Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-4360-2021Objectives: 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.Item Effects of Intracameral Drugs and Dyes on Corneal Endothelial Cell Apoptosis in a Rat Model: An In Vivo and In Vitro Analysis(2022) Bayar, Sezin Akca; Ozturker, Zeynep Kayaarasi; Akova, Yonca Aydin; Bilezikci, Banu; Karabay, Gulten; 0000-0001-5109-755X; 36578186; AAJ-2406-2021Objectives: To evaluate the effects of intracameral drugs and dyes on rat corneal endothelial apoptosis and cell morphology. Materials and Methods: The right eyes of 72 rats were injected intracamerally with 1% lidocaine, 0.01% adrenaline, triamcinolone acetonide (TA) 4 mg/mL, 1% trypan blue (TB), 0.5% indocyanine green (ICG), and fortified balanced salt solution as control. Corneal samples were taken 1 day and 1 week post-injection. Corneal endothelial apoptosis was assessed by the TUNEL technique, and the ratio of apoptotic cells in each group was compared with the control. Corneal endothelial cell morphology was evaluated in each specimen by transmission electron microscopy. Results: The mean apoptotic endothelial cell ratio was significantly higher at 1 day and 1 week after intracameral adrenaline injection when compared to controls (p=0.03 and 0.021, respectively). TB caused a significantly higher apoptotic cell ratio when compared to controls at 1 week after injection (p=0.043). Lidocaine caused a higher apoptotic cell ratio compared to TA and ICG at 1 week, although not statistically significant (p=0.058, 0.09, 0.69, respectively). In all experimental specimens, transmission electron microscopy showed morphological changes associated with apoptosis. Conclusion: This study showed that intracameral adrenaline, TB, and lidocaine injections may have toxic effects on corneal tissue, as indicated by ultrastructural and histopathological alterations. Therefore, these agents should be used with caution in intraocular surgery.Item Clinical Characteristics And Outcomes Of Ocular Injuries In Pediatric Patients(2022) Bayar, Sezin Akca; Ozturker, Zeynep Kayaarasi; Yilmaz, Gursel; 35485471BACKGROUND: 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.Item 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, SibelA 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.Item Ophthalmologic Findings in Children with Leukemia: A Single-Center Study(2016) Orhan, Betul; Malbora, Baris; Bayar, Sezin Akca; Avci, Zekai; Alioglu, Bulent; Ozbek, Namik; 27800262Objectives: Ophthalmologic disease in patients with acute leukemia occurs due to primary leukemic infiltration (involvement), or secondary to the disease and its treatment. In recent years the life expectancy of acute leukemia patients has increased with the advent of modern therapies. The present study aimed to determine the incidence of ocular manifestations in children with acute leukemia. Materials and Methods: The study included 120 patients diagnosed with acute leukemia at Baskent University Hospital, Pediatric Hematology Department between 1995 and 2010. All the patients were examined by an ophthalmologist via direct and indirect ophthalmoscopy. Results: Among the patients, 83 (69.2%) were diagnosed with acute lymphoblastic leukemia, 35 (29.1%) with acute myeloblastic leukemia, and 2 (1.7%) with mixed-lineage leukemia. In all, 58 ophthalmic manifestations were noted in 41 patients (34.2%). In our patients, 12 ophthalmologic involvements were present at admission and 46 ocular findings occurred during follow-up. The incidence of these manifestations increased with age. Conclusion: Ophthalmologic manifestations were not correlated with gender, hematological parameters at disease onset, type of leukemia, or the frequency of relapse and survival. To more clearly determine the effect of ophthalmologic manifestations on the prognosis of leukemia, larger scale and multi-center studies are needed.Item Spontaneous Regression of Optic Disc Pit Maculopathy in a Six-Year-Old Child(2017) Bayar, Sezin Akca; Sezenoz, Almila Sarıgul; Pinarci, Eylem Yaman; Yilmaz, Gusel; 0000-0001-5109-755X; 0000-0002-7030-5454; 28182177; AAJ-2406-2021; AAJ-4860-2021A 6-year-old boy with a complaint of blurred vision for two months was referred to our clinic. His visual acuity was 20/32 in the right eye and 20/20 in the left eye. Optical coherence tomography (OCT) revealed optic disc pit maculopathy in the right eye. The patient was followed for 6 months without any treatment. At the end of the 6-month period, the patient's visual acuity was 20/20 in both eyes. The OCT imaging showed spontaneous regression of the optic disc pit maculopathy. In this case report, it is concluded that in children, spontaneous regression of the optic pit maculopathy with full recovery of visual acuity is possible. The development of optic pit maculopathy in childhood is rare and there are not enough studies on the treatment methods. Therefore, our case report may be helpful in the management of similar cases of pediatric optic disc maculopathy.Item 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-2406-2021Objectives: 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.Item 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-4860-2021A 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.