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Gurlevik U, Kemeriz F, Yasar E. The effect of isotretinoin on meibomian glands in eyes: a pilot study. Int Ophthalmol 2022; 42:2071-2078. [PMID: 34978652 DOI: 10.1007/s10792-021-02205-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/24/2021] [Indexed: 01/21/2023]
Abstract
PURPOSE The aim of this pilot study was to quantify the meibography changes in patients administered with oral isotretinoin. METHODS This prospective pilot study included 30 eyes of 30 patients who received oral isotretinoin treatment due to acne. Each patient underwent a general ophthalmological examination. After fluorescence staining of the ocular surface, the tear film break-up time (TFBUT) test, meibography and Schirmer test were carried out and noted. All of these procedures were applied before the treatment and repeated at 1, 3, and 6 months after the treatment. RESULTS The percentage of upper meibomian gland (MG) loss at 3 and 6 months after the treatment was 22.2% (p = 0.001) and 23.6% (p = 0.001), respectively. The percentage of lower MG loss at 3 and 6 months after the treatment was 18.7% (p = 0.001) and 20.7% (p = 0.001), respectively. The corneal fluorescein staining score at 3 and 6 months after treatment was 0.57 (p = 0.001), and 0.47 (p = 0.012), respectively. CONCLUSION These findings show that oral isotretionin treatment may affect MG morphology. The study findings also suggest that isotretinoin may cause tear film instability with Meibomian gland dysfunction and may cause evaporative type of dryness.
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Affiliation(s)
- Ugur Gurlevik
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray, Turkey.
| | - Funda Kemeriz
- Department of Dermatology, Aksaray University Faculty of Medicine, Aksaray, Turkey
| | - Erdogan Yasar
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray, Turkey
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Gurlevik U, Kara H, Yasar E. Effect of methylphenidate as a dopaminergic agent on myopia: Pilot study. Int J Clin Pract 2021; 75:e14665. [PMID: 34324770 DOI: 10.1111/ijcp.14665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/05/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022] Open
Abstract
Background Methylphenidate (MPH) hydrochloride is used as a first-line treatment for attention deficit hyperactivity disorder (ADHD). However, there is concern that this treatment may be associated with increased risk of refractive disorder. The aim of this study was to investigate the effect of MPH therapy on myopic shifts in refraction in children diagnosed with ADHD. Methods This study, children with ADHD and meeting inclusion criteria were examined before the initiation of MPH treatment and 3, 6 and 12 months after the initiation of treatment. Twenty age-gender-matched participants who applied to the outpatient ophthalmology clinic with various complaints were included in the study as a control group. Cycloplegic refraction examination and detailed eye measurements were performed at each visit. Results Nineteen patients were included in this study and the group consisted of 11 (57.9%) females and 8 (42.1%) males. The mean age of patients was 11.3 ± 2. (range: 8-18) years. During 12 months of use of MPH, the spherical equivalent changed from -0.36 ± 1.08 to -0.39 ± 1.05, and this difference was not statistically significant (P = .187). Axial length ranged from 22.92 ± 0.66. There was a change to 22.93 ± 0.62, and this difference was not statistically significant (P = .076). In the control group, the spherical equivalent changed from -0.43 ± 0.62 to -0.56 ± 0.84, and this difference was statistically significant. (P = .012) There was a change in the axial length from 22.97 ± 0.78 to 22.99 ± 0.62, and this difference was statistically significant (P = .015). Conclusions No significant changes spherical equivalent and axial length were detected during 12-month MPH use, but the increased spherical equivalent and axial length in the control group in the similar age group may indicate that MPH may reduce myopic shifts in refraction progression through dopamine, similar to in vivo studies. What's known Myopia is spreading rapidly in technologically advanced societies. There is strong evidence that myopia develops as the axial length of the eye increases as a result of spending more time indoors and working in close distances in parallel with the increase in education level. Animal studies have shown that decreased dopamine release plays an important role in the development of myopia. What's new The effect of dopamine in slowing or stopping myopia in experimental studies has also been demonstrated in human studies. No significant change in spherical equivalent and axial length was observed in methylphenidate users compared with control patients of similar age group. A significant increase in spherical equivalent and axial length was detected in the control group. This pilot study will shed light on future studies on the safe use of dopamine in the treatment of myopic shifts.
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Affiliation(s)
- Ugur Gurlevik
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Halil Kara
- Department of Child and Adolescent Psychiatry, Aksaray University Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Erdogan Yasar
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
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Gurlevik U, Yasar E. Evaluation of the agreement of optical biometry and Scheimpflug corneal topography with different axial lengths. J Fr Ophtalmol 2021; 44:1576-1583. [PMID: 34563406 DOI: 10.1016/j.jfo.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/28/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare anterior segment parameters evaluated with optical low coherence reflectometry and combined Scheimpflug-Placido disc topography in eyes with different axial lengths. METHODS Deux cent quatre patients were divided into 3 groups according to their axial lengths. Central corneal thickness (CCT), anterior chamber depth (AD), mean keratometry value (K mean) and white-to-white distances (WTW) obtained from both devices were compared. All measurements were performed 3 times and averaged. RESULTS In group 1, a significant difference was detected between the two devices for CCT, WTW and Kmean measurements (P<0.001, P<0.001, p:0.005 respectively). In group 2, a significant difference was detected between the two devices for WTW measurement (P<0.001). In group 3, a significant difference was detected between the two devices for CCT and WTW measurement (P<0.001, P<0.001 respectively). In the Bland-Altman analysis, there was no match for Kmean obtained with both devices in group 1. In group 2, there was no agreement for AD obtained with both devices. In group 3, there was no match for AD, WTW or Kmean values obtained with both devices. CONCLUSION Some anterior segment parameters are not suitable for interchangeability in eyes with different axial lengths evaluated by Lenstar and Sirius anterior segment imaging systems. When planning critical surgery and treatment, more attention should be paid to measurements in eyes of different axial lengths.
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Affiliation(s)
- U Gurlevik
- Aksaray University Faculty of Medicine, Ophthalmology Department, Aksaray, Turkey.
| | - E Yasar
- Aksaray University Faculty of Medicine, Ophthalmology Department, Aksaray, Turkey
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Kara H, Yasar E, Gurlevik U. Is pseudomyopia associated with anxiety and related disorders? Pak J Med Sci 2021; 37:1514-1518. [PMID: 34475940 PMCID: PMC8377937 DOI: 10.12669/pjms.37.5.3991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/22/2021] [Accepted: 04/30/2021] [Indexed: 12/04/2022] Open
Abstract
Objectives: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders. Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined. Results: The average age of patients in the study was 15,4 ± 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D ± 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D ± 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D ± 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount. Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase.
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Affiliation(s)
- Halil Kara
- Halil Kara, MD. Assistant Professor, Department of Child and Adolescent Psychiatry, Aksaray Education and Research Hospital, Aksaray University, Faculty of Medicine, Aksaray, Turkey
| | - Erdogan Yasar
- Erdogan Yasar, MD. Assistant Professor, Department of Ophthalmology, Aksaray Education and Research Hospital, Aksaray University, Faculty of Medicine, Aksaray, Turkey
| | - Ugur Gurlevik
- Ugur Gurlevik, MD. Assistant Professor, Department of Ophthalmology, Aksaray Education and Research Hospital, Aksaray University, Faculty of Medicine, Aksaray, Turkey
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Yasar E, Tomac HS, Gurlevik U. A Case of Presumed Bonsai-induced Severe Toxic Optic Neuropathy. Neuroophthalmology 2021; 46:41-43. [PMID: 35095134 PMCID: PMC8794246 DOI: 10.1080/01658107.2021.1903510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 10/21/2022] Open
Abstract
Apart from the known factors that cause toxic optic neuropathy, there may be factors that have not yet been identified. We report a 32-year-old man who presented with a complaint of decreased vision. His optic discs were diffusely covered with a black pigment, and below were atrophic. The vessels appeared to have disappeared below the pigmentation. He reported smoking tobacco, drinking alcohol, and using cannabis. His vision in both eyes began decreasing gradually after he started using bonsai, a synthetic cannabinoid, 2 years previously. No case of toxic optic neuropathy with bilateral severe vision loss and intense pigmentation with the use of bonsai has been reported before, and our case will be reinforced if other such cases are reported in the future.
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Affiliation(s)
- Erdogan Yasar
- Ophthalmology Depertment, Aksaray University Faculte of Medicine, Aksaray, Turkey
| | - Hatice Suhan Tomac
- Ophthalmology Depertment, Aksaray University Faculte of Medicine, Aksaray, Turkey
| | - Ugur Gurlevik
- Ophthalmology Depertment, Aksaray University Faculte of Medicine, Aksaray, Turkey
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Abstract
Purpose: This study aimed to reveal the cause of meibomian gland disease and meibomian gland loss in patients with Sjögren's syndrome (SS) as the leading factor for dry eyes. Methods: The study included a total of 30 patients with SS and dry eye symptoms and a control group of 50 age- and gender-matched healthy subjects. The dryness parameters of all the participants were evaluated. At first, meibography was performed to measure meibomian gland loss using noninvasive methods. Later, meibomian gland expression and secretion quality were evaluated using silt-lamp biomicroscopy. Correlations between the measurements were analyzed statistically. Results: In patients with SS, MG loss was significantly greater than in the control group (19.7 ± 71%, 12.7 ± 9.6%, P < 0.001). All dry eye parameters (tear film breakup time, Schirmer's test score, OSDI, stain score, dry eye disease) were statistically significant in the SS group. There was an extremely negative correlation between upper MB loss and BUT (P = 0.08, r: 0.781). There was an extremely positive correlation between upper MB loss and staining (P = 0.015, r: 0.739). An extremely negative correlation was determined between sub-MB loss and BUT (P = 0.18, r:-0.781), and a moderately positive significant correlation was found between sub-MB loss and staining (P = 0.031, r: 0.659). Conclusion: The results of this study demonstrated that patients with SS were at a higher risk of being exposed to meibomian gland loss, which directly leads to the severe dry eye symptoms associated with SS.
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Affiliation(s)
- Ugur Gurlevik
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Ahmet Karakoyun
- Department of Rheumatology, Aksaray University Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
| | - Erdogan Yasar
- Department of Ophthalmology, Aksaray University Faculty of Medicine, Aksaray Education and Research Hospital, Aksaray, Turkey
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Abstract
PURPOSE To investigate the effect of oral isotretinoin use on refractive error, axial length, and anteroposterior segment parameters. MATERIALS AND METHODS In this prospective study, 50 eyes of 50 patients using isotretinoin with a diagnosis of acne vulgaris and 50 eyes of 50 healthy control subjects were included. After detailed biomicroscopy, measurements were taken of axial length, lens thickness, central corneal thickness, anterior chamber depth, central retinal thickness, and subfoveal choroidal thickness. The pupils of both eyes were dilated with one drop of cycloplegic drops after refraction measurement. Visual acuity examination was performed with a Snellen chart the next day. The same procedure was repeated at the end of the third and sixth month of drug treatment. RESULTS Forty-seven patients with acne vulgaris and 45 healthy controls met the inclusion criteria and were included in the analysis. The mean ages of the patients and the controls were 21.7 ± 2.5 years (range, 18-28 years) and 22.6 ± 2.7 years (range, 19-27 years), respectively. No significant changes were observed in any parameters in the third and sixth month in the control group (p > 0.05). The most important result was significant increases in myopia and axial length in the sixth month of isotretinoin use (p = 0.01, p = 0.04, respectively). There were no significant relationships between increases in myopia and axial length and patients' age, sex, drug dose, and initial refraction (p > 0.05). The changes in spherical equivalent and axial length differed significantly between the drug group and the control group (p = 0.001, p = 0.001, respectively). CONCLUSIONS Isotretinoin is one of the important molecules in the aetiology of myopia. Oral isotretinoin treatment may increase myopia and axial length, although not to a clinically significant degree. However, as this was a pilot study, there is a need for further studies with more patients and longer follow-up periods.
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Affiliation(s)
- Erdogan Yasar
- Department of Ophthalmology, Aksaray University Traininig ve Research Hospital, Aksaray, Turkey
| | - Ugur Gurlevik
- Department of Ophthalmology, Aksaray University Traininig ve Research Hospital, Aksaray, Turkey
| | - Funda Kemeriz
- Department of Dermatology, Aksaray University Traininig ve Research Hospital, Aksaray, Turkey
| | - Eray Atalay
- Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey
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Gurlevik U, Karakoyun A, Yasar E. When rheumatoid arthritis is mentioned, should only dryness come to mind? Clin Rheumatol 2020; 39:3317-3321. [PMID: 32388745 DOI: 10.1007/s10067-020-05124-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/09/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate corneal parameters of rheumatoid arthritis (RA) patients by corneal topography. METHODS One hundred two RA patients and 60 control subjects were enrolled. Corneal topography measurements and ophthalmologic findings were examined from all participants' files. RESULTS Corneal thickness measurements were significantly lower in the RA group (p = 0.025). All values of corneal curvatures (K1, K2, Kmean) in 3 mm, 5 mm, and 7 mm zones were found statistically significantly higher in the RA group compared with the control group. Forty-five RA patients had a dry eye. Disease duration was correlated with dry eye in the RA group. There was a significant correlation between the duration of disease in RA patients and mean corneal curvatures (p 0.012/0.010/0.007, 3/5/7 mm respectively) and central corneal thickness (p 0.025). There is no statistical difference between other topographic measurements. CONCLUSIONS The results suggest that RA patients have thinner and steeper corneas compared with control subjects. These parameters change in negative correlation as the duration of the disease increases. Key Points • Rheumatoid arthritis is an autoimmune disease with systemic involvement. • In rheumatoid arthritis, systemic involvement is affected in the eyes. • When it comes to eye involvement, it comes to mind that it makes the eyes more dryness. • In addition to dryness in the eyes, rheumatoid arthritis makes morphological changes in the cornea.
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Affiliation(s)
- Ugur Gurlevik
- Ophthalmology Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey. .,Physical Therapy and Rehabilitation Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey.
| | - Ahmet Karakoyun
- Ophthalmology Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey.,Physical Therapy and Rehabilitation Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey
| | - Erdogan Yasar
- Ophthalmology Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey.,Physical Therapy and Rehabilitation Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey
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Gurlevik U, Ozdamar Erol Y, Yasar E. Serum and vitreous resistin levels in patıents with proliferative diabetic retinopathy. Diabetes Res Clin Pract 2019; 155:107803. [PMID: 31362052 DOI: 10.1016/j.diabres.2019.107803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/12/2019] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Abstract
AIM The aim of the study was to investigate the serum and vitreous levels of resistin in patients with the proliferative diabetic retinopathy (PDR) and to compare those with age-matched control subjects. METHODS The study included 45 eyes with PDR (group 1) and a control group of 22 (group 2). All eyes underwent vitrectomy surgery. The lipid profile, fasting blood glucose (FBG), HbA1c and resistin levels were investigated in blood samples of all subjects. Complete ophthalmological examinations were evaluated. Vitreous samples were collected from both groups during vitrectomy surgery and resistin levels were investigated in those samples. The results were evaluated using SPSS 9.0 software. RESULTS The demographic characteristics of the diabetic group and the control group were similar (p > 0.05). There was no significant difference between the groups in respect of mean visual acuity (VA), body mass index (BMI) values, or lipid profiles (p ˃ 0.05). There was no measurable value of resistin in the vitreous samples of all the eyes. The mean blood resistin level was 367 ng/ml in the control group and 387 ng/ml in the study group and the difference was not statistically significant (p > 0.05). CONCLUSIONS In the light of the findings of this study, it can be assumed that resistin did not pass through the vitreous at measurable levels. However, the serum resistin levels of the diabetic patients were higher than those of the control group although not statistically significant. Therefore, it can be considered that resistin does not play a major role in retinal neovascularization.
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Affiliation(s)
- Ugur Gurlevik
- Aksaray University, Faculty of Medicine, Aksaray Education and Research Hospital, Ophthalmology Department, Aksaray, Turkey.
| | - Yasemin Ozdamar Erol
- University of Health Sciences, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Erdogan Yasar
- Aksaray University, Faculty of Medicine, Aksaray Education and Research Hospital, Ophthalmology Department, Aksaray, Turkey
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Ozdamar Y, Gurlevik U, Acaroglu G, Teke MY, Zilelioglu O. Combined cilioretinal artery and partial central retinal vein occlusion in the postpartum period. Retin Cases Brief Rep 2010; 4:99-101. [PMID: 25390374 DOI: 10.1097/icb.0b013e31819bfa44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a combined cilioretinal artery and partial central retinal vein occlusion shortly after delivery in a twin-pregnant woman. METHODS A 25-year-old woman presented to our clinic with the complaint of blurred vision in the right eye 1 week after delivery. She underwent detailed ophthalmic and systemic investigations. RESULTS The patient had an uncomplicated twin pregnancy. Ocular examination showed combined cilioretinal artery and partial central retinal vein occlusion in the right eye. Systemic diseases were excluded. Laboratory evaluations revealed increased plasma d-dimer level (1.64 mg/mL). Spontaneous recovery occurred without treatment 1 month after delivery. CONCLUSION Twin pregnancy may lead to exaggerated hypercoagulability and increased d-dimer level in pregnant women. This situation may be a risk factor for retinochoroidal vascular occlusions.
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Affiliation(s)
- Yasemin Ozdamar
- From the Departments of *Retinal Diseases and †Neuro-ophthalmology, Ankara Ulucanlar Eye Research Hospital, Ankara, Turkey
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