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    Bilateral multifocal pseudomonas aeruginosa keratitis in a contact lens -wearing diabetic patient treated with a custom compounded 5% imipenem-cilastatin topical solution
    (Ophthoscience Publ, 2020) Comez, Arzu Taskiran; Yildiz, Aydin
    Pseudomonas aeruginosa is a devastating agent of fulminant keratitis in contact lens-wearers, immunosuppressive patients, and refractive surgery patients which may lead to substantial loss of vision, and in severe cases, blindness. In this case report, a 30-year-old diabetic contact lens wearer who had history of sleeping with lenses and prolonged use of the same contact lens presented with multiple foci of keratitis in each eye. No pathogen was detected from corneal scrapings, but the contact lenses and the contact lens case were culture positive for Pseudomonas aeruginosa. The keratitis was only partially responsive to topical fortified ceftazidime, topical fortified vancomycin, and topical fluconazole. A decision was made to switch to topical imipenem-cilastatin due to the multiple risk factors, including diabetes, contact lens overuse, and bilateral multifocal corneal involvement, after which the keratitis resolved. Topical imipenem-cilastatin may be a successful alternative treatment in patients with Pseudomonas keratitis who do not respond to conventional antibiotic therapy.
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    Evaluation of Retinal Morphology and Contrast Sensitivity Function in Patients with Restless Legs Syndrome
    (Galenos Publ House, 2022) Cam, Mustafa; Yildiz, Aydin; Arikan, Sedat
    Objective: The decreased number of dopamine receptors in the putamen are considered to play an important role in the pathophysiology of restless legs syndrome (RLS). Retinal dopamine plays an important role in contrast sensitivity (CS) by establishing communication between retinal cells. It is also suggested that retinal dopaminergic neurons protect other retinal neurons. In this study, we aimed to investigate the thickness of retinal layers and CS function (CSF) of patients with RLS. Materials and Methods: A total of 68 participants were included in this prospective case-control study. The participants were divided into two groups as those with RLS (n=35) in group 1 and control subjects (n=33) in group 2. Optical coherence tomography was used to measure central macular thickness, retinal nerve fiber layer thickness (RNFL), and retinal ganglion cell inner plexiform layer thickness (GCIPL). RNFL thickness was measured as average and as sectoral (superior, inferior, nasal and temporal). Additionally, the CS test measured at all spatial frequencies of 1.5, 3, 6, 12 and 18 cycle per degree (cpd) was performed in all participants. Results: The average and superior sectoral RNFL thicknesses in group 1 were statistically significantly thinner than group 2 (p=0.03 and p=0.01 respectively). However, the thicknesses of other RNFL sectors were not different between group 1 and group 2. There were no statistically significant differences between group 1 and group 2 regarding the thicknesses of GCIPL and central macula. The mean values of CSF at all spatial frequencies of 1.5 cpd, 3 cpd, 6 cpd, 12 cpd and 18 cpd were statistically significantly higher in group 2 in comparison to group 1 (p<0.001 for all spatial frequencies). Conclusion: The decreased thickness of retinal layers and reduced CSF in patients with RLS support retinal dopaminergic dysfunction.
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    Ozone treatment for high-dose systemic Steroid-Induced retinal injury
    (Taylor & Francis Ltd, 2020) Yildiz, Aydin; Sehitoglu, Muserref Hilal; Karaboga, Ihsan; Arikan, Sedat
    Objective To investigate the effect of high-dose systemic steroids on retinal tissues and the effectiveness of ozone (O-3) therapy. Methods Twenty-four New Zealand white rabbits were divided into three groups of eight. Group 1 was accepted as the control group, Group 2 received intramuscular 20 mg/kg methylprednisolone acetate and Group 3 received 14 sessions of ozone treatment in addition to methylprednisolone acetate. The subjects were sacrificed on the 30(th)day. Retinal tissues were removed. Superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), total antioxidant status (TAS) and total oxidant status (TOS) levels were evaluated for tissue biochemistry and serum ischaemic modified albumin (IMA), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha) levels were evaluated with the ELISA method. Haematoxylin-eosin staining and TUNEL evaluation for apoptosis were evaluated as histopathological methods. Results In the treatment group, antioxidant parameters of TAS, SOD and CAT were higher, oxidative and ischaemic parameters of MDA, TOS and IMA were lower, inflammatory parameters of IL-6 and TNF-alpha were lower, retinal thickness was better and apoptosis amount was lower. Conclusion Apoptosis increases in retinal tissues due to high dose systemic steroid administration and the retina becomes thinner. With biochemical examination, oxidation parameters increased while antioxidant parameters decreased. Both histopathological and biochemical parameters improved significantly with ozone treatment.
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    Silicone perforated punctal plugs for the treatment of punctal stenosis
    (Consel Brasil Oftalmologia, 2019) Comez, Arzu Taskiran; Karakilic, Azersara Vural; Yildiz, Aydin
    Purpose: Punctal stenosis can result in symptoms such as epiphora and can significantly reduce the quality of life of patients. Perforated punctal plug insertion is an easy procedure that is commonly used as the first step of treatment for punctal stenosis. Methods: Clinical, demographic, and outcome data were retrospectively collected for 54 eyes of 21 males and 11 females who consecutively presented to our Oculoplastic Clinic and underwent silicone Micro Flow perforated punctal plug insertion. All patients had epiphora with punctal stenosis. Results: Of the 54 plugs, 26 plugs (48.1%) were lost and 28 (51.8%) stayed in place. Of the latter, eight were explanted because of the occlusion of the plug with secretions and recurrent conjunctivitis; moreover, two plugs migrated deep into the vertical canaliculus. Of the 54 plugs, only 18 (33.3%) were well-tolerated with significant symptomatic improvement. Conclusion: Plug loss is a prominent problem in patients implanted with perforated punctal plugs. Silicone punctal plugs failed in 66.7% of our patients over a mean follow-up of 14.2 months.
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    The comparison of the intraocular lens power calculation formulas in long eyes
    (Pakistan Medical Assoc, 2020) Yildiz, Aydin
    Objective: To investigate the accurate intraocular lens power formula in eyes with axial length over 26mm by using optical biometry. Methods: The retrospective case series was conducted at Medicana International Avcilar Hospital, Istanbul, Turkey from 2016 to 2018, and comprised data related to years between 2014 and 2018. Optical low-coherence reflectometry had been used in measurements. The calculation methods were included Hill-radial basis function, Sanders-Retzlaff-Kraff-Theoretical, Hoffer Q, Barrett Universal II, Olsen, Haigis and Holladay-2. The spherical equivalent values that were obtained with automated refractometer at the first postoperative month were recorded. Mean absolute error for each formula was estimated. SPSS 16 was used for data analysis. Results: There were 56 eyes of as many patients with a mean axial length of 26.70 +/- 0.88mm. The postoperative numerical error was within +/- 0.50 diopters in 46(82%) patients, and between the -0.50 and -1.00 diopters in 10(18%). The mean absolute error values were significantly lower in Haigis, Sanders-Retzlaff-Kraff-Theoretical, HofferQ and Holladay-2 formulas compared to the Barrett, Hill, and Olsen formulas (p<0.05). There was no statistically significant intra-group difference for Haigis, Sanders-Retzlaff-Kraff-Theoretical, Hoffer Q, and Holladay-2 formulas (p>0.05). Conclusion: In long eyes with an axial length over 26mm, Haigis, Sanders-Retzlaff-Kraff-Theoretical, Hoffer Q and Holladay-2 formulas yielded better postoperative refractive outcomes compared to Hill-radial basis function, Barrett Universal lland Olsen formulas. The Haigis formula had the lowest refractive numerical error.