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Öğe A case of weill-marchesani syndrome with a novel mutation and vitamin d deficiency(DERMAN MEDICAL PUBL, 2018) Yildirim, Malik Ejder; Vural, Ayse; Kurtulgan, Hande Kucuk; Kilicgun, Hasan; Baser, BurakWeill-Marchesani syndrome is an inherited connective tissue disorder. It is characterized by various ocular abnormalities and some skeletal problems. It is rarely seen in the world, but the clinical complications are significant and may require some interventions such as eye surgery, physical therapy or orthopedic procedures. Here we report on an eleven year old female with glaucoma, ectopia lentis, microspherophakia, brachydactyly and vitamin D deficiency from Sivas, Turkey. She was suffering from Weill-Marchesani syndrome with ADAMTS10 mutation.Öğe Central corneal thickness and Diaton transpalpebral tonometry(SPRINGER, 2008) Toker, Mustafa Ilker; Vural, Ayse; Erdogan, Haydar; Topalkara, Aysen; Arici, Mustafa KemalBackground To examine the effects of central corneal thickness on the measures obtained from transpalpebral tonometry (Diaton), and to identify correlations between intraocular pressure (IOP) measurements with Diaton and the Goldmann applanation tonometer (GAT). Methods In this cross-sectional study, 162 eyes of 81 participants were included. Intraocular pressure measurements were obtained in all patients using Diaton and GAT. Central corneal thickness was determined by ultrasound pachymetry. The participants were stratified by corneal thickness: group I < 530 mu m (n=56), group II 530-560 mu m (n=65), and group III > 560 mu m (n=41). Results There were moderate correlations between IOP readings obtained using the Diaton and corrected GAT (C-GAT) (r=0.303; P < 0.0001), and between corrected Diaton (C-Diaton), and C-GAT (r=0.399; P0.0001). The mean Diaton tonometer readings were lower than C-GAT measurements (Diaton-corrected GAT mean difference, 0.9 +/- 3.8 mmHg; c-Diaton-corrected GAT mean difference, 0.7 +/- 3.5 mmHg). Differences were detected between the groups of patients for the GAT values [2.4 +/- 3.6 mmHg for those with the thinnest corneas (< 530 mu m), 0.7 +/- 3.6 mmHg for those with moderate corneas (between 531 mu m and 560 mu m), and -0.6 +/- 3.6 mmHg for those with the thickest (> 560 mu m) corneas], whereas a significantly lower difference (0.9 +/- 3.8 mmHg) was noted for the Diaton values of all individuals. Conclusions The Diaton measurements show moderate correlation with those provided by applanation tonometry. The Diaton tonometer seems to be more affected by the corneal thickness, especially in the thinnest corneas.Öğe Clinical and histologic evaluations of experimental Acanthamoeba keratitis(SPRINGER, 2007) Polat, Zubeyde Akin; Ozcelik, Semra; Vural, Ayse; Yildiz, Esin; Cetin, AliAmoebic keratitis, a sight-threatening, progressive corneal disease, is commonly caused by ubiquitous, pathogenic, free-living Acanthamoeba spp., which are widely distributed in the environment. We investigated clinical findings and histology of Acanthamoeba keratitis in a rat cornea model. Experimental Acanthamoeba keratitis was induced in Wistar rats by intrastromal inoculation of Acanthamoeba castellanii trophozoites. The clinic features of Acanthamoeba keratitis by day 70 are observed. All rats inoculated with Acanthamoeba developed keratitis. Histologically, the eyes displayed blood vessels, edema, and amoebae in stroma. A mixed cellular response, including neutrophils, mononuclear cells, and spindle-shaped cells, was seen. In conclusion, progressive, suppurative Acanthamoeba keratitis can be induced in the rat cornea model. This rat cornea model assists researchers who study the pathogenesis of Acanthamoeba keratitis and devise treatment for this difficult condition.Öğe Effect of combined chlorhexidine gluconate and Neosporin on experimental keratitis with two pathogenic strains of Acanthamoeba(SPRINGER, 2012) Polat, Zubeyde Akin; Vural, AyseAcanthamoeba keratitis (AK) is a painful, sight-threatening, and difficult-to-treat corneal infection caused by the ubiquitous free-living amoebae Acanthamoeba species. The aim of the present study was to compare the severity of keratitis, caused by Acanthamoeba hatchetii and Acanthamoeba castellanii infections, and to assess the therapeutic effects of combined chlorhexidine (CHX) and NeosporinA (R) treatment in rats. The rats were first divided into two groups, in which the eyes of the animals were infected with A. hatchetii or A. castellanii trophozoites. On day 5, all corneas were examined in order to determine the degree of infection (grade 0 to 3), and animals were divided into two new groups, treatment and infected control groups. The treatment was continued for 28 days, followed by excision and histological evaluation of the corneas. In conclusion, the clinical picture progressed more rapidly and severely in eyes infected by A. castellanii, while it was non-invasive and slower to progress with A. hatchetii. Moreover, eyes infected by A. hatchetii responded quicker and more positively to therapy, consistent with its clinical course, while a longer recovery was seen with A. castellanii. Histological examinations revealed the presence of A. castellanii and A. hatchetii trophozoites in the stroma of eyes of the treatment and control groups. As a result, our findings suggest that a combination of Neosporin with lower doses of CHX may be beneficial to treat patients with early diagnosis of AK.Öğe The effect of propolis in experimental Acanthamoeba keratitis(WILEY, 2007) Vural, Ayse; Polat, Zubeyde Akin; Topalkara, Aysen; Toker, Mustafa Ilker; Erdogan, Haydar; Arici, Mustafa Kemal; Cetin, AliPurpose: To examine the effect of propolis in a rat model of Acanthamoeba keratitis and to determine its in vitro cytotoxicity in cultured corneal epithelial cells. Methods: Eighteen Wistar albino rats were used. Cultured corneal epithelial cells obtained from two healthy rats for in vitro cytotoxicity of propolis. Corneal stromal inoculation was performed in 16 rats with amoebic culture containing 1 x 10(6) amoeba/mL. Rats with Acanthamoeba keratitis 5 days later after the inoculation were divided randomly into four groups, and eight eyes of each group were treated with study drugs. The propolis, chlorhexidine (CHX), propolis plus CHX and control eyes were treated with topical propolis, 0.002% CHX, propolis plus 0.002% CHX and lubricant eye drops, respectively. The study drugs were instilled every one hour for 10 days. All eyes were examined and keratitis graded by slit-lamp biomicroscopy on days 2, 5 and 10 during the administration of the study drugs. After the completion of keratitis grading, all the 16 rats were humanely killed and their corneas were excised and used for Acanthamoeba culture to evaluate presence of Acanthamoeba growth after treatment 14 days later. Results: Concentrations of propolis higher than 7.81 mg/mL cause damage to corneal epithelial cells in the experiment of in vitro cytotoxicity of propolis on corneal epithelial cells. The keratitis grade on day 2 in the CHX eyes was significantly lower than that in the control eyes (P < 0.05). The keratitis grades on days 5 and 10 in the propolis, CHX and propolis plus CHX eyes were significantly lower compared with those on days 5 and 10 in the control eyes (P < 0.05). In the propolis eyes, the keratitis grade on day 5 was significantly lower than that on day 2 (P < 0.05), and it was significantly lower on day 10 compared with that on day 5 (P < 0.05). In the CHX and propolis plus CHX eyes, the keratitis grade on day 10 was significantly lower compared with that on days 2 and 5 (P < 0.05). In the control eyes, there was no significant difference in the keratitis grades on days 2, 5 and 10 (P > 0.05). The culture positivity at Acanthamoeba growth after treatment experiment in the propolis, CHX and propolis plus CHX eyes was significantly lower than that in the control eyes (P < 0.05). Conclusions: We suggest that propolis had amoebicidal properties in this rat model of Acanthamoeba keratitis. Further investigations to evaluate the antimicrobial activity of the individual fractions of the resin could yield more information about its mechanism of action in treating this disease.Öğe Efficacy of contact lens storage solutions against trophozoite and cyst of Acanthamoeba castellanii strain 1BU and their cytotoxic potential on corneal cells(SPRINGER, 2007) Polat, Zubeyde Akin; Vural, Ayse; Cetin, AliAcanthamoeba is a free-living amoeba causing a potentially blinding infection of the cornea. Contact lens wearers are most at risk and account for about 95% of cases. We investigated the in vitro effectiveness of 10 contact lens solutions against Acanthamoeba castellanii and their cytotoxicity on corneal cells in vitro. Contact lens solutions were evaluated for their amoebicidal activities using an inverted light microscope. To determine of their cytotoxicity on corneal cells, agar diffusion tests were performed. According to the results obtained from the tests, AVIZOR Aqua Soft Comfort and Elegances showed the best amoebicidal effect on A. castellanii trophozoites. Cysts were still viable after overnight (8 h) exposure. In the case of the cyctotoxic acitivities, All In One Light, AstekTm, SOLO-Care AquaTm, Maxima, and Horien showed no cytotoxicity on the corneal cells. ReNu MUltiplUSTm, AVIZOR Aqua Soft Comfort, Carrerav (R), and Elegance (R) showed mild cytotoxicity on the corneal cells. Plurisol.M presented moderate cytotoxicity on the corneal cells. All commercial solutions examined in this study are the lack of efficacy against A. castellanii. Improvement or development of new contact lens disinfecting systems by the manufacturers is needed to prevent Acanthamoeba keratitis.Öğe Efficacy of First Turkish Made Single-Piece Foldable Hydrophobic Acrylic Intraocular Lens Zaraccom F260 on Cataract Treatment(AMER SOC CONTEMPORARY MEDICINE SURGERY & OPHTHALMOLOGY, 2008) Toker, Mustafa Ilker; Vural, Ayse; Erdogan, Haydar; Topalkara, Aysen; Arici, Mustafa KemalWe evaluated the efficacy of Zaraccom F260 intraocular lenses (IOL) on cataract treatment in 97 adult cataract patients (114 eyes) who underwent phacoemulsification and IOL implantation. The mean preoperative best-corrected visual acuity (BCVA) was 0.26 +/- 0.26 at one week 0.49 +/- 0.25 and 0.9 +/- 0.28 at follow-ups. The Zaraccom F260 is an alternative for the patients requiring lens replacement.Öğe Efficacy of miltefosine for topical treatment of Acanthamoeba keratitis in Syrian hamsters(SPRINGER, 2012) Polat, Zubeyde Akin; Obwaller, Andreas; Vural, Ayse; Walochnik, JuliaAcanthamoeba keratitis is a painful corneal infection and difficult to treat because no sufficiently efficient drug has yet been available. The aim of the study therefore was to assess the therapeutic potential of miltefosine on Acanthamoeba keratitis-infected hamster eyes. The cornea of hamsters were infected with Acanthamoeba hatchetti, a human corneal isolate. On the fifth day, all the cornea were microscopically examined in order to determine the degree of infections (G, from 0 to 3). Four groups were then prepared: miltefosine (160 mu M); 0.1% propamidine isetionate plus 0.02% polyhexnide; infected control (0.05% ethanol in PBS) and a non-infected control (0.05% ethanol in PBS) groups. The treatment was continued for 28 days. After the treatment, the cornea were excised and used for Acanthamoeba culture to investigate the presence of Acanthamoeba growth. Miltefosine treatment yielded much higher cure scores than propamidine isetionate plus polyhexanide. On the last day of treatment, 85% of the miltefosine-treated eyes were graded as G0; no changes were observed in the uninfected control group eyes; G3 eyes showed only a partial improvement. Furthermore, no Acanthamoeba cells could be recovered from the miltefosine-treated eye samples. Miltefosine appeared to hold necessary therapeutic properties for the treatment of Acanthamoeba keratitis.Öğe Evaluation of Serum Homocysteine and Leptin Levels in Patients with Uveitis(TURKISH OPHTHALMOLOGICAL SOC, 2015) Elbay, Arif Emre; Topalkara, Aysen; Elbay, Ahmet; Erdogan, Haydar; Vural, Ayse; Cetin, Abdi BahadirObjectives: To evaluate the serum homocysteine (Hcy) and leptin levels in patients with uveitis. Materials and Methods: The 70 cases included in the study comprised 3 groups: patients with Behcet's uveitis (BU), patients with non-Behcet's uveitis (NBU) and healthy controls. Body mass index was calculated for each subject. Serum Hcy and leptin levels were measured. Furthermore, acute-phase reactants including erythrocyte sedimentation rate (ESR), C-reactive protein and neutrophil count were measured. Results: Serum Hcy levels were 15.04 +/- 4.59 mu mol/L in the BU group, 15.4 +/- 6.87 mu mol/L in the NBU group and 13.64 +/- 4.72 mu mol/L in the control group (p>0.05). The serum leptin levels of male patients in the BU group, NBU group and control group were 4.76 +/- 3.54 ng/ml, 6.33 +/- 3.74 ng/ml and 5.47 +/- 6.33 ng/ml, respectively (p>0.05). When we compared serum leptin levels in female patients and controls, the mean serum leptin concentrations were significantly higher in female BU and NBU patients (24.83 +/- 17.62 ng/ml and 28.46 +/- 13.90 ng/ml, respectively) than in healthy control volunteers (9.62 +/- 6.36 ng/ml, p<0.05). In addition, the ESR value differences between groups were statistically significant (p<0.05). Conclusion: A larger case series is necessary to investigate serum Hcy and leptin concentrations in uveitis patients.Öğe In vitro amoebicidal activity of propolis on Acanthamoeba castellanii(MARY ANN LIEBERT INC, 2007) Topalkara, Aysen; Vural, Ayse; Polat, Zubeyde; Toker, Mustafa I.; Arici, Mustafa K.; Ozan, Fatih; Cetin, AliPurpose: The aim of this study was to investigate the in vitro effects of an ethanolic extract of propolis on the growth and adherence of Acanthamoeba castellanii trophozoites and cysts. Methods: The effect of propolis with concentrations of 8.0, 6.0, 5.0, 4.0, 3.0, and 2.0 mg/mL on the proliferation of A. castellanii trophozoites, and with a concentration of 62.25, 31.25, 15.62, 7.81, 3.90, 1.95, and 0.97 mg/mL on the proliferation of A. castellanii cysts, at 1, 3, 6, 12, 24, 48, and 72 h were examined in vitro.. Results: After 1-72 h, incubation in concentrations between 2.0 and 6.0 mg/mL, its effect was amoebistatic; at concentrations of 8.0 mg/mL and higher, its effect was amoebicidal. After 48 h or longer incubation times at 15.62 mg/mL and at higher concentrations, the propolis extract was cysticidal. At concentrations of 1.97 mg/mL or lower, there was no observable effect at any time point. Conclusions: These findings indicate that ethanolic extract of propolis has amoebicidal, as well as cysticidal, properties for Acanthamoeba trophozoites and cysts. Propolis alone, or in combination with other amoebicidal agents, may be used in clinical practice after further investigations.Öğe In vitro effectiveness of Thymus sipyleus subsp sipyleus var. sipyleus on Acanthamoeba castellanii and its cytotoxic potential on corneal cells(SPRINGER, 2007) Polat, Zubeyde Akin; Tepe, Bektas; Vural, AyseAcanthamoeba species are an important cause of microbial keratitis that may cause severe ocular inflammation and visual loss. Acanthamoeba keratitis is difficult to treat, without total efficacy in some patients because of cysts which is less susceptible than trophozoites to the usual treatments. We investigated here the in vitro amoebicidal activity of methanolic extract of Thymus sipyleus subsp. sipyleus var. sipyleus from Turkish flora against Acanthamoeba castellanii and also its cytotoxicity on corneal cells in vitro. Extract was evaluated for its amoebicidal activity using an inverted light microscope. The effect of the polar extract with the concentrations ranging from 1.0 to 32.0 mg/ml on the proliferation of A. castellanii trophozoites and cysts were examined in vitro. For the determination of cytotoxicity of the extract on corneal cells, agar diffusion tests were performed. According to results obtained from the tests, the extract evaluated here showed remarkable amoebicidal effect on A. castellanii. In the case of the cytotoxic activities, it showed no cytotoxicity for corneal cells in the concentration of 32 mg/ml. As a result, polar subfraction of the methanolic extract of Thymus sipyleus subsp. sipyleus var. sipyleus could be concluded as a new natural agent for the treatment of Acanthamoeba infections. On the other hand, it still needs to be further evaluated by in vivo test systems to confirm the efficiency of its biological effect.Öğe In vitro evaluation of the amoebicidal activity of garlic (Allium sativum) extract on Acanthamoeba castellanii and its cytotoxic potential on corneal cells(MARY ANN LIEBERT, INC, 2008) Polat, Zubeyde Akin; Vural, Ayse; Ozan, Fatih; Tepe, Bektas; Oezcelik, Semra; Cetin, AliFree-living protozoa of the genus Acanthamoeba can cause one of the most severe, potentially sight-threatening infections of the eye, the so-called A. keratitis. A. keratitis is difficult to treat because, under adverse conditions, the amoeba encyst and medical therapy is often less effective against cysts than against trophozoites. The aim of this study was to investigate evaluate the in vitro effect of the nonpolar subfraction of the methanol extract of garlic (Allium sativum) on the growth of A. castellanii trophozoites and cysts and also its cytotoxicity on corneal cells in vitro. Extract was evaluated for its amoebicidal activity, using an inverted light microscope. The effect of the nonpolar extract with the concentrations, ranging from 0.78 to 62.5 mg/mL on the proliferation of A. castellanii trophozoites and cysts, were examined in vitro. For the determination of cytotoxicity of the extract on corneal cells, agar diffusion tests were performed. The present study demonstrates the in vitro effectiveness of the garlic against the A. castellanii growth curve. Evaluations revealed that garlic inhibits trophozoite growth in dose- and time-dependent ways. In the case of the cyctotoxic acitivities, it showed no cytotoxicity for the cornea cells in the concentration of 3.90 mg/mL. These findings indicate that nonpolar subfraction of the methanol extracts of garlic has amoebicidal, as well as its cysticidal, properties on Acanthamoeba trophozoites and cysts. Garlic alone, and in combination with other amoebicidal agents, may be used in clinical practices after further investigations.Öğe Purtscher-like Retinopathy Associated with Crimean-Congo Hemorrhagic Fever: A Case Report(Taylor & Francis Inc, 2022) Yalinbas, Duygu; Bozali, Erman; Vural, Ayse; Kocak, Husne; Erdogan, HaydarPurpose: To describe retinal findings and spectral-domain optical coherence tomographic (SD-OCT) features of a patient with Crimean-Congo hemorrhagic fever (CCHF) presenting as Purtscher-like retinopathy. Case report: A 70-year-old woman presented with the emerging bilateral blurring of vision. She had been diagnosed with CCHF one week ago and hospitalized in another hospital for treatment of disease. Fundoscopy of the patient revealed cotton-wool spots, retinal whitening areas, and few retinal hemorrhages in a Purtscher-like configuration in both eyes. Spectral-domain optical coherence tomography revealed inner retinal hyperreflectivity corresponding to the cotton-wool spots in both eyes, and also showed subretinal fluid in the left eye. Without any treatment retinal lesions and inner retinal hyperreflectivity on SD-OCT regressed within one month. Conclusion: Crimean-Congo hemorrhagic fever is known to cause mild ocular disease, and may also cause Purtscher-like retinopathy. It is important to aware of the ocular findings of CCHF.
