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Öğe Üst Oblik Paralizisine Bağlı Alt Oblik Aşırı Fonksiyonunda Tek Taraflı Alt Oblik Miyektomi Sonuçları(2016) Yumuşak, Mehmet Erhan; Yolcu, Ümit; Küçükevcilioğlu, Murat; Diner, Oktay; Mutlu, Fatih MehmetAmaç: Üst oblik paralizisine bağlı alt oblik aşırı fonksiyonu olgularında uyguladığımız tek taraflı alt oblik miyektomi sonuçlarını sunmaktır.Gereç ve Yöntem: 2002-2008 yılları arasında üst oblik paralizisine bağlı tek taraflı alt oblik miyektomi yapılan 27 hastanın 27 gözü çalışmaya dahil edildi. Hastaların ameliyat öncesi, ameliyat sonrası erken dönem (bir hafta içinde) ve ameliyat sonrası geç dönem (en erken 6. ayda) alt oblik aşırı fonksiyonu değerleri (0-4 arası) incelendi.Bulgular: On iki erkek, 15 kadın hasta mevcuttu. Çalışmada hastaların 18'i sağ 9'u ise sol gözünden ameliyat edildi. Yaş ortalaması 15,62±13,31 yıl ve ortalama takip süresi 17±11,28 ay (aralık: 6-60 ay) olarak bulundu. Horizontal komponent ve V patern deviyasyon olan olgular çalışma dışında bırakıldı. Ameliyat öncesi ve ameliyat sonrası erken dönem ortalama alt oblik aşırı fonksiyonu değerleri sırasıyla 2,55±0,75 ve 0,14±0,36 idi ve fark istatistiksel olarak anlamlıydı (p<0,01). Bu düzelmenin geç dönemde de korunduğu gözlendi.Sonuç: Gerek erken, gerekse geç dönem sonuçları açısından yüz güldürücü olması sebebiyle özellikle üst oblik paralizisine bağlı alt oblik aşırı fonksiyonlu olgularda alt oblik miyektomi ilk seçenek cerrahi yöntem olarak tercih edilebilirÖğe Kırıkkale Yöresinde Konjonktiva Lezyonlarının Histopatolojik Dağılımı(2016) Yumuşak, Mehmet Erhan; Onaran, Zafer; Örnek, Kemal; Balcı, Mahi; Gökçınar, Nesrin BüyüktortopAmaç: Üçüncü basamak bir sağlık merkezi olan Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi'nde konjonktival kitle şikayetiyle müracaat eden hastalardan alınan insizyonel yada eksizyonel biyopsi materyallerinin histopatolojik olarak incelenmesi ve klinik özellikleriyle beraber değerlendirilmesi. Gereç veYöntem: 2008-2016 yılları arasında konjonktiva lezyonu nedeniyle cerrahi uygulanan 80 hasta retrospektif olarak değerlendirildi. Klinik verilerhasta dosyalarından toplanarak elde edildi. Hastaların yaş ve cinsiyetleri ilelezyonun klinik ve histopatolojik özellikleri belirlendi. Bulgular: Çalışmadaki hastalardan 52'si (%65) erkek, 28'i (%35) kadın idi. Hastaların ortalama yaşı 42±21,6 yıl idi. Seksen konjonktival lezyondan 21'i pterjiyum-pingeikula (%26), 17'si kronik inflamasyon (%21.25), 13'u nevüs(%16.25), 6'sı aktinikkeratoz (%7.5) ,4'ü papillom (%5.0), 4'ü hemanjiom (%5.0), 3'ü lipom(%3.75), 1'i elastofibrom (%1.25), 1'i verrucavurgaris (%1.25), 1'i epidermal kist (%1.25), 9'u malign olgulardan (%11.25) oluştu. Malign olgular ise 5 intraepitelyal neoplazi (Tüm lezyonların %6.25'i), 3 skuamoz hücreli karsinom( tüm olguların %3.75'i), 1 malignmelanom (tüm olguların %1.25'i) olarak sıralandı. Sonuç: Çalışmamızda konjonktivanın en sık gözlenen lezyonu olarak pterjium benzeri lezyonlar bulunmuştur. Yaklaşık 8 olgudan birinde ise malign lezyon rapor edilmiştir.Öğe Göz Kapağı ve Perioküler Bölge Tümörlerinin Histopatolojik Dağılımı(2016) Yumuşak, Mehmet Erhan; Onaran, Zafer; Örnek, Kemal; Oğurel, Tevfik; Balcı, MahiAmaç: Kırıkkale ili ve çevresinde biyopsi alınarak histopatolojik değerlendirmesi yapılan göz kapağı ve perioküler bölge tümörlerinin epidemiyolojisinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: 2008-2016 yılları arasında 217 hastaya ait 239 lezyonun histopatolojik tanısı, yerleşim yeri ve lateralizasyonu geriye dönük olarak taranmış ve sınıflandırılmıştır. Hastalara ait demografik bilgiler derlenmiştir. Bulgular: 217 hastanın 104' ü erkek (%47.9), 113'ü kadın (%52.1) idi. Hastaların Yaş ortalaması 46.0±2.04 olarak bulundu.Lezyonların 117'si sağ (%48.9) 122'si (%51.1) sol tarafta yerleşmiş idi. Olguların 99'u alt kapaktan (%41.4), 120'si üst kapaktan (%50.2), 17'si (%7.1) medial kantus 3'ü (%1.3) ise dış kantusta idi. 239 olgunun %36.8'i epitelyal tümör (n=88), %5.8'i adneksiyal (n=14), % 3.8'i vasküler (n=9), %5'i ksantomatöz (n=12), %15.8 pigmente - melanositik (n=38), %21.3 inflamatuvar veya enfeksiyöz (n=51) , %11.2 u ise malign (n=27) olarak dağılım göstermekteydi. Sonuç: Yaklaşık olarak yapılan her 10 biyopsiden birinin malignite tanısı aldığı görülmektedir. Bir kısım literatür ile uyumlu olan sonuçlarımızın bazıları ile ise farklılık göstermesinin çevresel faktörlerden kaynaklanabileceği düşünülmüştürÖğe Keratokonuslu Gözlerde Kombine Scheimpflug-Placido Disk Ön Segment Analiz Sistemi Ölçümlerinin Tekrarlanabilirliği ve Güvenilirliği(2019) Gökçınar, Nesrin; Akbulut, YaprakAmaç: Kombine Scheimpflug-Placido disk ön segment analiz sistemi ile keratokonus hastalarında korneanın kurvatür, kalınlık, hacim, şekil ve keratokonus tarama endekslerinin tekrarlanabilirlik ve güvenilirliğini incelemek. Gereç ve Yöntem: Bu prospektif çalışmada keratokonus hastalarında kombine Scheimpflug-Placido disk ön segment analiz cihazı ile aynı gözlemci tarafından ardışık 3 tekrarlı ölçüm yapıldı. Apikal kurvatür, SimK, kornea hacmi ve şekil endeksleri ile beraber en ince kornea kalınlığı, simetri endeksi, keratokonus verteksi ve Baiocchi-Calossi-Versaci endeksi adı verilen keratokonus tarama endeksleri kaydedildi. Kerato - konuslu gözler şiddet açısından hafif, orta ve ileri olmak üzere 3 gruba ayrıldı. Tekrarlanabilirlik gözlem içi standart sapma, gözlem içi kesinlik, tekrarlanabilirlik endeksi ve değişkenlik katsayısı ile güvenilirlik sınıf içi korelasyon katsayısı ile değerlendirildi. Bulgular: Çalışmaya 62 keratokonus hastasının 88 gözü dahil edildi. Keratokonus şiddeti 20 gözde hafif, 45 gözde orta, 23 gözde ileri idi. Çalışmadaki tüm endeksler için tekrarlanabilirlik iyi (değişkenlik katsayısı <%6,25); güvenilirlik mükemmeldi (sınıf içi korelasyon katsayısı >0,900). Değişkenliği en az olan endeksler en düz ve en dik SimK ile en ince kornea kalınlığı idi (değişkenlik katsayısı sırasıyla %0,35, %0,39 ve %0,72). İleri evre gözlerde arka yüzey apikal kurvatür ölçüm değişkenliği ön yüzeye göre daha yüksekti (değişkenlik katsayısı %2,1’e karşın %0,80). Bazı ileri evre gözlerde arka yüzey simetri endeksi ile Baiocchi-Calossi-Versaci endeksi için ölçüm güvenilirliği iyi seviyeye inmekte idi (sınıf içi korelasyon katsayısı alt sınırı sırasıyla 0,868 ve 0,849 idi). Sonuç: Kombine Scheimpflug-Placido disk ön segment analiz sistemi ile keratokonus hastalarında yapılan ölçümler büyük ölçüde tekrarlanabilir ve güvenilirdi. Ancak ileri keratokonusta ölçüm değişkenliğinin biraz daha fazla olabileceği göz önünde bulundurulmalıdırÖğe İntravitreal Deksametazon İmplant (Ozurdex®) Uygulamasının Göz İçi Basıncı ve Ön Kamera Açısına Etkileri(2018) Güler, Hatice Ayhan; Örnek, Nurgül; Oğurel, Tevfik; Yumuşak, Mehmet Erhan; Gökçınar, Nesrin Büyüktortop; Örnek, KemalAmaç: İntravitreal deksametazon enjeksiyonunun göz içi basıncı (GİB) ve ön kamara açısı (ÖKA) üzerine etkisini incelemek. Gereç ve Yöntem: Otuz sekiz hastanın 40 gözü incelendi. Hastaların yaş ortalaması 61.39 yıl (aralık: 36-83) olup, %63.2’i kadın, %36.8’i erkekti. %70'i retina ven tıkanıklığı, %20’i diabet, %7.5‘i arka üveit ve %2.5’i psödofakik makula ödemi olgusuydu. GİB Goldmann ap- lanasyon tonometresi ile ölçüldü. GİB ve gonyoskopik muayene enjeksiyondan önce ve enjeksiyondan sonra 1.hafta, 1. 3. ve 6. aylarda ölçüldü. Spektral domain optik koherans tomografi (OKT) enjeksiyon öncesi ve sonrası 1. ay, 3. ay ve 6. ay da üst, nazal, alt, temporal kad- ranlardan alındı. OKT ile ön kamara açı derecesi (ÖKA), trabeküler iris yüzey alanı (TIYA500) ve açı açılma mesafesi (AAM500) ölçüldü. Bulgular: Enjeksiyon yapılan gözlerin GİB'ı enjeksiyon öncesi, enjeksiyon sonrası 1. hafta, 1. ve 3. aylardakine göre anlamlı düşük sap- tandı (sırasıyla p= 0.004, p= 0.002, p= 0.003). Enjeksiyon sonrası 6. ay ile enjeksiyon öncesi arasında ortalama GİB değerleri açısından anlamlı fark izlenmedi. Nazal kadranda enjeksiyon öncesi ve sonrası 1. haftadaki gonyoskopik derece, enjeksiyon sonrası 3. ve 6. aylara göre anlamlı yüksek saptandı (p= 0.007, p= 0,006; p= 0.008, p= 0,008). Gonyoskopide diğer kadranlarda anlamlı fark saptanmadı. Nazal kadranda OKT-ÖKA'nın enjeksiyon sonrası 3. ve 6. aydaki değerleri, enjeksiyon öncesi ve sonrası 1. aya göre anlamlı dar saptandı (p= 0.008, p= 0,008; p= 0.009, p= 0,008). Üst kadranda göz kapağı güvenilir ölçüm alınmasına engel olmuştur. Uygulama yapılan gözlerin alt kadran 3. ve 6. aylardaki OKT-AAM500 ve TİYA500 sonucu enjeksiyon öncesinden anlamlı olarak düşük saptanmıştır (p= 0.002, p= 0.004; p= 0.005, p= 0.001). Sonuç: İntravitreal deksametazon enjeksiyonu sonrası göz içi basıncı artabilir fakat çoğu olguda medikal tedaviyle kontrol altına alınabilir. Enjeksiyon sonrası gonyoskopide ve OKT’de bazı kadranlarda ön kamara açısında daralma olabilir.Öğe Antiglokomatöz Tedavi Alan Hastalar Gerçekten Glokom Hastası mı?(2017) Onaran, Zafer; Oğurel, Reyhan; Oğurel, TevfikAmaç: Glokom olmadığı halde glokom tanısı konularak yıllardır göz tansiyonu damlası kullanmak zorunda kalan hastalara nasıl tanı konduğu, hangi ilaçları kaç yıl süreyle kullandığı ve bu ilaçların hasta üzerinde olan etkileri araştırıldı.Gereç ve Yöntemler: Çalışma retrospektif olarak kullandığı glokom ilacını tekrar reçete etmeye ya da raporu bittiği için raporunu yenilemeye gelen hastalar ile glokomu olduğunu söyleyip kontrole gelen hastalar arasında yapıldı. Tüm hastalar glokomu olmayan, oküler hipertansiyonu olan ve gerçekten glokomu olan hastalar olarak 3 guruba ayrıldı. Bu hastalara rutin göz muayenesinden sonra santral kornea kalınlığı(SKK) ölçümleri, görme alanı testi ve sinir lifi analizleri yapıldı. Muayene sonrası hastalara hangi ilaçları kaç yıldır kullandıkları, yöntemler tarif edilerek hangi yöntemle göz içi basıncı (GİB) ölçüldüğü, SKK'nın ölçülüp ölçülmediği, daha önce görme alanı testi ve düzenli kontrol yaptırıp yaptırmadıkları soruldu. Hastalardan ilaçlarını kesmeleri istenerek 2 hafta sonra GİB takibine çağrıldı.Bulgular: Tüm hastalar değerlendirildiğinde hastaların yalnız %7.1'inde (8/113) gerçekten glokom mevcuttu. Hastaların ilaç kullanım süreleri ortalama 3.84±1.24 yıldı. Hastaların ortalama SKK sağlıklı gurupta 583.51±27.55 ?, oküler hipertansiyonu olan gurupta 558.12±36.80 ?ve glokomu olan hastalarda 552±23.10? idi. Hastaların yalnız 12'si(%10.6) daha önce tansiyonlarının aplanasyon tonometrisi ile ölçüldüğünü ifade etti, geri kalan tamamında ölçümler non-kontak tonometri ile yapılmıştı. Sonuç: Günlük uygulamada glokomun yanlış teşhisi yaygın bir konudur, glokom hastaları glokom kriterleri açıkça karşılanmadığında yeniden değerlendirilmelidirÖğe Bağ dokusu hastalıklarında koroidal kalınlık değişikleri(2016) Diner, Oktay; Ayyıldız, Önder; Durukan, Hakan; Özge, Gökhan; Küçükevcilioğlu, Murat; Yumuşa, ErhanAmaç: Çalışmanın amacı bağ dokusu hastalıklarında (BDH) koroid kalınlığı (KK) değişikliklerinin Spektral Domein optik koherens tomografi (SD OKT) kullanılarak değerlendirilmesidir.Gereç ve Yöntemler: Bu prospektif klinik çalışmada, en az 3 aydır remisyonda olan ve bağ dokusu hastalığı tanısı almış 34 hasta ve yaş ve cinsiyet uyumu olan 30 sağlam kişi kontrol grubu olarak değerlendirilmiştir. Santral makula kalınlığı (SMK) subfoveal, nazal ve temporal 500, 1500 mikron mesafelerdeki KK, SD OKT ile ölçülmüştür.Bulgular: Hasta grubunda ortalama SMK (219,2 ?m) kontrol grubuna göre (225,5 ?m) daha ince bulunmuştur. Ancak aradaki fark istatistiksel olarak anlamlı değildi (P = 0,2). Aynı zamanda ortalama KK her ölçüm noktası için hasta grubunda incelmiş olarak bulunmuştur fakat aradaki fark yine istatistiksel olarak anlamlı değildi (P > 0,05). Sonuçlar: İstatistiksel olarak anlamlı olmamasına rağmen BDH'larında koroid dokusu kalınlığı incelmiş olarak bulunmuşturÖğe Oxytocin-Induced Bilateral Serous Retinal Detachment(2019) Örnek, Nurgül; Örnek, Kemal; Timur, İnci Elif Erbahçeci; Tulmaç, Özlem BanuA 27-year-old multigravid patient was admitted with bilateral blurring of vision after caesarean delivery. She had history of oxytocin infusion for labor stimulation. Visual acuities were 1/10 in both eyes. Fundus examination showed bilateral serous retinal detachments affecting predominantly the posterior pole and the peripapillary area. Optical coherence tomography revealed bilateral serous retinal detachment of the macular area. Spontaneous resorption of the subretinal fl uid started promptly the following day after the delivery. Large volumes of hypotonic solution with oxytocin may induce water retension during labor. This should be considered in the differential diagnosis of bilateral serous RD in pregnancy.Öğe Evaluation of the effects of selective laser trabeculoplasty on anterior segment parameters by anterior segment optical coherence tomography(SPRINGER LONDON LTD, 2020) Ozer, Murat Atabey; Ogurel, Tevfik; Ozen, Serkan; Kucuksumer, YasarTo prospectively examine the effects of selective laser trabeculoplasty (SLT) on the anterior chamber angle (ACA) and its related parameters using anterior segment-optic coherence tomography (AS-OCT). Fifty eyes of 50 patients with primary open angle glaucoma (POAG) and ocular hypertension were included in the study. AS-OCT was performed before SLT application, immediately after and at 1 day and 1 month. Intraocular pressure (IOP), central corneal thickness (CCT) and anterior chamber depth (ACD) were also recorded and evaluated. No statistically significant difference was determined in ACA and other AS-OCT parameters (AOD, angle opening distance at 500 and 750 mm; TISA, trabecular-iris space area at 500 and 750 mm) before and 1 day after SLT application (p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal ACA, AOD and TISA values between the baseline and day 30 (p < 0.001). No statistically significant change was observed in the CCT or ACD values (p > 0.05). SLT resulted in an increase in ACA, AOD and TISA when evaluated using AS-OCT. We think that this study provides a different perspective concerning the effects of SLT in the angle region and the involved mechanism.Öğe 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, EbruIntroduction 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.Öğe Strain and Shear Wave Elastography in Diagnosis of Retrobulbar Neuritis(LIPPINCOTT WILLIAMS & WILKINS, 2020) Ogurel, Tevfik; Burulday, VeyselBackground: In the early stages of retrobulbar neuritis (RN), the optic disc appears normal on ophthalmoscopy. Therefore, the diagnosis of RN is usually made clinically. However, imaging tools are needed for precise diagnosis of RN, and usually MRI is used. In this study, we investigated the diagnostic performance of strain elastography (SE) and shear wave elastography (SWE) in patients with RN. Elastography is a new sonographic technique and a noninvasive ultrasound method for evaluating the elastic properties of tissues based on static compression: the elastographic techniques of SE compress the tissues axially, and SWE uses waves that are generated by transducers and interact with the tissue. Methods: The study included 40 eyes of 20 patients with sudden visual loss, who were diagnosed with RN. The eyes of the patients were divided into 2 groups: the eye with a diagnosis of RN was the group of RN eyes, and the healthy second eye was the group of control eyes. Ophthalmologic examination, orbital and brain MRI, SE, and SWE were performed. SE color mapping was divided into 3 types: blue-hardest tissue (Type 1), blue/green-hard tissue (Type 2), and green-intermediate tissue (Type 3). All patients were treated with high-dose corticosteroids. The measurements of SE and SWE were made immediately after diagnosis and 1 month after treatment. Results: The mean age of 11 male and 9 female patients was 38.3 +/- 12.2 years. At the time of diagnosis, the mean shear wave values for the control eyes were 18.47 +/- 7.26 kPa (kilopascals), and the mean shear wave values for the RN eyes were 37.21 +/- 8.24 kPa. There was a statistically significant difference between the control and RN eyes at the time of diagnosis (P < 0.001). The mean shear wave value was 19.92 +/- 4.77 kPa in the RN eyes after treatment. There was a statistically significant difference in values at the time of diagnosis and after treatment (P < 0.001). Strain types found in the RN eyes before treatment were Type 1 in 60% of eyes, Type 2 in 25%, and Type 3 in 15%; at the end of the treatment, Type 2 was observed in 25% of eyes and Type 3 in 75%, while Type 1 was not observed. Conclusions: SE and SWE may be important alternative diagnostic tools in the diagnosis of RN.Öğe Blood Chromium-Cobalt Levels In Patients After Total Knee Arthroplasty And Their Effect On The Retinal Nerve Fiber Layer And Macular Ganglion Cell Complex(LIPPINCOTT WILLIAMS & WILKINS, 2020) Ogurel, Tevfik; Serbest, Sancar; Ogurel, Reyhan; Tiftikci, Ugur; Olmez, YasarPurpose: To study blood cobalt (Co) and chromium (Cr) levels in patients who have undergone total knee arthroplasty and their effect on the retinal nerve fiber layer and macular ganglion cell complex. Methods: One hundred patients who had undergone total knee arthroplasty and 50 healthy individuals who had no implants were included in the study. The patients were separated into two groups based on how long ago the prosthesis had been implanted (Group 1: 1 to 5 years; Group 2: 5 to 10 years). After a complete ophthalmological examination, retinal nerve fiber layer and macular ganglion cell complex of the patients were evaluated with optical coherence tomography, performed on dilated pupils. To assess the metal ion levels of the patients, venous blood samples were drawn from each patient. Results: The mean age of the patients was 64.72 +/- 6.26 years in Group 1, 67.80 +/- 8.07 years in Group 2, and 63.42 +/- 7.90 years in the control group. In the comparison of age and sex, there were no statistically significant differences between the groups and the control group. Co and Cr levels were statistically higher in Group 1 and Group 2 compared with the control group (P < 0.001). Mean retinal nerve fiber layer thicknesses and mean macular ganglion cell complex thicknesses in Group 1 and Group 2 were statistically lower than in the control group. Conclusion: Levels of Co and Cr are higher in patients who undergone total knee arthroplasty than healthy subjects, and these higher levels were associated with changes in the retinal nerve fiber layer and macular ganglion cell complex.Öğe Corneal thickness and endothelial changes in long-term hydroxychloroquine use(Taylor & Francis Ltd, 2019) Oğurel, Tevfik; Özer, Murat Atabey; Akbulut, Yaprak; Gökçınar, Nesrin Büyüktortop; Onaran, Zafer; Üreten, KemalObjective: To determine possible associations between long-term HCQ use and corneal changes in patients who used HCQ for at least 3 years. Materials and methods: The study included 62 healthy controls and 62 consecutive patients who used HCQ for the treatment of rheumatologic disease and were referred to the ophthalmology department between August 2018 and November 2018 for HCQ retinal toxicity screening. Central corneal thickness (CCT), corneal endothelial cell density (ECD), the coefficient of variation (CV) of cell size, and the percentage of hexagonal cells (HEX%) were measured to evaluate changes in the cornea. Results: The mean age of the patient group and control group was 50.10 +/- 10.91 and 50.53 +/- 10.67 years, respectively. The mean ECD was 2742 +/- 347 (cells/mm(2)) in the patient group and 2875 +/- 188 cells/mm(2) in the control group. There was a significant difference between groups (p = 0.01). The mean CCT was 567.05 +/- 32.35 mu m in the patient group and 540.15 +/- 38.50 mu m in the control group. CCT was significantly higher in the patient group compared with control group (p < 0.001). There was no significant difference between groups in terms of mean CV and HEX values (p > 0.05). Conclusions: Patients using long-term HCQ demonstrated lower ECD and higher CCT than the control group. However, the CV of cell sizes and the HEX % values were not significantly different from the controls.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 Cystoid macular edema following selective laser trabeculoplasty in a patient with ocular hypertension(Springer, 2019) Örnek, Nurgül; Örnek, Kemal; Oğurel, Tevfik; Gökçinar, Nesrin BüyüktortopPurpose Presentation of a case with ocular hypertension who developed cystoid macular edema (CME) following selective laser trabeculoplasty (SLT). Case report A 62-year-old male patient who had undergone phacoemulsification surgery for traumatic cataract 9 years ago was on ocular hypertension treatment for the last 5 years. Due to uncontrolled intraocular pressure and side effect of medications, a 360 degrees SLT was performed. The patient returned with decrased visual acuity 1 week after the procedure. There was CME in the treated eye. It healed completely after topical prednisolone acetate QID and nepafenac QID for 1 week, and no recurrence was observed during follow-ups. Conclusion Cystoid macular edema may occur following SLT treatment in patients with previous traumatic cataract surgery which responds to topical treatment.Öğe Evaluation of the optic nerve using strain and shear-wave elastography in pre-eclampsia(W B Saunders Co Ltd, 2019) Asal, N.; Sayan, C. D.; Gokcinar, N. B.; Sahan, M. H.; Dogan, A.; Inal, M.AIM: To investigate the utility of strain elastography and shear-wave elastography for assessing optic nerve involvement in pre-eclampsia. MATERIAL AND METHODS: A total of 120 eyes were evaluated in 60 cases consisting of 30 participants in the pre-eclamptic and 30 participants in the non-pre-eclamptic pregnant patient group. The findings of strain and shear-wave elastography, grey-scale sonography, and optical coherence tomography were compared between the groups. RESULTS: There was a statistically significant difference for the average shear-wave elastography values between groups (17.6 +/- 4.1 and 9.4 +/- 2 kPa, p<0.01). The analysis of the strain elastography types also revealed a statistically significant difference between the groups (p<0.01). A statistically significant difference was found for the average values of the optic nerve sheath diameter between the two groups (p<0.05). A statistically significant difference was found in the average value of the superior quadrant of the retina nerve fibre layer between the groups in optical coherence tomography analysis (p=0.04). The peripapillary choroidal thickness values of pre-eclamptic pregnant women were higher than that of non-preeclamptic pregnant women, but the difference was not significant (p>0.05). CONCLUSION: Stiffness of the optic nerve was greater in patients with pre-eclampsia in the study. Elasticity changes in the optic nerve may be generally attributed to microvascular and biomechanical changes secondary to increased hypertension in pre-eclamptic patients. Elastography could be used as assistive diagnostic techniques to evaluate the optic nerve structure changes in pre-eclampsia. (C) 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.Öğe 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 BudakPurpose: 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?Öğe The comparison of the relationships about the presence of branch retinal vein occlusion and endothelial functions between diabetic and non-diabetic patients(Lippincott Williams & Wilkins, 2019) Demir, Vahit; Dogru, Mehmet Tolga; Onaran, Zafer; Kandemir, Huseyin; Alp, CaglarObjectives The aim of this study was to investigate the endothelial functions in both patients with diabetics and non-diabetics with branch retinal vein occlusion by using pulse wave analysis and flow-mediated dilatation methods. Patients and methods This cross-sectional study included a total of 136 participants (47 diabetic patients with branch retinal vein occlusion, 43 non-diabetic patients with branch retinal vein occlusion, and 46 otherwise healthy subjects). Evaluation of endothelial functions was performed by flow-mediated dilatation and pulse wave analysis methods. Stiffness index, reflection index (RI), and pulse propagation time were calculated. Results The mean stiffness index and RI were significantly higher in the diabetic branch retinal vein occlusion group compared with the non-diabetic branch retinal vein occlusion and the healthy controls (for stiffness index: 11.5 +/- 2.8 vs. 10.1 +/- 2.5 and 8.3 +/- 2.0, P < 0.001; and for RI: 75.1 +/- 11.7 vs. 65.4 +/- 8.4 and 60.2 +/- 18.8, P < 0.001, respectively), whereas the pulse propagation time was significantly lower in the diabetic group (156.4 +/- 32.3 vs. 174.4 +/- 46.5 and 205.0 +/- 58.5, P < 0.001, respectively). There was a significant negative correlation between visual acuity and stiffness index (r = -0.512, P < 0.001). Besides, there was also a significant positive correlation between visual acuity and pulse propagation time (r = 0.398, P < 0.001). Conclusion This study demonstrated that the stiffness index and RI values were higher in patients with branch retinal vein occlusion compared to the healthy subjects. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.Öğe Decreased choroidal thickness in vitiligo patients(Bmc, 2018) Demirkan, Serkan; Onaran, Zafer; Samav, Guzin; Ozkal, Fatma; Yumusak, Erhan; Gunduz, Ozgur; Karabulut, AyseBackground: Vitiligo is a disease characterized by depigmented macules and patches that occur as a result of the loss of functional melanocytes from the affected skin through a mechanism which has not been elucidated yet. Destruction of pigment cells in vitiligo may not remain limited to the skin; the eyelashes, iris, ciliary body, choroid, retinal pigment epithelium and meninges may also be affected. This study aims to compare the choroidal thickness of patients with and without vitiligo using optical coherence tomography (OCT). Methods: Spectral-domain optical coherence tomography (SD-OCT) (Retina Scan Advanced RS-3000 NIDEK, Japan) instrument (with lambda = 840 nm, 27,000 A-scans/second and 5 mu m axial resolution) was used for the imaging. Statistical analysis was performed using SPSS 21.0 software package. Results: In all values except optic nevre area measurements, the choroidal thickness of all vitiligo patients was found out to be thinner compared to the control group. Conclusions: In vitiligo, the choroidal thickness may be affected by the loss of melanocytes.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.
