Browsing by Author "Inan, ÜÜ"

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    Relationship of retinopathy and hearing loss in type 2 diabetes mellitus
    Kurt, E; Öztürk, F; Günen, A; Sadikoglu, Y; Sari, RA; Yoldas, TK; Avsar, A; Inan, ÜÜ
    This study investigated whether the degree of diabetic retinopathy correlates with degree of sensorineural hearing loss. Seventy-five diabetic patients and 45 sex- and age-matched healthy controls were evaluated audiologically. Patients were classified into groups by severity of retinopathy. group 1 (n=28), no retinopathy, group 2 (n= 4), background retinopathy, and group 3 (n=23), proliferative, or end-stage retinopathy. Diabetics had a statistically significant difference at all frequencies of hearing loss, as compared with controls.
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    Effect of propolis on endotoxin-induced uveitis in rabbits
    Öztürk, F; Kurt, E; Inan, ÜÜ; Emiroglu, L; Ilker, SS; Sobaci, G
    Purpose: To test the anti-inflammatory effect of propolis, a natural bee-produced compound, and compare it with corticosteroids fur the: treatment of endotoxin-induced uveitis (EIU). Methods: EIU was produced in all rabbits by unilateral intravitreal injection of 2,000 ng Salmonella typhimurium endotoxin. The animals were then divided randomly into three groups as follows: group A received no treatment (control), group B received methylprednisolone (5 mg/0.1 mL) (positive control); and group C received propolis (5 mg/0.16 mL) by anterior sub-Tenon injection at the time of uveitis induction and at 4 and 8 hours after induction. Inflammation was evaluated by clinical manifestations and by measuring the protein concentration and inflammatory cell content of the aqueous humor. Results: The clinical grade, cell count: and protein levels in the aqueous humor were: control group (6.0 +/- 0.8, 2,519 +/- 470 cells/mu L. 32.9 +/- 2.4 mg/mL); methylprednisolone group (1.8 +/- 0.7, 572 +/- 137 cells/mu L. 15.2 +/- 1.8 mg/mL); and propolis group (2.3 +/- 0.5, 503 +/- 124 cells/mu L, 13.8 +/- 1.5 mg/mL). Statistically significant differences were recorded in the treatment groups when compared to the control group (P < .001). The effects of methylprednisolone and propolIs on EIU were similar (P > .05). Conclusions: Propolis showed significant anti-inflammatory effects on EIU iii rabbits. The mechanism of its action warrants further investigation. Jpn J Ophthalmol 1999;43:285-289. (C) 1999 Japanese Ophthalmological Society.
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    Penetration of topical and oral ofloxacin into the aqueous and vitreous humor of inflamed rabbit eyes
    Öztürk, F; Kurt, E; Inan, ÜÜ; Kortunay, S; Ilker, SS; Basci, NE; Bozkurt, A
    Purpose: This study aimed to investigate the penetration of topical and oral ofloxacin into aqueous humor and vitreous humor in post-traumatic endophthalmitis model in rabbits. Methods: A standardized intraocular infection after penetrating injury was made in the right eyes of 16 rabbits. Intraocular infection was induced by intravitreal injection of a suspension of Staphylococcus aureus. The intact left eyes were maintained as controls. The animals were divided randomly into two groups. (1) In the topical group, two drops of offloxacin 0.3% eyedrops were instilled to both eyes every 30 min for 4 h. (2) In the topical-oral group, two doses of 25 mg/kg of ofloxacin at 12-h intervals were given orally, then the protocol of the first group was applied. Aqueous and vitreous humor samples were taken 30 min after the last drop. Ofloxacin concentrations were measured by using HPLC. Results: Mean aqueous levels of ofloxacin in control eyes were: 3.25 +/- 2.55 mu g/ml in topical group, 4.58 +/- 5.39 mu g/ml in topical-oral group. Mean aqueous levels in inflamed eyes were: 5.21 +/- 4.55 mu g/ml in topical group, 10.34 +/- 8.88 mu g/ml in topical-oral group. Mean vitreous levels of ofloxacin in control eyes were: 0.17 +/- 0.07 mu g/ml in topical group, 1.30 +/- 1.23 mu g/ml in topical-oral group. Mean vitreous levels in inflamed eyes were: 0.35 +/- 0.22 mu g/ml in topical group, 3.48 +/- 2.69 mu g/ml in topical-oral group. There was no significant difference among the groups (P > 0.05), however. Conclusions: The result of this study suggests that oral supplementation of ofloxacin to topical instillation increased the ocular levels of ofloxacin in the post-traumatic endophthalmitis model. Mean drug concentrations in aqueous and vitreous humors were above the 90% minimum inhibitory concentrations (MIC90) for most of the common microorganisms causing endophthalmitis in all eyes, except in the vitreous humors of the intact eyes instilled topically. (C) 2000 Elsevier Science B.V. All rights reserved.
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    Ofloxacin levels after intravitreal injection -: Effects of trauma and inflammation
    Öztürk, F; Kortunay, S; Kurt, E; Inan, ÜÜ; Ilker, SS; Basci, NE; Bozkurt, A; Kayaalp, SO
    Purpose: This study was carried out to get an insight into the ofloxacin elimination after intravitreal injection in rabbits. We also studied the effects of trauma and inflammation on the vitreous ofloxacin levels after intravitreal injection of ofloxacin. Methods: A penetrating eye injury in the right eye was inflicted on 24 rabbits and another 12 animals were used as control. A standardized intraocular inflammation was induced by intravit-real injection of a suspension of Staphylococcus aureus in half of the traumatized eyes. Ofloxacin (200 mu g/0.1 ml) was injected into the midvitreous cavity of both traumatized and control right eyes, and samples were obtained at 2, 8, 24 and 48 h after injection. Drug concentrations were measured using high-pressure liquid chromatography analysis. Results: Vitreous levels of ofloxacin were above the MIC90 at 2 and 8 h in all groups for most of the common microorganisms causing endophthalmitis and also at 24 h in traumatized-infected eyes. At the second hour, the mean vitreous concentrations of ofloxacin both in traumatized and traumatized infected eyes were lower than that in the control eyes (p < 0.05). At 8 h, the mean vitreous concentrations of ofloxacin in the traumatized and in the traumatized-infected eyes were higher than that in the control eyes (p < 0.05). At 24 h, the mean ofloxacin concentration was higher in the traumatized-infected eyes than that in control (p < 0.01) and traumatized eyes (p < 0.05), and also higher in the traumatized eyes than that in the control eyes (p < 0.05). The mean ofloxacin concentrations in the traumatized and traumatized-infected eyes were significantly higher (p < 0.01) than those in the controls at 48 h. The elimination half-life of ofloxacin in the control eyes was 5.65 h and trauma and inflammation prolonged the half-life to 9.47 and 9.72 h, respectively. Conclusion: Clearance of ofloxacin is fast and appears to be reduced by trauma and inflammation. Therapeutic drug levels in traumatized-infected eyes were maintained up to 24 h. This may be an important pharmacokinetic advantage in treating endophthalmitis unless the dose used has local toxicity and allows a longer dose interval when the dose is repeated.
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    The effect of long-term use and inflammation on the ocular penetration of topical ofloxacin
    Öztürk, F; Kortunay, S; Kurt, E; Inan, ÜÜ; Ilker, SS; Basci, N; Bozkurt, A
    Purpose. To study the,penetration of ofloxacin into the aqueous and vitreous humors after long-term topical administration and to investigate the effects of inflammation on drug penetration in rabbits. Methods. A standardized model of intraocular infection after penetrating injury was achieved in the right eyes of 16 rabbits. The animals were randomly and equally-divided into two groups. The intact left eyes of the groups were maintained as the control. Ofloxacin eyedrops (0.3%) were instilled into all eyes at a frequency of 2 drops every hour for 7 hours in the first group and for 14 hours in the second group. Half an hour after the last drop, samples of the aqueous and vitreous humors were taken and ofloxacin concentrations were measured by using HPLC. Results. The mean aqueous humor concentrations of ofloxacin in control eyes after 7:and 14 hours of instillation were: 1.45 +/- 0.93 mu g/ml and 2.48 +/- 0.33 mu g/ml, respectively; those in infected eyes 2.35 +/- 1.84 mu g/ml and 3.49 +/- 1.47 mu g/ml, respectively. However the differences among the groups were not significant (p > 0.05). The vitreous ofloxacin concentrations in the control eyes were similar after 7 and 14 hours of instillation (0.23 +/- 0.14 mu g/ml, 0.27 +/- 0.10 mu g/ml, respectively). In infected eyes, the mean vitreous ofloxacin concentration after 14 hour of instillation was significantly higher than that in control eyes (p < 0.05; 0.4 +/- 0.09 mu g/ml, 0.29 +/- 0.11 mu g/ml, respectively). The mean vitreous ofloxacin concentration in infected eyes after 14 hours instillation was not significantly higher than that after 7 hours instillation. Conclusions. Topical ofloxacin instillation for 7 or 14 hours yields aqueous concentrations above the MIC90 for common ocular pathogens. Prolonged application and the presence of inflammation increased the penetration of ofloxacin into the vitreous humor.
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    Effects of trauma and infection on ciprofloxacin levels in the vitreous cavity
    Öztürk, F; Kortunay, S; Kurt, E; Ilker, SS; Inan, ÜÜ; Basci, NE; Bozkurt, A; Kayaalp, SO
    Objective: This study was designed to determine the effects of trauma and infection on vitreous ciprofloxacin levels after intravitreal injection of ciprofloxacin in rabbits. Methods: A penetrating injury was made in the right eyes of 24 rabbits, in the eyes of half of the traumatized animals, a standardized intraocular infection was induced by intravitreal injection of a suspension of Staphylococcus aureus. The intact left eyes of the traumatized group were maintained as controls. Ciprofloxacin (200 mug/0.1 mL) was injected into the midvitreous cavity of both eyes in all animals and samples were obtained at 2, 8, 24, and 48 hours after injection. Drug concentrations were measured using high-pressure liquid chromatography analysis. Results: At the second hour, the mean Vitreous concentration of ciprofloxacin in the traumatized eyes was lower than that in control eyes (P < 0.05). The mean ciprofloxacin concentrations were significantly higher (P < 0.05) in the traumatized-infected eyes than were those in control or traumatized eyes at 24 and 48 hours. The elimination half-life of ciprofloxacin in control and traumatized eyes was 6.02 hours and 5.02 hours, respectively, and infection prolonged the half-life to 15.06 hours. Vitreous levels of ciprofloxacin were above the minimum inhibitory concentration (MIC90) for most of the common microorganisms causing endophthalmitis in all groups at 2 and 8 hours, but also at 24 and 48 hours in traumatized-infected eyes. Conclusion: Infection appears to decrease the clearance of ciprofloxacin. Therapeutic drug levels in traumatized-infected eyes were maintained up to 48 hours. Assuming that the animal model used may have a predictive Value for the drug elimination in traumatized-infected human eyes, we suggest that local administration of ciprofloxacin every 2 days may be relevant from the therapeutic perspective.
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    Chiasmal decussation in tilted disc syndrome PVER in tilted disc
    Öztürk, F; Kurt, E; Yoldas, T; Ilker, SS; Inan, ÜÜ
    The tilted disc syndrome is a benign congenital abnormality of the optic nerve head. Since it can be confused with papilledema and chiasmal lesions, differential diagnosis is important. The tilting anomaly may be associated with other abnormalities along the optic nerve. Visual field defects may be similar to those in chiasmal lesions. In order to determine whether the normal crossover of nerve fibers at the chiasm is altered, the crossed and the uncrossed fibers were investigated using the pattern visual evoked responses (PVER) test. Thirty-four eyes of 17 patients diagnosed with tilted disc syndrome were evaluated for refraction, keratometry, color vision with Ishihara, visual field, and PVER. The presence of abnormal nerve fiber decussation was determined by recording PVER from the electrodes mounted on the scalp of both hemispheres. The amplitude and latency differences between the 'crossed' and 'uncrossed' fibers were not statistically significant (p>0.05). As a result, the tilting abnormality of papilla was found to be without chiasmal abnormal decussation.
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    Efficacy of eye patching for corneal healing after removal of corneal foreign body
    Kurt, E; Öztürk, F; Inan, ÜÜ; Emiroglu, ML; Ilker, SS
    Standard treatment of corneal epithelial loss includes an eye patch with antibiotic ointment. We compared the efficacy of eye patching with no eye patching on corneal epithelial healing of 84 patients after foreign body removal. Since no significant difference between two groups for corneal healing was found, antibiotic treatment alone may he sufficient for treatment of corneal epithelial loss after foreign body removal.
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    The effects of acetylcholine and propolis extract on corneal epithelial wound healing in rats
    Özturk, F; Kurt, E; Inan, ÜÜ; Emiroglu, L; Ilker, SS
    Purpose. To investigate the effects of topical acetylcholine and topical administration of propolis, a natural beehive product, on corneal epithelial wound healing. Methods. The whole corneal epithelium was debrided in 42 eyes of 21 rats by mechanical scraping with a dulled scalpel blade. Animals were divided into three groups. Group 1 received topical 1% water extract of propolis (WEP), group 2 received topical acetylcholine (ACh), and group 3 (control group) received topical phosphate-buffered saline, 6 times a day for 3 days, starting immediately after debridemenl. The area of the corneal epithelial defect was stained with fluorescein, photographed, and then measured every 12 h. The mean epithelial defect area and the mean percentage of epithelial defect remaining at each follow-up were compared between the groups. Results. The mean epithelial defect area and the mean percentage of epithelial defect remaining at each time were significantly smaller (p < 0.001, p < 0.05, respectively) in the ACh and propoIis groups as compared with control groups. There was no statistically significant difference between the propolis or ACh groups at any lime (p > 0.05), At 72 h, the mean percentage of defect remaining was 2.58%, in the ACh group, 1.3% in the propolis-treated group, and 8.68% in the control group. Conclusions. This study demonstrated that ACh and propolis facilitated corneal epithelial wound healing of rats. Although the mechanisms of the effect of propolis on wound healing and its clinical use still remain to be determined, ACh may have a place in the treatment of corneal epithelial injuries.
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    The efficacy of 2.5% phenylephrine and flurbiprofen combined in inducing and maintaining pupillary dilatation during cataract surgery
    Öztürk, F; Kurt, E; Inan, ÜÜ; Ilker, SS
    PURPOSE. TO evaluate the effectiveness of phenylephrine 2.5% and flurbiprofen 0.03% combined in inducing and maintaining mydriasis during extracapsular cataract extraction (ECCE). METHODS. One hundred patients undergoing ECCE + intraocular lens (IOL) implantation were randomly divided into four groups. The first group was given phenylphrine 10%, the second group phenylephrine 10% + flurbiprofen, the third group phenylephrine 2.5% and fourth group phenylephrine 2.5% + flurbiprofen. Cyclopentolate 1% was used in ail patients. Phenylephrine and cyclopentolate were instilled preoperatively four times during I hour and flurbiprofen was given four times the day before surgery and twice with an hour's interval before operation. Pre-operative and post-cortex aspiration horizontal pupil diameters were measured with callipers Viewed through the operating microscope. RESULTS. Pupil diameters in pre-operative and post-cortex aspiration were no different in the 2.5% and 10% phenylephrine groups (p>0.05). Both diameters were larger and pupillary constriction was smaller in the flurbiprofen groups (p<0.05). CONCLUSIONS. 2.5% phenylephrine was as effective as 10% phenylephrine, with and without flurbiprofen, in inducing and maintaining pupil dilatation during ECCE surgery.
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    Prevention of posterior capsule opacification by retinoic acid and mitomycin
    Inan, ÜÜ; Öztürk, F; Kaynak, S; Ilker, SS; Özer, E; Güler, C
    Background: Our aim was to evaluate the effect of an intraoperative single dose of retinoic acid (RA) or mitomycin C (MMC) in preventing posterior capsule opacification (PCO). Methods: Twenty-seven rabbits were divided randomly into three groups. RA (250 mug/ml) and MMC (0.04 mg/ml) were given 0.1 ml by hydrosection and 0.9 ml into the capsular bag after phacoemulsification. The third group served as a control group. Three months after intervention PCO was graded clinically. Furthermore, proliferation of lens epithelial cells was evaluated histologically. Results: Two eyes developed corneal edema in the MMC group. On clinical assessment, RA and MMC were significantly effective in preventing PCO compared with controls (P <0.005). On histological analysis, there was significantly reduced proliferative activity on posterior capsules in the treatment groups, in contrast to multilayer cells in the control group. Conclusion: Intraoperative single-dose administration of RA and MMC significantly prevented the development of PCO in rabbit eyes. The optimal biocompatible dosage must be carefully determined by further investigation.
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    The effects of prolonged acute use and inflammation on the ocular penetration of topical ciprofloxacin
    Öztürk, F; Kurt, E; Inan, ÜÜ; Kortunay, S; Ilker, SS; Basci, NE; Bozkurt, A
    Purpose: To study the aqueous and vitreous penetration of ciprofloxacin after prolonged acute topical administration and to investigate the effects of inflammation on drug penetration. Methods: A standardized model of intraocular infection after penetrating injury was made in the right eyes of eight rabbits. The intact left eyes were maintained as the control. Two drops of ciprofloxacin 0.3% eyedrops were instilled topically every 1 h for 7 h to all eyes of the rabbits. Aqueous and vitreous samples (100 mu l) were obtained half an hour after the last drop. Instillation was continued for 7 h more and samples were obtained as before. Drug concentrations were measured using HPLC. Results: The mean aqueous humor levels of ciprofloxacin were: in control eyes 1.31 +/- 0.78 mu g/ml after 7 h and 1.85 +/- 1.69 mu g/ml after 14 h of instillation; in inflamed eyes 2.18 +/- 1.02 mu g/ml after 7 h and 2.91 +/- 2.12 mu g/ml after 14 h. The mean vitreous humor levels were: in control eyes 0.65 +/- 0.44 mu g/ml after 7 h and 0.72 +/- 0.8 mu g/ml after 14 h of instillation; in inflamed eyes 0.67 +/- 0.77 mu g/ml after 7 h and 1.01 +/- 0.43 mu g/ml after 14 h. However, the differences among the groups were not significant (P > 0.05). Conclusions: Ciprofloxacin penetration into aqueous humor was higher in 14-h topical application than that for 7 h. Inflammation increased the penetration of topical ciprofloxacin into aqueous while administered for 7 h and into both aqueous and vitreous humor while administered for 14 h. (C) 2000 Elsevier Science B.V. All rights reserved.
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    Prevention of posterior capsule opacification by intraoperative single-dose pharmacologic agents
    Inan, ÜÜ; Özturk, F; Kaynak, S; Kurt, E; Emiroglu, L; Özer, E; Ilker, SS; Güler, C
    Purpose. To determine whether an intraoperative single dose of dexamethasone, diclofenac, ethylenediaminetetraacetic acid (EDTA), a combination of EDTA and RGD peptide (arginine-glycin-aspartic acid sequence), or mitomycin-C (MMC) is a pharmacological means of preventing or reducing the development of posterior capsule opacification (PCO). Setting. Department of Ophthalmology, Celal Bayar University, School of Medicine, Manisa, and Department of Pathology, Dokur Eylul University, School of Medicine, izmir, Turkey. Methods: Fifty-four rabbits were randomly divided into 6 groups. Dexamethasone (4 mg/cc), diclofenac (2.5 mg/cc), EDTA (8 mg/cc), a combination of EDTA and RGD peptide (2.5 mg/cc), or MMC (0.04 mg/cc) was given, 0.1 cc by hydrodissection and 0.9 cc into the capsular bag after phacoemulsification. The sixth group served as a control group. After 3 months, the PCO was graded clinically and the proliferation of lens epithelial cells (LECs) was evaluated histologically. Results: The drugs were significantly effective in preventing PCO compared with the control (P < .005). Dexamethasone had a weaker effect than the other drugs. In histological analysis, although monolayer LECs in the dexamethasone and diclofenac groups were observed, there was no proliferative activity on the posterior capsules in the EDTA, EDTA+RGD, and MMC groups in contrast to the multilayer cells in the control. Conclusions: Intraoperative single-dose application of EDTA, EDTA+RGD peptide combination, and MMC significantly prevented the development of PCO in rabbit eyes. Diclofenac was less effective but also reduced PCO. Although dexamethasone did not prevent the proliferation of LECs, it decreased PCO clinically. (C) 2001 ASCRS and ESCRS.