumusak, Erhan; Gokcinar, Nesrin Buyuktortop; Ornek, KemalTo evaluate the changes in subfoveal retinal, and choroidal thicknesses (CT) in the non-treated acute and the ranibizumab-treated chronic central serous chorioretinopathy (CSCR) patients. This retrospective study included 32 eyes of 32 consecutive patients with CSCR. There were 12 patients who presented with a spontaneous resolution of CSCR (Group 1) and 20 patients who were treated with ranibizumab for persistent subretinal fluid (SRF) (Group 2). Optical coherence tomography (OCT) imaging of subfoveal retinal thickness and enhanced depth imaging OCT of CT at subfoveal; at nasal and temporal 500 mu m (T500); at nasal and temporal 1500 mu m (T1500) were analyzed. The Student t test and multivariate analysis were used to compare variables within and between groups, respectively and correlations were analyzed using Pearson correlation coefficient. A P value of P<.05 was accepted as significant. The mean patient age was 38.94 +/- 8.41 years (range, 20-53 years). Female/male ratio was 4/28. The mean duration of follow-up was 21.6 +/- 8.2 months in the chronic CSCR group. Visual acuity improved and central foveal thickness (FT) decreased significantly in both groups. CT decreased significantly only at nasal 1500mm (N1500) in the acute group and at all measured points in the chronic group compared with baseline, except at T500 (P =. 07). No significant difference in central FT was detected between the 2 groups. Compared with the acute group, baseline subfoveal CT was significantly higher in chronic patients. There was a significant difference between the groups in baseline and final CT at T500. No significant difference was found at T1500. At nasal 500mm and N1500, the difference between the groups was significant only for final CT values. Chronic CSCR was associated with higher baseline CT values in the subfoveal region and at T500. CT significantly decreased at most of the measured points in ranibizumab-treated chronic CSCR patients, whereas it significantly decreased only at 1 point in spontaneously resolved acute CSCR patients.Öğe Choroidal thickness in obese women(Biomed Central Ltd, 2016) Yumusak, Erhan; Ornek, Kemal; Durmaz, Senay Arikan; Cifci, Aydin; Guler, Hatice Ayhan; Bacanli, ZehraBackground: Excessive weight is a well-known risk factor for microvascular diseases. Changes in thickness in a vascular tissue, such as the choroid, can be useful to evaluate the effect of obesity on the microvascular system. The aim of this study was to evaluate the choroidal thickness (CT) changes in obese women, using optical coherence tomography (OCT). Methods: The prospective clinical study included examination of the right eyes of 72 patients. The right eyes of 68 patients were examined and served as the controls. A complete ophthalmological examination and OCT imaging were performed for each group studied. The CT in each eye was measured using OCT. Results: The obese group consisted of 72 female patients with a mean age of 37.27 +/- 1.18 years. The control group included 68 female subjects with a mean age of 37.85 +/- 7.98 years (p > 0.05). There was no statistical significant difference for the foveal retinal thickness measurements between the two groups (p > 0.5). Our study revealed significant choroidal tissue thickening subfoveally and at areas 500 mu m temporal, 500 mu m nasal, and 1500 mu m nasal to the fovea in the obese group (all p < 0.05). There was a positive correlation between body mass index (BMI) and CT changes. Conclusions: CT may increase in obese women and a positive correlation was found between BMI and CT. The trial protocol was approved by the Local Ethical Committee of the Kirikkale University, date of registration: April 27, 2015 (registration number: 10/11).Öğe Comment: Retinal Thickness in Essential Tremor and Early Parkinson Disease: Exploring Diagnostic Insights(Lippincott Williams & Wilkins, 2024) Ornek, Kemal; Ornek, Nurgul[Abstract No tAvailable]Öğe Comparison of choroidal thickness changes following intravitreal dexamethasone, ranibizumab, and triamcinolone in eyes with retinal vein occlusion(Sage Publications Ltd, 2016) Yumusak, Erhan; Ornek, Kemal; Dikel, Nevin H.Purpose: To evaluate short-term choroidal thickness changes following intravitreal dexamethasone implant (DEX), ranibizumab (RAN), and triamcinolone acetonide (TA) in eyes with retinal vein occlusion (RVO) and macular edema (ME). Methods: In this prospective study, 35 eyes of 35 patients with RVO and ME who were treated with intravitreal injections of DEX, RAN, and TA were included. Choroidal thickness was measured using semiautomated segmentation of enhanced depth imaging with optical coherence tomography at fovea and parafoveal areas. Changes in choroidal thickness following treatment were compared statistically. Results: Choroidal thickness decreased following DEX, RAN, and TA treatments (all p>0.05). In the DEX group, at the first month nasal 1,500 mu m (N1(1,500)) and at the third month subfoveal (SF3) and nasal 500 mu m (N3(500)) choroidal thickness revealed a significant reduction compared to RAN and TA groups (all p<0.05). In the TA group, choroidal thickness showed a significant reduction only at nasal 1,500 mu m (N3(1,500)) at the third month (p<0.05). Conclusions: Choroidal thickness was decreased in all 3 groups. The DEX and TA groups showed a significant reduction at some areas. Ranibizumab had the smallest effect on choroidal thickness after 3 months among all groups.Öğe Comparison of Perioperative Ranibizumab Injections for Diabetic Macular Edema in Patients Undergoing Cataract Surgery(Hindawi Ltd, 2016) Yumusak, Erhan; Ornek, KemalPurpose. To compare the efficacy of perioperative ranibizumab injections on diabetic macular edema (DME) in patients undergoing cataract surgery. Methods. This study included 59 eyes of 59 patients. All patients had advanced cataract with DME and underwent an uneventful phacoemulsification surgery. There were 3 subgroups. The first group received intravitreal ranibizumab injection 2 weeks preoperatively, the second group received intraoperatively, and the third group received 2 weeks postoperatively. Follow-up examinations were performed at 1 week as well as at 1 and 3 months. Results. Baseline visual acuity showed a significant increase in all groups at 1 month. In group 1, compared to baseline value, foveal thickness (FT) increased significantly at 1 month and showed a significant decrease up to month 3. In group 2, FT increased at month 1 and this continued up to month 3. In group 3, FT increased at month 1 and was almost stable up to month 3. There were not any significant differences for visual acuity and FT between the groups. Conclusions. Although intrapostoperative ranibizumab injection for DME seems to be more effective than preoperative injections in patients undergoing cataract surgery, the treatment still needs to be continued following surgery.Öğe Compressive Optic Neuropathy Presenting With Psychiatric Symptoms(Lippincott Williams & Wilkins, 2014) Ornek, Nurgul; Buyuktortop-Gokcinar, Nesrin; Dag, Ersel; Ornek, KemalWe report a case of bilateral optic neuropathy presenting with psychiatric symptoms. A 50-year-old woman was admitted with blurry vision in both eyes. She had a 3 months' history of depressed mood. Both optic discs had mild temporal pallor with visible spontaneous venous pulsations. Magnetic resonance imaging of the brain showed a large frontal mass compressing the optic nerves. The tumor was surgically resected, and tissue pathology demonstrated an olfactory groove meningioma.Öğe Congenital hypothyroidism in Rieger Syndrome(Taylor & Francis Inc, 2016) Ornek, Nurgul; Ogurel, Reyhan; Ornek, KemalRieger syndrome (RS) is a multiple malformation syndrome characterized by ocular manifestations and extraocular defects. Herein, we report a 9-year-old boy who exhibited Rieger Syndrome phenotype as well as congenital hypothyroidism which may be an underappreciated feature of RS.Öğe Corneal and Conjunctival Sensitivity Changes Following Intravitreal Ranibizumab Injection in Diabetic Retinopathy(Mary Ann Liebert, Inc, 2015) Ornek, Nurgul; Ornek, Kemal; Erbahceci, Inci ElifPurpose: To evaluate corneal and conjunctival sensitivity changes following intravitreal ranibizumab (IVR) injection in eyes with diabetic retinopathy. Methods: Forty-six eyes of 46 patients with diabetic macular edema who underwent intravitreal injection of ranibizumab were included in this prospective study. Fifty eyes of 50 type 2 diabetes mellitus patients served as controls. Each participant underwent a complete ophthalmological examination. Fundus florescein angiography and optical coherence tomography were performed to assess the posterior segment details. IVR (0.5 mg/0.05 mL) was injected from the lower temporal quadrant. Corneal and conjunctival sensitivities were measured using the Cochet-Bonnet esthesiometer. Results: Corneal sensitivity (CS) increased significantly on the first day in temporal and nasal corneas in treated eyes (P=0.005 and P=0.000, respectively). At week one the increase continued and the difference was significant in central, temporal, and nasal corneas (all P=0.000). In fellow eyes, CS increased significantly only in nasal cornea (P=0.004). Only nasal conjunctival sensitivity increased significantly both in treated and fellow eyes at week one (P=0.000 and P=0.005, respectively). Conclusion: IVR may have a potential to increase corneal and conjunctival sensitivities in diabetic retinopathy.Öğe Corneal and conjunctival sensitivity in rosacea patients(Elsevier Science Bv, 2016) Ornek, Nurgul; Karabulut, Ayse Anil; Ornek, Kemal; Onaran, Zafer; Usta, GulsahPurpose: To assess corneal and conjunctival sensitivity in rosacea patients. Methods: A total of 55 patients with rosacea and 37 control subjects participated in the study. Corneal and conjunctival sensitivity was determined by Cochet-Bonnet esthesiometer. Subjective symptoms of ocular dryness were evaluated using Ocular Surface Disease Index (OSDI). Schirmer's I test (ST), tear breakup time (tBUT) and ocular surface staining with fluorescein were carried out to measure objective signs. Results: The mean corneal and conjunctival sensitivity did not differ significantly between rosacea patients and controls (all p > 0.05). Schirmer's I test and tBUT were significantly reduced (p = 0.004 for OD and p < 0.001 for OS) and grade of ocular surface staining was significantly high (p = 0.018 for OD and p = 0.038 for OS) in rosacea patients. Corneal and conjunctival sensitivity did not show significant correlation with ST, tBUT, ocular surface staining (Oxford Schema), duration of rosacea and OSDI score. Conclusions: Corneal and conjunctival sensitivity did not change significantly in rosacea.Öğe Corneal Endothelial Cell Density and Morphology in Different Trimesters of Pregnancy(Lippincott Williams & Wilkins, 2018) Ornek, Nurgul; Dag, Zeynep Ozcan; Ornek, KemalObjectives: To evaluate corneal endothelial cell density (CD) and morphology in different trimesters of pregnancy. Methods: This prospective study included 66 (66 eyes) pregnant women. The patient group was divided into three subgroups comprised of 22 women in the first, second, and third trimesters of pregnancy. An age-matched group of 22 (22 eyes) volunteers served as controls. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical). Central corneal thickness (CCT) and CD, hexagonal cell ratio (HEX), and coefficient of variation (CV) of the corneal endothelial cell layer of the patients were measured at each trimester. Results: Central corneal thickness did not change significantly during the pregnancy compared to controls (P>0.05). Endothelial CD was decreased in the first trimester and increased in the second and third trimesters, but the difference was not significant (P>0.05). Hexagonal cell ratio was decreased significantly in the first trimester (P<0.05).There was an increase in the second and third trimesters, which was not statistically significant (P>0.05). Coefficient of variation was increased significantly in the first trimester and showed a significant decrease in the second and third trimesters (P<0.05, respectively). Endothelial CD had a significant positive correlation with CV and HEX had a negative correlation with CV in the second trimester (r=0.438, P=0.041 and r=-0.822, P<0.001, respectively). Conclusion: Central corneal thickness and endothelial CD did not change significantly throughout the pregnancy. Hexagonal cell ratio and CV showed a significant but transient increase in the first trimester.Öğe Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma(Springer, 2018) Ornek, Nurgul; Ornek, KemalPurposeTo evaluate corneal endothelial cell parameters after a single session of selective laser trabeculoplasty (SLT) in pseudoexfoliative glaucoma (PEG) patients.MethodsCorneal endothelial cell parameters of 18 PEG patients were compared with 18 healthy subjects following SLT treatment. All patients underwent SLT treatment to 180 degrees of inferior trabecular meshwork. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical, Hyogo, Japan). Endothelial cell density (ECD), hexagonal cell ratio (HEX), coefficient of variation (CV) of the corneal endothelial cell layer and central corneal thickness of the patients were measured at each visit.ResultsThere was a statistically significant decrease in ECD (p=0.004) and a statistically significant increase in CV (p=0.041) at superior cornea 1week after SLT. They returned to pre-SLT values at 1month. One hour post-SLT HEX of inferior cornea was statistically significantly reduced (p=0.01). At central cornea, there was a significant increase in HEX after 1week (p=0.001). Post-SLT IOP showed a significant positive correlation with CV and significant negative correlation with HEX at superior and inferior cornea. There was no correlation between total laser energy used and endothelial cell parameters.ConclusionEffect of a single session ofSLT on corneal endothelium of PEG patients appears to be transient, and superior cornea was more affected than central and inferior cornea. All parameters returned to pre-SLT values at 1month after treatment.Öğe Corneal Sensitivity and Tear Function in Neurodegenerative Diseases(Taylor & Francis Inc, 2015) Ornek, Nurgul; Dag, Ersel; Ornek, KemalPurpose: To measure corneal sensitivity and tear function in neurodegenerative diseases (NDs) and to compare them with age and sex-matched controls. Methods: Twenty patients with Alzheimer's disease (AD), 20 patients with multiple sclerosis (MS), 30 patients with Parkinson's disease (PD), 10 patients with Friedreich's ataxia (FA) and 21 patients with epilepsy (EP) who were recruited from the Kirikkale University Neurology Department during 2012 were included in this prospective study. Five groups of age and sex-matched subjects were selected as controls. Corneal sensitivity was measured using a Cochet-Bonnet esthesiometer. Tear function tests included tear break-up time (TBUT) and Schirmer's 1 tests. Results: Compared to their controls, mean corneal sensitivity was significantly reduced in AD, MS, PD and EP patients (all p<0.05), mean TBUT level was significantly shorter in patients with AD and MS (all p<0.05) and mean Schirmer's 1 test score was significantly lower in EP patients (p<0.05). When all groups were compared with each other, reduction of mean corneal sensitivity in AD and PD groups were significantly more than in FA and MS groups (overall p = 0.034). Mean TBUT levels in AD, MS and PD groups were significantly shorter than in FA and EP groups (overall p = 0.001). Mean Schirmer's 1 test scores in AD and PD groups were significantly lower than in MS, FA and EP groups (overall p = 0.040). Conclusions: Neurodegenerative diseases may be associated with reduced corneal sensitivity and abnormal tear function.Öğe Öğe Early results of dexamethasone implant, ranibizumab, and triamcinolone in macular edema due to branch retinal vein occlusion(Sage Publications Ltd, 2016) Yumusak, Erhan; Buyuktortop, Nesrin; Ornek, KemalPurpose: To compare the short-term results of the efficacy and safety of dexamethasone intravitreal implant (DEX), ranibizumab (RAN), and intravitreal triamcinolone acetonide (IVTA) in macular edema secondary to branch retinal vein occlusion (BRVO). Methods: One eye each of 32 patients who were treated with intravitreal injections for macular edema secondary to BRVO was studied. This retrospective study included 3 groups. The patients received DEX in group 1 (n = 11), RAN in group 2 (n = 11), and IVTA in group 3 (n = 10). Data were collected before and after the injections at the first and third months. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were analyzed statistically. Results: The median duration of the follow-up was 3.0 months in overall groups. The BCVA increased significantly in all groups (p = 0.018, p = 0.034, p = 0.014, respectively). The CMT increased significantly in groups 1 and 3 (p = 0.02, p<0.001, respectively), but not in group 2 (p = 0.14). The IOP increased significantly in groups 1 and 3 (p = 0.05, p<0.001, respectively). Antiglaucomatous treatment was required only in group 3. Cataract developed in 2 patients (20%) in group 3 and surgery was required. Conclusions: Although RAN was the safest among the 3 agents, DEX and IVTA reduced CMT more than RAN, while significant improvement was achieved in BCVA in all groups. All 3 agents can be effectively used in the treatment of macular edema due to BRVO.Öğe Evaluation Of Optic Nerve With Strain And Shear Wave Elastography In Patients With Behcet's Disease And Healthy Subjects(Elsevier Science Inc, 2017) Inal, Mikail; Tan, Sinan; Demirkan, Serkan; Burulday, Veysel; Gunduz, Ozgur; Ornek, KemalThe objective of this study was to investigate the elasticity characteristics of the optic nerve using strain and shear wave elastography in patients with Behc, et's disease and to compare the results with those of healthy volunteers. Forty-six optic nerves from patients with Behc, et's disease and 54 optic nerves from healthy volunteers were investigated prospectively in this study using strain and shear wave elastography. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p < 0.001). Elastographic images of healthy volunteers revealed most optic nerves to be type 3 (51.8%); however, type 2 (40.7%) and type 1 (7.5%) were also observed. Elastographic examination of Behc, et's disease patients revealed type 2 in 52.2%, type 1 in 43.5% and type 3 in 4.3% of patients. Statistically significant differences were observed between patients and healthy volunteers in the analysis of shear wave elastography values (p < 0.001). Receiver operating characteristic curve analysis was perfect (0.933) (95% CI = 0.885-0.980), and a cutoff value of 16.5 kPa shear had very high sensitivity and specificity for the patient group. Strain and shear wave elastography findings for the optic nerves of patients with Behc, et's disease were significantly different from those for healthy volunteers. (E-mail: inal_m@hotmail.com) (C) 2017 World Federation for Ultrasound in Medicine & Biology.
