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Amaç: Göz tüberkülozu hem terminoloji, hem tanı kriterleri hem de tedavi seçenekleri açısından halen tartışmalı bir konu olarak kabul edilmektedir. Yeni yaklaşımlar olmasına rağmen ortak bir tanı/tedavi algoritması bulunmamaktadır. Bu çalışmada “Göz tüberkülozu hastalarının” tedavi sonuçları değerlendirilmiştir. Gereç ve Yöntem: Latent tüberküloz enfeksiyonu olan, başka tanısı olmayan, steroid tedavisine yanıt vermeyen ve göz tüberkülozu düşünülen olgulara antitüberküloz tedavisi verildi. Bulgular: Göz tüberkülozu düşünülen ve en az üç ay süreyle antitüberküloz tedavisi gören ve düzenli takipleri yapılan 64 olgu (32 kadın, 32 erkek, ortalama 42,1±12,09 yıl) değerlendirildi. Ortalama antitüberküloz tedavi süresi 8,18±2,17 ay (3-15 ay) idi. Tedaviden sonra 64 hastanın toplam 47’si (%73,4) görmesinde iyileşme bildirdi. Bu hastaların sadece 36’sında (31 bilateral, 5 tek taraflı, toplam 67 göz) tedavi öncesi ve sonrası objektif görme değerlendirmesi yapılabildi. Bu hastalarda hastalık tutulumu 61 gözde (%91) üveit (ön, orta, arka, panüveit), 6 gözde (%9) retinal vaskülitti. Altmış yedi gözde yapılan görme analizine göre, 42 (%62,7)’sinin görme keskinliklerinde değişken düzeylerde iyileşme tespit edildi. Ortalama sağ göz görme keskinliği tedavi öncesi 0,56±0,049, tedavi sonrası 0,71±0,047 idi (p, Objective: Ocular tuberculosis is still considered to be a controversial issue in terms of both terminology and diagnostic criteria and treatment options. There is no common diagnostic/treatment algorithm even though new approaches exist.In this study, the results of the treatment of “presumed ocular tuberculosis patients” are evaluated. Materials and Methods: Anti-tuberculosis treatment was given to cases who had latent tuberculosis infection, had no other diagnosis and who did not respond to steroid treatment. These cases were considered to have presumed ocular tuberculosis. Results: Sixty four cases who were considered to have “presumed ocular tuberculosis” received anti-tuberculosis treatment for a minimum of three months and were followed up regularly. The 64 cases were made up of 32 women and 32 men, with a mean age of 42.1±12.09 years. Mean antituberculosis treatment duration was 8.18±2.17 months (3-15 month). After the treatment, 47 (73.4%) of 64 patients reported improvement in vision. Only 36 of these 64 cases (31 bilateral, 5 unilateral, 67 eyes in total) were evaluated with objective vision test before and after the treatment. Disease involvement was uveitis (anterior, intermediate, posterior, panuveitis) in 61 eyes (91%), and retinal vasculitis in 6 eyes (9%). According to the vision analysis among 67 eyes, 42 (62.7%), visual acuities were detected to be improved at variable levels. Mean right eye visual acuity was 0.56±0.049 before treatment, and 0.71±0.047 after treatment (p

Fungal infections like Paecilomyces keratitis have emerged in childhood recently. The diagnosis and treatment of Paecilomyces keratitis is difficult and the outcome is usually poor. Corneal culture should be performed on fungal media such as Sabouraud glucose neopeptone agar (SDA) as soon as possible for diagnosis. We report a rare case of Paecilomyces keratitis in an immunocompetent child, which was unresponsive to amphotericin B. The case was managed by a multidisciplinary approach involving the departments of ophthalmology, microbiology and pediatric infectious diseases. We want to draw attention once again that fungal keratitis caused by unusual agents are increasing. Physicians should consider fungal causes of keratitis, in patients with some predisposing factors like ocular surgery and prolonged use of topical corticosteroids.The Pan African Medical Journal 2016;24

We present a case of silent polypoidal choroidal vasculopathy (PCV) in a patient with angioid streaks. PCV was detected during a routine ophthalmic examination and confirmed by fluorescein angiography, indocyanine green angiography, and optical coherence tomography. After 2 years of follow-up, the PCV remained silent without any complications. We report this rare coexistence and review literature on this topic. RESUMO Nós apresentamos um relato de vasculopatia polipoidal de coroide (PCV) em paciente com estrias angióides. Vasculopatia polipoidal de coroide detectada em exame oftalmológico de rotina e confirmado por angiofluoresceinografia, angiografia com indocianina verde e tomografia de coerência óptica. Após 2 anos de seguimento a vasculopatia polipoidal de coroide permaneceu quiescente, sem qualquer complicação. Nós relatamos esta coexistência rara e apresentamos revisão da literatura.

Amaç: Bu çalışmada vernal keratokonjonktivitte (VKK) topikal %0.05 siklosporin A tedavisinin hastalığın klinik bulguları ve şikayetleri üzerine etkinliğinin ve gözyaşı sitokinleri üzerine etkisinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmaya aktif VKK'i olan 21 hasta dahil edildi. Hastalara topikal % 0.05 siklosporin A göz damlası ile tedaviye başlandı. Tedaviden önce ve tedavinin 1. ve 3. aylarında hastaların şikayetleri ve klinik bulguları puanlandırıldı. Tedaviden önce ve tedavinin 3. ayında gözyaşı ve serum örnekleri toplandı. `Multiplex bead analysis' yöntemi ile gözyaşı ve serumda IL-2, IL-2ra, IL-3, IL-4, IL-5, IL-6, IL-9, IL-13, IL-17, eotaksin, TNF- ? ve INF- ? düzeyleri ölçüldü.Bulgular: Topikal %0.05 siklosporin A tedavisinin 1. ve 3. aylarının sonunda hastaların şikayet ve bulgularında istatistiksel olarak anlamlı düzelme görüldü (p

Objectives: To describe ocular manifestations, diagnosis, and treatment of cat scratch disease. Materials and Methods: Clinical records of patients with ocular cat scratch disease were reviewed. Results: Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9 +/- 18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, = 0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47 +/- 14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye. Conclusion: Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations., NA

Purpose: to investigate the effect of interferon alfa-2a on T regulatory (Treg) cells, T helper 17 (Th17) cells, and expression of Toll-like receptors (TLRs) in Behçet disease (BD) patients with uveitis. Methods: twenty-seven patients who received interferon alfa-2a for active BD uveitis despite conventional immunomodulatory therapies and healthy controls were enrolled. Peripheral blood Treg and Th17 cell frequencies were determined by flow cytometry as gated cells for CD3 + CD4 + Foxp3 + and CD3 + CD4 + IL17A + , respectively. Th17 RAR-related orphan receptor (ROR)γt mRNA expression was verified by real-time PCR (RT-PCR). Treg and Th17 cell cytokines were detected by ELISA in the supernatant of short-term cell cultures. RT-PCR was used to assess expression of TLR-2, TLR-3, TLR-4, TLR-8, and TLR-9 using cDNA prepared from CD4 + T cells and monocytes. Results: Treg and Th17 cell frequencies and Th17 RORγt expression were significantly elevated, and IL-10 concentration in Treg cell supernatants was significantly lower in BD patients than in controls. Th17 IL-17, IL-6, IL-21, IL-22, IL-23, IFN-γ, and TNF-α concentrations were significantly higher and all TLR expressions were significantly elevated in patients. Interferon alfa-2a led to a significant reversal in Treg and Th17 cell frequencies, Th17 RORγt expression, Treg and Th17 cell cytokine production, and TLR expression by CD4 + T cells and monocytes. Conclusions: despite a relative increase in Treg cells, impaired IL-10 production suggests that Treg dysfunction may play a role in induction of BD uveitis. Favorable effects of interferon alfa-2a may be associated with recovery of Treg cell function, suppression of Th17 cells, and reduced expression of TLRs on CD4 + T cells and monocytes., Scientific and Technological Research Council of Turkey (TÜBİTAK)

Purpose: To quantitatively analyze in vivo morphology of subfoveal choroid during an acute attack of Behçet uveitis. Methods: In this prospective study, 28 patients with Behçet uveitis of, Istanbul University