We assessed the long-term effects of cyclophosphamide and colchicine on visual prognosis and atta... more We assessed the long-term effects of cyclophosphamide and colchicine on visual prognosis and attack frequency in 64 patients with Behcet's disease who were studied in two separate groups between the years of 1976 and 1989. No statistically significant positive changes in visual acuity or attack frequency which might be attributed to the treatment could be shown when the period of treatment was compared with the period after treatment.
Journal of Pediatric Ophthalmology & Strabismus, 1998
Objective: The aim of this study is to determine the clinical features and outcome of Behcet'... more Objective: The aim of this study is to determine the clinical features and outcome of Behcet's disease in the pediatric age group. Method: Twenty cases within a pediatric age group whose ages differ from 5 to 1 5 years were studied retrospectively to determine the age of onset, the initial signs, and the progress of the disease. Results: In 18 of the patients whose average age were 13.3 years (5 to 18 years), the initial symptoms associated with Behcet's disease were oral aphtous lesions or genital ulcers. Among them, 16 developed ocular symptoms in a later stage, at an average of 15.5 years of age (11 to 18 years). Posterior uveitis was the most common manifestation, detected in 75% of the cases. Three patients had neurobehçet's disease, and the neurologic manifestations were dural thrombosis, pseudotumor cerebri, and quadriparesis. Conclusions: In this study, after an average 4 years' follow up (6 months to 13 years) the clinical progress of Behcet's disease in...
The diagnosis of chorioretinal diseases largely depends on their clinical presentation rather tha... more The diagnosis of chorioretinal diseases largely depends on their clinical presentation rather than etiologic or systemic investigations. We report on a patient whose examination revealed a peculiar fundus pattern, almost completely different from disorders such as multifocal choroiditis, presumed ocular histoplasmosis, myopic degeneration, acute multifocal placoid pigment epitheliopathy, vitiliginous chorioretinitis, and punctate outer retinal toxoplasmosis. It resembled punctate inner choroidopathy, described by Watzke in 1984.
Eales disease is an idiopathic type of retinal perivasculitis characterized by recurrent retinal ... more Eales disease is an idiopathic type of retinal perivasculitis characterized by recurrent retinal and vitreous hemorrhages. Neurologic involvement is rare. We report the case of a patient with Eales disease who had internuclear ophthalmoplegia thought to be a neurologic manifestation of this disease.
Journal of Pediatric Ophthalmology & Strabismus, Nov 1, 2003
ABSTRACT Purpose: To review the etiologic factors and complications of uveitis in patients younge... more ABSTRACT Purpose: To review the etiologic factors and complications of uveitis in patients younger than 16 years. Patients and Methods: Between January 1989 and December 1999 in the Department of Ophthalmology of Hacettepe University School of Medicine, 219 patients were diagnosed or observed as having pediatric uveitis. After complete ocular and physical examinations, routine and specific laboratory and radiologic investigations were performed. Medical or surgical treatment was employed when necessary. Results: Of the 219 patients, 112 were girls, with a mean age of 7.4 ± 4.2 years, and 107 were boys, with a mean age of 8.3 ± 3.4 years. In 24.2% of the cases, no etiologic factor could be ascertained; these cases comprised the idiopathic group. Among the remaining cases, the most common etiologies were toxoplasmosis, juvenile rheumatoid arthritis ORA), pars planitis, Behçet's disease, and Fuchs' heterochromic iridocyclitis. Anatomically, anterior uveitis was the most common form. The mean follow-up time was 37 ± 6.2 months. Complications for which surgical treatment was employed were identified in 71 eyes (20.9%), most of which were due to JRA, pars planitis, or Behçet's disease. Conclusion: Uveitis in childhood may be idiopathic or most commonly due to toxoplasmosis, JRA, and pars planitis. Due to inflammation itself or to prolonged therapy especially with corticosteroids, pediatric uveitis entities (mostly JRA, pars planitis, or Behçet's disease) may result in complications necessitating a surgical approach. J Pediatr Ophthalmol Strabismus 2003;40:335-340.
PurposeThe aim of this systematic literature review was to describe patient‐reported outcomes, me... more PurposeThe aim of this systematic literature review was to describe patient‐reported outcomes, mental health and caregiver burden in patients with neovascular age‐related macular degeneration (nAMD) treated with anti‐vascular endothelial growth factor (VEGF) agents in routine clinical practice.MethodsElectronic searches were conducted in Embase and MEDLINE according to pre‐defined criteria.ResultsOf 856 records identified, 63 met inclusion criteria. Depression or depressive symptoms were reported in up to 42% of patients with nAMD. Of 25/63 (40%) studies evaluating quality of life (QoL) and using various tools, eight studies reported composite National Eye Institute Visual Functioning Questionnaire scores following anti‐VEGF treatment. Of these, seven reported a statistically significant improvement at the earliest time point measured (Month 3–12) and approximately 50% reported sustained QoL benefits at 12 months. In studies comparing the attributed or different regimens, the most important factor from the patient's perspective was the likelihood that a particular regimen would maintain vision. There was a preference towards treat and extend, which was associated with a perceived reduction in patient and caregiver burden, compared to fixed dosing.ConclusionsA coordinated holistic approach to patient care is key to optimizing patient well‐being as well as visual outcomes. Further research regarding the patient‐reported impact of nAMD management outside the trial setting (particularly international longitudinal studies) is warranted. Standardization of QoL studies would assist in establishing whether sustained QoL improvement, rather than prevention of QoL decline, should be a realistic expectation of treatment of nAMD in the longer term.
We assessed the long-term effects of cyclophosphamide and colchicine on visual prognosis and atta... more We assessed the long-term effects of cyclophosphamide and colchicine on visual prognosis and attack frequency in 64 patients with Behcet's disease who were studied in two separate groups between the years of 1976 and 1989. No statistically significant positive changes in visual acuity or attack frequency which might be attributed to the treatment could be shown when the period of treatment was compared with the period after treatment.
Journal of Pediatric Ophthalmology & Strabismus, 1998
Objective: The aim of this study is to determine the clinical features and outcome of Behcet'... more Objective: The aim of this study is to determine the clinical features and outcome of Behcet's disease in the pediatric age group. Method: Twenty cases within a pediatric age group whose ages differ from 5 to 1 5 years were studied retrospectively to determine the age of onset, the initial signs, and the progress of the disease. Results: In 18 of the patients whose average age were 13.3 years (5 to 18 years), the initial symptoms associated with Behcet's disease were oral aphtous lesions or genital ulcers. Among them, 16 developed ocular symptoms in a later stage, at an average of 15.5 years of age (11 to 18 years). Posterior uveitis was the most common manifestation, detected in 75% of the cases. Three patients had neurobehçet's disease, and the neurologic manifestations were dural thrombosis, pseudotumor cerebri, and quadriparesis. Conclusions: In this study, after an average 4 years' follow up (6 months to 13 years) the clinical progress of Behcet's disease in...
The diagnosis of chorioretinal diseases largely depends on their clinical presentation rather tha... more The diagnosis of chorioretinal diseases largely depends on their clinical presentation rather than etiologic or systemic investigations. We report on a patient whose examination revealed a peculiar fundus pattern, almost completely different from disorders such as multifocal choroiditis, presumed ocular histoplasmosis, myopic degeneration, acute multifocal placoid pigment epitheliopathy, vitiliginous chorioretinitis, and punctate outer retinal toxoplasmosis. It resembled punctate inner choroidopathy, described by Watzke in 1984.
Eales disease is an idiopathic type of retinal perivasculitis characterized by recurrent retinal ... more Eales disease is an idiopathic type of retinal perivasculitis characterized by recurrent retinal and vitreous hemorrhages. Neurologic involvement is rare. We report the case of a patient with Eales disease who had internuclear ophthalmoplegia thought to be a neurologic manifestation of this disease.
Journal of Pediatric Ophthalmology & Strabismus, Nov 1, 2003
ABSTRACT Purpose: To review the etiologic factors and complications of uveitis in patients younge... more ABSTRACT Purpose: To review the etiologic factors and complications of uveitis in patients younger than 16 years. Patients and Methods: Between January 1989 and December 1999 in the Department of Ophthalmology of Hacettepe University School of Medicine, 219 patients were diagnosed or observed as having pediatric uveitis. After complete ocular and physical examinations, routine and specific laboratory and radiologic investigations were performed. Medical or surgical treatment was employed when necessary. Results: Of the 219 patients, 112 were girls, with a mean age of 7.4 ± 4.2 years, and 107 were boys, with a mean age of 8.3 ± 3.4 years. In 24.2% of the cases, no etiologic factor could be ascertained; these cases comprised the idiopathic group. Among the remaining cases, the most common etiologies were toxoplasmosis, juvenile rheumatoid arthritis ORA), pars planitis, Behçet's disease, and Fuchs' heterochromic iridocyclitis. Anatomically, anterior uveitis was the most common form. The mean follow-up time was 37 ± 6.2 months. Complications for which surgical treatment was employed were identified in 71 eyes (20.9%), most of which were due to JRA, pars planitis, or Behçet's disease. Conclusion: Uveitis in childhood may be idiopathic or most commonly due to toxoplasmosis, JRA, and pars planitis. Due to inflammation itself or to prolonged therapy especially with corticosteroids, pediatric uveitis entities (mostly JRA, pars planitis, or Behçet's disease) may result in complications necessitating a surgical approach. J Pediatr Ophthalmol Strabismus 2003;40:335-340.
PurposeThe aim of this systematic literature review was to describe patient‐reported outcomes, me... more PurposeThe aim of this systematic literature review was to describe patient‐reported outcomes, mental health and caregiver burden in patients with neovascular age‐related macular degeneration (nAMD) treated with anti‐vascular endothelial growth factor (VEGF) agents in routine clinical practice.MethodsElectronic searches were conducted in Embase and MEDLINE according to pre‐defined criteria.ResultsOf 856 records identified, 63 met inclusion criteria. Depression or depressive symptoms were reported in up to 42% of patients with nAMD. Of 25/63 (40%) studies evaluating quality of life (QoL) and using various tools, eight studies reported composite National Eye Institute Visual Functioning Questionnaire scores following anti‐VEGF treatment. Of these, seven reported a statistically significant improvement at the earliest time point measured (Month 3–12) and approximately 50% reported sustained QoL benefits at 12 months. In studies comparing the attributed or different regimens, the most important factor from the patient's perspective was the likelihood that a particular regimen would maintain vision. There was a preference towards treat and extend, which was associated with a perceived reduction in patient and caregiver burden, compared to fixed dosing.ConclusionsA coordinated holistic approach to patient care is key to optimizing patient well‐being as well as visual outcomes. Further research regarding the patient‐reported impact of nAMD management outside the trial setting (particularly international longitudinal studies) is warranted. Standardization of QoL studies would assist in establishing whether sustained QoL improvement, rather than prevention of QoL decline, should be a realistic expectation of treatment of nAMD in the longer term.
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