Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Gungor, Sirel Gur

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    Peripapillary and Macular Vascular Densities in Healthy, Ocular Hypertensive, and Different Stages of Glaucomatous Eyes
    (2023) Ozturk, Caner; Gungor, Sirel Gur; Eksioglu, Umit; Sezenoz, Almila Sariguel; Colak, Meric; 0000-0002-3061-7162; 38111931; ABG-2501-2020
    AIM: To investigate vascular changes in different stages of glaucoma and to evaluate the role of optical coherence tomography angiography (OCTA) in the early diagnosis of glaucoma.METHODS: Glaucoma patients and healthy controls (n= 29 eyes) were investigated in this cross-sectional comparative study. Glaucoma patients were grouped as ocular hypertension (n=44 eyes), preperimetric glaucoma (PPG; n=32 eyes), early glaucoma (EG; n=35 eyes), moderate stage glaucoma (MG; n=36 eyes), and advanced glaucoma (AG; n=35 eyes). Peripapillary and macular vascular densities (VDs) of all participants were compared and correlations of VDs and retinal nerve fiber layer thickness (RNFLT), ganglion cell analysis (GCA), and visual field (VF) tests were evaluated. Area under the receiver operation characteristic curves (AUC) of the peripapillary and macular VD parameters were obtained.RESULTS: VD values decreased with the progression of glaucoma. Most peripapillary and macular VD parameters of PPG and EG groups were lower than healthy controls (P<0.001). There was no significant difference in RNFLT between the PPG and EG groups, but most peripapillary and macular VDs were found to be lower in EG group than in PPG group (P<0.05). In most disease group, VDs were significantly correlated with OCT parameters (P<0.001) and VF index (P<0.05). There were no significant correlations between VF and RNFLT indices in the AG group, but significant correlations were found between VF and VD values (P<0.05). AUC for discriminating between healthy and glaucomatous eyes were highest in whole image peripapillary VD (AUC: 0.865, 0.929, and 0.986, respectively in EG, MG, and AG groups).CONCLUSION: OCTA can be used in the early diagnosis of glaucoma and can be useful in follow-up of the advanced disease. In cases where limitations or suspicions in structural and functional tests are present, OCTA can be used as a supportive diagnostic test, both in EG and AG.
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    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.
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    Comparison of Keratometry Obtained by a Swept Source OCT-Based Biometer with a Standard Optical Biometer and Scheimpflug Imaging
    (2018) Asena, Leyla; Akman, Ahmet; Gungor, Sirel Gur; Altinors, Dilek Dursun; 0000-0001-5223-0279; 0000-0002-6848-203X; 0000-0001-6178-8362; 29630418; AAK-8077-2021; E-5914-2016; AAD-5967-2021
    Purpose: To assess agreement of a swept source-optical coherence tomography (SS-OCT) based Biometer with a standard IOLMaster device and Scheimpflug Imaging (SI) to acquire keratometric measurements in cataract patients. Methods: In this prospective comparative study, 101 eyes of 101 cataract surgery candidates, aged 24-81years, were sequentially examined using three devices. Keratometry values at the flat (K1) and steep (K2) axis, mean corneal power (Km) and magnitude of corneal astigmatism as well as J0 and J45 vectoral components of astigmatism obtained with the SS-OCT based biometer (IOLMaster 700) were compared with those obtained with the IOLMaster 500 and SI. The agreement between measurements was evaluated by the Bland-Altman method, intraclass correlation coefficients (ICCs) and repeated-measures analysis of variance. Results: Mean K1 values from the three devices were similar (p=0.09). Mean K2 and Km values of IOLMaster 700 were higher than SI and lower than IOLMaster 500 (p=0.04 for K2 and p=0.02 for Km). There was a strong correlation between K1, K2, Km and magnitude of astigmatism obtained with all devices (r >= 0.80 and p<0.01). The 95% limits of agreement (LoA) width for each keratometric value were highest for the comparison between IOLMaster 500 and SI and lowest for the comparison between IOLMaster 700 and 500. The mean differences (width of 95% LoA) for J0 and J45 vectoral components were 0.005 (2.19) and 0.12 (2.92) for the measurements obtained by IOLMaster 700 vs IOLMaster 500 and 0.06 (1.79) and 0.02 (1.58) for the measurements obtained by IOLMaster 700 vs SI, respectively. Conclusions: With ICCs close to 1, the agreement between all devices was excellent for keratometric measurements. Mean K2, Km and astigmatism measurements from IOLMaster 700 were lower than IOLMaster 500 and higher than SI. However, the differences were quite small and are not expected to affect the final IOL power.
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    Comparison of Keratometric Measurements Obtained by the Verion Image Guided System with Optical Biometry and Auto-Keratorefractometer
    (2017) Asena, Leyla; Gungor, Sirel Gur; Akman, Ahmet; 0000-0002-6848-203X; 0000-0001-6178-8362; 27271763; E-5914-2016; AAD-5967-2021
    The aim of this study was to compare the keratometric measurements of Verion Image Guided System with an optical biometer (Zeiss IOLMaster 500, Carl Zeiss Meditec, Jena, Germany) and an automated keratorefractometer (AKR) (Topcon KR-8900, Topcon, Japan). In this prospective clinical trial, the right eyes of 52 patients with cataract were examined (mean age 62.25 +/- 12.16 years). The measurements were taken by the three systems in a random order. Keratometric data, magnitude of astigmatism, and astigmatic axis measurements from all three instruments were compared. The results were evaluated using, intraclass correlation coefficients (ICC), Bland-Altman plots, and paired samples t tests. The mean flat/steep K of Verion, IOLMaster, and AKR were 43.22 +/- 1.38D/44.23 +/- 1.46D, 43.07 +/- 1.26D/44.05 +/- 1.34D, and 43.07 +/- 1.31D/43.89 +/- 1.42D, respectively. Flat K readings of Verion were higher than IOLMaster and AKR (p < 0.05 for both). Steep K readings were different for all three (p < 0.05). The magnitude of astigmatism by Verion and IOLMaster were 0.98 +/- 0.65D and 0.98 +/- 0.59D (p = 0.88). The mean astigmatism measured by the AKR was 0.82 +/- 0.62D, less than the other two instruments (p < 0.001). Astigmatic axis measurements of Verion and AKR differed < 10A degrees in 38, between 10A degrees and 20A degrees in 5, and > 20A degrees in 9 eyes; the same difference was 30, 11, and 11 eyes, respectively, between Verion and IOLMaster. Although, keratometric and astigmatic results obtained from Verion were not completely interchangeable with IOLMaster and AKR, especially the agreement between Verion and IOLMaster was excellent with ICCs close to one. However, there were pronounced astigmatic axis measurement differences between three instruments.
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    Non-Contact and Contact Tonometry in Corneal Edema
    (2016) Gungor, Sirel Gur; Akman, Ahmet; Kucukoduk, Ali; Asena, Leyla; Simsek, Cem; Yazici, Ayse Canan; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0001-8024-4758; https://orcid.org/0000-0002-6848-203X; https://orcid.org/0000-0001-8003-745X; https://orcid.org/0000-0002-3132-242X; 26583789; AAD-5967-2021; E-5914-2016; N-8970-2018; AAS-6810-2021
    Purpose To compare the intraocular pressure (IOP) values by Goldmann applanation tonometry (GAT) and Reichert 7 CR noncontact tonometry (R7CR-NCT) in patients with postsurgical corneal edema and to examine the impact of postoperative corneal edema on these values. Methods Forty-six patients with grade 4 and 5 cataracts were included in this study. Intraocular pressure was measured using GAT and R7CR-NCT before and 1 day after phacoemulsification. Central corneal thickness (CCT) was determined before and after surgery to quantify postsurgical corneal edema. The R7CR-NCT provided a Goldmann-correlated IOP (IOPg) and corneal-compensated IOP (IOPcc). Results The CCT increased significantly 1 day after surgery (the mean preoperative CCT, 543.5 25.4 m; the mean postoperative CCT, 681.5 +/- 19.8 m; p < 0.001), a mean increase of 26.7%. The preoperative R7CR-NCT measurements (the mean IOPcc, 18.8 +/- 5.6 mm Hg; the mean IOPg, 17.8 +/- 4.5 mm Hg) were significantly higher than GAT measurements (the mean GAT-IOP, 16.0 +/- 3.4 mm Hg) (p < 0.001). On postoperative day 1, the R7CR-NCT measurement (the mean IOPcc, 27.0 +/- 9.8 mm Hg; the mean IOPg, 25.1 +/- 8.9 mm Hg) were significantly higher than GAT measurements (the mean GAT-IOP, 18.3 +/- 7.9 mm Hg) (p < 0.001). The difference between postoperative R7CR-NCT and GAT-IOP values were significantly higher than the difference between preoperative R7CR-NCT and GAT-IOP values (p < 0.001 for both IOPcc to GAT-IOP and IOPg to GAT-IOP). The difference between postoperative IOPcc and GAT-IOP was significantly correlated to the change in CCT (r = 0.526, p < 0.001). Similarly, the difference between postoperative IOPg and GAT-IOP was significantly correlated to the change in CCT (r = 0.536, p < 0.001). Conclusions The R7CR-NCT IOP values were high in patients with postsurgical intensive corneal edema. Consequently, the difference between R7CR-NCT IOP and GAT-IOP increased in edematous corneas.
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    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
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    Circumferential Ciliary Body Cysts Presenting as Acute Pigment Dispersion and Ocular Hypertension
    (2018) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Kiratli, Hayyam; Akman, Ahmet; 0000-0002-7030-5454; 0000-0001-6178-8362; 0000-0003-2100-4740; 28914584; AAJ-4860-2021; AAD-5967-2021
    Purpose: To report a case of circumferential neuroepithelial cyst of the ciliary body presenting with pigment dispersion (PD) and ocular hypertension. Case report: 48-year-old female patient presented with a complaint of pain in the left eye. On examination, visual acuity of the left eye was 0.9, and the intraocular pressure was 48 mmHg. Biomicroscopic anterior segment examination of the left eye revealed 4+ pigmented cells in the anterior chamber. Active PD from the pupillary region at 11 o'clock was noticed at the time of the examination. Ultrasound biomicroscopy demonstrated 360o cystic lesions of the ciliary body in the left eye. The patient was diagnosed as neuroepithelial cyst of the ciliary body. Conclusion: Our case is unique as it is the first case of circumferential neuroepithelial ciliary body cyst presenting with acute PD and ocular hypertension.
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    A Case of Transient Visual Field Defect following Administration of Pfizer-BioNTech COVID-19 Vaccine
    (2022) Sezenoz, Almila Sarigul; Gungor, Sirel Gur; Kibaroglu, Seda; https://orcid.org/0000-0002-7030-5454; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-3964-268X; 35404749; AAJ-4860-2021; AAD-5967-2021; AAJ-2956-2021
    Purpose To report a case of transient visual field (VF) defect after coronavirus disease-19 (COVID-19) vaccination. Case Report A 38-year-old Caucasian, otherwise healthy female patient, presented with a complaint of vision loss in the outer quadrant in her left eye after the second dose of Pfizer (R)-BioNTech (TM) COVID-19 vaccine. The Snellen visual acuity was 20/20 in both eyes. She did not have relative afferent pupillary defect nor disturbance of color vision. Her intraocular pressures, slit lamp and fundus examinations were normal. In the VF test, a temporal hemifield defect in the left eye and a nasal peripheral VF defect in the right eye were detected. Other imaging characteristics and neurological examination were normal. She was followed without any treatment. One week later, the patient was re-evaluated and complete resolution of the VF defect was observed. Conclusion Clinicians should be aware that patients can experience transient visual symptoms following COVID-19 vaccination.
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    Quantitative Evaluation of Macular Vessel Density Measurement by Optical Coherence Tomography Angiography in Patients with Inactive Ocular Sarcoidosis
    (2023) Gungor, Sirel Gur; Sezenoz, Almila Sarigul; Adwan, Noor; Gokgoz, Gulsah; Aksoy, Mustafa; Karadas, Mustafa; Colak, Meric; 0000-0001-6178-8362; 35404733; AAD-5967-2021
    Purpose To evaluate the macular vessel density (VD) in inactive ocular sarcoidosis (OS) and investigate the relationship between VD and both disease duration and visual acuity (VA). Methods This cross-sectional study was performed at a tertiary hospital. The macular VDs of patients with OS were obtained using optical coherence tomography angiography and compared with healthy subjects. Results Deep whole image macular VD (WI-MVD), parafoveal, and perifoveal VDs were lower in OS group (p = .01, p = .01, p = .02, respectively). Negative correlation between disease duration and both superficial and deep WI-MVD, parafoveal, and perifoveal VDs was obtained (for all p < .05). There was a positive correlation between VA and superficial VD (p < .001, r = 0.848 for WI-MVD). Conclusion OS affects deep VD significantly. Changes in superficial VD affect VA more. Disease duration is an important factor affecting macular VD.
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    Letter to the Editor: Peripapillary and Macular Vessel Density Measurement With Optical Coherence Angiography in Exfoliation Syndrome
    (2021) Gungor, Sirel Gur; Sezenoz, Almila Sarigul; Ozturk, Caner; Gokgoz, Gulsah; Akman, Ahmet; 0000-0002-4837-7937; 33273286; AAY-7932-2021