Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Comparison of Choroidal Thickness in Patients with Pseudoexfoliation Syndrome and Pseudoexfoliative Glaucomawith Normal Subjects
Psödoeksfoliasyon Sendromu ve Psödoeksfoliasyon Glokomu Olan Hastalarda Koroid Kalınlığının Normal Olgularla Karşılaştırılması
Melek TÜFEKa, Nihat AYDINb, Caner KARAc, Pınar NALÇACIOĞLUd
aSabuncuoğlu Şerefeddin Training and Research Hospital, Clinic of Ophthalmology, Amasya, TURKEY
bBaşkent University Alanya Application and Research Center, Department of Ophthalmology, Antalya, TURKEY
cZübeyde Hanım Women's Training and Research Hospital, Clinic of Ophthalmology, Ankara, TURKEY
dYıldırım Beyazıt University Faculty of Medicine, Department of Ophthalmology, Ankara, TURKEY
Turkiye Klinikleri J Ophthalmol. 2020;29(3):231-8
doi: 10.5336/ophthal.2019-72739
Article Language: EN
Full Text
ABSTRACT
 Objective: To compare the choroidal thickness in pseudoexfoliation syndrome (PES) and pseudoexfoliative glaucoma (PEG) cases with healthy individuals. Material and Methods: We included 31 eyes of 31 patients with PES, 31 eyes of 31 patients with PEG, and 33 eyes of 33 healthy individuals in this study. All patients underwent choroidal thickness measurement at the subfoveal, nasal 500 µm, nasal 1000 µm, temporal 500 µm, and temporal 1000 µm areas by using the optical coherence tomography (3D OCT-2000, Topcon, Japan) device. Results: There was no difference between the groups for gender and axial length (p>0.05). The subfoveal, nasal 500 µm and temporal 500 µm choroidal thickness values of the PEG cases were statistically significantly lower than the PES cases and the healthy group (p0.05). Conclusion: We found the subfoveal, nasal 500 µm and temporal 500 µm choroidal thicknesses to be significantly lower in the PEG cases than the other two groups. Choroidal thicknesses at the subfoveal and nasal 500 µm areas were also lower in the PES group than the control group but without statistical significance.

Keywords: Choroid; exfoliation syndrome; optical coherence tomography
ÖZET
 Amaç: Psödoeksfoliasyon sendromu (PES) ve psödoeksfoliasyon glokomu (PEG) olan olgularda koroid kalınlığının sağlıklı bireylerle karşılaştırılması. Gereç ve Yöntemler: 31 PES'li hastanın 31 gözü, 31 PEG'li hastanın 31 gözü ve 33 sağlıklı bireyin 33 gözü çalışmaya dahil edildi. Tüm hastalara optik koherens tomografi (3D OCT2000, Topcon, Japan) cihazı ile koroid kalınlığı ölçümleri subfoveal, nazal 500 µm, nazal 1000 µm, temporal 500 µm ve temporal 1000µm mesafeden yapıldı. Bulgular: Gruplar arasında cinsiyet ve aksiyel uzunluk açısından anlamlı farklılık tespit edilmedi (p>0,05). PEG'li olguların subfoveal, nazal 500 µm ve temporal 500 µm'luk koroidal kalınlık değerleri, PES'li olgular ve sağlıklı gruba göre istatistiksel olarak anlamlı olarak daha ince bulundu (p0,05). Sonuç: Bu bulgulara göre PEG'li olgularda subfoveal, nazal 500 µm ve temporal 500 µm'luk koroid kalınlık ölçümü diğer iki gruba göre anlamlı olarak ince saptandı. Ayrıca PES grubunda subfoveal ve nazal 500 µm'deki koroid kalınlığı da kontrol grubuna göre istatistiksel olarak anlamlı olmamakla birlikte daha ince bulundu.

Anahtar Kelimeler: Koroid; eksfoliasyon sendromu; optik koherens tomografi
REFERENCES:
  1. Ekström C. Prevalence of open-angle glaucoma in central Sweden. The Tierp Glaucoma Survey. Acta Ophthalmol Scand. 1996;74(2):107-12. [Crossref]  [PubMed] 
  2. Shrum KR, Hattenhauer MG, Hodge D. Cardiovascular and cerebrovascular mortality associated with ocular pseudoexfoliation. Am J Ophthalmol. 2000;129(1):83-6. [Crossref] 
  3. Yalaz M, Othman I, Nas K, Eroğlu A, Homurlu D, Cikintas Z, et al. The frequency of pseudoexfoliation syndrome in the eastern Mediterranean are of Turkey. Acta Ophthalmol (Copenh). 1992;70(2):209-13. [Crossref]  [PubMed] 
  4. Schlötzer-Schrehardt U, Küchle M, Naumann GO. Electron-microscopic identification of pseudoexfoliation material in extrabulbar tissue. Arch Ophthalmol. 1991;109(4):565-70. [Crossref]  [PubMed] 
  5. Repo LP, Suhonen MT, Teräsvirta ME, Koivisto KJ. Color Doppler imaging of the ophthalmic artery blood flow spectra of patients who have had a transient ischemic attack. Correlations with generalized iris transluminance and pseudoexfoliation syndrome. Ophthalmology. 1995;102(8):1199-205. [Crossref] 
  6. Prince AM, Ritch R. Clinical signs of the pseudoexfoliation syndrome. Ophthalmology. 1986;93(6):803-7. [Crossref] 
  7. Koz OG, Turkcu MF, Yarangumeli A, Koz C, Kural G. Normotensive glaucoma and risk factors in normotensive eyes with pseudoexfoliation syndrome. J Glaucoma. 2009;18(9):684-8. [Crossref]  [PubMed] 
  8. Konstas AG, Quaranta L, Katsanos A, Riva I, Tsai JC, Giannopoulos T, et al. Twenty-four hour efficacy with preservative free tafluprost compared with latanoprost in patients with primary open angle glaucoma or ocular hypertension. Br J Ophthalmol. 2013;97(12):1510-5. [Crossref]  [PubMed] 
  9. Ritch R. Systemic associations of exfoliation syndrome. Asia Pac J Ophthalmol (Phila). 2016;5(1):45-50. [Crossref]  [PubMed] 
  10. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E, et al. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003;121(1):48-56. [Crossref]  [PubMed] 
  11. Martinez A, Sanchez M. Ocular haemodynamics in pseudoexfoliative and primary open-angle glaucoma. Eye (Lond). 2008;22(4):515-20. [Crossref]  [PubMed] 
  12. Dadaci Z, Doganay F, Oncel Acir N, Aydin HD, Borazan M. Enhanced depth imaging optical coherence tomography of the choroid in migraine patients: implications for the association of migraine and glaucoma. Br J Ophthalmol. 2014;98(7):972-5. [Crossref]  [PubMed] 
  13. Kur J, Newman EA, Chan-Ling T. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res. 2012;31(5):377-406. [Crossref]  [PubMed]  [PMC] 
  14. Gugleta K, Polunina A, Kochkorov A, Waldmann N, Portmann N, Katamay R, et al. Association between risk factors and glaucomatous damage in the untreated primary open-angle glaucoma. J Glaucoma. 2013;22(6):501-5. [Crossref]  [PubMed] 
  15. Mwanza JC, Hochberg JT, Banitt MR, Feuer WJ, Budenz DL. Lack of association between glaucoma and macular choroidal thickness measured with enhanced depth-imaging optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;18;52(6):3430-5. [Crossref]  [PubMed]  [PMC] 
  16. Hirooka K, Fujiwara A, Shiragami C, Baba T, Shiraga F. Relationship between progression of visual field damage and choroidal thickness in eyes with normal-tension glaucoma. Clin Exp Ophthalmol. 2012;40(6):576-82. [Crossref]  [PubMed] 
  17. Bayhan HA, Bayhan SA, Can İ. Evaluation of the macular choroidal thickness using spectral optical coherence tomography in pseudoexfoliation glaucoma. J Glaucoma. 2016;25(2):184-7. [Crossref]  [PubMed] 
  18. Dursun A, Ozec AV, Dogan O, Dursun FG, Toker MI ,Topalkara A, et al. Evaluation of choroidal thickness in patients with pseudoexfoliation sydrome and pseudoexfoliation glaucoma. J Ophthalmol. 2016;2016:3545180. [Crossref]  [PubMed]  [PMC] 
  19. Moghimi S, Mazloumi M, Johari MK, Fard MA, Chen R, Weinreb R, et al. Comparison of macular choroidal thickness in patients with pseudoexfoliation syndrome to normal control subjects with enhanced depth SD-OCT imaging. J Curr Ophthalmol. 2017;12;29(4):258-63. [Crossref]  [PubMed]  [PMC] 
  20. Demircan S, Yılmaz U, Kucuk E, Ulusoy MD, Ataş M, Gülhan A, et al. The effect of pseudoexfoliation sydrome on the retinal nerve layer and choroid thickness. Semin Ophtalmol. 2017;32(3):341-7. [Crossref]  [PubMed] 
  21. Yüksel N, Karabaş VL, Arslan A, Demirci A, Çağlar Y. Ocular hemodynamics in pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Ophthalmology. 2001;108(6):1043-9. [Crossref] 
  22. Vesti E, Kivelä T. Exfoliation syndrome and exfoliation glaucoma. Prog Retin Eye Res. 2000;19(3):345-68. [Crossref] 
  23. Tan CS, Ouyang Y, Ruiz H, Sadda SR. Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2012;23;53(1):261-6. [Crossref]  [PubMed] 
  24. Goldenberg D, Moisseiev E, Goldstein M, Loewenstein A, Barak A. Enhanced depth imaging optical coherence tomography: choroidal thickness and correlations with age, refractive error, and axial length. Ophthalmic Surg Lasers Imaging. 2012;1;43(4):296-301. [Crossref]  [PubMed] 
  25. Henry JC, Krupin T, Schmitt M, Lauffer J, Miller E, Ewing MQ, et al. Long-term follow-up of pseudoexfoliation and the development of elevated intraocular pressure. Ophthalmology. 1987;94(5):545-52. [Crossref] 
  26. Bengtsson B, Heijl A. A long-term prospective study of risk factors for glaucomatous visual field loss in patients with ocular hypertension. J Glaucoma. 2005;14(2):135-8. [Crossref]  [PubMed] 
  27. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komaroff E, et al. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003;121(1):48-56. [Crossref]  [PubMed] 
  28. Schlötzer-Schrehardt U, Naumann GOH. Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol. 2006;141(5):921-37. [Crossref]  [PubMed] 
  29. Grunwald JE, Piltz J, Hariprasad SM, DuPont J. Optic nerve and choroidal circulation in glaucoma. Invest Ophthalmol Vis Sci. 1998;39(12):2329-36.
  30. Sugiyama T, Schwartz B, Takamoto T, Azuma I. Evaluation of the circulation in the retina, peripapillary choroid and optic disk in normal-tension glaucoma. Ophthalmic Res. 2000;32(2-3):79-86. [Crossref]  [PubMed] 
  31. Satilmis M, Orgül S, Doubler B, Flammer J. Rate of progression of glaucoma correlates with retrobulbar circulation and intraocular pressure. Am J Ophthalmol. 2003;135(5):664-9. [Crossref] 
  32. Goktas S, Sakarya Y, Ozcimen M, Sakarya R, Bukus A, Ivacik IS, et al. Choroidal thinning in pseudoexfoliation syndrome detected by enhanced depth imaging optical coherence tomography. Eur J Ophthalmol. 2014;24(6):879-84. [Crossref]  [PubMed] 
  33. Detorakis ET, Achtaropoulos AK, Drakonaki EE, Kozobolis VP. Hemodynamic evaluation of the posterior ciliary circulation in exfoliation syndrome and exfoliation glaucoma. Graefes Arch Clin Exp Ophthalmol. 2007;245(4):516-21. [Crossref]  [PubMed] 
  34. Dayanır V, Topaloğlu A, Ozsunar Y, Keceli M, Okyay P, Harris A, et al. Orbital blood flow parameters in unilateral pseudoexfoliation synrome. Int Ophthalmol. 2009;29(1):27-32. [Crossref]  [PubMed] 
  35. Novais EA, Badaró E, Allemann N, Morales MS, Rodrigues EB, de Sauza Lima R, et al. Correlation between choroidal thickness and ciliary artery blood flow velocity in normal subjects. Ophthalmic Surg Lasers Imaging Retina. 2015;46(9):920-4. [Crossref]  [PubMed] 
  36. Kinoshita T, Mitamura Y, Shinomiya K, Egawa M, Iwata A, Fujihara A, et al. Diurnal variations in luminal and stromal areas of choroid in normal eyes. Br J Ophthalmol. 2017;101(3):360-4.
  37. Dallinger S, Bobr B, Findl O, Eichler HG, Schmetterer L. Effects of acetazolamide on choroidal blood flow. Stroke. 1998;29(5):997-1001. [Crossref]  [PubMed] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com