Browsing by Author "Muhafiz, Ersin"

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Evaluation of Meibomian Glands in Obstructive Sleep Apnea-Hypopnea Syndrome
(Lippincott Williams & Wilkins, 2020) Muhafiz, Ersin; Olcen, Merhamet; Erten, Remzi; Bozkurt, Erdinc
Purpose: To evaluate the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on the meibomian glands, ocular surface, and tear parameters. Methods: The study included 59 individuals (32 subjects with OSAHS, 27 control subjects) who underwent polysomnography in the Chest Diseases Clinic. The right eyes of all individuals were evaluated in the Ophthalmology Clinic. The first noninvasive tear break-up time (f-NTBUT) and the average noninvasive tear break-up time were measured, and Schirmer test was applied. Meibography was taken (Sirius; CSO, Florence, Italy), and meiboscore was used for indexing meibography. Finally, a sample was taken for conjunctival impression cytology. Results: In the study and control groups, the median of f-NTBUT was 2.1 seconds [interquartile range (IQR); 1.5-5.0] and 5.7 seconds (IQR; 2.9-8.8) and the median of average noninvasive tear break-up time was 5.6 seconds (IQR; 3.6-9.5) and 7.2 seconds (IQR; 4.2-10.7), respectively (P= 0.007 andP= 0.487, respectively). The mean Schirmer value was 16.3 +/- 5.9 mm (range; 5-25) and 17.3 +/- 6.6 mm (range; 5-30) in the study and control groups (P= 0.604). In upper eyelid meibography, the median of loss in the meibomian glands was 20.10% (IQR; 11.60%-40.80%) in the study group and 14.70% (IQR; 10.40%-21.30%) in the control group (P= 0.043). In lower eyelid meibography, the median of loss in the meibomian glands was 19.00% (IQR; 13.60%-35.30%) in the study group and 12.40% (IQR; 9.10%-16.40%) in the control group (P= 0.002). The median of the Nelson grade in conjunctival impression cytology was 1 (IQR; 0-1) in the study group and 1 (IQR; 0-1) in the control group (P= 0.445). Conclusions: The loss in the meibomian glands together with the shortened f-NTBUT shows that there could be a predisposition in OSAHS for evaporative dry eye originating from meibomian gland damage.
Impression Cytology and Meibomian Glands in Conjunctivochalasis
(Sage Publications Ltd, 2022) Muhafiz, Ersin; Bozkurt, Erdinc; Erten, Remzi
Purpose: To evaluate the tear parameters, meibomian glands and lid margin and tarsal conjunctival impression cytology in patients with conjunctivochalasis (CCH). Methods: The study included 57 patients diagnosed with CCH and 35 healthy volunteers. Tear break-up time (TBUT) was measured and Schirmer test was performed. Meibomian gland morphologies, dropout rates, and meiboscores were evaluated using meibography. Finally, impression cytology samples were taken by pressing the impression filters on the lower lid margin and lower tarsal conjunctiva. The samples were evaluated according to the Nelson grading system. Results: Schirmer test was longer and TBUT was shorter in the study group (p = 0.035 and p < 0.001, respectively). The median of meibomian gland dropout rate was 33.45% (Interquartile range [IQR]; 23.17%-49.75%) and 18.80% (IQR; 12.35%-26.50%) in the study and control groups, respectively (p < 0.001). There was no significant difference in terms of lid-margin cytology between the two groups (p = 0.481). In tarsal conjunctiva cytology, the median value of Nelson grade of the study group was 2 (IQR; 1-2) and that of the control group was 1 (IQR; 1-2) (p = 0.040). When Nelson grade-2 and above was accepted as the pathological limit, it was found that 27.5% of the study group and 15.2% of the control group showed pathological findings (p = 0.204). Conclusions: In patients with CCH, damage occurs in the tarsal conjunctiva with the effects of redundant conjunctival folds. In these patients, atrophy occurs in the meibomian glands and tear stability is impaired. Therefore, CCH should not be overlooked in clinical practice.
Nasal Mucociliary Clearance and Hearing Loss in Pseudoexfoliation Syndrome
(Springer, 2021) Muhafiz, Ersin; Cetin, Yaser Said
Purpose To evaluate nasal mucociliary clearance (NMC) and hearing loss in patients with pseudoexfoliation (PEX) syndrome. Methods The study included 36 patients with PEX syndrome as the study group, and 39 healthy individuals as the control group. The duration of NMC was measured using the saccharine test. Audiometry was applied at 250, 500, 1000, 2000, 4000, 6000 and 8000 Hz frequencies to determine hearing thresholds and prevalence of hearing loss. Results No statistically significant difference was determined between the groups in respect of age and gender (p = 0.23 and p = 0.36, respectively). In the saccharine test, the mean NMC time was 18.41 +/- 8.53 min for the study group and 11.69 +/- 4.96 min for the control group. The mean NMC time of study group was significantly longer than that of the controls (p < 0.001). In the comparisons of the two groups in terms of the prevalence of hearing loss, no statistically significant difference was found at any of the evaluated frequencies (p > 0.05, for all). There was also no statically significant difference between groups in relation to hearing thresholds at these frequencies (p > 0.05, for all). Conclusion The NMC time was significantly prolonged in patients with PEX syndrome. This result indicates that nasal mucosa cilia, which have similar elastic and mobile structures as the iris, are damaged in PEX syndrome, which is an infiltrative disease increasing the rigidity of affected tissues. In upper respiratory tract infections of unknown cause, PEX syndrome should be considered among the etiological factors. In this study, no significant relationship was detected between PEX and hearing loss.
Ocular Surface Characteristics in Acne Vulgaris
(Taylor & Francis Ltd, 2022) Muhafiz, Ersin; Ozturk, Murat; Erten, Remzi
Background: To evaluate the ocular surface features, meibomian glands, and tear parameters of patients with acne vulgaris. Methods: The right eyes of 70 individuals (34 patients with acne vulgaris, 36 healthy volunteers) were evaluated. The tear break-up time of participants was measured, and the Schirmer test was performed. Then, to determine ocular surface characteristics, samples were taken from the conjunctiva for impression cytology. Finally, the loss rates of the upper and lower eyelid meibomian glands were determined by taking meibography (Sirius, CSO, Florence, Italy). Results: Tear break-up time was significantly lower in the study group compared to the control group (p < 0.001). No statistically significant difference was determined between the groups in respect of Nelson grade in the conjunctival impression cytology (p = 0.141). Grade 3 cytological changes were not observed in either group. The median value of the loss rate in the meibomian glands in the upper eyelid of patients with acne vulgaris was 19.10% (IQR: 18%), while it was 8.75% (IQR: 9.53%) in the control group (p = 0.001). The median value of the loss rate in the meibomian glands in the lower eyelid was 15.70% (IQR: 15.13%) and 7.70% (IQR: 6.53%) in the acne vulgaris and control groups, respectively (p < 0.001). Conclusion: Our study shows that patients with acne vulgaris may have a predisposition to meibomian gland damage and tear instability. Therefore, we consider that a more detailed ophthalmologic examination should be performed in patients with acne vulgaris.