Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Aksoy, MustafaHas files: Yes

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    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
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    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.
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    İntravitreal ranibizumab enjeksiyonuna dirençli diyabetik maküler ödem tedavisinde intravitreal deksametazon implant enjeksiyonu veya intravitreal aflibercept enjeksiyonu uygulanmış olguların koroid kalınlıklarının incelenmesi
    (Başkent Üniversitesi Tıp Fakültesi, 2017) Aksoy, Mustafa; Akkoyun, İmren
    Çalışmamızda, intravitreal ranibizumab (İVR) tedavisine dirençli diyabetik maküler ödemi (DMÖ) bulunan olgularda intravitreal deksametazon (İVD) veya intravitreal aflibercept (İVA) uygulanan hastaların subfoveal koroidal kalınlıklarının (SFKK) değerlendirilmesi ve tedavi seçeneklerine göre koroid kalınlıklarının karşılaştırılması amaçlanmıştır. Ayrıca olguların koroid kalınlıklarındaki değişimine göre görme keskinliği ve santral retinal kalınlık (SRK) ölçümlerindeki değişikliklerin korelasyonu incelenmiştir. Çalışmaya 6 doz İVR tedavisine dirençli DMÖ olan 52 hasta ve 25 sağlıklı birey dahil edildi. Yirmiyedi hastaya İVR sonrası İVA tedavisi uygulanırken, 25 hastaya İVR sonrası İVD tedavisi uygulandı. Hastaların detaylı oftalmolojik muayenesi yapıldı. Hastaların ve sağlıklı bireyden oluşan kontrol grubunun SFKK ölçümleri spektral domain enhaced depth imaging optik koherens tomografi (SD-EDI-OKT) (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany) ile ölçüldü. Retrospektif değerlendirilen tıbbi kayıtlarda, İVD veya İVA enjeksiyonu öncesi ve sonrası fonksiyonel ve morfolojik bulgular, en iyi düzeltilmiş görme keskinliği (EİDGK), Goldmann applanasyon tonometri ile ölçülen göz içi basıncı (GİB), SD-OKT (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany) ile saptanan SRK ölçümü, SD-EDI-OKT ile değerlendirilen SFKK ölçümü incelendi. Olguların İVD veya İVA enjeksiyonundan 1 gün önce ve enjeksiyon sonrası 1., 2. ve 3. aylardaki bulguları analiz edildi. İVD enjeksiyonu öncesi SFKK değerleri enjeksiyon sonrası değerler ile (2= 1. ay, 3=2. ay, 4=3. ay) karşılaştırıldığında 1/2, 1/3 ve 1/4 süreçleri arasından istatistiksel anlamlı fark bulunurken (p=0.0001), 2/3, 2/4 ve 3/4 süreçleri arasında anlamlı fark tespit edilmedi (p=0,0001; 0,0001; 0,006). İVA enjeksiyonu öncesi SFKK değerleri enjeksiyon sonrası değerler ile (2= 1. ay, 3=2. ay, 4=3. ay) karşılaştırıldığında 1/2, 1/3 ve 1/4 süreçleri arasında istatistiksel anlamlı fark görüldü (p=0.0001), ayrıca 2/3, 2/4 ve 3/4 süreçleri arasında da anlamlı fark bulundu (p=0,0001; 0,014; 0,0001). İVD enjeksiyon öncesi EİDGK değerleri (1) enjeksiyon sonrası değerler ile (2= 1. ay, 3=2. ay, 4=3. ay) karşılaştırıldığında 1/2, 1/3 ve 1/4 süreçleri arasında istatistiksel anlamlı fark bulundu (p=0.0001). Ayrıca enjeksiyon sonrası süreçte EİDGK karşılaştırıldığında 2/3, 2/4 ve 3/4 süreçleri arasında da anlamlı fark görüldü (p=0,0001; 0,0001; 0.032). İVA enjeksiyon öncesi EİDGK değerleri (1) enjeksiyon sonrası değerler ile (2= 1. ay, 3=2. ay, 4=3. ay) karşılaştırıldığında 1/2, 1/3 ve 1/4 süreçleri arasında istatistiksel anlamlı fark bulundu (p=0,0001; 0,0001; 0,0001). Ayrıca enjeksiyon sonrası süreçte 2/3 ve 2/4 süreçleri arasında da anlamlı fark görülürken (p=0,0001; 0,0001), 3/4 süreçleri arasında anlamlı fark görülmedi (p=0,057). İVD enjeksiyon öncesi SRK değerleri (1) enjeksiyon sonrası değerler ile (2= 1. ay, 3=2. ay, 4=3. ay) karşılaştırıldığında 1/2, 1/3 ve 1/4 süreçleri arasında istatistiksel anlamlı fark bulunurken (p=0.0001), 2/3, 2/4 ve 3/4 süreçleri arasında anlamlı fark görülmedi (p=0,9; 0,9; 1,0). İVA enjeksiyon öncesi SRK değerleri enjeksiyon sonrası değerler ile (2= 1. ay, 3=2. ay, 4=3. ay) karşılaştırıldığında 1/2, 1/3 ve 1/4 süreçleri arasında istatistiksel anlamlı fark bulunurken (p=0.0001), 2/3, 2/4 ve 3/4 süreçleri arasında anlamlı fark görülmedi (p=0,9; 0,9; 1,0). Sonuç olarak, çoklu İVR enjeksiyonlarına cevapsız DMÖ olgularının, İVD ve İVA enjeksiyonu sonrası 3 aylık takiplerinde SFKK’da istatistiksel anlamlı incelme, görme keskinliğinde istatistiksel anlamlı artış elde edilmiştir. SRK’daki azalma EİDGK’deki artış ile anlamlı korelasyon göstermektedir. SFKK enjeksiyon sonrası dönemde anlamlı incelmeye devam ederken SRK sabit kalmaktadır. Prospektif randomize daha uzun takipli çalışmalar bu verilere ışık tutacaktır. The purpose of the study was to evaluate the subfoveal choroidal thicknesses of patients with ranibizumab resistant diabetic macular edema (DME), treated with intravitreal dexamethasone (İVD) or intravitreal aflibercept (IVA) and to compare the subfoveal choroidal thickness (SFCT) after different treatments. Also, the correlation between choroidal thickness and change in visual acuity and central retinal thickness (CRT) was investigated. Fifty-two patients with resistant DME after 6 doses of intravitreal ranibizumab (IVR) and 25 healthy subjects were included in the study. Twenty-seven patients were administered IVA after IVR, 25 patients İVD treatment after IVR. Detailed ophthalmologic examinations of all patients were done. The SFCT of the patients and the control group with healthy subjects were measrued using spectral-domain enhanced depth imaging optical coherence tomography (SD-EDI OKT) (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany). In the retrospectively evaluated medical records, the functional and morphological findings best corrected visual acuity (BCVA), intraocular pressure (IOP), CRT obtained by SD-OCT and SFCT obtained by SD-EDI OKT (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany), before and after IVD or IVA were evaluated. The findings of the subjects 1 day before IVD or IVA injection and the findings at 1st, 2nd and 3rd months after injection were analyzed. When the SFCT values before IVD injection (1) and after IVD injection (2=1st month, 3=2nd month, 4=3rd month) were compared, the differences between 1/2, 1/3, 1/4 were found statistically significant (p=0.0001 for all). Also, statistically significant differences were found between 2/3, 2/4 and 3/4 periods (p=0,0001; 0,0001; 0,006 respectively). When the SFCT values before IVA injection (1) and after IVA injection (2=1st month, 3=2nd month, 4=3rd month) were compared, the differences between 1/2, 1/3, 1/4 were found statistically significant (p=0.0001 for all). Also, statistically significant differences were found between 2/3, 2/4 and 3/4 periods (p=0,0001; 0,014; 0,0001 respectively). When the BCVA values before IVD injection (1) and after IVD injection (2=1st month, 3=2nd month, 4=3rd month) were compared, the differences between 1/2, 1/3, 1/4 were found statistically significant (p=0.0001 for all). Also, statistically significant differences were found between 2/3, 2/4 and 3/4 periods (p=0,0001; 0,0001; 0.032 respectively). When the BCVA values before IVA injection (1) and after IVA injection (2=1st month, 3=2nd month, 4=3rd month) were compared, the differences between 1/2, 1/3, 1/4 were found statistically significant (p=0,0001; 0,0001; 0,0001 respectively). Also, statistically significant differences were found between 2/3, 2/4 periods (p=0,0001; 0,0001 respectively) while no significant difference was observed between 3/4 periods (p=0,057). When CRT values before IVD injection (1) and after IVD injection (2=1st month, 3=2nd month, 4=3rd month) were compared, the differences between 1/2, 1/3, 1/4 were significant (p=0.0001 for all), while no significant difference was observed between 2/3, 2/4 and 3/4 periods (p=0,9; 0,9; 1,0 respectively). When CRT values before IVA injection (1) and after IVA injection (2=1st month, 3=2nd month, 4=3rd month) were compared, the differences between 1/2, 1/3, 1/4 were significant (p=0.0001 for all), while no significant differences was obtanined between 2/3, 2/4 and 3/4 periods (p=0,9; 0,9; 1,0 respectively). In conclusion, in DME patients resistant to multiple IVR injections, both IVD and IVA injections lead to a decrease in SFCT and a significant increase in BCVA after 3 months of follow-up. Decrease in CRT shows a significant correlation with BCVA increase. While the decrease in SFCT continues, the CRT stabilizes. Our data should be supported with prospective randomized studies with longer follow up periods.