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Öğe 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, ZaferPurpose 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.Öğe Comment: Retinal Thickness in Essential Tremor and Early Parkinson Disease: Exploring Diagnostic Insights(Lippincott Williams & Wilkins, 2024) Ornek, Kemal; Ornek, Nurgul[Abstract No tAvailable]Öğe Compressive Optic Neuropathy Presenting With Psychiatric Symptoms(Lippincott Williams & Wilkins, 2014) Ornek, Nurgul; Buyuktortop-Gokcinar, Nesrin; Dag, Ersel; Ornek, KemalWe report a case of bilateral optic neuropathy presenting with psychiatric symptoms. A 50-year-old woman was admitted with blurry vision in both eyes. She had a 3 months' history of depressed mood. Both optic discs had mild temporal pallor with visible spontaneous venous pulsations. Magnetic resonance imaging of the brain showed a large frontal mass compressing the optic nerves. The tumor was surgically resected, and tissue pathology demonstrated an olfactory groove meningioma.Öğe Congenital hypothyroidism in Rieger Syndrome(Taylor & Francis Inc, 2016) Ornek, Nurgul; Ogurel, Reyhan; Ornek, KemalRieger syndrome (RS) is a multiple malformation syndrome characterized by ocular manifestations and extraocular defects. Herein, we report a 9-year-old boy who exhibited Rieger Syndrome phenotype as well as congenital hypothyroidism which may be an underappreciated feature of RS.Öğe Corneal and Conjunctival Sensitivity Changes Following Intravitreal Ranibizumab Injection in Diabetic Retinopathy(Mary Ann Liebert, Inc, 2015) Ornek, Nurgul; Ornek, Kemal; Erbahceci, Inci ElifPurpose: To evaluate corneal and conjunctival sensitivity changes following intravitreal ranibizumab (IVR) injection in eyes with diabetic retinopathy. Methods: Forty-six eyes of 46 patients with diabetic macular edema who underwent intravitreal injection of ranibizumab were included in this prospective study. Fifty eyes of 50 type 2 diabetes mellitus patients served as controls. Each participant underwent a complete ophthalmological examination. Fundus florescein angiography and optical coherence tomography were performed to assess the posterior segment details. IVR (0.5 mg/0.05 mL) was injected from the lower temporal quadrant. Corneal and conjunctival sensitivities were measured using the Cochet-Bonnet esthesiometer. Results: Corneal sensitivity (CS) increased significantly on the first day in temporal and nasal corneas in treated eyes (P=0.005 and P=0.000, respectively). At week one the increase continued and the difference was significant in central, temporal, and nasal corneas (all P=0.000). In fellow eyes, CS increased significantly only in nasal cornea (P=0.004). Only nasal conjunctival sensitivity increased significantly both in treated and fellow eyes at week one (P=0.000 and P=0.005, respectively). Conclusion: IVR may have a potential to increase corneal and conjunctival sensitivities in diabetic retinopathy.Öğe Corneal and conjunctival sensitivity in rosacea patients(Elsevier Science Bv, 2016) Ornek, Nurgul; Karabulut, Ayse Anil; Ornek, Kemal; Onaran, Zafer; Usta, GulsahPurpose: To assess corneal and conjunctival sensitivity in rosacea patients. Methods: A total of 55 patients with rosacea and 37 control subjects participated in the study. Corneal and conjunctival sensitivity was determined by Cochet-Bonnet esthesiometer. Subjective symptoms of ocular dryness were evaluated using Ocular Surface Disease Index (OSDI). Schirmer's I test (ST), tear breakup time (tBUT) and ocular surface staining with fluorescein were carried out to measure objective signs. Results: The mean corneal and conjunctival sensitivity did not differ significantly between rosacea patients and controls (all p > 0.05). Schirmer's I test and tBUT were significantly reduced (p = 0.004 for OD and p < 0.001 for OS) and grade of ocular surface staining was significantly high (p = 0.018 for OD and p = 0.038 for OS) in rosacea patients. Corneal and conjunctival sensitivity did not show significant correlation with ST, tBUT, ocular surface staining (Oxford Schema), duration of rosacea and OSDI score. Conclusions: Corneal and conjunctival sensitivity did not change significantly in rosacea.Öğe Corneal Endothelial Cell Density and Morphology in Different Trimesters of Pregnancy(Lippincott Williams & Wilkins, 2018) Ornek, Nurgul; Dag, Zeynep Ozcan; Ornek, KemalObjectives: To evaluate corneal endothelial cell density (CD) and morphology in different trimesters of pregnancy. Methods: This prospective study included 66 (66 eyes) pregnant women. The patient group was divided into three subgroups comprised of 22 women in the first, second, and third trimesters of pregnancy. An age-matched group of 22 (22 eyes) volunteers served as controls. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical). Central corneal thickness (CCT) and CD, hexagonal cell ratio (HEX), and coefficient of variation (CV) of the corneal endothelial cell layer of the patients were measured at each trimester. Results: Central corneal thickness did not change significantly during the pregnancy compared to controls (P>0.05). Endothelial CD was decreased in the first trimester and increased in the second and third trimesters, but the difference was not significant (P>0.05). Hexagonal cell ratio was decreased significantly in the first trimester (P<0.05).There was an increase in the second and third trimesters, which was not statistically significant (P>0.05). Coefficient of variation was increased significantly in the first trimester and showed a significant decrease in the second and third trimesters (P<0.05, respectively). Endothelial CD had a significant positive correlation with CV and HEX had a negative correlation with CV in the second trimester (r=0.438, P=0.041 and r=-0.822, P<0.001, respectively). Conclusion: Central corneal thickness and endothelial CD did not change significantly throughout the pregnancy. Hexagonal cell ratio and CV showed a significant but transient increase in the first trimester.Öğe Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma(Springer, 2018) Ornek, Nurgul; Ornek, KemalPurposeTo evaluate corneal endothelial cell parameters after a single session of selective laser trabeculoplasty (SLT) in pseudoexfoliative glaucoma (PEG) patients.MethodsCorneal endothelial cell parameters of 18 PEG patients were compared with 18 healthy subjects following SLT treatment. All patients underwent SLT treatment to 180 degrees of inferior trabecular meshwork. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical, Hyogo, Japan). Endothelial cell density (ECD), hexagonal cell ratio (HEX), coefficient of variation (CV) of the corneal endothelial cell layer and central corneal thickness of the patients were measured at each visit.ResultsThere was a statistically significant decrease in ECD (p=0.004) and a statistically significant increase in CV (p=0.041) at superior cornea 1week after SLT. They returned to pre-SLT values at 1month. One hour post-SLT HEX of inferior cornea was statistically significantly reduced (p=0.01). At central cornea, there was a significant increase in HEX after 1week (p=0.001). Post-SLT IOP showed a significant positive correlation with CV and significant negative correlation with HEX at superior and inferior cornea. There was no correlation between total laser energy used and endothelial cell parameters.ConclusionEffect of a single session ofSLT on corneal endothelium of PEG patients appears to be transient, and superior cornea was more affected than central and inferior cornea. All parameters returned to pre-SLT values at 1month after treatment.Öğe Corneal Sensitivity and Tear Function in Neurodegenerative Diseases(Taylor & Francis Inc, 2015) Ornek, Nurgul; Dag, Ersel; Ornek, KemalPurpose: To measure corneal sensitivity and tear function in neurodegenerative diseases (NDs) and to compare them with age and sex-matched controls. Methods: Twenty patients with Alzheimer's disease (AD), 20 patients with multiple sclerosis (MS), 30 patients with Parkinson's disease (PD), 10 patients with Friedreich's ataxia (FA) and 21 patients with epilepsy (EP) who were recruited from the Kirikkale University Neurology Department during 2012 were included in this prospective study. Five groups of age and sex-matched subjects were selected as controls. Corneal sensitivity was measured using a Cochet-Bonnet esthesiometer. Tear function tests included tear break-up time (TBUT) and Schirmer's 1 tests. Results: Compared to their controls, mean corneal sensitivity was significantly reduced in AD, MS, PD and EP patients (all p<0.05), mean TBUT level was significantly shorter in patients with AD and MS (all p<0.05) and mean Schirmer's 1 test score was significantly lower in EP patients (p<0.05). When all groups were compared with each other, reduction of mean corneal sensitivity in AD and PD groups were significantly more than in FA and MS groups (overall p = 0.034). Mean TBUT levels in AD, MS and PD groups were significantly shorter than in FA and EP groups (overall p = 0.001). Mean Schirmer's 1 test scores in AD and PD groups were significantly lower than in MS, FA and EP groups (overall p = 0.040). Conclusions: Neurodegenerative diseases may be associated with reduced corneal sensitivity and abnormal tear function.Öğe Intravitreal Dexamethasone Implant (Ozurdex) for Refractory Macular Edema Secondary to Retinitis Pigmentosa(Turkish Ophthalmological Soc, 2016) Ornek, Nurgul; Ornek, Kemal; Erbahceci, Inci ElifMacular edema (ME) in retinitis pigmentosa (RP) often impairs central vision dramatically. A 41-year-old woman diagnosed with RP was referred to our outpatient clinic due to severe visual deterioration in both eyes. The patient was treated with topical carbonic anhydrase inhibitors, topical corticosteroids and intravitreal triamcinolone acetonide injections, but her ME recurred. Intravitreal 0.7 mg dexamethasone implant (Ozurdex, Allergan) was administered into both eyes without complications. On the fourth day after both injections, visual acuity improved and ME almost totally resolved. No recurrence was observed at follow-up six months later.Öğe Ocular blood flow in polycystic ovary syndrome(Wiley, 2015) Ornek, Nurgul; Inal, Mikail; Tulmac, Ozlem Banu; Ozcan-Dag, Zeynep; Ornek, KemalAimThe aim of this study was to evaluate whether the presence of polycystic ovary syndrome (PCOS) alters ocular blood flow parameters. Material and MethodsColor Doppler imaging of the orbital vessels was performed in 41 eyes of 41 patients with PCOS. Forty-eight eyes of 48 age-matched volunteers served as controls. The ophthalmic artery (OA), the central retinal artery and the posterior ciliary artery were examined. Ocular blood flow indices of the peak systolic velocity, diastolic velocity, end-diastolic velocity, systolic/diastolic ratio, resistive index and pulsatility index were computed. ResultsThe peak systolic velocity, diastolic velocity and end-diastolic velocity of the OA, central retinal artery and posterior ciliary artery were significantly increased in PCOS patients in comparison to the controls (all P<0.001). The mean systolic/diastolic ratio, resistive index and pulsatility index of the OA in PCOS patients were significantly decreased (all P<0.05). Ocular blood flow velocity was positively correlated with serum luteinizing hormone, follicle-stimulating hormone and total cholesterol levels. There was a significant negative correlation between serum glucose and insulin levels and ocular blood flow velocity. ConclusionOcular blood flow velocity is increased in PCOS patients and vascular resistance seems to decrease only in the OA.Öğe Optical Coherence Tomography and Visual Field Findings in Patients With Friedreich Ataxia(Lippincott Williams & Wilkins, 2014) Dag, Ersel; Ornek, Nurgul; Ornek, Kemal; Erbahceci-Timur, Inci ElifBackground: To investigate the optical coherence tomography (OCT) and visual field findings in Friedreich ataxia (FRDA). Methods: Ten eyes of 10 patients with genetically confirmed FRDA were included in this study. Twenty-two eyes of 22 age- and sex-matched volunteers served as controls. All eyes were examined with spectral domain OCT (Retinascan Advanced RS-3000; NIDEK) and Humphrey Field Analyzer (HFA II 750; Zeiss-Humphrey Systems). Results: OCT measurements of the average peripapillary retinal nerve fiber layer (RNFL) thickness, average peripapillary retinal thickness (RT), and foveal RT showed a statistically significant reduction in patients with FRDA (P, 0.0001). There was no statistically significant difference in choroidal thickness. OCT measurements of horizontal cup-to-disc (C/D) ratio, vertical C/D ratio, and average cup area were significantly increased in patients with FRDA. Visual acuity was significantly correlated with age at onset (P = 0.021) and average RNFL value (P = 0.045). There was a significant correlation between foveal thickness and disease duration (P = 0.014). Mean RNFL thickness was significantly correlated with the severity of neurological involvement (P = 0.039). Visual field testing (VFT) revealed a generalized reduction of sensitivity in the patients. Conclusion: Patients with FRDA may have a measurable degree of retinal thinning as determined by OCT and a generalized reduction of sensitivity in VFT. Combining structural and functional findings may be used in the follow-up of patients with FRDA. (C) 2013 by North American Neuro-Ophthalmology SocietyÖğe The Relationship between Serum Homocysteine Levels and Nonproliferative Diabetic Retinopathy in Type 2 Diabetes Mellitus(Gazi Univ, Fac Med, 2015) Demirci, Huseyin; Onaran, Zafer; Gokcmar, Nesrin; Erdamar, Husamettin; Ornek, NurgulObjective: To evaluate the relationship between serum homocysteine levels and the presence of nonproliferative diabetic retinopathy (NPDR) in type 2 Diabetes Mellitus (T2DM) patients Methods: One-hundred patients with a diagnosis of T2DM and 30 healthy control subjects whose age and sex were similar were included in this study. In diabetic patients retinopathy was assessed by ophthalmological examination. Homocysteine, fasting glucose, HbA1C, triglyceride, total cholesterol, high density lipoprotein and low density lipoprotein levels were analyzed in the blood samples in both groups. Also microalbumin levels were analyzed in 24-hour urine samples. T2DM patients were further divided into two groups according to the presence of retinopathy as patients with NPDR (Group 1, n=32) and without retinopathy (Group 2, n=68). Results: There was no statistically significant difference in the homocysteine levels between the T2DM group and the control group (13.13 +/- 4.35 mu mol/l and 12.29 +/- 4.81 mu mol/l, respectively, p>0.05). Although homocysteine levels were higher in the patients with diabetic retinopathy (Group 1) than the diabetic patients without any diabetic complication (Group 2), the difference was not statistically significant (13.21 +/- 4.23mmol/l and 12.96 +/- 4.60mmol/l, respectively, p>0.05). Conclusion: There was no increase in serum homocysteine levels in T2DM when there was no additional diabetic or cardiovascular complication other than NPDR. Our study, by demonstrating that serum homocysteine level was irrelevant to the presence of NPDR, suggests that homocysteine does not play a role at the early stages of retinopathy.Öğe Tear Fluid and Serum Vitamin D Concentrations in Unilateral Pterygium(Lippincott Williams & Wilkins, 2021) Ornek, Nurgul; Ogurel, Tevfik; Kisa, UclerSIGNIFICANCE Vitamin D has antiangiogenic, anti-inflammatory, and antifibrotic properties, which may play an inhibitory role on pterygium formation. Vitamin D concentration was measured in few studies, and contradictory results have been reported. There is no study investigating tear fluid concentration of vitamin D in pterygium patients. PURPOSE This study evaluated tear fluid and serum vitamin D concentrations of pterygium patients in comparison with healthy controls. METHODS Thirty-five (21 male, 14 female) patients with unilateral pterygium and 25 (18 male, 7 female) healthy controls were included in this case-control study. After full ophthalmic examination, blood samples were taken, and basal tear fluid was collected using glass microcapillary tubes. Tear fluid and serum vitamin D concentrations were analyzed using enzyme-linked immunosorbent assay and analyzed statistically. RESULTS The mean +/- standard deviation age of patients was 51.7 +/- 16.7 years in the study group and 50.6 +/- 18.7 years in the control group, respectively (P = .82). The mean tear fluid vitamin D concentration was statistically significantly higher than the mean serum concentration in the study groups (P < .0001). The mean tear fluid (P = .76) and serum vitamin D concentrations (P = .53) did not reveal statistically significant difference between patients and controls. There was no statistically significant difference for tear fluid vitamin D concentration between pterygium eyes and fellow eyes (P = .93). The difference in concentrations was compared within the pterygium subgroups, and it was found that the mean serum vitamin D concentration trended toward lower values as the stage of pterygium increased, and the mean tear fluid vitamin D concentration trended toward higher values as the stage of pterygium increased, although these differences were not statistically significant (all, P > .05). CONCLUSIONS Tear fluid and serum vitamin D concentrations do not seem to have a role in pterygium pathogenesis.Öğe The use of selective laser trabeculoplasty to treat glaucoma(Routledge Journals, Taylor & Francis Ltd, 2018) Ornek, Nurgul; Ornek, KemalIntroduction: Selective laser trabeculoplasty (SLT) is used successfully for management of early to advanced glaucoma and ocular hypertension (OHT). Primary open-angle glaucoma (OAG), pseudoexfoliation glaucoma (PXFG), pigmentary glaucoma, normal-tension glaucoma, primary angle-closure glaucoma, steroid-induced glaucoma, silicone oil-induced glaucoma, and high intraocular pressure after canaloplasty and trabeculectomy are the main indications. Areas covered: A review of the literature was performed to highlight recent advances in terms of suggested mechanisms, indications, efficacy, prognostic factors, surgical technique, postoperative care, complications, repeatability, cost-effectiveness, and quality of life (QoL) implications of SLT in glaucoma patients. Expert commentary: SLT is a safe, cost-effective, and repeatable procedure. It increases QoL, but it has not received wide application it deserves in glaucoma management. SLT may be a first-line treatment option in mild-to-moderate glaucoma. It may also be an adjuvant treatment in OHT and in all subtypes of glaucoma. SLT use may gain popularity in all types of OAGs, closed-angle glaucomas and OHT in the future.
