ISSN: 2459-1777 | E-ISSN 2587-0394
Volume : 2 Issue : 2 Year : 2024
Beyoglu Eye Journal - Beyoglu Eye J: 2 (2)
Volume: 2  Issue: 2 - 2017
EDITORIAL COMMENT
1. Treatment of Malignant Glaucoma
Cigdem Altan, Isıl Pasaoglu, Sukru Bayraktar
doi: 10.14744/bej.2017.58077  Pages 41 - 42
Malignant glaucoma is one of the most challenging conditions in ophthalmology. The exact etiology of this complication is not fully understood, and its management is usually challenging. This brief report discusses current treatment strategies for this relatively uncommon form of secondary glaucoma.

INVITED REVIEW
2. A Current Overview of Diagnosis and Treatment in Retinopathy of Prematurity
Irfan Perente, Tulin Aras Ogreden
doi: 10.14744/bej.87597  Pages 43 - 48
Retinopathy of prematurity (ROP) is the interruption of the physiological development of retinal vascularization due to preterm delivery and is a proliferative vitreoretinopathy characterized by an evolving pathological process. Many innovations have emerged in the naming, screening, follow-up, and treatment of the disease in the 70 years since then first defined by Terry. This review is an examination of this difficult and dynamic area of modern-day ophthalmology practice in the light of current information.

ORIGINAL ARTICLE
3. Surgical Dose-Response Relationship in Patients with Down Syndrome with Esotropia: A Comparative Study
Osman Bulut Ocak, Asli Inal, Ebru Demet Aygit, Serap Yurttaser Ocak, Can Ozturker, Ahmet Demirok, Birsen Gokyigit
doi: 10.14744/bej.2017.02419  Pages 49 - 52
INTRODUCTION: This study is a comparison of the effectiveness of bimedial rectus recession surgery in patients with Down syndrome and those with normal neurological development.
METHODS: Records of patients with Down syndrome (age range: 2-17 years) who underwent bimedial rectus recession surgery for esotropia (ET) between April 2005 and April 2016 were reviewed retrospectively. A control group was also selected from age-matched patients with normal neurological development who underwent the same surgical procedure during the period. Ocular alignment was measured with the Krimsky test. Surgical success was defined as within 10 prism diopters (PD) of orthotropia 1 year after surgery. The case and control groups were compared in terms of preoperative and postoperative esodeviation angle at 1-year follow-up, the size of the bimedial rectus recession, and postoperative surgical success.
RESULTS: A total of 21 patients with Down syndrome and 42 control subjects were included. The groups did not differ in either preoperative (Down syndrome group: 39.73±8.47 PD; control group: 37.91±7.65 PD) or postoperative near deviation angle (Down syndrome group: 5.45±11.45 PD; control group: 2.36±7.13 PD) or size of bimedial rectus recession (Down syndrome group: 4.68±0.40 mm; control group: 4.78±0.38 mm). Surgical success had been achieved in 15 patients with Down syndrome (80.90%), and in 35 control patients (83.33%) at 1-year follow-up. There was a significant difference between the preoperative and postoperative deviation angles in both groups (p<0.05).
DISCUSSION AND CONCLUSION: Surgical success rate was similar in ET patients with or without Down syndrome who underwent bimedial rectus recession surgery.

4. Intravitreal Ranibizumab for Diabetic Macular Edema Patients with Good Baseline Visual Acuity: A Real-Life Study
Abdullah Ozkaya, Mehmet Ozveren, Zeynep Alkin
doi: 10.14744/bej.2017.87598  Pages 53 - 57
INTRODUCTION: This is a report of 12-month real-life outcomes of ranibizumab treatment in diabetic macular edema (DME) patients who had a baseline visual acuity (VA) ≥0.6 in decimals.
METHODS: Newly diagnosed treatment-naïve DME patients with a VA ≥0.6 who completed a follow-up of 12 months after treatment with ranibizumab were included retrospectively. The patients were evaluated in terms of change in best corrected visual acuity (BCVA) and central retinal thickness (CRT), and the total number of visits and injections.
RESULTS: A total of 27 eyes of 24 patients were included. Mean BCVA at baseline, month 3, 6, 9, and 12 was 0.77±0.11 in decimals, 0.72±0.23, 0.72±0.18, 0.70±0.21, and 0.71±0.19, respectively. Mean CRT at baseline, month 3, 6, 9, and 12 was 420±79, 394±97, 341±54, 360±102, and 350±106 microns, respectively. The mean number of visits and injections was 4.8±1.0 and 3.5±1.5, respectively.
DISCUSSION AND CONCLUSION: Ranibizumab seems to be effective in maintaining VA and improving anatomy in DME patients with a good baseline VA. However, adherence to the needed treatment regimen seems to be insufficient in real life and probably limits the visual success in this group of patients.

5. The Clinical Features and Management of Duane’s Retraction Syndrome Type 2 in Pediatric Patients
Asli İnal, Osman Bulut Ocak, Ebru Demet Aygit, Selcen Celik, Berkay Inal, Ahmet Demirok, Birsen Gokyigit
doi: 10.14744/bej.2017.25744  Pages 58 - 61
INTRODUCTION: The aim of this study was to describe the demographic details, features, and clinical management of pediatric patients with Duane retraction syndrome (DRS) type 2.
METHODS: A total of 632 charts from patients who were diagnosed with DRS between January 1998 and January 2016 were retrospectively reviewed. DRS type 2 patients who were <18 years old were identified. Demographic data and clinical findings from pediatric patients with a follow-up time >1 year were collected. Orthotropia or ±10 prism diopters (PD) at near and distance fixation in primary position with available optical correction at the last visit was considered a satisfactory outcome.
RESULTS: There were 5 girls (62.5%) and 3 boys (37.5%). The average age at the first visit was 8.87±6.70 years (range: 2-18 years). The left eye was affected in 4 patients, the right eye in 3 patients, and 1 patient had bilateral involvement. Amblyopia was detected in 4 patients. Four patients had abnormal head posture (AHP). All of the patients had exotropia (XT). The near deviation angle was 24.75±16.45 PD (range: 4-60 PD), and the distance deviation angle was 29±23.12 PD (range: 10-80 PD). Orthotropia/<10 PD XT was seen in 5 patients with refractive correction. Three patients underwent surgery to correct deviation. In the final examination, 2 patients had AHP and orthophoria/<10 PD XT was observed in 6 patients.
DISCUSSION AND CONCLUSION: Amblyopia and deviation in primary position was common in children with DRS type 2 in our small group; therefore, detailed patient examinations are very important. Surgery would be appropriate for patients with strabismus and/or AHP.

6. One-Year Outcomes Comparison of Anti-VEGF Monotherapy and Combined Anti-VEGF+Photodynamic Therapy for Retinal Angiomatous Proliferation
Cem Kesim, Ali Demircan, Zeynep Alkin, Korhan Fazil, Abdullah Ozkaya, Muhittin Taskapili
doi: 10.14744/bej.2017.46036  Pages 62 - 63
INTRODUCTION: This study was a comparison of the results achieved in patients with age-related macular degeneration and retinal angiomatous proliferation (RAP) diagnosis receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) monotherapy and receiving photodynamic treatment (PDT) combined with anti-VEGF treatment.
METHODS: A retrospective chart review of patients with RAP who were treated in the retina clinic of Beyoglu Eye Training and Research Hospital was conducted. Patients were divided into 2 groups: patients who received anti-VEGF monotherapy formed Group I, and Group II comprised those who underwent combined therapy with PDT. Best corrected visual acuity (BCVA) and central macular thickness values at baseline and at months 6 and 12, and the number of anti-VEGF injections and PDT sessions were recorded.
RESULTS: Fifteen eyes of 14 patients were included. Six of the patients were female and 8 were male; the mean age was 73.2±9.7 years. The mean baseline BCVA was 0.70±0.52 log of the minimum angle of resolution. Visual acuity increased in 1 of 15 eyes (6.6%), remained stable in 10 eyes (66.6%), and decreased in 4 eyes (26.6%). A total of 7 eyes received anti-VEGF monotherapy, and 8 eyes received combined PDT and anti-VEGF treatment. The mean number of injections was 10.7±7.8. Five eyes received 1 PDT session and 3 eyes received 2 sessions.
DISCUSSION AND CONCLUSION: In this study, visual acuity was preserved in the majority of patients receiving anti-VEGF monotherapy and combined PDT and anti-VEGF treatment for RAP lesions.

SURGICAL TECHNIQUE
7. Surgical Technique for Palsy of Superior Division of Oculomotor Nerve
Birsen Gokyigit, Selcen Celik, Asli Inal
doi: 10.14744/bej.2017.92486  Pages 67 - 70
This report is a description of a new surgical technique for palsy of the superior division of the oculomotor nerve. A 52-year-old female who had previously been operated on for an intracranial tumor described ocular motility restriction. A complete ophthalmological examination revealed elevation deficiency of -4 and accompanying ptosis in the left eye. Botulinum toxin injection was administered, and recession of the inferior rectus muscle, and tucking of the superior rectus following union of the medial and lateral rectus muscles were performed. In our technique, no scleral suture was used during the union of muscles procedure. Postoperatively, elevation improved significantly and hypotropia was fully corrected. In addition to being as effective as the previously described Knapp procedure, our technique is safer and easier.

CASE REPORT
8. Posterior Scleritis after Extraocular Horizontal Muscle Transposition Surgery: A Case Report
Osman Bulut Ocak, Asli Inal, Ebru Demet Aygit, Ihsan Yilmaz, Ahmet Demirok, Birsen Gokyigit
doi: 10.14744/bej.2017.43531  Pages 71 - 74
A male patient was diagnosed with bilateral congenital third nerve palsy when he presented at the clinic for the first time in 2001 at the age of 22 with the complaints of decreased visual acuity in the right eye, exodeviation, and movement disability in the medial, upper, and inner gaze. The right eye was diagnosed with anterior segment ischemia and stem cell deficiency, which had developed after strabismus surgery. Lateral rectus (LR) augmented recession and conjunctival recession were performed in the left eye of the patient in 2001. The clinical follow-up was completed. The patient presented at the clinic again in 2014. In 2015, the left LR was transposed to the medial rectus region after being divided in 2 with a Y-split. The inferior part was passed under the inferior rectus and inferior oblique muscles, and the superior part was passed under the superior rectus and superior oblique muscles. When the patient described reduced vision on the postoperative first day, fundus examination was performed, followed by fundus fluorescein angiography. Optical coherence tomography findings were assessed and posterior scleritis was diagnosed. Medical treatment was planned and the case was closely monitored. Posterior scleritis had resolved at the fourth month after the operation. At the last visit, it was observed that preoperative visual acuity values and orthophoria in the primary position had been achieved.

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