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Öğe Accommodative esotropia following surgical treatment of infantile esotropia: Frequency and risk factors(2008) Uretmen O.; Civan B.B.; Kose S.; Yuce B.; Egrilmez S.Purpose: We aimed to examine the frequency of and risk factors for the development of accommodative esotropia following surgical treatment for infantile esotropia. Methods: A total of 29 children were recruited. Potential risk factors for the development of accommodative esotropia included: sex; angle of deviation at initial and final visits; cycloplegic refractive error at initial and final visits; increase in hyperopia; amblyopia; amblyopia treatment; age at surgical treatment; pre- and postoperative latent nystagmus; dissociated vertical deviation or inferior oblique muscle overaction; additional surgical procedures; unstable alignment, and binocular sensory status. Result: Overall, 14 (48.2%) of 29 children developed accommodative esotropia during the 36- to 132-month postoperative follow-up period. Twelve (85.7%) of the 14 patients developed refractive accommodative esotropia and two developed non-refractive accommodative esotropia. The onset of accommodative esotropia occurred at a mean of 8.8 months (range 6-24 months) after the initial surgical alignment. This corresponded to a mean age of onset for accommodative esotropia of 43.2 months. We determined that, among children with infantile esotropia, those who had hyperopia of ?3.0D and increasing hyperopia after surgery and those who did not develop dissociated vertical deviation during the follow-up period were more likely to develop accommodative esotropia. Conclusions: Children who have the established risk factors should be followed closely for the development of accommodative esotropia. The treatment of these children with appropriate glasses may prevent the development of adverse effects of accommodative esotropia on sensory and motor functions. © 2008 The Authors Journal compilation © 2008 Acta Ophthalmol.Öğe The evaluation of binocular visual function in patients with congenital Brown's syndrome(2005) Afrashi F.; Uretmen O.; Kose S.; Pamukcu K.We evaluated the binocular visual function of 14 patients with Brown's syndrome and compared this data with that collected from 14 visually normal subjects of similar age and sex. Patients with Brown's syndrome underwent a full ophthalmologic examination including a detailed strabismological evaluation. Stereoacuity was measured with the Titmus and TNO stereotests. Visual evoked potentials (VEPs) were recorded. Patients with congenital Brown's syndrome had reduced stereoacuity levels compared to the control group. They also had longer binocular VEP latencies and smaller VEP amplitudes. Binocular enhancement of VEP amplitude was present in both groups but more evident in the control group. In conclusion, partial binocular visual functional abnormalities could be found in patients with congenital Brown's syndrome in addition to the characteristic ocular motility restrictions.Öğe Functional and morphological assessment of ocular structures and follow-up of patients with early-stage Parkinson’s disease(Springer Netherlands, 2019) Hasanov S.; Demirkilinc Biler E.; Acarer A.; Akkın C.; Colakoglu Z.; Uretmen O.Purpose: To evaluate and follow-up of functional and morphological changes of the optic nerve and ocular structures prospectively in patients with early-stage Parkinson’s disease. Materials and methods: Nineteen patients with a diagnosis of early-stage Parkinson’s disease and 19 age-matched healthy controls were included in the study. All participants were examined minimum three times at the intervals of at least 6 month following initial examination. Pattern visually evoked potentials (VEP), contrast sensitivity assessments at photopic conditions, color vision tests with Ishihara cards and full-field visual field tests were performed in addition to measurement of retinal nerve fiber layer (RNFL) thickness of four quadrants (top, bottom, nasal, temporal), central and mean macular thickness and macular volumes. Results: Best corrected visual acuity was observed significantly lower in study group within all three examinations. Contrast sensitivity values of the patient group were significantly lower in all spatial frequencies. P100 wave latency of VEP was significantly longer, and amplitude was lower in patient group; however, significant deterioration was not observed during the follow-up. Although average peripapillary RNFL thickness was not significant between groups, RNFL thickness in the upper quadrant was thinner in the patient group. While there was no difference in terms of mean macular thickness and total macular volume values between the groups initially, a significant decrease occurred in the patient group during the follow-up. During the initial and follow-up process, a significant deterioration in visual field was observed in the patient group. Conclusion: Structural and functional disorders shown as electro-physiologically and morphologically exist in different parts of visual pathways in early-stage Parkinson’s disease. © 2018, Springer Science+Business Media B.V., part of Springer Nature.Öğe Massive iatrogenic orbital cysts following glaucoma drainage implant and strabismus surgery(BMJ Publishing Group, 2016) Demirkilinc Biler E.; Yagci A.; Uretmen O.; Palamar M.We describe 2 paediatric patients who developed large orbital conjunctival epithelium-lined inclusion cysts postsurgery. Case 1 underwent Ahmed glaucoma valve implant surgery 8 months ago and case 2 underwent strabismus surgery 7 years ago. Both cases had either symptomatic strabismus or a mass causing some degree of proptosis or incomitance due to lesions in the intraorbital space. Following total excision of the cysts all associated symptoms were resolved. Conjunctival cysts following ocular surgery can develop anywhere in the anterior segment; however, large orbital cysts following anterior segment surgery are quite rare. We think that implantation cysts should be considered in the differential diagnosis of patients that have signs of orbital mass with a history of previous anterior segment surgery. Complete excision of the cysts results in resolution of all associated signs and symptoms. © 2016 BMJ Publishing Group Ltd.Öğe Non-penetrating deep sclerectomy and collagen implant surgery in glaucoma patients with advanced field loss(1999) Ates H.; Andac K.; Uretmen O.Purpose: The aim of the study was to determine the medium term intraocular pressure (IOP) lowering effects and the potential complications of non-penetrating deep sclerectomy and collagen implant (DSCI) surgery in glaucoma patients. Patients and methods: 54 eyes of 52 patients with medically uncontrolled open angle glaucoma with advanced field loss underwent DSCI under topical anaesthesia. Follow-up period was 24 months. Results: The mean preoperative IOP was 24.7 ± 6.2 mmHg and decreased to 15.1 ± 4.0 mmHg at 24 months (p = 0.0068). During the follow-up period, 36 of 54 eyes (66%) received no topical antiglaucomatous medications. In 18 eyes, monotherapy with topical beta blockers (Betaxolol HCl) was added to the regimen. At last visit, only two patients (3.8%) had IOP greater than 18 mmHg. We did not detect any additional optic disc changes, visual field or visual acuity defects postoperatively. Detailed slit-lamp examination revealed no anterior segment complications regarding the probable complications of trabeculectomy. None of the patients developed surgery related cataract. As a complication, we diagnosed one case of self-limited, shallow choroidal detachment. Conclusion: DSCI appears to provide considerable medium term IOP decrease with few postoperative complications without deteriorating visual acuity. Owing to our medium term results, we believe that DSCI could be a valuable alternative to trabeculectomy especially in cases of advanced medically uncontrolled open angle glaucoma.Öğe Retroequatorial recession of horizontal recti with loop suture in the treatment of congenital nystagmus(2003) Köse S.; Egrilmez D.G.; Uretmen O.; Celebisoy N.; Pamukçu K.PURPOSE: The authors wished to evaluate the effectiveness and safety of retroequatorial recession of all four horizontal recti using loop sutures for the treatment of congenital nystagmus. SUBJECTS AND METHODS: Twelve patients with congenital nystagmus were enrolled in this prospective study. All patients underwent retroequatorial recession of horizontal recti with loop sutures. All recti were recessed 8mm measuring from the insertion, then the amount of loop suture was determined according to the preoperative ocular alignment of the patients. Electronystagmographic recordings were made in every patient preoperatively and postoperatively as well as an ophthalmological examination. The follow-up period ranged from 6 to 26 months. RESULTS: All four horizontal recti were recessed 9 to 12mm including the loop suture (range 1-4mm). Compared to preoperative values, postoperative amplitude and intensity of nystagmus decreased statistically significantly in all patients (p = 0.002). The postoperative decrease in the frequency of nystagmus was not statistically significant (p = 0.173). Improvement of both distance and near visual acuity was achieved in 10 patients. Five of seven patients who had ocular misalignment preoperatively were aligned within 10 PD postoperatively. Improvement in head posture was seen in two of three patients. The authors determined that the improvement in the nystagmus characteristics was most prominent in the immediate post-operative period. CONCLUSION: Retroequatorial recession of all four horizontal recti using loop sutures is a safe and effective procedure for the management of congenital nystagmus.Öğe Strabismus in infants following congenital cataract surgery(Springer Verlag, 2015) Demirkilinc Biler E.; Bozbiyik D.I.; Uretmen O.; Kose S.Purpose: This study aimed to determine the incidence and characteristics of strabismus following congenital cataract surgery in infants. Materials and methods: Patients aged <12 months who underwent surgery for congenital cataract and were followed-up for ?1 years were included. Patients that had strabismus prior to surgery were excluded. Data regarding gender, cataract laterality, morphology, and density, age at the time of cataract surgery, ocular motility post surgery, and the presence of nystagmus were retrospectively obtained from the patients’ records. Results: The study included 79 patients (48 male and 31 female). Unilateral surgery was performed in 14 of the patients, versus bilateral surgery in 65. Strabismus did not occur post surgery in 32 (40.5 %) of the patients (group 1), whereas 47 (59.5 %) (group 2) developed strabismus following surgery. The patients in group 1 were followed-up for a mean 50.7 ± 38.5 months, versus 50.3 ± 39 months in group 2. Mean age at the time of cataract surgery in groups 1 and 2 was 3.6 ± 1.9 years and 4.6 ± 3.2 months respectively. Mean duration of time between cataract surgery and the development of strabismus was 13.3 ± 13 months (range: 1–60 months). Unilateral cases were more prone to develop strabismus, which was statistically significant (p = 0.028). Age at the time of cataract surgery, gender, cataract density, the occurrence of aphakic glaucoma, the presence of nystagmus, and additional ocular surgery were not significantly associated with the development of strabismus. Conclusion: Strabismus develops more frequently in children undergoing cataract surgery. In the present study strabismus occurred in more of the patients that underwent unilateral surgery. Based on the present findings, we think that long-term careful follow-up to monitor the development of strabismus is required in all infants undergoing cataract surgery, especially unilateral cases. © 2015, Springer-Verlag Berlin Heidelberg.Öğe Transient subretinal hemorrhage after photodynamic therapy of subfoveal choroidal osteoma(2012) Palamar M.; Uretmen O.; Gündüz K.Purpose: To report a case of choroidal osteoma that developed subretinal hemorrhage after photodynamic therapy (PDT). Methods: Interventional case report. Results: An 8-year-old boy was brought to our attention because of mild visual loss in his left eye. The visual acuity was 20/25. A subfoveal yellow-orange-colored lesion, measuring 5.0 mm 3 4.5 mm in base diameter was detected in the left eye. B-mode ultrasonography showed an acoustically solid 2.0-mm-thick mass with orbital shadowing. Orbital computed tomography confirmed the presence of calcium, and choroidal osteoma was diagnosed. As there was a decrease in the best-corrected visual acuity (20/30) and the lesion showed growth (6.0 mm 3 6.0 mm), PDT was performed at 6 months follow-up. The day after PDT, the visual acuity was counting fingers at 1 m and a subretinal hemorrhage over the lesion was detected. Two weeks after PDT, subfoveal hemorrhage dissappeared with some retinal pigment epithelial hyperplasia and visual acuity increased back to 20/30. Conclusion: Although PDT can induce decalcification in choroidal osteomas, it should not be performed in subfoveal osteomas unless there is evidence to treat the lesion such as the presence of choroidal neovascularization.
