An Update on the Management of Vitreoretinal Diseases

.: PREFACE
PREFACE
ÖN SÖZ
Prof. Dr. Tongalp H. TEZEL
Columbia University, Vagelos College of Physicians and Surgeons, Department of Ophthalmology, Edward S. Harkness Eye institute, New York, NY, USA
Article Language: EN
''Change is the only constant in life.'' What the philosopher Heraclitus of Ephesus said almost 2,500 years ago summarizes the times we live in now best. The rapid development of technology, especially the internet, resulted in the exponential growth of human knowledge. In the 1900s, it required 100 years to double human knowledge, which decreased to 25 years in 1945 and now to 12 hours. Medical knowledge has taken its share from this rapid growth of new information. When my father graduated from medical school in 1952, it required 50 years to double his medical knowledge. When I graduated from Hacettepe University Medical School in 1984, the doubling time decreased to 7 years. Unfortunately, when my daughter graduates in 2024, half of what she learned in medical school will be outdated in 2 months. Although educational tools and systems have adapted to the rapid phase of knowledge expansion, the human brain is not built to grasp exponential changes. The human brain is rather accustomed to natural changes, which usually happen linearly, like the aging of living beings or timely changes in seasons. This disparity naturally creates an adaptation problem. To keep up with the evolving medical field's pace, utmost attention must be paid to infusing the habit of reading current literature to the trainees. Through post-graduate medical education programs, current practitioners must also continuously be trained in new fields such as genomics, robotics, and artificial intelligence. Physicians who don't educate themselves about evolving technologies and knowledge are destined to be outdated and fail to adhere to the principles of modern clinical practice. Thus, the greater physician is no longer the one who has the greatest experience but the one who also enriches this experience with a continuous search for knowledge through reading and learning.

In this book of the Türkiye Klinikleri, we hope to serve this purpose by presenting recent advances and evolving technologies in the clinical and surgical management of vitreoretinal diseases. Drs. Şermet and Yanık summarized the current and developing clinical imaging modalities, such as Quantitative Autofluorescence Imaging, Fluorescence Lifetime Imaging Ophthalmoscopy, and the use of Adaptive Optics technology in retinal imaging. Drs. Silverman and Urs have taken us out of the boundaries of A- and B-scan of ultrasonography and introduced linear arrays to perform ultrafast plane-wave imaging and display choroid blood flow. Dr. Akar Doğan gave us a summary of completed Diabetic Retinopathy Clinical Research Network (DRCR Network) studies which has become the main source of our clinical knowledge in managing diabetic retinopathy. Artificial intelligence is a rapidly evolving field. Over more than 400 publications appeared within the last five years about artificial intelligence applications in ophthalmology. Drs. Koenigstein and Tezel described the use of advanced machine learning and deep learning with convo lutional networks in diabetic retinopathy screening. Despite time and effort spent, age-related macular degeneration remains the leading cause of irreversible vision in the elderly population. After the initial hype, long-term experience with anti-VEGF agents revealed that almost 20% of the patients still lose sight, and almost half of them end up with visual acuities less than 20/40. This resulted in development of longer-acting drugs, ocular depot systems, and different targets. Drs. Saatci and Kartı will briefly summarize the recent advances in pharmacotherapy for agerelated macular degeneration. Although the rate of introducing new drugs into the market lags the pace of medical knowledge growth, approximately 20 to 30 new drugs have been added to pharmacists' shelves per year within the last 30 years. Introducing new drugs has resulted in new reports about the ocular side effects of some new agents, such as Pentosan Polysulphate, Vemurafenib, and Immune Checkpoint Inhibitors. Drs. Ustaoğlu and Wang summarized the clinical presentations of the ocular side effects of these drugs. Inherited retinal diseases are a heterogeneous group of visually debilitating diseases affecting more than 2 million people worldwide. 50-70% of these degenerations have been attributed to pathogenic variants of more than 300 genes. Gene discovery and advances in gene treatment strategies have led to the approval of several clinical trials of gene treatment. The recent approval of voretigene neparvovec-rzyl (Luxturna), for treating biallelic RPE65 mutation-associated Leber's Congenital Amaurosis, created an important tranche in the evolution of ocular gene therapy. Dr. Tsang and his colleagues gave us a comprehensive review of the ocular gene therapy with ongoing clinical trials. Considering that more than 60 genes are involved in retinitis pigmentosa, the development of gene-specific treatment for each of these mutations will not be possible in the near future. Drs. Kaplan and Piri took a gene-independent approach that can be used for all outer retinal degenerations. He describes the rationale and the method of reactivating dormant cones in his chapter. Although the dislocation of an intraocular lens is not a common complication, alternatives to fix this problem may sometimes be puzzling. Drs. Avcı and Yıldız gave us a synopsis of different techniques to manage dislocated intraocular lenses in our surgery section. Surgical management of lamellar holes has always been challenging. In this book, Drs. Chang and Chang describe their experience, shed light on the timing, and employed surgical techniques for treating lamellar macular holes. Epiretinal human amniotic membrane grafting for complex macular pathologies, such as large failed macular holes or complications of degenerative myopia, is a technique, we have been employing at our clinic for the last four years. This technique differs from stuffing the amniotic or internal limiting membrane into the hole or underneath the retina. In this book, my colleagues and I briefly describe our rationale, preclinical research, and clinical experience. Finally, Drs. Yeager and Marr update us on the treatment of choroidal malignant melanomas.

I would like to thank the contributing authors for sharing their experiences and insights with us. Also, I would like to extend my sincere gratitude to the editor-in-chief of Türkiye Klinikleri, Prof. Dr. Hikmet Akgül, Ms. Ayfer Koç, and all members of the publication team who created this platform for the distribution of knowledge and wisdom among colleagues. Through such noble efforts, medical education and patient care can excel.

Prof. Dr. Tongalp H. TEZEL
Editor
''Değişmeyen tek şey değişimin kendisidir. ''Efesli Heraklitos'un yaklaşık 2.500 yıl önceki sözü, günümüzü de en iyi şekilde özetliyor. Teknolojinin, özellikle internetin hızlı gelişimi, insanlığın bilgisinin de katlanarak artmasını sağladı. 1900'lü yıllarda, insanlığın bilgisinin ikiye katlanması için 100 yıl gerekti, 1945'te 25 yıla düşen bu süre, şu an ise 12 saat. Tıp bilgisi de bu yeni bilgi birikiminden nasibini aldı. Babam 1952'de tıp fakültesinden mezun olduğunda, tıbbi bilgisini ikiye katlaması 50 yılını aldı. Ben 1984'te Hacettepe Üniversitesi Tıp Fakültesi'nden mezun olduğumda, bu süre 7 yıla düştü. Kızım ise 2024'te mezun oluyor ancak tıp fakültesinde öğrendiklerinin yarısı 2 ay içerisinde eskimiş olacak. Eğitim araçları ve sistemleri, bu hızlı bilgi artışına adapte olmuş olsa bile, insan beyni katlanarak çoğalan değişiklikleri kavramak için yaratılmamıştır. İnsan beyni daha çok canlıların yaşlanması, zamanla mevsimlerin değişmesi gibi doğrusal olarak gerçekleşen doğal değişimlere alışmıştır. Bu eşitsizlik de doğal olarak bir uyum sorunu yaratır. Gelişen tıp alanının hızına yetişebilmek için, öğrencilere güncel literatürleri okuma alışkanlığı kazandırılmasına azami özen gösterilmelidir. Mezuniyet sonrası tıbbi eğitim programları aracılığıyla, mevcut pratisyenlerin de genomik, robotik ve yapay zekâ gibi yeni alanlarda devamlı olarak eğitilmeleri gerekir. Gelişen teknoloji ve bilgi konusunda kendini eğitmeyen hekimlerin kaderi modern klinik uygulama ilkelerinden uzaklaşmak ve nihayetinde çağ dışı kalmaktır. Bu yüzden, daha iyi hekim artık daha çok tecrübesi olan hekim değil, bu tecrübesini okuyarak ve öğrenerek sürekli bilgi arayışıyla zenginleştiren hekimdir.

Türkiye Klinikleri'nin bu kitabında, vitreoretinal hastalıkların klinik ve cerrahi yönetimindeki son gelişmeleri ve gelişen teknolojileri sunarak biz de bu amaca hizmet etmeyi umuyoruz. Dr. Şermet ve Yanık, retinal görüntülemede Kantitatif Otofloresans Görüntüleme, Floresans Ömür Boyu Görüntüleme Oftalmoskopi gibi güncel ve gelişen klinik görüntüleme yöntemlerini ve Adaptif Optik teknolojisinin kullanımını özetlemişlerdir. Dr. Silverman ve Urs, bizi ultrasonografi A- ve B-taramalarının sınırlarının ötesine taşımışlardır ve ultra hızlı düzlem dalga görüntüleme gerçekleştirmek ve koroid kan akışını görüntülemek için linear array teknolojisini tanıtmışlardır. Dr. Akar ve Doğan, bize diyabetik retinopati yönetimindeki klinik bilgilerimizin ana kaynağına dönüşen, tamamlanmış Diyabetik Retinopati Klinik Araştırma Ağı [Diabetic Retinopathy Clinical Research Network (DRCR Network)] çalışmalarının özetini sunmuştur. Yapay zekâ hızla gelişen bir alandır. Son 5 yılda oftalmolojide yapay zekâ kullanımı ile ilgili 400'den fazla yayın literatüre girmiştir. Dr. Koenigstein ve Tezel, diyabetik retinopati görüntülemede gelişmiş makine öğreniminin ve evrişimsel ağların derin öğreniminin kullanımını tanımlamıştır. Harcanan zaman ve emeğe rağmen yaşa bağlı makula dejenerasyonu, yaşlı popülasyonda geri dönüşü olmayan görme kaybının en baştaki nedenlerinden olmaya devam etmektedir. İlk enjeksiyondan sonra, anti-VEGF ajanlarla uzun süreli deneyim, hastaların yaklaşık %20'sinin hâlâ görme kaybı yaşadıklarını ve neredeyse yarısının görme keskinliğinin 20/40'tan düşük olduğunu ortaya çıkardı. Bu da, daha uzun etkili ilaçların, oküler depo sistemlerinin ve farklı hedeflerin gelişmesiyle sonuçlandı. Dr. Saatci ve Kartı, yaşa bağlı makula dejenerasyonu için farmakoterapide son gelişmeleri kısaca özetlemişlerdir. Piyasaya yeni ilaç sunma hızı tıbbi bilginin büyüme hızının gerisinde kalsa da, son 30 yıl içinde eczacıların raflarına yılda yaklaşık 20-30 yeni ilaç eklenmiştir. Yeni ilaçların eklenmesi; Pentosan Polysulphate, Vemurafenib ve Bağışıklık Kontrol Noktası İnhibitörleri gibi bazı yeni ajanların oküler yan etkileri hakkında yeni bilgilerin ortaya çıkmasını sağlamıştır. Dr. Ustaoğlu ve Wang bu ilaçların oküler yan etkilerinin klinik sunumlarını özetlemişlerdir. Kalıtsal retinal hastalıklar, dünya çapında 2 milyondan fazla insanı etkileyen, görmeyi zayıflatan heterojen bir hastalık grubudur. Bu dejenerasyonların %50-70'i, 300'den fazla genin patojenik varyantlarına dayandırılır. Genlerin keşfi ve gen tedavisi stratejilerinin gelişmesi, gen tedavisine yönelik birkaç klinik denemenin kabul edilmesini sağlamıştır. Bialelik RPE65 mutasyonuna bağlı Leber konjenital amorozisi tedavisinde kullanılan Voretigene neparvovec-rzyl (Luxturna)'nın güncel kabulü, oküler gen terapisi evriminde önemli bir dilim yaratmıştır. Dr. Tsang ve meslektaşları, devam eden klinik denemelerle, oküler gen terapisinin kapsamlı bir incelemesini sunmuşlardır. Retinitis pigmentosada 60'tan fazla genin rol oynadığı göz önünde bulundurulursa, bu mutasyonların her birinin gen spesifik tedavisi yakın bir gelecekte de mümkün olmayacaktır. Dr. Kaplan ve Piri, tüm dış retinal dejenerasyonlar için kullanılabilecek genlerden bağımsız bir yaklaşım ele almıştır. Aktif olmayan konileri yeniden aktifleştirmenin mantığını ve yöntemini kendi bölümünde açıklamıştır. İntraoküler lensin yerinden çıkması yaygın bir komplikasyon olmasa da, bu sorunu çözme alternatifleri bazen anlaşılmaz olabilir. Dr. Avcı ve Yıldız, cerrahi bölümümüzde yerinden çıkmış intraoküler lensleri tedavi etmenin farklı tekniklerinin bir özetini sunmuştur. Lamellar deliklerin cerrahi tedavisi her zaman zorlayıcı olmuştur. Bu kitapta, Dr. Chang ve Chang, lamellar makula deliklerinin tedavisi konusunda deneyimlerini paylaşmış, zamanlamaya ışık tutmuş ve cerrahi teknikler kullanmıştır. Geniş makula delikleri ya da dejeneratif miyopinin makulada yarattığı komplikasyonlar gibi tedavisi zor karmaşık makula hastalıkları için epiretinal insan amniotik membranı nakli, kliniğimizde son 4 yıldır kullandığımız bir tekniktir. Bu teknik, amniyotik veya iç sınırlayan zarın deliğe ya da retinanın altına doldurulmasından farklıdır. Bu kitapta, meslektaşlarım ve ben, mantığımızı, ön klinik araştırmalarımızı ve klinik tecrübemizi kısaca paylaşıyoruz. Son olarak, Dr. Yeager ve Marr, koroid malign melanoma tedavisi hakkında bizi son gelişmelerden haberdar ediyor.

Katkıda bulunan yazarlara deneyimlerini ve görüşlerini bizimle paylaştıkları için teşekkür ediyorum. Ayrıca meslektaşlarımız arasında bilgi ve birikimlerimizi yayma amaçlı bu platformu kuran Türkiye Klinikleri baş editörü Prof. Dr. Hikmet Akgül, Ayfer Koç ve yayın ekibinin tüm üyelerine en içten teşekkürlerimi sunmak istiyorum. Böyle asil emekler sayesinde, tıp eğitimi ve hasta bakımı en üst seviyeye çıkabilir.

Prof. Dr. Tongalp H. TEZEL
Editör

.: Up To Date

.: Process List

Login



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