Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Assessment of Tear Meniscus with Optical Coherence Tomography in Thyroid-Associated Ophtalmopathy(2014) Sizmaz, Selcuk; Altan-Yaycioglu, Rana; Bakiner, Okan Sefa; Bozkirli, Emre; Coban-Karatas, Muge; Ulas, Burak; https://orcid.org/0000-0002-9139-8848; 24215623; AAG-3306-2019; AAK-5525-2021; E-9887-2014; AEP-4897-2022Purpose: To evaluate the tear-film meniscus with optical coherence tomography (OCT) in patients with Graves' disease (GD). Materials and methods: Patients with GD without clinical features of thyroid-associated ophthalmopathy (TAO) (Group 1, n = 35), patients with signs of TAO (Group 2, n = 31) and healthy participants (Group 3, n = 31) were enrolled. Palpebral fissure width, Schirmer test, tear break-up time (TBUT) test and tear-film meniscus height and area obtained with Fourier-domain-OCT were analyzed. Results: TBUT test scores were 8 s (2-25) in Group 1, 8 s (2-15) in Group 2 (p = 0.380); and10 s (5-17) in Group 3 (p = 0.000 Group 1 versus 3, and 0.000 for Group 2 versus 3). Tear-film meniscus height did not significantly differ between Groups 1 and 2 (257.5 mm (86-962) and 258 mm (99-1340), respectively, p = 0.980). In Group 3, tear-film meniscus height was 316 mm (122-720) (p = 0.005 Group 1 versus 3 and 0.004 for Group 2 versus 3). Tear-film meniscus area did not significantly differ between Groups 1 and 2 (0.025mm(2) (0.004-0.250) and 0.024mm(2) (0.003-0.316), respectively, p = 0.850). In Group 3, tear-film meniscus area was 0.048mm(2) (0.006-0.75) (p = 0.000 Group 1 versus 3 and 0.000 for Group 2 versus 3). Conclusion: Tear function is significantly disturbed in GD. OCT is an effective way to assess the tearing function also in patients with GD.Item Interexaminer Reproducibility of Optical Coherence Tomography for Measuring the Tear Film Meniscus(2014) Canan, Handan; Altan-Yaycioglu, Rana; Ulas, Burak; Sizmaz, Selcuk; Coban-Karatas, Muge; https://orcid.org/0000-0002-5877-6536; https://orcid.org/0000-0002-9139-8848; 24749829; AAB-6394-2021; AAG-3306-2019Purpose: New optical coherence tomography (OCT) devices with anterior segment module are able to measure the tear meniscus height (TMH) and tear meniscus area (TMA). Since the borders of the area and the height are to be marked by an examiner, the measurements are prone to be subjective. Herein, we aimed to evaluate the interexaminer reproducibility of the tear meniscus measurements with OCT. Materials and Methods: In this prospective cross-sectional study, both eyes of 300 consecutive patients with and without dry eye were studied. Following routine ophthalmologic examination, tear-film OCT images were obtained. Two examiners, who were unaware of the other examiner's results, measured the TMH (i. e. the line connecting the intersection of the meniscus with the cornea/sclera and eyelid) and cross-sectional TMA. The reliability and correlation of the two examiners' results were assessed. Results: Four right and six left eyes were excluded from the final analysis, so a total of 590 eyes were evaluated. The mean difference of the two examiners' measurements of both eyes was - 0.001 +/- 0.027mm(2) in TMA, and - 21.29 +/- 39.95 mm in TMH. An agreement between the two examiners was found regarding TMA and TMH measurements for right and left, as well as both eyes (Cronbach's alpha > 0.900, for all). Also, the correlation between both variables was high (inter item correlation matrix > 0.840, for all). Conclusions: We showed a strong statistical agreement for both TMA and TMH measurements. According to our results, we believe that FD-OCT device is dependable in measuring the TMA and TMH values, given that its results are reproducible.Item Retinal and Choroidal Thickness Changes After Single Anti-VEGF Injection in Neovascular Age-Related Macular Degeneration: Ranibizumab vs Bevacizumab(2014) Sizmaz, Selcuk; Kucukerdonmez, Cem; Kal, All; Pinarci, Eylem Yaman; Canan, Handan; Yilmaz, Gursel; https://orcid.org/0000-0002-5877-6536; https://orcid.org/0000-0002-2589-7294; 24803153; AAB-6394-2021; AAK-6987-2021Purpose: To evaluate and compare the effects of single intravitreal injection of ranibizumab and bevacizumab on central retinal and choroidal thickness in patients with neovascular age-related macular degeneration (AMD). Methods: Forty eyes of 40 patients with neovascular AMD that underwent intravitreal injection of vascular endothelial growth factor inhibitors (anti-VEGFs) were included. Patients were randomized into 2 groups: 20 eyes received ranibizumab and 20 eyes received bevacizumab injection. Central retinal and choroidal thicknesses of all eyes at baseline and 1 month postinjection scans were measured with Fourier-domain optical coherence tomography (OCT). Student t test and Mann-Whitney U test were used to compare the data. Results: The mean central retinal thickness (CRT) showed significant decrease after single injection of ranibizumab (from 345.0 mu m to 253.5 mu m, p<0.01) and bevacizumab (from 329.5 mu m to 251.0 mu m, p<0.01) at the first month, respectively. There was no significant difference regarding the CRT change between groups (p = 0.39). The mean choroidal thickness decreased from 158.6 mu m (115-317) to 155.5 mu m (111-322) in the ranibizumab group and from 211.5 mu m (143-284) to 201.5 mu m (93-338) in bevacizumab group. The decrease was not significant between groups (p = 0.35). Conclusions: Intravitreal injection of both ranibizumab and bevacizumab provided a significant decrease in CRT; however, the agents caused no significant change in choroidal thickness. Additionally, no difference between ranibizumab versus bevacizumab was observed related to macular edema inhibition.Item Serum Immunoglobulin G4 Levels are Elevated in Patients with Graves' Ophthalmopathy(2015) Bozkirli, Emre; Bakiner, Okan Sefa; Bozkirli, Emine Duygu Ersozlu; Haydardedeoglu, Filiz Eksi; Sizmaz, Selcuk; Torun, Aysenur Izol; Ertorer, Melek Eda; 0000-0002-1644-6790; 0000-0002-0179-9673; 0000-0001-7357-8709; 25400133; E-9887-2014; AAK-5525-2021; AAK-5003-2021; ABI-3705-2020Objective Recent studies have shown close association between serum Immunoglobulin G4 (IgG4) levels and forms of autoimmune thyroiditis. However, there are limited data about the relationship between IgG4 and Graves' ophthalmopathy (GO). In the present study, we aimed to determine the possible association between IgG4 and GO. Design Cross-sectional study. Patients Sixty-five patients with Graves' disease (GD) and 25 healthy controls were recruited into the study. Thirty-two of these patients had GO. Measurements Serum IgG4 levels, thyroid functions and thyroid volumes were measured in all participants. Ophthalmological examination including Hertel's exophthalmometer readings (HER), Schirmer's test (ST), 'NO SPECS' classification and clinical activity score evaluation (CAS) were performed to all patients with GD. Results IgG4 levels were significantly elevated in patients with Graves' disease compared to controls (P = 0.0001). Also, IgG4 levels were significantly higher in patients with and without GO when compared to control subjects (P = 0.0001 and P = 0.002, respectively). Furthermore, IgG4 levels were significantly higher in the GO group compared with GD patients without GO (P = 0.024). IgG4 levels were observed to increase in parallel to CAS. Compared with other GD patients, 15 GD patients with serum IgG4 levels >= 135 mg/dl had higher CAS scores (P = 0.012). None of the factors including, TSH, T3, T4 levels, thyroid volume, HER and ST measurements, affect IgG4 levels as an independent factor. Conclusion IgG4 levels are evidently increased in patients with GD, and there is a possible relationship between IgG4 and GO. Our results suggest that IgG4 may be helpful in screening GD patients with high risk for GO and may well become a good indicator for the selection of right medication in the future.Item Efficacy of Topical 0.05% Cyclosporine Treatment in Children with Severe Vernal Keratoconjunctivitis(2014) Coban-Karatas, Muge; Ozkale, Yasemin; Altan-Yaycioglu, Rana; Sizmaz, Selcuk; Pelit, Aysel; Metindogan, Sevda; Canturk-Ugurbas, Silay; Aydin-Akova, Yonca; https://orcid.org/0000-0003-3009-336X; https://orcid.org/0000-0002-9139-8848; https://orcid.org/0000-0002-0662-2033; 25818961; AAL-6136-2021; AAL-4440-2020; F-2809-2015We aimed to determine the efficacy of topical cyclosporine in children with vernal keratoconjunctivitis refractory to topical mast cell stabilizer and antihistamine therapy. Thirty-one patients, 24 boys and 7 girls younger than 16 years of age, were included in the study. All patients were scored on a four-point scale from 0 to 3 for symptoms and signs. Each patient received topical cyclosporine 0.05% emulsion (Restasis, Allergan Inc., Irvine, CA, USA) four times daily in addition to preservative-free artificial tears and was followed for 6 months. The data was recorded before the initiation of treatment (day 0) and at the 1st, 3rd, and 6th months following treatment. After six months of treatment, severity of all symptoms and signs showed a statistically significant decrease (p<0.05). Patients did not report any serious adverse effects. Topical cyclosporine 0.05% emulsion treatment is a safe and effective treatment option for controlling the symptoms and signs of vernal keratoconjunctivitis in children.