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Biomedical subjects

H Kiratli

Publications and source records attributed to H Kiratli.

At least 19 recordsLinked to original sources
PubMed2006

[Multiple bilateral retinomas. A case study].

The case of an asymptomatic 29-year-old male patient with bilateral multiple retinomas is described. Initially misdiagnosed as unilateral pathological myopia 10 years earlier, his ocular tumors were recognized only when examined after detection of bilateral retinoblastoma in his daughter. There was a large gray translucent mass and extensive chorioretinal atrophy in the right fundus and four small discrete tumors in the nasal periphery of the left fundus. There was no progression over 4 years of follow-up. Timely and correct diagnosis of retinoma is essential for appropriate genetic counseling, which would minimize the risk of retinoblastoma in future generations.

Adult↗
PubMed2006

[Mycosis fungoides of the eyelids. Two case reports].

Mycosis fungoides is a distinct variant of cutaneous T cell lymphoma. We describe two male patients presenting with the third stage of the disease at the age of 56 and 67 years. The patients had large, patchy pigmented tumors all over the face and eyelids. Incisional biopsy from the lid skin revealed full-thickness involvement of the dermis by malignant lymphocytes, angiotropism, and rare figures of epidermotropism. Immunohistochemical studies showed that these malignant lymphocytes expressed CD2, CD3, CD4, CD5, and CD8 antigens but were negative for CD7 antigen. Multiagent chemotherapy and PUVA treatment were administered with limited successful outcome on their cutaneous lesions. Both patients died from problems related to the progression of the systemic disease. These two cases demonstrate the poor prognosis of the tumor stage because of strong association with widespread systemic involvement and emphasize the need for early diagnosis.

Aged↗
PubMed2005

Primary lacrimal sac non-Hodgkin's lymphoma in a child.

Primary lacrimal sac lymphoma is extremely rare in children. To our knowledge, only two previous cases have been reported in the literature. Here, we report the case of a 9-year-old girl with primary lacrimal sac lymphoma who has recurrent mass.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2005

Exclusion of LCA5 locus in a consanguineous Turkish family with macular coloboma-type LCA.

BACKGROUND: Leber's congenital amaurosis (LCA) is an inherited retinal dystrophy, which causes severe visual impairment in early childhood. Recent molecular genetic studies have linked 11 loci (AIPL1, CRB1, CRX, GUCY2D, RPE65, RDH12, RPGRIP1, TULP1, LCA3, LCA5, and LCA9) to LCA. LCA5 is a new locus, which maps to the 6q11-q16 chromosomal region and was found to be associated with macular coloboma-type LCA in a Pakistani family. Herein, we describe the molecular genetic features of a consanguineous Turkish family in which four children have macular coloboma-type LCA. METHODS: Haplotype analysis was performed on the DNA of the family members using microsatellite markers against GUCY2D, RPE65, and LCA5. Genomic DNA was screened for mutations by means of single-strand conformational polymorphism (SSCP) analysis in exons of the RPE65 and CRX genes. RESULTS: In haplotype analysis, no linkage to LCA5 or GUCY2D loci was detected. None of the tested markers showed homozygosity or segregation between affected siblings. PCR-SSCP mutation analysis revealed no mutations in the screened RPE65 and CRX genes. CONCLUSION: We excluded LCA5 as the genetic cause of macular coloboma-type LCA in this Turkish family. Macular coloboma-type LCA shows genetic heterogeneity and it is not possible to establish a phenotype-genotype correlation with LCA5 and macular coloboma.

Adolescent↗
PubMed2005

[Ciliary body leiomyomas. Three case reports].

We present our experience with three patients, two of whom were women, 16, 28 and 44 years of age, presenting with leiomyomas of the ciliary body. Salient clinical features were involvement of the left eye and temporal quadrants in two cases and extension into the anterior chamber in the other. Two patients underwent enucleation and the third had iridocyclochoroidectomy. Immunohistochemical studies showed strong positivity for muscle-specific actin, smooth muscle actin and desmin, whereas staining against vimentin, HMB-45 and S-100 protein was negative. Although there are no specific clinical or imaging signs for intraocular leiomyoma, this tumor should be suspected when pigmented ciliary body tumors are encountered, especially in young female patients.

Adolescent↗
PubMed2004

Tumour-lysis-related elevation of intraocular pressure following high-dose rate brachytherapy for choroidal melanoma.

PURPOSE: To describe the clinical course and management of acute tumour lysis-related intraocular pressure (IOP) elevation, which is a rare late complication of brachytherapy for choroidal melanoma. METHODS: Seven patients out of 36 treated with Iodine-125 brachytherapy were identified who had in common: an uneventful latent period with continuing tumour regression, ended by a sudden massive release of pigmented debris in association with elevated IOP without iris neovascularization. Medications that reduce aqueous production (timolol, dorzolamide, betaxolol, and acetozolamide) were used in combinations to lower IOP. RESULTS: Tumour lysis developed after a mean period of 17.4 months. IOPs ranged between 28 and 35 mmHg, which normalized in a mean period of 10.7 months under topical medications. The seven patients were inadvertently prescribed apical dose rates ranging between 118.3 to 289.16 cGy/h that were significantly higher than the rest of the group (P = 0.000). This complication did not develop in patients whose apical dose rates did not exceed 109 cGy/h. CONCLUSIONS: Acute tumour lysis associated with an elevated IOP after brachytherapy appears to be related to large tumour size and high dose rates. IOP can be lowered by topical medications but visual prognosis is poor. There is no evidence of any effect on overall prognosis of tumour lysis, elevation of IOP, or its treatment.

Adult↗
PubMed2002

[Macular coloboma type Leber's congenital amaurosis].

Three brothers, with the macular coloboma type Leber's congenital amaurosis aged 10, 8, and 6 years respectively, are described in this report. Only the two elder brothers were symptomatic while the third patient had no complaint at the time of diagnosis. The patients had no associated systemic or ocular disorders, including nystagmus. They had mild myopic astigmatism. All three had a relatively well-circumscribed bilateral macular atrophy with a seemingly normal peripheral retina. The electroretinogram was non recordable but the visualy evoked potential responses were within normal limits. During three years of follow-up, the macular lesions did not progress and the visual acuity did not deteriorate further. Our experience with these three familial cases supports the general view that the macular coloboma variant does not necessarily have the typical signs and symptoms and perhaps also the dismal prognosis of classic Leber's congenital amaurosis, and as such should stand as a distinct subtype of the disease.

Blindness↗
PubMed2001

Late normalization of melanocytomalytic intraocular pressure elevation following excision of iris melanocytoma.

BACKGROUND: Melanocytoma of the iris is a rare tumor which may sometimes undergo necrosis that could result in elevated intraocular pressure through pigment dispersion. Only nine similar patients have been previously reported. METHODS: A 27-year-old woman presented with a dark brown iris stromal mass located between the 4 and 8 o'clock positions in the inferior quadrant. Her left visual acuity was 20/60. The tumor encroached on the lens and caused focal cataract. There was massive pigmented debris over the iridocorneal angle and the intraocular pressure was 42 mmHg. RESULTS: Fine needle aspiration biopsy did not suggest malignancy. A wide sector iridectomy was performed and histopathological examination of the lesion revealed melanocytoma of the iris. There was no ciliary body involvement. In the postoperative period, intraocular pressure, which persisted in the mid-twenties, was successfully lowered with topical dorzolamide and betaxolol drops. These drugs were continued for 2 years while the angle pigmentation gradually disappeared. There has been no documented glaucomatous damage to the optic nerve and visual fields. A year after the cessation of the drops, the left intraocular pressure stabilized and did not rise above 15 mmHg. Her left visual acuity remained 20/25. CONCLUSION: In contrast to previously reported cases, the normalization of intraocular pressure in this patient took 26 months, a period that could be associated with the self-clearing process of pigment from the iridocorneal angle. Close follow-up with medical treatment averted a pressure lowering surgical procedure in this case.

Adult↗
PubMed2001

Calcification in choroidal melanoma after transpupillary thermotherapy.

PURPOSE: To report the response of calcification in choroidal melanoma after transpupillary thermotherapy. METHODS: Interventional case report. A 66-year-old male with a posterior uveal melanoma measuring 10 x 8 x 4.4 mm underwent infrared diode laser transpupillary thermotherapy three times, each 12 weeks apart. For each treatment, a 3-mm spot size of 1-minute duration was used, and the power setting varied between 450 mW and 500 mW. RESULTS: Two months after the last transpupillary thermotherapy session, A- and B-mode echographic patterns strongly suggestive of intratumor calcification were observed. The tumor regressed to 2.8 mm in thickness, but calcification persisted. Local recurrence or distant metastasis was not detected during a follow-up of 14 months. CONCLUSION: Clinically detectable calcification is extremely rare in choroidal melanomas. Tumor regression with slowly progressive calcification may occur after transpupillary thermotherapy.

Aged↗
PubMed2001

Anthrax as the cause of preseptal cellulitis and cicatricial ectropion.

A 54-year-old female farmer with anthrax infection of the eyelids is presented. She was initially managed with high dose intravenous penicillin G treatment. Following complete healing of the eyelid lesions, significant cicatricial ectropion resulted. Her right lower eyelid ectropion was corrected by surgical reconstruction using full thickness skin graft after a period of 6 months during which the cicatrization process stabilized. Satisfactory cosmetic and functional improvement was achieved. Anthrax of the eyelid must be considered in the differential diagnosis of preseptal or orbital cellulitis and any reconstructive procedure should be attempted only after the cessation of the healing process.

Anthrax↗
PubMed2001

Presumed sertraline maculopathy.

PURPOSE: To report a unique case of a woman who developed simultaneous bilateral maculopathy presumed to result from intake of sertraline hydrochloride, a serotonin reuptake inhibitor. METHODS: Full clinical ocular examination, color vision testing, automated static perimetry, electroretinography, electrooculography and fundus fluorescein angiography were performed. Living members of her family were also examined. RESULTS: The patient had normal electroretinography and electrooculography results. Automated static perimetry showed generalized reduction of sensitivity and central scotomas. Macular lesions resolved 6 months after discontinuation of sertraline, however, during twenty months of follow-up her visual acuity and abnormalities in other psychophysical tests did not improve. CONCLUSION: Patients started on sertraline should be informed of the potential risk of developing maculopathy, and they should be examined regularly to detect possible early alterations.

Electrooculography↗
PubMed2001

Scedosporium apiospermum chorioretinitis.

PURPOSE: A case of a 24-year-old immunocompetent woman who developed unilateral Scedosporium apiospermum chorioretinitis and diffuse cervical lymphadenitis 10 years after facial steroid injection is described. METHODS: The patient was initially treated for the misdiagnosis of tuberculous lymphadenitis. Contemporaneous to the enlargement of her lymph nodes, she experienced gradual loss of vision in her left eye. She subsequently underwent lymph node biopsy. RESULTS: Histopathologic sections stained with Grocott's methenamine silver showed branched septate hyphae and cultures on Sabouraud's agar yielded Scedosporium apiospermum. The patient received oral itraconazole 200 mg twice daily. Lymphadenitis regressed within a year and chorioretinitis scarred within two years. CONCLUSION: Scedosporium apiospermum may cause isolated chorioretinitis in an immunocompetent individual years after local surgery or trauma and result in significant visual morbidity. Treatment may require prolonged use of systemic itraconazole.

Adult↗
PubMed2001

Peripapillary staphyloma associated with orofacial capillary hemangioma.

Peripapillary staphyloma is usually unassociated with other ocular and systemic anomalies. A 5-year-old girl presented with peripapillary staphyloma in association with extensive ipsilateral orofacial capillary hemangioma involving the right forehead, right upper and lower eyelids, the right cheek, and the hard palate. She had received oral corticosteroids to induce regression of the hemangiomas at six months of age. On our examination, her visual acuity was counting fingers at two meters right eye and 20/20 left eye. She had mild right upper eyelid ptosis and right exotropia. Imaging studies did not show any central nervous system abnormality. There has been no progression or contraction in the staphylomatous lesion during 24 months of follow-up. Like the morning glory disk anomaly, peripapillary staphyloma may be associated with facial capillary hemangioma.

Child, Preschool↗
PubMed2001

Scintigraphic imaging of uveal melanoma with 99Tcm-glutathione.

A prospective study with a new tumour-seeking agent, 99Tcm-glutathione (GSH), was performed on 17 patients with choroidal melanoma. Planar and SPECT images using 99Tcm-GSH clearly demonstrated melanotic melanoma but failed to show amelonotic melanomas. Following confirmation of our results by concurrent ultrasonography and magnetic resonance imaging or computed tomography, patients were managed by either 125I plaque brachytherapy, diode laser transpupillary thermotherapy or enucleation depending on the site and location. In combination with other diagnostic tests, 99Tcm-GSH scintigraphy may play a role in the detection of uveal melanoma and its possible distant metastases.

Adult↗
PubMed2000

Sequential development of bilateral primary choroidal melanoma.

PURPOSE: A case of a woman who had bilateral choroidal melanoma diagnosed sequentially 20 months apart and managed conservatively is described. METHODS: The first eye having a juxtapapillary melanoma was treated with a notched episcleral radioactive plaque. The second eye, initially containing a small nevus with unequivocal rapid growth, was managed with diode laser transpupillary thermotherapy. RESULTS: Both tumors regressed considerably following treatment and the patient retained good visual acuity in both eyes. No other malignancies or metastasis were detected during the follow-up period. CONCLUSIONS: A small choroidal nevus rapidly grew after treating a choroidal melanoma in the fellow eye. Close follow-up of such patients is mandatory. Also, conservative treatment should be opted whenever possible given the unpredictable course of the opposite melanocytic lesion.

Aged↗
PubMed2000

Retinitis pigmentosa associated with peripheral sea fan neovascularization.

PURPOSE: To describe a case with retinitis pigmentosa associated with sea fan type retinal neovascularization. METHODS: Complete ocular examination including fluorescein angiography was performed in a 9-year-old girl. RESULTS: Ophthalmoscopically, in addition to arteriolar narrowing and bone corpuscular pigmentation of both retinae, a vascular lesion with surrounding intraretinal exudation was noted in the upper equatorial region of the right eye. On fluorescein angiography, the lesion stained in the form of a sea fan neovascularization. CONCLUSION: Sea fan type of neovascularization can be seen in association with retinitis pigmentosa. Fluorescein angiography is important in identifying the exact nature of such a lesion.

Child↗