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    Agreement and repeatability of central corneal thickness measurements by four different optical devices and an ultrasound pachymeter
    (Springer, 2019) Gokcinar, Nesrin Buyuktortop; Yumusak, Erhan; Ornek, Nurgul; Yorubulut, Serap; Onaran, Zafer
    Purpose To compare the repeatability and agreement of central corneal thickness (CCT) measurements by spectral-domain optical coherence tomography (OCT), corneal topography (CT) with a combined Scheimpflug-Placido system, optical biometry (OB), specular microscopy (SM), and ultrasound pachymetry (UP). Methods A single observer measured CCT twice in 150 eyes of 150 subjects with each of five devices: Nidek RS-3000 Advance OCT, CSO Sirius combined Scheimpflug-Placido disc system CT, Nidek AL-Scan partial coherence interferometry-based OB, Tomey EM-3000 SM, and Reichert iPac ultrasonic pachymeter. Pachymetry values corrected by the SM device software were also recorded. Levels of agreement between devices were evaluated by Bland-Altman plots with 95% limits of agreement, and repeatability for each device was analysed with intraclass correlation coefficients. Results The mean CCTs measured by OCT, CT, OB, SM, corrected SM, and UP were 544.60 +/- 29.56, 536.19 +/- 32.14, 528.29 +/- 29.45, 524.88 +/- 32.38, 537.88 +/- 32.38, and 545.29 +/- 30.75 mu m, respectively. Mean CCT differed significantly between the devices (p<0.05) apart from between OCT and UP, and between CT and corrected SM. Mean paired differences between devices ranged between 0.68 and 20.41 mu m. Repeatability with all devices was excellent (>0.99). The range of limits of agreement was the least between OCT and UP. Conclusions Different CCT measurement techniques produce quite different results, so CCT evaluation and follow-up should be performed using the same device or devices with close compatibility.
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    Choroidal thickness changes in non-treated acute and ranibizumab-treated chronic central serous chorioretinopathy
    (Lippincott Williams & Wilkins, 2018) Yumusak, Erhan; Gokcinar, Nesrin Buyuktortop; Ornek, Kemal
    To evaluate the changes in subfoveal retinal, and choroidal thicknesses (CT) in the non-treated acute and the ranibizumab-treated chronic central serous chorioretinopathy (CSCR) patients. This retrospective study included 32 eyes of 32 consecutive patients with CSCR. There were 12 patients who presented with a spontaneous resolution of CSCR (Group 1) and 20 patients who were treated with ranibizumab for persistent subretinal fluid (SRF) (Group 2). Optical coherence tomography (OCT) imaging of subfoveal retinal thickness and enhanced depth imaging OCT of CT at subfoveal; at nasal and temporal 500 mu m (T500); at nasal and temporal 1500 mu m (T1500) were analyzed. The Student t test and multivariate analysis were used to compare variables within and between groups, respectively and correlations were analyzed using Pearson correlation coefficient. A P value of P<.05 was accepted as significant. The mean patient age was 38.94 +/- 8.41 years (range, 20-53 years). Female/male ratio was 4/28. The mean duration of follow-up was 21.6 +/- 8.2 months in the chronic CSCR group. Visual acuity improved and central foveal thickness (FT) decreased significantly in both groups. CT decreased significantly only at nasal 1500mm (N1500) in the acute group and at all measured points in the chronic group compared with baseline, except at T500 (P =. 07). No significant difference in central FT was detected between the 2 groups. Compared with the acute group, baseline subfoveal CT was significantly higher in chronic patients. There was a significant difference between the groups in baseline and final CT at T500. No significant difference was found at T1500. At nasal 500mm and N1500, the difference between the groups was significant only for final CT values. Chronic CSCR was associated with higher baseline CT values in the subfoveal region and at T500. CT significantly decreased at most of the measured points in ranibizumab-treated chronic CSCR patients, whereas it significantly decreased only at 1 point in spontaneously resolved acute CSCR patients.
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    Elevated Tear Human Neutrophil Peptides 1-3, Human Beta Defensin-2 Levels and Conjunctival Cathelicidin LL-37 Gene Expression in Ocular Rosacea
    (Taylor & Francis Inc, 2019) Gokcinar, Nesrin Buyuktortop; Karabulut, Ayse Anil; Onaran, Zafer; Yumusak, Erhan; Yildiran, Fatma Azize Budak
    Purpose: To investigate the role of innate immunity in ocular rosacea. Methods: Thirty-two patients with ocular rosacea patients (group-1) and 28 healthy volunteers (group-2) who served as controls were enrolled in the study. Tear function parameters were assessed, conjunctival impression cytology was performed and tear samples were collected. Human-neutrophil-peptides (HNP) 1?3 and human-beta-defensin-2 (hBD-2) levels were measured in tears by using ELISA tests. Cathelicidin leucin-leucin-37 (LL-37), hBD-2, human-beta-defensin-9 (hBD-9) gene expression levels were measured in the conjunctival impression cytology samples using real-time polymerase chain reaction. Results: Tear HNP1-3 (p?=?0.024), hBD-2 (p?
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    Optical coherence tomography neurodegenerative findings in patients with bipolar disorder
    (WILEY, 2020) Gokcinar, Nesrin Buyuktortop; Buturak, Sadiye Visal; Ozkal, Fatma; Ozcicek, Gamze; Yumusak, Mehmet Erhan; Turgal, Ebru
    Introduction Neuroimaging studies of patients with bipolar disorder (BD) have recently revealed neurodegenerative changes in the central nervous system. Optical coherence tomography (OCT) imaging of the retina, as an extension of brain, may be a biomarker in understanding the neurobiology of the disease. To assess OCT as a tool to detect neurodegeneration in BD we compared the retinal changes between patients with BD and healthy individuals. Methods We performed complete ophthalmological examinations and took OCT images for 70 eyes of 70 patients with BD, and for age and sex-matched individual controls. We compared retinal nerve fiber layers (RNFLs) and total retinal (TR) thickness in the peripapillary areas; and ganglion cell complexes (GCCs) and TR thickness in the maculas between the groups. Results The mean age of the patients was 40.41 +/- 13.22 years and that of the controls 40.20 +/- 13.03 years. The men/women ratios were 37/33 in both groups. BD was significantly associated with a decrease in the average peripapillary RNFL, with the average peripapillary TR, and with the average GCC thickness (P = .033, P = .008, and P = .009, respectively). The peripapillary RNFL and TR thinnings were prominent in the superior (P = .039, P = .033, respectively) and inferior quadrants (P = .031, P = .018, respectively). The BD effects on GCC thinning was prominent in the superior half (P = .001) and in the nasal sectors (except in the inner superonasal sector; all P < .05). BD was associated with a decrease in macular TR thickness only at the inner superior sector (P = .014). Disease duration was inversely correlated with the peripapillary RNFL, TR, and macular GCC thicknesses (P < .05). Discussion Our findings support the neurodegeneration hypothesis in the etiopathogenesis of BD. OCT, a non-invasive neuro-imaging method, may be useful for BD diagnosis and follow-ups.