Browsing by Author "Yilmaz, Gursel"

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Antiproliferative and anti-apoptotic effect of astaxanthin in an oxygen-induced retinopathy mouse model
(2019) Kucukoduk, Ali; Helvacıoglu, Fatma; Haberal, Nihan; Dagdeviren, Atilla; Bacanli, Didem; Yilmaz, Gursel; Akkoyun, Imren; 0000-0001-8990-8282; 30851776; P-2877-2014
Objective: To evaluate the impact of intravitreal (IV) and intraperitoneal (IP) astaxanthin (AST) injections on neovascular development (ND), retinal morphology, and apoptotic activity in a C57BL/6J mouse model with hyperoxia-induced retinopathy (HIR). Design: C57BL/6J mouse model. Methods: Two negative control groups (n = 6 each; one of which received IV sterile dimethyl sulfoxide [DMSO]) of C57BL/6J-type mice were exposed to room air. The HIR groups included 36 C57BL/6J-type mice exposed to 75% +/- 2% oxygen from postnatal day (PD) 7 to PD 12. On PD 12, these mice were randomized into 6 groups (n = 6 each): 2 HIR control groups (one of which received IV-DMSO), 2 IV-AST groups (10 and 100 mu g/mL), and 2 IP-AST groups (0.5 and 5 mg/kg). We measured ND by counting neovascular tufts in cross sections and examined histological, ultrastructural changes via light and electron microscopy. Apoptosis was detected using terminal deoxynucleotidyl transferase-mediated nick end-labeling. Results: No ND was detected in the negative control groups. ND levels were not significantly different between high- and low-dose AST for either means of administration. However, ND levels were significantly lower in the AST groups, regardless of delivery, compared to the control groups. The means of delivery (IP versus IV) also yielded significant differences in ND. The incidence of mitochondrial dysmorphology and apoptosis were lower in groups receiving AST. Conclusions: AST seems to suppress ND and has anti-apoptotic activity in the HIR mouse model.
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).
Bilateral Asymmetric Rhegmatogenous Retinal Detachment in a Patient with Stickler Syndrome
(2018) Yilmaz, Gursel; Ozturk, Caner; Sezenoz, Almila Sarigul; Akkoyun, Imren; 0000-0002-2589-7294; 0000-0002-2860-7424; 29755825; AAK-6987-2021; AAK-7713-2021
Here we present the long-term anatomical and visual outcomes of bilateral asymmetric rhegmatogenous retinal detachment repair in a patient with Stickler syndrome. A 17-year-old girl presented with decreased visual acuity in both eyes for more than one year. Her best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.05 in the left eye. Slit-lamp anterior segment examination revealed subcapsular cataract in both eyes. Fundus examination showed bilateral rhegmatogenous retinal detachment, chronic retinal detachment accompanied by multiple retinal holes, tears and membranous fibrillary vitreous in the peripheral retina. Grade C2 proliferative vitreoretinopathy was observed in the left eye. Scleral buckling surgery was performed initially for both eyes. After the primary surgical procedure, retinal reattachment was achieved in the right eye and the left eye underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy (PPV), and silicone oil injection. After these surgical procedures retinal reattachment was achieved in the left eye. Silicone oil removal was performed six months after PPV surgery. After surgical treatment, BCVA was 0.6 in the right eye at the end of the 3.5-year follow-up period. After silicone oil removal, BCVA reached 0.2 in the left eye after 36 months of follow-up and retinal reattachment was achieved in both eyes. Scleral buckling surgery and PPV are effective and confidential methods for the treatment of chronic retinal detachment cases in Stickler syndrome.
Choroidal Osteoma and Secondary Choroidal Neovascularization Treated with Ranibizumab
(2017) Bayar, Sezin Akca; Sezenoz, Almila Sarıgul; Yilmaz, Gursel; 0000-0002-2589-7294; 0000-0001-5109-755X; 0000-0002-7030-5454; 28845332; AAK-6987-2021; AAJ-2406-2021; AAJ-4860-2021
A 47-year-old female patient presented with a complaint of decreased vision in the right eye. Her visual acuity was 0.16 in the right eye and 1.0 in the left eye. Fundus examination revealed a slightly elevated, yellowish-white lesion with regular borders at the macula of the right eye. Early and late hyperfluorescence related with choroidal neovascularization (CNV) was detected in the right eye on fundus fluorescein angiography. B-scan ultrasonography revealed a hyperechoic choroidal lesion with acoustic shadowing. The lesion was diagnosed as choroidal osteoma. The patient received 3 injections of intravitreal ranibizumab. After 4 months, the visual acuity of the right eye was 0.9 and the CNV had regressed. Follow-up at about 7 months revealed reduced visual acuity in the right eye with an increase in subretinal fluid. An additional ranibizumab injection was administered. In this case report, we discuss the findings and treatment of a rare case of choroidal osteoma with secondary CNV.
Choroidal Thickness After Dexamethasone Implant or Aflibercept in Patients with Diabetic Macular Edema Persistent to Ranibizumab
(2020) Aksoy, Mustafa; Yilmaz, Gursel; Vardarli, Irfan; Akkoyun, Imren; 0000-0002-2589-7294; 0000-0003-1513-7686; 0000-0002-2860-7424; 32460600; AAK-6987-2021; AAK-7713-2021
Purpose: This study aims to compare subfoveal choroidal thicknesses (SFCTs) after intravitreal dexamethasone (IVD) or intravitreal aflibercept (IVA) treatment in patients with persistent diabetic macular edema (DME) unresponsive to intravitreal ranibizumab (IVR). Methods: The study consisted of patients with DME unresponsive to IVR treatment in which 37 were administered 1 dose IVD (group A) and 34 patients who were administered 3 doses of IVA (group B), as well as 35 healthy individuals (group C). Detailed ophthalmological examination and optical coherence tomography parameters of group A and group B, including central retinal thickness and SFCT, were retrospectively evaluated before and after treatment. Results from preinjection, and 1, 2, and 3 months after injection were analyzed. Results of group A and group B were compared within themselves and also compared with group C. Results: SFCT measurements were compared within group A and group B (1 = preinjection; 2 = 1 month postinjection; 3 = 2 months postinjection; 4 = 3 months postinjection). There was significant thinning in SFCT between 1-2, 1-3, 1-4, 2-3, 2-4, and 3-4 time intervals within both group A and group B (both P < 0.001). Comparison of SFCT measurements showed preinjection, 1-, and 2-month values of group A were significantly thicker than those of group C (P < 0.001), whereas there was no significant difference between 3-month values (P = 0.09). Preinjection, 1-, and 2-month values of group B were significantly thicker than those of group C (P < 0.001), whereas there was no significant difference between 3-month values (P = 0.06). Conclusions: Three month follow-up showed thinning in SFCT measurements in patients with persistent DME unresponsive to IVR who were applied IVD or IVA treatment.
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.
Choroidal Vascularity Index Changes in Different Treatments for Vitreomacular Traction
(2023) Ercan, Zeynep Eylul; Gokgoz, Gulsah; Akkoyun, Imren; Yilmaz, Gursel; 0000-0002-2860-7424; 37572736; AAK-7713-2021
Introduction: The aim of this study was to examine if choroidal vascularity index (CVI) is different in eyes with unilateral vitreomacular traction (VMT) from their healthy fellow eyes; and whether different treatments affect the CVI. Methods: The baseline and 8-week post treatment CVIs of 56 unilateral VMT patients that underwent spontaneous resolution (n = 30), vitreoretinal surgery (n = 16) or pneumatic vitreolysis (n = 10) were compared with fellow eyes using paired samples t-test. Partial correlation analyses correcting age and gender was used for calculations between treatment groups. P values < 0.05 were considered statistically significant. Results: The mean baseline CVI for VMT and control eyes had no statistically significant difference (p = 0.81, r= -0.38). The post traction release follow-up CVI of VMT eyes and contralateral eyes had no significant difference (p = 0.12, r = 0.49). In spontaneous resolution group, vitreoretinal surgery group and pneumatic vitreolysis group the baseline and follow up CVIs of VMT eyes were statistically similar (p = 0.72, p = 0.32 and p = 0.79 respectively).Spontaneous detachment patients' CVIs showed a 0.57 +/- 5.81% increase, vitreoretinal surgery group had a reduction of 1.098 +/- 4.76%, and the pneumatic vitreolysis patients showed a CVI reduction of 0.307 +/- 4.24%. However, none of these changes was found to be statistically significant when compared between the groups (p = 0.21, r = 0.02). Discussion: Previous studies have argued that vitreomacular traction might have a role on the choroidal changes seen in the vitreoretinal interface disorders. This study has shown that VMT alone does not cause any significant changes in choroidal vascular index pre or post traction release.
Choroidal vascularity index changes with phacovitrectomy for vitreoretinal interface disorders
(2022) Ercan, Zeynep Eylul; Gokgoz, Gulsah; Yilmaz, Gursel; 35918960
Purpose: Vitreomacular interface disorders have long been argued to change choroidal structure. The aim of this study was to determine the choroidal vascularity index (CVI) changes following internal limiting membrane peeling for epiretinal membrane (ERM) and full thickness macular hole (FTMH). Methods: Fifty-nine patients with unilateral ERM and 56 with unilateral FTMH were induded in the study. Axial length, pre- and post-surgery intraocular pressure, baseline and post-phacovitrectomy CVI were calculated and compared with the normal fellow eyes. To compare the baseline and the final measurements, Wilcoxon test was used. Mann-Whitney U test was used for independent data comparisons. Median and standard deviations were compared. Results: Axial length, pre- and post-surgery intraocular pressure differences were insignificant between study and fellow eyes within all groups. CVI were significantly lower in post-vitrectomy study eyes of all groups compared with pre-surgery (P < 0.001). There were no significant changes before and after the surgeries in fellow eyes. Baseline CVI of ERM study eyes (median 65.90%) and FTHM study eyes (median 65.59%) did not differ significantly between groups (U = 1336, P = 0.07, r = 0.16). Conclusion: There are conflicting results of vitreoretinal interface disorders CVI in the literature. In this study, both FTMH and ERM eyes showed reduced CVI postoperatively compared with the baseline. Preoperatively, there were no difference between study eyes and the fellow eyes.
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 Characteristics And Outcomes Of Ocular Injuries In Pediatric Patients
(2022) Bayar, Sezin Akca; Ozturker, Zeynep Kayaarasi; Yilmaz, Gursel; 35485471
BACKGROUND: Childhood eye injuries are one of the most common causes of acquired unilateral blindness. In this study, our purpose was to investigate the demographics, etiology, and outcome of pediatric patients with ocular injury. METHODS: The charts of children with ocular trauma who presented to Baskent University Hospitals, between January 1, 2017 and December 31, 2019 were retrospectively reviewed. All patients who were under 16 years of age were included. Data were collected on age, sex, time of trauma, injury type, associated injuries, treatments, visual impairment, intraocular pressure (IOP), and ophthalmic sequelae. Ocular traumas were classified according to the Birmingham Eye Trauma Terminology (BETT) system. RESULTS: A total of 21 patients were identified. Male-female ratio was 13/8. The mean age of the patients was 8.5??3.4 years. Mean post-treatment follow-up was 8.2??4.3 months. Injury was unilateral in all cases (10 right eye, 11 left eye). Fifteen patients (71.4%) had open globe, and 6 (28.5%) had closed globe injury. Type of injury was rupture in 7 cases, perforation in 5, penetration in 4, and intraocular foreign body in 4. A total of 5 cases were documented to have retinal detachment during the follow-up. Sharp injuries were documented in 11 (64.7%) cases, and blunt in 6 (35.2%). The most frequent finding was hyphema in blunt injury, and corneal laceration in perforating injury. Five patients had choroidal hemorrhage, 3 had commotio retinae, 2 had intravitreal hemorrhage, 1 had subhyaloidal hemorrhage, 1 had macular hole, and 1 had optic nerve avulsion. Lens aspiration was performed in 12 (57.1%) cases, and 2 of them had intraocular lens implantation. In children whose initial vision was able to be taken, 4 had no light perception, 7 had light perception-counting fingers, and 5 had best-corrected visual acuity of 0.05???0.3. At final visit, 61.9% of patients had a VA of 0.05???0.8. Corneal scar or leucoma was observed in 14 (66.6%) cases at last visit. One eye was enucleated due to post-traumatic endophthalmitis that did not respond to treatment. At final visit, IOP 6 mmHg was identified in 2 cases and 21 mmHg in 4. CONCLUSION: Anterior segment damage is the main cause of visual morbidity in pediatric ocular trauma. Injuries with sharp objects occur twice as often as blunt trauma and reduce vision with residual corneal scarring in about two-thirds of patients. Understanding the pattern of eye injuries is useful in determining the strategies required to protect children???s eye health.
Clinical Features of Untreated Type 2 Macular Telangiectasia and Efficacy of Anti-Vascular Endothelial Growth Factor Therapy in Macular Neovascularization
(2022) Karatas, Muge Coban; Yilmaz, Gursel; Sezen, Aslihan Yuce; Sariturk, Cagla; 35196839
Objectives: To compare best corrected visual acuity (BCVA), central macular thickness (CMT), and central choroidal thickness (CCT) in patients with type 2 macular telangiectasia (MacTel 2) and a control group and to evaluate the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in MacTel 2 patients with macular neovascularization (MNV). Materials and Methods: We conducted a retrospective chart review of consecutive MacTel 2 patients who underwent a full ophthalmologic examination including BCVA and dilated fundus examination with slit-lamp biomicroscopy, fluorescein angiography, and optical coherence tomography imaging at baseline and follow-up visits. BCVA, CMT, and CCT were compared between all identified patients (n=26) and a control group (n=30). A subgroup analysis was performed among eyes with MNV (n=7) before and after treatment. Results: CMT and CCT were significantly lower in the MacTel 2 group compared to the control group. Forty-one treatment-naive eyes without MNV proliferation showed no significant change in BCVA, CMT, or CCT during follow-up. Eight eyes of 7 MacTel 2 patients developed MNV during follow-up. All of the patients were treated with intravitreal anti-VEGF. Conclusion: It is important to closely follow MacTel 2 patients for MNV development. To avoid adverse effects, we prefer to monitor patients who have not yet developed MNV. Patients with proliferative MacTel 2 with decreasing visual function may benefit from intravitreal anti-VEGF treatment.
Comparison of intravitreal bevacizumab and triamcinolone acetonide theraphies for diffuse diabetic macular edema
(2015) Aksoy, Sibel; Yilmaz, Gursel; Akkoyun, Imren; Yazici, Ayse Canan; 26086006
AIM: To compare therapeutic effects of intravitreal triamcinolone acetonide (IVTA) versus intravitreal bevacizumab (IVB) injections for bilateral diffuse diabetic macular edema (DDME). METHODS: Forty eyes of 20 patients with bilateral DDME participated in this study. For each patient, 4 mg/0.1 mL IVTA was injected to one eye and 2.5 mg/0.1 mL IVB was injected to the other eye. The effects of injection for diabetic macular edema (DME) were evaluated using best -corrected visual acuity (BCVA), central macular thickness (CMT) by optical coherence tomography (OCT) and intraocular pressure (IOP) by applanation tonometer. Patients underwent eye examinations, including BCVA, CMT, and IOP at pre-injection, 1, 4, 8, 12 and 24wk after injection. During the follow -up, second injections were performed to eyes which have CMT greater than 400 pm at 12wk for salvage therapy. RESULTS: BCVA (logarithm of the minimum angle of resolution) at pre -injection, 1, 4, 8, 12 and 24wk after injection was 0.71 +/- 0.19, 0.62 +/- 0.23, 0.63 +/- 0.12, 0.63 +/- 0.13, 0.63 +/- 0.14 and 0.61 +/- 0.24 in the IVTA group and 0.68 +/- 0.25, 0.61 +/- 0.22, 0.60 +/- 0.24, 0.62 +/- 0.25, 0.65 +/- 0.26 and 0.59 +/- 0.25 in the IVB group, respectively. CMT (mu m) at pre-injection, 1, 4, 8, 12 and 24wk after injection was 544 +/- 125, 383 +/- 96, 335 +/- 87, 323 +/- 87, 333 +/- 92, 335 +/- 61 in the IVTA group and 514 +/- 100, 431 +/- 86, 428 +/- 107, 442 +/- 106, 478 +/- 112, 430 +/- 88 in the IVB group respectively. Reduction ratios of mean CMT were 29% at 1wk, 38% at 4wk, 40% at 8wk, 38% at 12wk, and 38% at 24wk in the IVTA group. Second IVTA injections were performed to the 6 eyes (30%) at 12wk. Reduction ratios of mean CMT were 16% at 1wk, 17% at 4wk, 14% at 8wk, 7% at 12wk, and 16% at 24wk in the IVB group. Second IVB injections were performed to the 15 eyes (75%) at 12wk. CONCLUSION: This study showed earlier and more frequent macular edema recurrences in the eyes treated with bevacizumab compared with the ones treated with triamcinolone acetonide. Triamcinolone acetonide was found to provide more efficient and long-standing effect in terms of reducing CMT compared with the bevacizumab.
Comparison of The Effects of Anti-Vascular Endothelial Growth Factor Treatments on Pigment Epithelial Detachment in Age-Related Macular Degeneration
(2021) Ulusoy, Mahmut Oguz; Kal, Ali; Yilmaz, Gursel; 0000-0001-7544-5790; 0000-0002-2589-7294; 33481151; AAJ-4936-2021; AAK-6987-2021
Purpose The aim of this study is to compare structural and visual outcomes of naive neovascular age-related macular degeneration patients with significant pigment epithelial detachment (PED), treated with ranibizumab and aflibercept. Methods This was a retrospective case series that included 33 naive patients treated with ranibizumab and 25 with aflibercept. The patients were followed with pro re nata (PRN) after first three intravitreal injections. LogMAR visual acuity, PED height and radius on spectral domain optical coherence tomography findings were compared. Results Baseline mean PED height was 270.39 +/- 114.14 mu m and 315.24 +/- 115.8 mu m (p = 0.14); baseline mean PED radius was 2063.64 +/- 942.75 mu m and 1958.88 +/- 452.22 mu m (p = 0.61); and baseline BCVA was 1.16 +/- 0.73 and 1.09 +/- 0.69 (p = 0.73), for ranibizumab, and aflibercept group, respectively. In aflibercept group, there was statistically significant decrease in PED height at first, third and 12th months. In PED radius, decrease was greater in aflibercept group, however not significant. In addition, in aflibercept group visual acuity was better at all three months; however, none of them were significant. Conclusion Although the maximum improvement was seen at third month, final visual acuity and parameters of PED were better in aflibercept group. The efficacy of the both drug to choroidal neovascularization was known; however, in cases with significant PED, aflibercept can be consider for the first-level treatment.
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
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
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
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.
Enhanced Depth Imaging Optical Coherence Tomography in Patients with Different Phases of Behcet's Panuveitis
(2017) Yesilirmak, Nilufer; Lee, Wen-Hsiang; GurGungor, Sirel; Yaman Pinarci, Eylem; Akkoyun, Imren; Yilmaz, Gursel; https://orcid.org/0000-0002-8632-2873; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-2860-7424; https://orcid.org/0000-0002-2589-7294; 28237149; AAD-7299-2020; AAD-5967-2021; AAK-7713-2021; AAK-6987-2021
OBJECTIVE: To evaluate the changes in choroidal thickness (CT) at 13 different points between "active," "remission," and "end-stage" phase of Behcet's panuveitis and compare this with the age, sex, and spherical equivalent matched healthy controls using enhanced depth imaging optical coherence tomography. DESIGN: Prospective study. PARTICIPANTS: Eighty-five eyes of 45 patients with Behcet's panuveitis (19 eyes with active phase, 48 eyes with remission phase, and 18 eyes with end-stage phase) and 84 eyes of 42 controls were enrolled in this study. METHODS: CT measurements were obtained beneath the fovea and at 500-mu m intervals for 3 mm nasal and temporal to the centre of the fovea. Correlation analyses were calculated to assess the relationship of the CT with age and disease duration. RESULTS: At all 13 measurement points, CT was significantly thinnest in end-stage-phase eyes and thickest in active-phase eyes (p < 0.01). CT was thicker in remission-phase eyes compared with control eyes at foveal and perifoveal points, but the trend was not statistically significant. The mean CT at each of the 13 measured points showed a negative correlation with age and disease duration (p < 0.01). CONCLUSIONS: Submacular CT, as measured by enhanced depth imaging optical coherence tomography, was significantly reduced in eyes with Behcet's panuveitis in the end-stage phase and increased in those in the active phase.
Evaluation of choroidal and retinal thickness measurements in adult hemodialysis patients using spectral-domain optical coherence tomography
(2016) Kal, Ali; Kal, Oznur; Eroglu, Fatma Corak; Omer, Ozlem; Kucukdonmez, Cem; Yilmaz, Gursel; 0000-0002-2589-7294; 0000-0003-3003-0756; 27626146; AAK-6987-2021; D-5308-2015
Purpose: To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods: In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (lambda=840 mm; 26.000 A-scans/s; 5 mu m resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 mu m and 1000 mu m nasal to the fovea and 500 mu m, 1000 mu m, and 1500 mu m temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared. Results: The median choroidal thicknesses before and after hemodialysis were 182 mu m (range, 103-374 mu m) and 161 mu m (range, 90-353 mu m), respectively (P<0.001). The median retinal thicknesses were 246 mu m (range, 179-296 mu m) before and 248 mu m (range, 141-299 mu m) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540). Conclusion: Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.
Impact of Platelet Count in Retinopathy of Prematurity
(2020) Keskek, Nedime Sahinoglu; Gulcan, Hande; Yilmaz, Gursel; Akkoyun, Imren; 0000-0001-8544-103X; 33389935; T-4258-2017
Objectives: The aim of the study was to investigate the risk factors for retinopathy of prematurity (ROP), including platelet count. Materials and Methods: This retrospective study analyzed 137 infants in 3 subgroups: no ROP; mild RAP, and severe ROP requiring laser treatment (type 1 ROP). A retrospective review of records was performed and statistical analysis of possible risk factors for ROP including platelet count was evaluated by using logistic regression. Results: Birth weight (BW), gestational age (GA), and low platelet count in the first week after birth were significant risk factors for developing ROP (p=0.038, 0.02, and 0.004, respectively). BW, GA, ventilation, and lower platelet count were associated with progression to type 1 ROP (p=0.004; 0.027, and 0.021, respectively). Conclusion: Lower platelet count in the first week after birth is a risk factor for ROP development in addition to the previously established factors of ventilation need, low BW, and low GA.