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  • Küçük Resim
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    Evaluation of high-risk features of primary enucleation of patients with retinoblastoma in a tertiary center of a developing country in the era of intra-arterial chemotherapy
    (Springer, 2018) Dikkaya, Funda; Sarıcı, Ahmet Murat; Erbek, Firuze; Celkan, Tiraje; Mangan, Mehmet Serhat; Aydın, Övgü; Demirkesen, Cüyan; Pazarlı, Halit
    Purpose To evaluate the frequency of high-risk histopathologic factors in Turkish children enucleated for retinoblastoma and to analyze the association between growth pattern, rosetta formation, tumor thickness, presence of necrosis, calcification, neovascularization, rate of mitosis, and high-risk histopathologic factors. Methods Pathology reports of 59 eyes who had received enucleation for retinoblastoma were reviewed retrospectively. The histopathologic data included presence of choroidal invasion, optic nerve invasion, scleral extension, tumor thickness, presence of necrosis, calcification, neovascularization, rosetta formation and lymphocyte infiltration, rate of mitosis, and growth pattern. Results This study included 59 eyes from 30 (50.8%) male and 29 (49.2%) female patients. The mean age was 22.87 +/- 18.99 months. There were 30 (50.8%) eyes with choroidal invasion, 30 (50.8%) eyes with optic nerve invasion, and 5 (8.5%) eyes with scleral invasion. Endophytic growth pattern was seen in 27 (45.8%) eyes, exophytic growth pattern was seen in 2 (3.4%) eyes, and combined growth pattern was seen in 30 (50.8%) eyes. Exophytic growth pattern was found statistically related to choroidal invasion (p = 0.00). Although tumor with greater thickness tended to have more choroidal invasion (p = 0.02), there was no relation between tumor thickness and optic nerve invasion (p = 0.09). Conclusions Incidences of choroidal and optic nerve invasion showed similarity with other developing countries. Because of higher incidence of high-risk factors, intra-arterial chemotherapy with its targeted effect should be preferred carefully.
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    Long term predictive ability of preoperative retinal nerve fiber layer thickness in visual prognosis after chiasmal decompression surgery
    (Elsevier B.V., 2021) Mangan, Mehmet Serhat; Gelegen, Erdem; Başerer, Tahire; Gazio?lu, Nurperi; Aras, Cengiz
    Objective: To investigate the relationship between preoperative retinal nerve fiber layer (RNFL) thickness and the recovery of visual field (VF) and visual acuity (VA) 1 year after surgery in chiasmal compression patients presenting with visual impairment. Patients and methods: Twenty-nine eyes of 16 patients with chiasmal compression and 14 eyes of 14 control subjects were enrolled. All patients undergoing chiasmal decompression surgery via a transsphenoidal approach were prospectively evaluated before and 1 year after surgery with best corrected visual acuity (BCVA, logMAR), mean deviation (MD) value with standard automated perimetry (SAP) and RNFL thickness with optical coherence tomography. Eyes with chiasmal compression were divided into two groups according to the mean preoperative RNFL thickness: ? 100 µm (Group 1) and < 100 µm (Group 2). The relationship between the mean preoperative RNFL thickness and visual prognosis parameters (VF, VA) was analyzed. Results: The mean preoperative RNFL thickness was 115.92 ± 8.97 µm, 84.0 ± 8.85 µm, and 114.21 ± 7.75 µm in Group 1 (n = 15 eyes), Group 2 (n = 14 eyes) and the control group (n = 14 eyes), respectively. The mean preoperative BCVA was 0.15 ± 0.3 in Group 1, and 0.41 ± 0.39 in Group 2. The mean BCVA increased to 0.03 ± 0.1 in Group 1 in the postoperative period but did not change in Group 2. MD value was ? 6.10 ± 5.54 in the preoperative period and ? 2.59 ± 2.23 in the postoperative period for Group 1 (p = 0.014), while it was ? 18.97 ± 4.14 in the preoperative period and ? 18.57 ± 4.51 in the postoperative period in Group 2 (p = 0.24). Conclusions: This study suggests that lower mean preoperative RNFL thickness was associated with poorer long-term visual prognosis. Preoperative RNFL thickness measurements may be helpful in predicting the recovery of VF and VA after decompression surgery in patients with chiasmal lesion presenting with visual impairment.
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    Ocular herpes simplex virus activation following high dose oral fluoxetine intake
    (2016) Atalay, Eray; Mangan, Mehmet Serhat; Çapar, Olgu; Arıcı, Ceyhun
    A 51-year-old man with high intraocular pressure on the left eye was referred to our clinic. A laser iridotomy was performed with full anti-glaucoma medication prior to the referral. There was a fixed dilated irregular pupil of the left eye, accompanied with mild corneal edema, a paracentral stromal corneal haze, patchy iris atrophy, fine keratic precipitates, trace amounts of cells and pigments in the anterior chamber and a patent iridotomy. Medical history was revealed a previous herpetic episode 7 years ago and fluoxetine use for major depression for 2 years which he overdosed 5 days before his ocular symptoms have started. Ocular herpes simplex virus activation associated with high dose fluoxetine was suspected. Fluoxetine was discontinued. Oral acyclovir, topical steroids and anti-glaucoma medication has been prescribed. A week later, on his control visit, the intraocular pressure was normalized and clinical findings have subsided. Fluoxetine, a selective serotonin re-uptake inhibitor, and some other anti-depressants, has been proved to suppress cellular immunity. Herpes simplex virus activation after surreptitious self-administration of high dose fluoxetine in this case is much more probable than coincidence. This is the first reported case of ocular herpes activation related to fluoxetine use.