Browsing by Author "Oto, Sibel"

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Antiproliferative and Mitochondrial Protective Effects of Apigenin in an Oxygen-Induced Retinopathy In Vivo Mouse Model
(2021) Sezenoz, Almila Sarigul; Akkoyun, Imren; Helvacioglu, Fatma; Haberal, Nihan; Dagdeviren, Attila; Bacanli, Didem; Yilmaz, Gursel; Oto, Sibel; 0000-0002-2860-7424; 34665015; AAK-7713-2021
Purpose: To investigate the effects of a common dietary flavonoid apigenin on retinal endothelial cell proliferation, retinal morphological structure, and apoptotic cell death in an oxygen-induced retinopathy (OIR) mouse model to evaluate the possibility of the use of apigenin in the treatment of ocular neovascular diseases (ONDs). Methods: Ninety-six newborn C57BL/6J mice were included. Eight groups were randomized, each including 12 mice. Two negative control groups were kept in room air: the first without any injection and the second received intravitreal (IV) dimethyl sulfoxide (DMSO), which is the solvent we used. The OIR groups were exposed to 75% +/- 2% oxygen from postnatal days (PD) 7 to 12. On PD 12, the mice were randomly assigned to 6 groups: 2 OIR control groups (1 received no injection, 1 received IV-DMSO), 2 IV-apigenin groups (10 and 20 mu g/mL), and 2 intraperitoneal (IP)-apigenin groups (10 and 20 mg/kg). We quantified retinal endothelial cell proliferation by counting neovascular tufts in cross-sections and examined histological and ultrastructural changes through light and electron microscopy. We evaluated apoptosis by terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL). Results: We detected a significant increase in endothelial cell proliferation in the OIR groups. Groups receiving apigenin, both IP and IV, had significant decreases in endothelial cells, atypical mitochondrion count, and apoptotic cells compared with the groups receiving no injections. None of the apigenin-injected groups revealed cystic degeneration or cell loss. Conclusions: Apigenin suppresses neovascularization, has antiapoptotic and antioxidative effects in an OIR mouse model, and can be considered a promising agent for treating OND. Clinical trial (Project number: DA15/19).
A Case of Multiple Sclerosis Presented with 5th, 6th and 7th Cranial Nerve Paralysis
(2015) Sarıgul, Almila; Bayar, Sezin Akca; Singar, Evin; Pinarci, Eylem Yaman; Oto, Sibel
A 36-year-old female patient was admitted to our clinic with complaints of numbness in hands, double vision, and inability to close her left eye. Her physical examination revealed horizontal diplopia, underactivity of the left lateral rectus muscle, left peripheral facial paralysis, and trigeminal sensorial neuropathy. The magnetic resonance imaging revealed hyperintense lesions, which were compatible with multiple sclerosis (MS). Therefore, systemic steroid treatment (1000 mg/day intravenous methylprednisolone for 5 days, 1 mg/kg/day oral prednisolone, reduced slowly) was administered to the patient. Within five weeks, her symptoms were regressed, and no recurrence was observed during the follow-up period of 4 years. As this case proves, MS can present with cranial nerve palsies in addition to many other different neurological symptoms. Although 5th nerve palsy is the most common cranial nerve palsy detected in MS patients, 7th and 6th nerve involvement are rarely reported in the literature. MS should always be considered in the differential diagnosis of cranial nerve palsies especially in young patients.
Clear Lens Phacoemulsification in Alport Syndrome: Refractive Results and Electron Microscopic Analysis of The Anterior Lens Capsule
(2014) Bayar, Sezin Akca; Pinarci, Eylem Yaman; Karabay, Gulten; Akman, Ahmet; Oto, Sibel; Yilmaz, Gursel; https://orcid.org/0000-0001-5109-755X; https://orcid.org/0000-0003-0171-4200; https://orcid.org/0000-0002-2589-7294; 24170525; AAJ-2406-2021; AAJ-4668-2021; AAK-6987-2021
Purpose: To report the ocular findings of patients with Alport syndrome and the results of clear lens extraction in this patient group. Methods: Twenty-three eyes of 15 patients with a diagnosis of Alport syndrome were included in this study. Clear corneal phacoemulsification and intraocular foldable lens implantation was performed in eyes with indeterminate refractive errors and/or poor visual acuity and anterior capsule samples were analyzed with electron microscopy. Results: All patients had a history of hereditary nephritis and/or deafness as systemic involvement. Ophthalmologic examination revealed anterior lenticonus with high myopia and/or irregular astigmatism in all patients. The mean best-corrected visual acuity (BCVA) was 0.67 +/- 0.17 logMAR (range 1.0-0.4) preoperatively and 0.17 +/- 0.08 logMAR (range 0.3-0.0) postoperatively. Postoperative refractive lenticular astigmatism dramatically decreased and no ocular complications arose during the follow-up period. Transmission electron microscopic analysis of the lens capsules supported the diagnosis of Alport syndrome. Conclusions: Clear lens phacoemulsification and foldable intraocular lens implantation is a safe and effective therapeutic choice for the management of uncorrectable refractive errors and low visual acuity due to anterior lenticonus in patients with Alport syndrome.
Clinical outcomes of deep anterior lamellar keratoplasty (DALK) in keratoconus patients.
(2019) Altinors, Dilek Dursun; Asena, Leyla; Oto, Sibel
Clinical Spectrum of Ocular and Visual Dysfunction in Children with Periventricular Leukomalacia: A Need for an Interdisciplinary Approach
(2021) Ozturker, Zeynep Kayaarasi; Bayar, Sezin Akca; Oto, Sibel; Aksoy, Sibel; Akkoyun, Imren; Sezer, Taner; 0000-0001-5109-755X; 0000-0003-0171-4200; 0000-0003-1395-6207; 0000-0002-2860-7424; AAJ-2406-2021; AAJ-4668-2021; AAK-7713-2021
The study aimed to evaluate the ocular motility and visual and optic disc abnormalities in children diagnosed with periventricular leukomalacia (PVL). A retrospective analysis was performed on 51 consecutive children who had ophthalmic symptoms and were diagnosed with PVL by using magnetic resonance imaging. The patients were assessed for visual function, strabismus, cycloplegic refraction, fundus examination, and if appropriate, spectral-domain optical coherence tomography and visual field testing were applied. The primary outcome measures were the prevalence and visual and ocular motility dysfunctions. Mean age was 5.72 +/- 2.6 years (range = 1-12), median birth weight was 2,740 g (range =1,240-3,460), and median gestational age was 34 weeks (range = 28-38). In total, 21 patients (39.6%) had neurological deficit, 11 (21.5%) had intellectual disability, and 19 (37.2%) had no neurological symptom. In the spherical equivalent refractive error and cylinder power analysis, 10 patients had >= 3.0 D myopia, 15 had >= 3.0 D hyperopia, and eight had >= 2.50 D astigmatism. Thirteen (25.4%) children had a best-corrected visual acuity between 20/40 and 20/20 for Snellen card, while 9 (17.6%) had strabismic amblyopia and 6 (11.7%) had anisometropic amblyopia. Manifest strabismus was present in 35 patients (68.6%); of whom 12 had esotropia (23.5%), 16 had exotropia (31.3%) and 6 had vertical deviation (11.7%). Manifest or latent nystagmus was detected in 14 patients (27.4%). In 28 patients (54.9%), there was optic nerve abnormality. Two patients had hypoplastic disc, 14 had optic disc pallor, 7 had large cupping, and 5 had total optic atrophy. Six subjects underwent reliable visual field (VF) examinations, and all six had abnormal VFs, with inferior fields being most affected. Ocular motility disorders, optic nerve abnormalities, VF defects, and low visual acuity are common findings in this cohort of PVL patients and maybe the only presenting signs of the disease. The recognition of the visual disabilities and implementation of early rehabilitation may have a significant benefit in these children.
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
Comparison of Visual Performance and Quality of Life with A New Nondiffractive EDOF Intraocular Lens and A Trifocal Intraocular Lens
(2023) Asena, Leyla; Dogan, Irem Kirci; Oto, Sibel; Altinors, Dilek Dursun; 0000-0003-0171-4200; 0000-0002-6848-203X; 0000-0002-5574-7318; 36700928; AAJ-4668-2021; E-5914-2016
Purpose: To compare visual performance and quality of life (QoL) following bilateral implantation of a new nondiffractive extended depth-of-focus (EDOF) intraocular lens (IOL) and a trifocal IOL. Setting: Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey. Design: Prospective comparative interventional case series. Methods: 104 eyes of 52 patients with cataract, bilaterally implanted with a nondiffractive EDOF IOL or a trifocal IOL, were included. Outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), distance corrected intermediate visual acuity and distance corrected near visual acuity, defocus curves, QoL (Visual Function Index 14), quality of vision (Quality of Vision [QoV] index), contrast sensitivity (Pelli-Robson chart), and binocular reading speed. Results: Twenty-six patients were included in each group. The UDVA and CDVA were better in the EDOF group (0.05 +/- 0.04 and 0.01 +/- 0.04) than the trifocal group (0.13 +/- 0.06 and 0.11 +/- 0.07) (P=.02 and .01). Defocus curves showed that visual acuity was better with the EDOF IOL for vergences at 0.00, -0.50, and -1.00 and better with the trifocal IOL for vergences at -2.50, -3.00, -3.50, and -4.00. Contrast sensitivity scores were similar with both IOLs (P=.12). The overall mean QoL scores were lower in the EDOF group, indicating a better QoL (P=.04). The QoV was better in the EDOF group with significantly less glare, halos, and blurry vision (P<.01). Conclusions: The EDOF IOL performed better at distance, and the trifocal IOL performed better at near. Overall QoL and quality of vision were better with the EDOF IOL. Copyright (c) 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS
Contrast Sensitivity in Microtropic and Anisometropic Eyes of Successfully Treated Amblyopes
(2017) Bayar, Sezin Akca; Oner, Ozlem; Oto, Sibel; Gokmen, Onur; Tekindal, Mustafa Agah; 0000-0003-0171-4200; 0000-0002-6058-4226; 0000-0002-4060-7048; 0000-0001-5109-755X; 28405480; AAJ-4668-2021; AAB-1096-2021; U-9270-2018; AAJ-2406-2021
Objectives: To assess and compare contrast sensitivity function in the previously amblyopic and non-amblyopic "normal" eyes of patients with microtropia and anisometropia who achieved 20/20 visual acuity after occlusion therapy. Materials and Methods: Contrast sensitivity was tested monocularly on both eyes of 34 successfully treated microtropic and 15 anisometropic subjects (visual acuity 20/20 in both eyes). Contrast sensitivity function was evaluated by CSV-1000E and age-matched nomograms were used (spatial frequencies of 3, 6, 12, and 18 cycles per degree [cpd]) for comparison. Results: The mean age of subjects was 11.2 +/- 1.3 years in the microtropic group, 9.8 +/- 1.7 years in the anisometropic group (7-12 years); the mean follow-up time was 16.4 +/- 3.2 months (12 to 92) in the microtropic group and 27.7 +/- 1.8 months (12-84) in the anisometropic group. Statistical comparison of the microtropic amblyopic eyes versus non-microtropic eyes showed significant differences at spatial frequencies of 3, 12 and 18 cpd (3 cpd, t= 2.8, p= 0.007; 6 cpd, t= 1.1 p= 0.261; 12 cpd, t= 2.2, p= 0.033; 18 cpd, t= 2.2, p= 0.030). When anisometropic eyes were compared with non-anisometropic eyes, there was a significant difference only at 12 cpd (t= 2.1 p= 0.049). The comparison of non-amblyopic eyes versus age-matched nomograms revealed no differences at any of the spatial frequencies (p> 0.05 for all). Conclusion: Contrast sensitivity was decreased in patients with amblyopia, especially in the microtropic group. The assessment of contrast sensitivity function may serve as a new parameter for termination of occlusion therapy.
Customizing Illumination by the Operating Microscope Aids the Visualization of DMEK Grafts
(2018) Altinors, Dilek Dursun; Asena, Leyla; Yilmaz, Gursel; Oto, Sibel; 0000-0001-5223-0279; 0000-0002-2589-7294; 0000-0003-0171-4200; AAK-8077-2021; AAK-6987-2021; AAJ-4668-2021
Değişik katarakt tiplerinde nano indentasyon ile ön lens kapsülünün elastik modülüs özellikleri ve kapsül morfolojisinin değerlendirilmesi
(Başkent Üniversitesi Tıp Fakültesi, 2014) Şimşek, Hüseyin Cem; Oto, Sibel
Bu çalışmada nano indentasyon cihazı kullanılarak, katarakt dışında herhangi bir oküler patolojisi olmayan, psödoeksfoliasyon sendromu olan ve ön kameraya tripan mavisi verilen olgularda lens ön kapsülünün elastik modülüs ve sertlik gibi mekanik özelliklerinin değerlendirilmesi aynı zamanda bu değerlerin yaşla korelasyonunun ölçülmesi amaçlanmıştır. Ayrıca tarayıcı elektron mikroskop ile bu 3 grupta kapsül kalınlığının ölçülerek karşılaştırılması hedeflenmiştir. Ocak 2014 ve Haziran 2014 tarihleri arasında Başkent Üniversitesi Tıp Fakültesi Göz Bölümü’nde normal senil katarakt tanısıyla opere edilen (grup1) psödoeksfoliasyonu olan hastalar (grup2) ve ön kamarada kapsül boyası olarak tripan mavisi(TM) (0,06% Blue Rhexis) verilen (grup3) 3 grup oluşturulmuştur. Her grupta 24 olgu olmak üzere toplam 72 ol yer almaktadır. Hastaların katarakt operasyonu sırasında çıkarılan ön lens kapsülleri çalışmaya alınmıştır. Çalışmaya alınan hastalarda gözde katarakt dışında ek patoloji, göze herhangi bir ilaç uygulaması ve sistemik herhangi bir hastalık bulunmamaktadır. CSM instrument nanoindentasyon tester cihazı kullanılarak Oliver & Pharr metodu ile esneklik, Martens Hardness metodu ile sertlik değerlendirilmiştir. Buna ek olarak FEI Quanta 400F Tarayıcı elektron mikroskop (SEM) kullanılarak kapsül kalınlıkları ölçülmüştür. Yaş ve cinsiyet bakımından gruplar arasında istatistiksel olarak anlamlı farklılık görülmedi (p= 0,997). FEI Quanta 400F Tarayıcı elektron mikroskop (SEM) kullanılarak kapsül kalınlığı açısından değerlendirildiğinde katarakt dışında herhangi bir oküler patolojisi olmayan hastalar grubunun kapsül kalınlığı ortalaması 18.19±2.18 μm, psödoeksfoliasyon sendromu olan olgular grubunda 18.41±2.64 μm, katarakt operasyonu sırasında kapsül boyası kullanılan grupta ise 18.36±1.95 olarak ölçüldü. Kapsül kalınlığı açısından bakıldığında üç grup arasında istatistiksel olarak anlamlı fark tespit edilmedi (p=0,975). Nano indentasyon tester cihazı ile Oliver & Pharr metodu kullanılarak yapılan Young’s modülüs ölçümlerde grup 1 de ön kapsül esneklikortalaması 7.53±1.07 GPa, grup 2de ortalama 6.007±1.25 GPa, grup 3 te iseortalama 8.12±0.98 GPa olarak ölçüldü. Psödoeksfoliasyon sendromu olan olgular grubu diğer iki gruptanda anlamlı derecede esnekliği fazla olarak ölçüldü (p=0.000). TM kullanılan grupta kapsül esnekliği normal gruptan daha az bulundu ancak bu istatistiksel olarak anlamlı değildi (p=0,942). Nano indenter ile ön kapsül sertliği ölçümlerinde grup 1 de kapsül sertliği ortalama 326.41±98.40 MPa, grup 2 de 210,5±52.32 MPa, grup 3 de ise ortalama 315.54±163.15 MPa olarak ölçüldü. Psödoeksfoliasyon sendromu olan olgular grubunda kapsül sertliği diğer iki gruptan anlamlı derecede az olarak saptandı (p<0.01). TEM kullanılarak ölçülen ön lens kapsül kalınlık değerlerine bakıldığında 3 grup arasında kapsül kalınlığı açısından anlamlı fark görülmezken yaşla olan korelasyonunda yaş artışıyla birlikte kapsül kalınlığında da artış saptanmıştır. Nano indenter kullanılarak ön lens kapsülü sertlik ve esneklik değerlerine bakıldığında ise psödoeksfoliasyonlu kapsülü olan hastalar grubunun normal hasta grubuna ve TM kullanılan hasta grubuna göre esnekliğinin daha fazla sertliğinin ise daha az olduğu bulunmuştur. TM kapsül sertliğini arttıran ve esnekliği azaltan bir faktör olarak bulunmadı.
Deneysel ayarlanabilir sütür ile şaşılık cerrahisi modelinde suramin, genistein ve duragen bariyer matriksin mekanik, immünhistokimyasal ve histopatolojik etkileri
(Başkent Üniversitesi Tıp Fakültesi, 2007) Öktem, Çağlar; Oto, Sibel
Ayarlanabilir sütür cerrahisi ile ilgili araştırmalarda temel hedeflerden biri dokuda fibrozis ve yapışıklıkları engellemek ve ayarlanabilirlik süresini arttırmaktır. Geç dönemdeki ayarlamalarda sonucun daha stabil olduğu düşünülmektedir. Çalışmamızda şaşılık cerrahisinde ayarlanabilir sütür uygulamasında fibrozis ve enflamasyonun önlenmesi ve ayarlamanın geciktirilebilmesi için antifibrotik bir ajan olan suramin, antiadeziv ve antiproliferatif özellikte olan genistein ve mekanik bariyer oluşturan selüler matriks (DuraGen) kullanılmıştır. Bu amaçla, 18 Yeni Zelanda albino tavşanının 36 gözünde ayarlanabilir sütür tekniği kullanılarak üst rektus kasına geriletme yapılmıştır. Kas ve komşu dokular arasında yapışıklığın önlenebilmesi amacıyla suramin (250 mg / ml), genistein (0,5 mg / ml) ve DuraGen bariyer matriks (1 x 0,5 cm büyüklük ve 0,2 mm kalınlıkta) üst rektus kasının üst ve alt yüzeyine uygulanmış ve bunların mekanik, histopatolojik ve immünohistokimyasal etkileri incelenmiştir. Bu üç çalışma grubuyla karşılaştırılmak üzere iki kontrol grubu oluşturulmuştur. Bu kontrol gruplarından birisinde genistein preparatının çözücüsü olduğu için olası çapraz etkiyi gözlemek amacı ile dimetilsülfoksit (DMSO) kullanılmış, diğer kontrol grubunda ise herhangi bir ilaç kullanılmadan serum fizyolojik (SF) ile yıkama yapılarak üst rektus kasına 5 mm geriletme işlemi uygulanmıştır. Cerrahi işlem yapıldıktan sonra 2, 7, 14 ve 21. günlerde ayarlama sırasında kasın hareket miktarı ölçülmüş, kas çekilirken uygulanan kuvvet düzeyleri, kas ve sklera dokuları ile kas ve konjonktiva dokuları arasında oluşan yapışıklık düzeyi derecelendirilerek kaydedilmiştir. Yirmibirinci günde tüm gözlere enükleasyon yapılmış, kas, komşu sklera ve konjonktivayı içeren dokular, histopatolojik ve immünhistokimyasal inceleme için % 10 formaldehit solüsyonuna konulmuştur. Hematoksilen eosin (HE) boyası kullanılarak histopatolojik inceleme yapılmış, immünohistokimyasal incelemede ise VEGF, MAC 387, TGF-β, b-FGF ekspresyonları araştırılmıştır. Mekanik inceleme sonuçları değerlendirildiğinde, kas-sklera ve kaskonjonktiva dokuları arasındaki yapışıklığın tüm gruplarda süreyle birlikte arttığı görülmüştür. Genistein grubundaki bir göz dışında 14. günde tüm gruplardaki gözlere ayarlama yapmak mümkün olmuştur. Yirmibirinci günde DuraGen grubundaki tüm gözlere ayarlama yapılabilirken, suramin grubunda 3 göze ayarlama yapılmış, diğer gruplarda üst rektus kasını hareket ettirmek mümkün olmamıştır. Kas-konjonktiva dokuları arasındaki yapışıklığın gruplar arasındaki karşılaştırılmasında 2 ve 7. günde anlamlı fark bulunmuştur. Bu fark, suramin ve DuraGen gruplarındaki yapışıklığın az olmasından kaynaklanmıştır. Kas-sklera dokuları arasındaki yapışıklık 2. ve 7. günde istatistiksel olarak anlamlı fark göstermiş, bu farkın hem 2, hem de 7. günde genistein ve DMSO gruplarında yapışıklığın az olmasından kaynaklandığı saptanmıştır. Kas çekilirken uygulanan kuvvet düzeyleri incelendiğinde 14 ve 21. günlerde farkın anlamlı olduğu görülmüştür. Bu fark, 14. günde suramin ve duragen gruplarında, 21. günde ise duragen grubunda kası çekmek için gereken kuvvet miktarının düşük olmasından kaynaklanmıştır. HE ile yapılan histopatolojik incelemede dev hücre sayısının sadece genistein grubunda kontrol grubundan anlamlı olarak az olduğu görülmüştür. İmmünohistokimyasal incelemede ise suramin ve genistein gruplarında VEGF, MAC 387, TGF-β ve b-FGF ekspresyonunun anlamlı olarak az olduğu saptanmıştır. DuraGen grubunda da kas içinde damar endoteli ve stromal yangısal infiltratta b-FGF ekspresyonu ve stromal yangısal infiltratta VEGF ekspresyonu SF kontrol grubundan anlamlı düzeyde düşük bulunmuştur. Çalışmamızın sonucunda suramin ve genisteinin cerrahi sahada fibrotik cevabı belirgin azalttığı görülmüştür, ancak selüler bariyer matriks olarak kullanılan DuraGen en etkin şekilde geç dönem ayarlamaya olanak sağlamıştır. One of the main goals of investigation about adjustable suture surgery has been to prevent adhesions and fibrosis in surgical tissue, and to increase the period before adjustment procedure. The results of delayed adjustment have been considered as more stabile. In our study, suramin an antifibrotic agent , genistein an agent with antiadhesive and antiproliferative features, and a cellular matrix (DuraGen) which constitutes a mechanical barrier and hold apart the tissues were used in adjustable suture surgery to prevent fibrosis and inflammation, reduce scarring and to delay adjustment procedure. For this purpose, using adjustable suture technique, 5 mm recession of superior rectus muscle has been performed in 36 eyes of 18 New Zealand albino rabbits. Suramin (250 mg/ml), genistein (0,5 mg/ml) and DuraGen barrier matrix (1 x 0,5x0,2 cm dimensions) has been applied over and under the surface of superior rectus muscle to prevent adhesions between the muscle and surrounding tissues and their mechanical, histopathological and immunohistochemical effects have been investigated. Two control groups have been designed, one with DMSO, the solvent of genistein solution, and the second control group has been constituted by only rinsing the surgical area by SF. After surgery the necessary force to adjust and the length of adjustment was measured on days 2, 7, 14 and 21, and the degree of adhesion between the muscle, sclera and conjunctiva were graded on a 0 to 4+ scale. Enucleation was done in all eyes at the twenty-first day, tissues containing muscle, adjacent sclera and conjunctiva were placed into % 10 formaldehyde solution for histopathological and immunohistochemical investigation. Histopathological investigation was done by using hematoksilen eosin (HE) staining, and VEGF, MAC 387, TGF-β, FGF expressions were investigated by immunohistochemical stains. Histopathological investigation with HE displayed significantly less number of giant cells in genistein group compared with control groups. In immunohistochemical investigation suramin and genistein groups revealed significantly less tissue expressions of VEGF, MAC 387, TGF-β and b-FGF. However, in DuraGen group b-FGF expression in vascular endothelial cells within muscle tissue and in stromal infiltrative cells and VEGF expression in stromal infiltrative cells were also found lower than SF control group. When mechanical results were evaluated, adhesions between muscle-sclera and muscle-conjunctiva tissues in all groups displayed a progressive increase during the observational time period. It has been possible to make adjustment in all eyes except one eye in genistein group on day 14. On day 21 all eyes in DuraGen group and 3 eyes in suramin group could be adjusted however it was not possible to move superior rectus muscle in other groups. When the amount of force necessary for adjustment was evaluated a significant difference was observed between the groups on days 14 and 21. This difference was exerted by Suramin and DuraGen groups on day 14 and DuraGen group on day 21 where less force was required for adjustment. When the groups were compared for muscle-conjunctiva and muscle-sclera adhesions Suramin and DuraGen groups displayed significantly less muscleconjunctiva adhesions on days 2 and 7 and Genistein and DMSO groups revealed substantially less muscle-sclera adhesions on days 2 and 7. The difference between groups was not different on days 14 and 21. In conclusion suramin and genistein induced a significant decrease in fibrotic reaction in surgical area, however DuraGen constituting a cellular barrier matrix provided the longest period for delayed adjustment.
Descemet's Membrane Endothelial Keratoplasty (DMEK): 6-Month Clinical Outcomes
(2018) Altinors, Dilek Dursun; Asena, Leyla; Yilmaz, Gursel; Oto, Sibel; 0000-0001-5223-0279; 0000-0002-2589-7294; 0000-0003-0171-4200; AAK-8077-2021; AAK-6987-2021; AAJ-4668-2021
THE EFFECT OF CORNEAL TRANSPLANTATION ON VISUAL FUNCTION AND VISION-RELATED QUALITY OF LIFE
(2020) Asena, Leyla; Altinors, Dilek Dursun; Oto, Sibel
LIMBAL STEM CELL TRANSPLANTATION FOR RESTORATION OF THE OCULAR SURFACE HEALTH IN BILATERAL LIMBAL STEM CELL DEFICIENCY
(2020) Altinors, Dilek Dursun; Asena, Leyla; Oto, Sibel
Macular Imaging Characteristics in Children with Myelinated Retinal Nerve Fiber and High Myopia Syndrome
(2023) Sezenoz, Almila Sarigul; Oto, Sibel; Akkoyun, Imren; Bayar, Sezin Akca; Yilmaz, Gursel; Colak, Meric Yavuz; 0000-0003-0171-4200; 0000-0002-2860-7424; 0000-0001-5109-755X; 0000-0002-7030-5454; 0000-0002-0294-6874; 37602641; AAJ-4668-2021; AAK-7713-2021; AAJ-2406-2021; AAJ-4860-2021; AAA-4360-2021
Objectives: To investigate the macular imaging features in patients with unilateral myelinated retinal nerve fiber (MRNF) and high myopia syndrome. Materials and Methods: Six patients with unilateral MRNF and high myopia syndrome and 13 myopic controls were enrolled in this study. Spectral domain (SD) optical coherence tomography (OCT), SD enhanced depth imaging OCT, and OCT angiography (OCTA) imaging results of MRNF-affected eyes were compared with the fellow eyes and myopic controls. Results: All patients had abnormal foveal reflex and/or ectopia. No significant difference in retinal thickness parameters were noted between the groups. In OCT scans, posterior vitreous detachment (PVD) was observed in 4 out of the 6 MRNF-affected eyes. Regarding OCTA parameters, only a significant increase in acircularity index was noted in myelinated eyes (p=0.01). Conclusion: All patients demonstrated normal foveal contours, macular structure, and OCTA features except for a higher acircularity index. The incidence of PVD was notably increased in the myelinated eyes.
Macular Vessel Density Measurement in Pediatric Renal and Liver Transplant
(2022) Sezenoz, Almila Sarigul; Tortumlu, Gokhan; Akkoyun, Imren; Oto, Sibel; Haberal, Mehmet; 0000-0002-2860-7424; 0000-0002-3462-7632; 0000-0003-0171-4200; 0000-0002-7030-5454; 35570609; AAK-7713-2021; AAJ-8097-2021; AAJ-4668-2021; AAJ-4860-2021
Objectives: Microcirculatory dysfunction is known to be associated with organ failure and increased mortality in transplant patients. Noninvasive monitorization of retinal structures of the eye could be a predictor for systemic microvasculature in these patients. Therefore, in this study we aimed to evaluate the retinal microvascular changes in pediatric patients who had undergone liver or renal transplant surgery, using optical coherence tomography angiography. Materials and Methods: The medical records of pediatric patients who had liver or renal transplant in the past 10 years were reviewed. The macular vessel density parameters were obtained by optical coherence tomography angiography (Avanti RTVue XR). The results were compared with the age-matched, sex-matched, and spherical equivalent-matched healthy participants (control group). The IBM SPSS (version 25.0) statistics program was used for data analysis. Results: We included 32 eyes of 16 liver transplant patients, 20 eyes of 10 renal transplant patients, and 64 eyes of 32 healthy participants (control group). Superficial macular whole image, superficial perifoveal, and deep foveal vessel densities were found to be lower in the liver transplant group compared with the healthy control group (P = .02, P = .01, and P = .01, respectively). Superficial foveal, deep macular whole image, deep foveal, and deep perifoveal vessel densities were found to be lower in the renal transplant group compared with the healthy control group (P = .03, P = .04, P = .01, and P = .02, respectively). Conclusions: Macular vessel density measurements are affected in pediatric renal and liver transplant patients. In those patients, retinal optical coherence tomography and optical coherence tomography angiography measurements may provide a noninvasive window to the microcirculation.
Refractive Change in Pediatric Patients with Intermittent Exotropia
(2023) Oruz, Oguzhan; Pelit, Aysel; Akar, Serpil; Ates, Eylem Gul; Oto, Sibel; 0000-0002-4771-4698; 37730159; U-5246-2018
PURPOSE To determine the relationship between intermittent exotropia (IXT) and refractive change and the effects of the methods applied in IXT follow-up on refractive change.METHOD The medical records of 228 patients with IXT (group 1) and 110 patients without strabismus (group 2) who were followed between 2008 and 2022 were analyzed retrospectively. Group 1 was divided into three subgroups: overminus correction (group 1A), patients who underwent surgery (group 1B), and patients who were observed (group 1C).RESULTS Annual myopic progression was-0.21 +/- 0.32 D (range,-1.26 to +1.92) in group 1 and -0.07 +/- 0.30 D (range,-1.13 to +1.00) in group 2 (P < 0.001). Annual myopic progression was-0.26 +/- 0.29 D (range,-1.26 D to +0.12 D) in group 1A,-0.25 +/- 0.35 D (range, -1.15 D to +0.25 D) in group 1B, and-0.19 +/- 0.33 D (range,-1.12 D to +1.92 D) in group 1C. There was no difference in annual myopic progression between the subgroups (P = 0.670). The annual change in myopic refraction between each of the group 1 subgroups and group 2 was statistically significantly different (P < 0.001, P = 0.023, P < 0.001, resp.).CONCLUSIONS Myopia progression was significantly greater in children with IXT than in the normal population. Myopia progression did not vary with exotropia treatment.
Results of Combined Penetrating Keratoplasty and Implantation of Posterior Chamber Intraocular Lenses
(2018) Asena, Leyla; Altinors, Dilek Dursun; Yilmaz, Gursel; Oto, Sibel; 0000-0001-5223-0279; 0000-0002-2589-7294; 0000-0003-0171-4200; AAK-8077-2021; AAK-6987-2021; AAJ-4668-2021
Risk Factors for Treatment Failure and Recurrence of Anisometropic Amblyopia
(2017) Kirandi, Ece Uzun; Akar, Serpil; Gokyigit, Birsen; Onmez, Funda Ebru Aksoy; Oto, Sibel; https://orcid.org/0000-0001-6442-250X; https://orcid.org/0000-0003-0171-4200; 27620472; AAK-6325-2021; AAJ-4668-2021
The aim of this study was to identify factors associated with failed vision improvement and recurrence following occlusion therapy for anisometropic amblyopia in children aged 7-9 years. We retrospectively reviewed the medical records of 64 children aged 7-9 years who had been diagnosed as having anisometropic amblyopia and were treated with patching. Functional treatment failure was defined as final visual acuity in the amblyopic eye of worse than 20/32. Improvement of fewer than two logMAR lines was considered relative treatment failure. Recurrence was defined as the reduction of at least two logMAR levels of visual acuity after decreased or discontinued patching. Functional and relative success rates were 51.6 and 62.5 %, respectively. The most important factor for functional treatment failure [adjusted odds ratio (OR) (95 % confidence interval, CI) 11.57 (1.4-95.74)] and the only risk factor for recurrence [adjusted OR (95 % CI) 3.04 (1.13-8.12)] were the same: high spherical equivalent (SE) of the amblyopic eye. A large interocular difference in the best-corrected visual acuity was found to be a risk factor for both functional and relative failure. High SE of the amblyopic eye was the most influential risk factor for treatment failure and recurrence in compliant children aged 7-9 years.
The Role of Heredity and the Prevalence of Strabismus in Families with Accommodative, Partial Accommodative, and Infantile Esotropia
(2020) Eroglu, Fatma Corak; Oto, Sibel; Sahin, Feride Iffet; Terzi, Yunus; Kaya, Ozge Ozer; Tekindal, Mustafa Agah; 0000-0003-0171-4200; 0000-0001-7308-9673; 0000-0001-5612-9696; 32631000; AAJ-4668-2021; AAC-7232-2020; B-4372-2018
Objectives: To investigate the prevalence of strabismus in families of a proband with accommodative, partial accommodative, or infantile esotropia, and to evaluate the mode of inheritance and the role of consanguineous marriages in this prevalence. Materials and Methods: Families of probands with comitant strabismus were invited to participate in the study. The family members of 139 subjects with accommodative, 55 with partial accommodative, and 21 with infantile esotropia agreed to participate. Detailed family trees were constructed. The first- and second-degree relatives were invited for a complete ophthalmological examination, and 518 individuals from 168 families were evaluated. The role of consanguinity, the presence of tropia, phoria (>= 8 PD), microtropia, and hypermetropia (>= 3.00 D) among first- and second-degree relatives were analyzed. Results: A non-Mendelian pattern was found in 49 families (23%), an autosomal dominant pattern in 39 families (18%), and an autosomal recessive pattern in 6 families (3%). The prevalence of consanguineous marriages among parents of probands was 18.1%, 22.6%, and 14.3% in the accommodative, partial accommodative, and infantile esotropia groups, respectively (p=0.652). The prevalence of strabismus in first-degree relatives was 58.9%, 45.5%, and 38.1%, respectively (p=0.07). The prevalence of microtropia in probands' siblings was significantly higher in the accommodative esotropia group (p=0.034). Conclusion: Sporadic cases and non-Mendelian inheritance were more frequent than autosomal recessive inheritance. Autosomal recessive inheritance was found not to be frequent in consanguineous marriages. The prevalence of strabismus and microtropia was significantly higher in families of esotropia cases than in the general population.