Browsing by Author "Gungor, Sirel Gur"

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Are All Retinal Nerve Fiber Layer Defects on Optic Coherence Tomography Glaucomatous?
(2017) Gungor, Sirel Gur; Akman, Ahmet; 0000-0001-6178-8362; 29109895; AAD-5967-2021
Objectives: In this study, we investigated the patients who were referred to our clinic with a prediagnosis of glaucoma based on retinal nerve fiber layer (RNFL) defects on optic coherence tomography (OCT) but were determined to have nonglaucomatous RNLF defects upon detailed examination. Materials and Methods: The ophthalmic examination notes, OCT images, Heidelberg retinal tomography (HRT) II and fundus photographs of 357 patients were retrospectively evaluated. Final diagnoses of these patients were investigated. Results: Of the 357 patients, 216 (60.5%) were diagnosed as open angle glaucoma, 33 (9.2%) as low-tension glaucoma, 39 (10.9%) as pre-perimetric glaucoma. The ophthalmic examinations of 14 patients (3.9%) were normal and there were no RNFL defects in OCT examinations after dilatation. In 39 patients (10.9%), the ophthalmic and optic disc examinations were completely normal and no etiologic factor explaining RNFL defects was found. Twenty-two eyes of 16 patients (4.5%) were included in this study (the mean age was 53.8 +/- 11.5 years; 9 men and 7 women). After detailed questioning of the medical history and systemic and neurologic examinations, a diagnosis of ischemic optic neuropathy was made in 11 eyes (10 patients) (2.8%), optic neuritis in 3 eyes (2 patients) (0.6%), optic disc drusen in 4 eyes (2 patients) (0.6%), pseudotumor cerebri in 2 eyes (1 patient) (0.3%), and cerebral palsy in 2 eyes (1 patient) (0.3%). Conclusion: Decrease in RNFL thickness on OCT images alone may be misleading in glaucoma examination. In cases where optic disc cupping is not evident, diagnosis should not be based on OCT RNFL examinations alone, and the patient's medical history, detailed ophthalmic examination, OCT optic disc parameters, HRT, and visual field tests should all be carefully evaluated together.
Atypical Intrapapillary Hemorrhage in a Patient with Glaucoma
(2015) Gungor, Sirel Gur; Ozisik, Gulce Gokgoz; Akman, Ahmet; Asena, Leyla
A 73-year-old man presented for routine follow-up. There were primary open-angle glaucoma, diabetes mellitus, and usage of acetylsalicylic acid in patient's history. Dilated fundus examination demonstrated cup hemorrhage in the right eye. Because of the progression of the superotemporal retinal nerve fiber layer defect in the last seven months, we think that the disk hemorrhage could be associated with glaucoma. (Turk J Ophthalmol 2015; 45: 77-8)
A Case of Lyme Disease Accompanied by Uveitis and White Dot Syndrome
(2016) Gungor, Sirel Gur; Muftuoglu, Ilkay Kilic; Akova, Yonca Aydin; 0000-0001-6178-8362; 28058168; AAD-5967-2021
In this case report we aimed to present a case of Lyme disease presenting as peripheral retinal vasculitis, intermediate uveitis and multifocal white dots in the posterior pole. The patient exhibited vitritis and snowball opacities in both eyes. A diagnosis of Lyme disease was made based on clinical, angiographic and laboratory findings. Fundus fluorescein angiography revealed optic nerve and retinal venous leakage as well as multiple hyperfluorescent foci in both eyes. The patient's symptoms and ocular findings significant improved after treatment with a combination of systemic antibiotics and steroids. Ophthalmologists should bear in mind that conditions presenting with uveitis and multifocal white dots may be related to Lyme disease.
A Case of Transient Visual Field Defect following Administration of Pfizer-BioNTech COVID-19 Vaccine
(2022) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Kibaroglu, Seda; https://orcid.org/0000-0002-7030-5454; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-3964-268X; 35404749; AAJ-4860-2021; AAD-5967-2021; AAJ-2956-2021
Purpose To report a case of transient visual field (VF) defect after coronavirus disease-19 (COVID-19) vaccination. Case Report A 38-year-old Caucasian, otherwise healthy female patient, presented with a complaint of vision loss in the outer quadrant in her left eye after the second dose of Pfizer (R)-BioNTech (TM) COVID-19 vaccine. The Snellen visual acuity was 20/20 in both eyes. She did not have relative afferent pupillary defect nor disturbance of color vision. Her intraocular pressures, slit lamp and fundus examinations were normal. In the VF test, a temporal hemifield defect in the left eye and a nasal peripheral VF defect in the right eye were detected. Other imaging characteristics and neurological examination were normal. She was followed without any treatment. One week later, the patient was re-evaluated and complete resolution of the VF defect was observed. Conclusion Clinicians should be aware that patients can experience transient visual symptoms following COVID-19 vaccination.
Changes in Anterior Chamber Depth after Phacoemulsification in Pseudoexfoliative Eyes and their Effect on Accuracy of Intraocular Lens Power Calculation
(2016) Gungor, Sirel Gur; Akman, Ahmet; Asena, Leyla; Aksoy, Mustafa; Sezenoz, Almila Sarıgul; 0000-0002-6848-203X; 0000-0002-7030-5454; 0000-0001-6178-8362; 0000-0003-1513-7686; 28050320; E-5914-2016; AAJ-4860-2021; AAD-5967-2021
Objectives: To compare anterior chamber depth (ACD) changes after phacoemulsification surgery in patients with pseudoexfoliation syndrome (PEX) and normal patients using an anterior segment imaging method. Another aim of this study was to evaluate the effect of these changes on the accuracy of intraocular lens (IOL) power calculation and postoperative refraction. Materials and Methods: Twenty-two eyes of 22 patients with PEX and 30 eyes of 30 normal patients who underwent uneventful phacoemulsification surgery and IOL implantation were included in the study. The ACD of all patients was evaluated preoperatively and at 3 months postoperatively with the ALLEGRO Oculyzer (WaveLight (R) Oculyzer (TM) II, Alcon, Novartis)-Scheimpflug imaging system. Results: The postoperative mean ACD values were significantly larger than the preoperative ACD values in both groups (p < 0.001 for both groups). The pre- to postoperative change in ACD was 0.46 +/- 0.3 mm in the PEX group, which was a larger change than seen in the normal patients (0.12 +/- 0.1 mm) (p = 0.04). The mean absolute errors (MAE) calculated with different IOL formulas (SRK/T, Haigis, Hoffer and Holladay 1 formulas) were comparable and no statistically significant difference was observed between the two groups (p = 0.21). Conclusion: Phacoemulsification induces more significant ACD changes in patients with PEX compared to normal patients. However, the MAE did not differ significantly between the groups.
Changes in ocular biometric parameters after renal transplantation
(2020) Aksoy, Mustafa; Asena, Leyla; Gungor, Sirel Gur; Soy, Ebru H. Ayvazoglu; Akman, Ahmet; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-0993-9917; 0000-0001-6178-8362; 0000-0002-6848-203X; 0000-0003-1513-7686; 32415655; AAJ-8097-2021; AAC-5566-2019; E-5914-2016; AAD-5967-2021
Purpose This study aimed to investigate the changes in postoperative ocular biometric parameters in end-stage renal disease patients who underwent renal transplantation. Material and methods This retrospective study included a total of 33 eyes of 33 patients. The ocular biometric measurements which were evaluated were axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), corneal keratometry (K1 and K2), degree of astigmatism, lens thickness (LT), and intraocular pressure (IOP). Refractive prediction error (RE) was calculated before and after renal transplantation using the same diopter (D) for intraocular lens (IOL) power calculation and evaluated for potential cataract surgery. Results The study included 15 male (45%) and 18 female (55%) patients. Mean patient age was 31.55 +/- 8.24 (range: 18-49 years). In the comparison of preoperative and 1-month postoperative measurements, there was a statistically significant difference in AL, LT, ACD, and CCT (p < 0.001). There was no statistically significant difference between K1, K2, and astigmatism measurements (p = 0.72; p = 0.35; p = 0.62, respectively). There was no statistically significant difference in RE (p = 0.61-Holladay 2). Conclusion While renal transplantation surgery does not lead to significant changes in astigmatism, predicted refractive error, corneal keratometry, or intraocular pressure, it causes significant decrease in axial length, lens thickness, and central corneal thickness and significant increase in anterior chamber depth. However, these changes do not result in significant changes in IOL power calculation in planned cataract surgery.
CHANGES IN OCULAR BIOMETRIC PARAMETERS AFTER RENAL TRANSPLANTATION
(2020) Aksoy, Mustafa; Asena, Leyla; Gungor, Sirel Gur; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet A.
Choroidal Thickness in Ocular Sarcoidosis during Quiescent Phase Using Enhanced Depth Imaging Optical Coherence Tomography
(2014) Gungor, Sirel Gur; Akkoyun, Imren; Reyhan, Nihan Haberal; Yesilirmak, Nilufer; Yilmaz, Gursel; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-2860-7424; https://orcid.org/0000-0001-9852-9911; https://orcid.org/0000-0002-8632-2873; https://orcid.org/0000-0002-2589-7294; 24912003; AAD-5967-2021; AAK-7713-2021; AAK-4587-2021; AAD-7299-2020; AAK-6987-2021
Purpose: To evaluate the choroidal thickness in patients with ocular sarcoidosis during quiescent phase using enhanced depth imaging optical coherence tomography (EDI-OCT) and comparing it with normal subjects. Method: Eighteen eyes of 9 patients with ocular sarcoidosis (8 women, 1 man, mean age: 59.12 +/- 18.49 years) were enrolled in this study. Their subfoveal choroidal thickness was measured using EDI-OCT in the quiescent phase of uveitis, and compared with the age-, sex-, and spherical equivalent-matched normal subjects (6 women, 3 men, mean age: 59.6 +/- 14.22 years). Results: The mean subfoveal choroidal thickness was 281.76 +/- 88.1 mm in patients with sarcoidosis and 342.32 +/- 71.02 mm in controls. Significant differences were found at points between nasal 1500 mm and temporal 1000 mm to the fovea between patients and control group (p = 0.002, at fovea). Conclusions: Patients with ocular sarcoidosis had thinner choroids in the quiescent phases when compared to normal subjects.
Circumferential Ciliary Body Cysts Presenting as Acute Pigment Dispersion and Ocular Hypertension
(2018) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Kiratli, Hayyam; Akman, Ahmet; 0000-0002-7030-5454; 0000-0001-6178-8362; 0000-0003-2100-4740; 28914584; AAJ-4860-2021; AAD-5967-2021
Purpose: To report a case of circumferential neuroepithelial cyst of the ciliary body presenting with pigment dispersion (PD) and ocular hypertension. Case report: 48-year-old female patient presented with a complaint of pain in the left eye. On examination, visual acuity of the left eye was 0.9, and the intraocular pressure was 48 mmHg. Biomicroscopic anterior segment examination of the left eye revealed 4+ pigmented cells in the anterior chamber. Active PD from the pupillary region at 11 o'clock was noticed at the time of the examination. Ultrasound biomicroscopy demonstrated 360o cystic lesions of the ciliary body in the left eye. The patient was diagnosed as neuroepithelial cyst of the ciliary body. Conclusion: Our case is unique as it is the first case of circumferential neuroepithelial ciliary body cyst presenting with acute PD and ocular hypertension.
The Clinical Characteristics of Pediatric Non-Infectious Uveitis in Two Tertiary Referral Centers in Turkey
(2019) Yalcindag, F. Nilufer; Gungor, Sirel Gur; Degirmenci, Mehmet Fatih Kagan; Sezenoz, Almila Sarigul; Ozcaklar, Zeynep Birsin; Baskin, Esra; Yalcinkaya, Fatma Fatos; Atilla, Huban; 31687865
Purpose: To report the manifestations, patterns of disease, treatment strategies and outcomes in pediatric patients with noninfectious uveitis. Methods: Demographic information of 76 cases was recorded. Symptoms, anatomic location, laterality, visual acuity (VA), intraocular pressure, associated systemic diseases, therapeutic strategies, side effects, complications were reviewed. Results: Thirty-one patients were diagnosed as uveitis on routine surveillance because of underlying systemic disease. The most common anatomic location was intermediate uveitis (34.2%). Juvenile idiopathic arthritis (JIA) was the most common underlying systemic disease (25%). Glaucoma was the most common complication (7.7%). The patients with refractory uveitis received adalimumab (26.5%), infliximab (4.6%) and tocilizumab (3.1%). The mean first-year VA was between 20/32 and 20/20 in 116/140 eyes. Conclusion: Most pediatric noninfectious uveitis cases have bilateral intermediate uveitis. JIA was the most common systemic association. The first-year VA was good in most eyes which may be due to early use of corticosteroid-sparing agents.
Comparison of intracameral dexamethasone and intracameral triamcinolone acetonide injection at the end of phacoemulsification surgery
(2014) Gungor, Sirel Gur; Bulam, Begum; Akman, Ahmet; Colak, Meric; 25230962
Purpose: To compare the results of intracameral dexamethasone and intracameral triamcinolone acetonide injection in patients that underwent cataract surgery with phacoemulsification. Materials and Methods: Sixty eyes of 60 patients that underwent cataract surgery with phacoemulsification were randomized into two groups. Preoperative visual acuity of all patients was 0.5 or lower and intraocular pressures were under 21mmHg. After surgery, eyes in group 1 (30 eyes) were injected with 0.4 mg/0.1 ml dexamethasone into the anterior chamber, and eyes in group 2 (30 eyes) were injected with 2 mg/0.05 ml triamcinolone acetonide into the anterior chamber. All eyes received standard postoperative prednisolone acetate and moxifloxacin eye drops. The biomicroscopic evaluation, visual acuity, and intraocular pressure measurements were done at baseline (preoperatively) and on postoperative days 1, 7 and 30. Results: There were no statistically significant differences in mean visual acuity, the amount of anterior cells and flare between the two groups (P >= 0.05). Mean intraocular pressure values at postoperative first day were significantly higher in group 2 than in group 1 (P = 0.009). The mean intraocular pressures on days 7 and 30 after surgery were not statistically different between the two groups (P >= 0.05). Conclusions: Intracameral dexamethasone and intracameral triamcinolone acetonide were similarly effective in controlling postoperative inflammation following phacoemulsification. However, the intraocular pressures on postoperative first day were higher in patients receiving intracameral triamcinolone acetonide. The highest intraocular pressure in triamcinolone acetonide group was 24 mmHg, and stabilized in a few days, therefore using triamcinolone acetonide may impose a minimal risk to patients. Nevertheless, intracameral dexamethasone seems to be a better alternative to apply at the end of surgery to suppress the inflammation during the first 24 hours.
Comparison of intracameral dexamethasone and intracameral triamcinolone acetonide injection at the end of phacoemulsification surgery Reply
(2015) Gungor, Sirel Gur; Bulam, Begum; Akman, Ahmet; Colak, Meric
Comparison of Keratometric Measurements Obtained by the Verion Image Guided System with Optical Biometry and Auto-Keratorefractometer
(2017) Asena, Leyla; Gungor, Sirel Gur; Akman, Ahmet; 0000-0002-6848-203X; 0000-0001-6178-8362; 27271763; E-5914-2016; AAD-5967-2021
The aim of this study was to compare the keratometric measurements of Verion Image Guided System with an optical biometer (Zeiss IOLMaster 500, Carl Zeiss Meditec, Jena, Germany) and an automated keratorefractometer (AKR) (Topcon KR-8900, Topcon, Japan). In this prospective clinical trial, the right eyes of 52 patients with cataract were examined (mean age 62.25 +/- 12.16 years). The measurements were taken by the three systems in a random order. Keratometric data, magnitude of astigmatism, and astigmatic axis measurements from all three instruments were compared. The results were evaluated using, intraclass correlation coefficients (ICC), Bland-Altman plots, and paired samples t tests. The mean flat/steep K of Verion, IOLMaster, and AKR were 43.22 +/- 1.38D/44.23 +/- 1.46D, 43.07 +/- 1.26D/44.05 +/- 1.34D, and 43.07 +/- 1.31D/43.89 +/- 1.42D, respectively. Flat K readings of Verion were higher than IOLMaster and AKR (p < 0.05 for both). Steep K readings were different for all three (p < 0.05). The magnitude of astigmatism by Verion and IOLMaster were 0.98 +/- 0.65D and 0.98 +/- 0.59D (p = 0.88). The mean astigmatism measured by the AKR was 0.82 +/- 0.62D, less than the other two instruments (p < 0.001). Astigmatic axis measurements of Verion and AKR differed < 10A degrees in 38, between 10A degrees and 20A degrees in 5, and > 20A degrees in 9 eyes; the same difference was 30, 11, and 11 eyes, respectively, between Verion and IOLMaster. Although, keratometric and astigmatic results obtained from Verion were not completely interchangeable with IOLMaster and AKR, especially the agreement between Verion and IOLMaster was excellent with ICCs close to one. However, there were pronounced astigmatic axis measurement differences between three instruments.
Comparison of Keratometry Obtained by a Swept Source OCT-Based Biometer with a Standard Optical Biometer and Scheimpflug Imaging
(2018) Asena, Leyla; Akman, Ahmet; Gungor, Sirel Gur; Altinors, Dilek Dursun; 0000-0001-5223-0279; 0000-0002-6848-203X; 0000-0001-6178-8362; 29630418; AAK-8077-2021; E-5914-2016; AAD-5967-2021
Purpose: To assess agreement of a swept source-optical coherence tomography (SS-OCT) based Biometer with a standard IOLMaster device and Scheimpflug Imaging (SI) to acquire keratometric measurements in cataract patients. Methods: In this prospective comparative study, 101 eyes of 101 cataract surgery candidates, aged 24-81years, were sequentially examined using three devices. Keratometry values at the flat (K1) and steep (K2) axis, mean corneal power (Km) and magnitude of corneal astigmatism as well as J0 and J45 vectoral components of astigmatism obtained with the SS-OCT based biometer (IOLMaster 700) were compared with those obtained with the IOLMaster 500 and SI. The agreement between measurements was evaluated by the Bland-Altman method, intraclass correlation coefficients (ICCs) and repeated-measures analysis of variance. Results: Mean K1 values from the three devices were similar (p=0.09). Mean K2 and Km values of IOLMaster 700 were higher than SI and lower than IOLMaster 500 (p=0.04 for K2 and p=0.02 for Km). There was a strong correlation between K1, K2, Km and magnitude of astigmatism obtained with all devices (r >= 0.80 and p<0.01). The 95% limits of agreement (LoA) width for each keratometric value were highest for the comparison between IOLMaster 500 and SI and lowest for the comparison between IOLMaster 700 and 500. The mean differences (width of 95% LoA) for J0 and J45 vectoral components were 0.005 (2.19) and 0.12 (2.92) for the measurements obtained by IOLMaster 700 vs IOLMaster 500 and 0.06 (1.79) and 0.02 (1.58) for the measurements obtained by IOLMaster 700 vs SI, respectively. Conclusions: With ICCs close to 1, the agreement between all devices was excellent for keratometric measurements. Mean K2, Km and astigmatism measurements from IOLMaster 700 were lower than IOLMaster 500 and higher than SI. However, the differences were quite small and are not expected to affect the final IOL power.
Comparison of refractive outcomes using Scheimpflug Holladay equivalent keratometry or IOLMaster 700 keratometry for IOL power calculation
(2021) Aksoy, Mustafa; Asena, Leyla; Gungor, Sirel Gur; Kucukoduk, Ali; Akman, Ahmet; 0000-0001-8024-4758; 33733281
Purpose This study aims to compare postoperative refractive error results using Pentacam (Oculus Optikgerate GmbH) Holladay equivalent keratometry readings (EKR) or IOLMaster 700 (Carl Zeiss Meditec AG) keratometry (K) values in IOL power calculation. Material and methods This retrospective study included 54 eyes of 31 patients who underwent cataract surgery. Preoperative biometric measurements of all patients were obtained using IOLMaster 700 followed by Pentacam measurements. IOLMaster 700 K measurements on horizontal (K1) and vertical (K2) axes and EKR measurements on 2 mm (EKR2mm), 3 mm (EKR3mm) and 4.5 mm (EKR4.5 mm) corneal zones were recorded. EKR4.5 mm value and IOLMaster 700 K values were used in Holladay-II, SRK/T, Haigis, and Hoffer-Q formulas to calculate predictive refractive error (PRE). Absolute refractive error (ARE) was calculated as the absolute difference between actual postoperative refractive error (APRE) and PRE values. Results Mean age was 72.2 +/- 8.3 (51-87) years and mean IOL power was 21.5 +/- 2.9 D (18-23 D). There was no significant difference between PRE values when IOLMaster 700 K measurements and EKR4.5 mm K measurements were used in Holladay-II, SRK/T, Haigis, and Hoffer-Q formulas (p = 0.571, p = 0.833, p = 0.165, p = 0.347, respectively). There was no significant difference between APRE and ARE values (p = 0.124). According to mean ARE results, the closest estimate was achieved when the IOLMaster 700 K values were used in the Holladay-II formula (p = 0.271). Conclusion IOLMaster 700 K measurement and Pentacam EKR4.5 mm measurements can be used interchangeably. IOLMaster 700 K values yielded the most predictive measurement of the refractive result using the Holladay-II formula.
Comparison of The Mechanical Properties of The Anterior Lens Capsule in Senile Cataract, Senile Cataract with Trypan Blue Application, and Pseudoexfoliation Syndrome
(2017) Simsek, Cem; Oto, Sibel; Yilmaz, Gursel; Altinors, Dilek Dursun; Akman, Ahmet; Gungor, Sirel Gur; https://orcid.org/0000-0001-8003-745X; https://orcid.org/0000-0003-0171-4200; https://orcid.org/0000-0002-2589-7294; https://orcid.org/0000-0001-5223-0279; https://orcid.org/0000-0001-6178-8362; 28917406; N-8970-2018; AAJ-4668-2021; AAK-6987-2021; AAK-8077-2021; AAD-5967-2021
Purpose: To evaluate the elastic modulus, hardness, and mechanical properties of the anterior lens capsule in different types of cataract and to assess the correlation with age. Setting: Baskent University Hospital, Department of Ophthalmology, Ankara, Turkey. Design: Prospective comparative study. Methods: Patients were divided into 3 groups. Group 1 comprised patients with senile cataract, Group 2 patients had pseudoexfoliation (PXF) syndrome, and Group 3 patients had dye-enhanced cataract surgery. The capsules were analyzed using a nanoindentation device. Young's modulus of elasticity was measured by the Oliver-Pharr method and capsule hardness by the Martens method. Results: The study comprised 72 patients, 24 per group. The mean Young's modulus was 7.53 GPa +/- 1.07 (SD) in Group 1, 6.01 +/- 1.25 GPa in Group 2, and 8.12 +/- 0.98 GPa in Group 3. The capsules in Group 2 were more elastic than in Group 1 and Group 3 (P < .001). The capsules in Group 3 had lower elasticity than in Group 1, although the difference was not significant (P = .94). The mean capsule stiffness was 326.41 +/- 98.40 MPa in Group 1, 210.5 +/- 52.32 MPa in Group 2, and 315.54 +/- 163.15 MPa in Group 3. The lens capsules in Group 2 were less stiff than those in Group 1 and Group 3 (P < .001). Conclusions: Capsule thickness was positively correlated with increasing age in all groups. The anterior lens capsules of patients with PXF had more elasticity and less stiffness than the other groups. Intracameral trypan blue application had no effect on capsule elasticity and stiffness. (C) 2017 ASCRS and ESCRS
Corneal, Scleral, Choroidal, and Foveal Thickness in Patients with Rheumatoid Arthritis
(2017) Akman, Ahmet; Gungor, Sirel Gur; Gokmen, Onur; Yesilirmak, Nilufer; Yucel, Ahmet Eftal; Yesil, Hilmi; Yildiz, Fatih; Sise, Adam; Diakonis, Vasilios; 29326847; I-6542-2012
Objectives: To investigate corneal, scleral, choroidal, and foveal thicknesses in female patients with rheumatoid arthritis (RA) and compare them with healthy subjects. Materials and Methods: This prospective study included consecutive female patients diagnosed with RA and healthy subjects. Corneal, scleral, choroidal, and retinal (foveal) thicknesses were obtained by using optical coherence tomography and a comparison was performed between groups for all outcome measures. Results: Thirty-six eyes of 36 female patients diagnosed with RA (group 1) and 36 eyes of 36 healthy female volunteers (group 2) were included. Mean corneal, scleral, choroidal thicknesses and retinal thickness at the fovea of group 1 were 543.3 +/- 33.7 mu m, 343.7 +/- 42.2 mu m, 214.6 +/- 50, and 213.5 +/- 18.9 mu m, respectively; in group 2, these values were 549.9 +/- 29.6 mu m, 420.9 +/- 42.4 mu m, 206.4 +/- 41.9 mu m, and 222 +/- 15.5 mu m, respectively. The comparison between group 1 and 2 with respect to corneal, choroidal, and foveal thicknesses did not reveal statistical significant differences (p>0.05). On the contrary, there was a statistically significant difference with respect to scleral thickness between the groups, with the RA patients demonstrating a thinner scleral layer (p<0.001). Conclusion: Female patients with RA seem to demonstrate statistically significant scleral thinning when compared with healthy subjects, while there was no difference concerning corneal, choroidal, and foveal thickness.
The Diagnostic Ability of Ganglion Cell Complex Thickness-to-Total Retinal Thickness Ratio in Glaucoma in a Caucasian Population
(2020) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Akman, Ahmet; Ozturk, Caner; Cezairlioglu, Sefik; Aksoy, Mustafa; Colak, Meric; 0000-0002-0294-6874; 0000-0002-7030-5454; 0000-0001-6178-8362; 0000-0003-1513-7686; 0000-0002-1507-8148; 32167260; AAA-4360-2021; AAJ-4860-2021; AAD-5967-2021
Objectives: To evaluate the diagnostic accuracy of the macular ganglion cell complex-to-total retinal thickness (G/T) ratio in a Caucasian population. Materials and Methods: A total of 86 patients were enrolled in this cross-sectional study. Patients were divided into 4 groups: healthy; ocular hypertension; preperimetric glaucoma; and early glaucoma. Macular ganglion cell complex (mGCC) thickness, total retinal thickness, and retinal nerve fiber layer thickness (RNFLT) in one randomly selected eye of each patient were measured with measured with Heidelberg HD spectral domain optical coherence tomography (Heidelberg Engineering, Inc., Heidelberg, Germany). G/T ratio (%) was calculated as (mGCC thickness / total retinal thickness) x100. The ability of each parameter to diagnose glaucoma was examined by area under the receiver operating characteristic curve (AUROC) analysis and sensitivity evaluation at a fixed level of specificity. Unpaired t test was used to compare the measured values between the healthy subjects and the different patient groups. Results: The study included 9 healthy individuals, 18 patients with ocular hypertension, 28 with preperimetric glaucoma, and 31 with early glaucoma. Total retinal thickness, mGCC thickness, RNFLT, and G/T ratio were highest in the healthy group and decreased progressively in patients with ocular hypertension, preperimecric glaucoma, and early glaucoma. All comparisons between the groups were significant for these parameters (p<0.001 for all). Average RNFLT, average GCC, and total retinal thickness showed consistently higher AUROC than G/T ratio in the differentiation between healthy individuals and patients with ocular hypertension, preperimetric glaucoma, and early glaucoma. Conclusion: G/T ratio does not contribute to separation of ocular hypertension, preperimetric glaucoma, and early glaucoma patients from the healthy population. Compared to the other parameters investigated, G/T had lower diagnostic value
A diagnostic dilemma in a patient with delayed onset endophthalmitis
(2019) Ercan, Zeynep Eylul; Akkoyun, Imren; Gungor, Sirel Gur; Yilmaz, Gursel; 0000-0001-6178-8362; 0000-0002-9915-3781; 30930672; AAD-5967-2021; AAQ-3136-2020
We report a case of nonpainful uveitis nine months after an uncomplicated phacoemulsification cataract surgery. Chronic postoperative endophthalmitis was suspected. Diagnostic vitrectomy and partial capsular bag removal was performed, but the specimens cultured in microbiology laboratory showed no pathogens. Systemic workup came positive for skin Tuberculosis test, and presumed intraocular tuberculosis treatment was started accordingly. Inflammation persisted, so a repeat vitrectomy was performed with removal of the lens implant with the capsule, and this time bedside culture inoculation was performed in operating room, revealing Pseudomonas infection. Delayed-onset postoperative endophthalmitis typically progresses slowly and therefore can be confused with uveitis and treated with steroid and immunosuppressant treatment regimes. Our case confirms both the value of immediate bacterial inoculation and the necessity of aggressive surgical treatment in chronic postoperative endophthalmitis cases.
Evaluation and comparison of the new swept source OCT-based IOLMaster 700 with the IOLMaster 500
(2016) Akman, Ahmet; Asena, Leyla; Gungor, Sirel Gur; 0000-0001-6178-8362; 0000-0002-6848-203X; 26674777; AAD-5967-2021; E-5914-2016
Purpose To compare the measurements and failure rates obtained with a new swept source optical coherence tomography (OCT)-based biometry to IOLMaster 500. Setting Eye Clinic, Baskent University Faculty of Medicine, Ankara, Turkey. Design Observational cross-sectional study and evaluation of a new diagnostic technology. Methods 188 eyes of 101 subjects were included in the study. Measurements of axial length (AL), anterior chamber depth (ACD), corneal power (K1 and K2) and the measurement failure rate with the new Zeiss IOLMaster 700 were compared with those obtained with the IOLMaster 500. The results were evaluated using Bland-Altman analyses. The differences between both methods were assessed using the paired samples t test, and their correlation was evaluated by intraclass correlation coefficient (ICC). Results The mean age was 68.3212.71years and the male/female ratio was 29/72. The agreements between two devices were outstanding regarding AL (ICC=1.0), ACD (ICC=0.920), K1 (ICC=0.992) and K2 (ICC=0.989) values. IOLMaster 700 was able to measure ACD AL, K1 and K2 in all eyes within high-quality SD limits of the manufacturer. IOLMaster 500 was able to measure ACD in 175 eyes, whereas measurements were not possible in the remaining 13 eyes. AL measurements were not possible for 17 eyes with IOLMaster 500. Nine of these eyes had posterior subcapsular cataracts and eight had dense nuclear cataracts. Conclusions Although the agreement between the two devices was excellent, the IOLMaster 700 was more effective in obtaining biometric measurements in eyes with posterior subcapsular and dense nuclear cataracts.