Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Effect of Fingolimod (FTY720) on Choroidal Thickness in Patients with Multiple Sclerosis(2017) Kal, Ali; Ulusoy, Mahmut Oguz; Horasanli, Bahriye; Cezairlioglu, Sefik; Kal, Oznur; 0000-0002-7751-4961; 0000-0001-7544-5790; 0000-0003-3142-1011; 28619430; AAJ-7586-2021; AAJ-4936-2021Objective: Using spectral domain optical coherence tomography (SD-OCT), to compare the choroidal thickness in a healthy population (group 1), with newly diagnosed multiple sclerosis (MS) patients (group 2), with MS patients who underwent beta-interferon monotherapy (group 3) and MS patients who underwent fingolimod therapy for 1 year (group 4) Methods: Twenty-five control subjects (25 eyes), 24 newly diagnosed (24 eyes) MS patients, 22 MS patients who underwent fingolimod monotherapy for 1 year (22 eyes), and 24 MS patients who underwent beta-interferon monotherapy for 1 year (24 eyes) were included in this study. The control group consisted of age- and gender matched healthy individuals. The choroidal thickness measurements were performed using a high-speed and high-resolution SD-OCT device. The choroidal thickness measurements were compared using a One Way Anova and Post-Hoc Tukey test. Results: Ninety-five eyes of 95 participants were included in this study. The mean age of the control group was 27.83 +/- 4.60, and it was 26.83 +/- 6.79, 27.87 +/- 6. 46 and 27.58 +/- 6.65 in the newly diagnosed MS group, fingolimod group and beta-interferon group, respectively. In fingolimod group N-1000, N-1500 and T-1500 was significantly lower than control group. (p = 0.026, p = 0.06 p = 0.13) Conclusion: Choroidal thickness values at N-1000, N-1500 and T-1500 levels in fingolimod group were found lower than in control but higher than in newly diagnosed MS group. This result can be explained with the therapeutic effect of the fingolimod on MS.Item Unfavorable Outcome of Pediatric Onset Multiple Sclerosis: Follow-Up in the Pediatric and Adult Neurology Departments of One Referral Center, in Turkey(2016) Derle, Eda; Kurne, Asli Tuncer; Konuskan, Bahadir; Karabudak, Rana; Anlar, Banu; 0000-0001-6727-6229; 0000-0003-2122-1016; 27645334; HJH-2490-2023; I-9090-2013; AAI-8830-2021Background:: The prevalence of MS starting under 18 years of age ranges between 2-10% of the total MS population. Objective:: We aimed to examine the clinical and long term follow-up data of pediatric-onset cases in our institutional MS database. Method:: We evaluated the clinical data from the MS database of the Departments of Neurology and Pediatric Neurology of Hacettepe University Hospital. Results:: The clinical features of 74 patients who had experienced the first attack before age 18 years comprised 3.9% of our MS population. Median age at onset was 15 (3, 5-17, IQR=3.63) years, and female: male ratio was 2.4. The most frequent symptom at onset was brainstemicerebellar dysfunction (32.4%). Seventy two patients (97.3%) initially had relapsing remitting course and in the follow-up, 17 (23%) of them developed secondary progressive (SP) course. The median interval to develop SPMS course was 10 (5-21, IQR=8) years. At the last visit, median disease duration was 6.67 (0.83-25, IQR=9.06) years, 41 (55.4%) of them had EDSS of >= 4. Conclusion:: These findings illustrate the profile of our pediatric MS patients: almost all are relapsing remitting initially; about one fourth become secondarily progressive in 10 years, and about half acquire disability EDSS >= 4 in mean 8 years. (C) 2016 Elsevier B.V. All rights reserved.Item Optical coherence tomography angiography findings of multiple sclerosis with or without optic neuritis(2020) Ulusoy, Mahmut Oguz; Horasanli, Bahriye; Isik-Ulusoy, Selen; 32048550Objective: Nowadays, retinal microvascular structures can be investigated using optical coherence tomography angiography (OCTA). We aimed to evaluate the probable vascular changes in the foveal and peripapillary regions of patients with multiple sclerosis (MS). Methods: A total of 20 patients with relapsing remitting multiple sclerosis (RRMS) and 24 healthy controls were recruited in this study. All participants' superficial and deeper retinal and peripapillary layers were evaluated using OCTA after a total ophthalmologic examination. Results: In the superficial plexus, the whole image (49.53 +/- 3.9% and 51.83 +/- 2.1%, p = 0.009), superior hemisphere (49.44 +/- 4.11% and 51.63 +/- 2.3%, p = 0.018), inferior hemisphere (49.75 +/- 3.9% and 52.03 +/- 2.2%, p = 0.012), parafoveal (51.87 +/- 3.9% and 53.08 +/- 3.46%, p = 0.048) and perifoveal (50.41 +/- 3.86% and 52.76 +/- 2.1%, p = 0.007) vascular densities were statistically significant lesser in patients with RRMS than in controls. In the optic disc OCTA parameters, the vessel density of the inferior (50.15 +/- 6.99% and 53.04 +/- 3.63% p = 0.043) and temporal sector (48.09 +/- 5.47% and 50.85 +/- 5.24%, p = 0.045) were statistically significantly lesser in patients with RRMS than in controls. Conclusion: The reductions in vessel density of the retinal or peripapillary area of patients with RRMS shown in this study should be investigated further to determine whether it is a secondary lesion to optic neuritis (ON) or a primary vasculopathic condition of MS.Item 'Is RLS a harbinger and consequence of MS?: Striking results of the 'RELOMS-T' study'(2020) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat; Boz, Cavit; Tuncel, Deniz; Karabudak, Rana; Siva, Aksel; Ozcan, Abdulcemal; Neyal, Munife; Goksel, Basak Karakurum; Balal, Mehmet; Sen, Sedat; Ekmekci, Ozgul; Oksuz, Nevra; Kaya, Derya; 0000-0003-2766-2277; 32473575; AAE-2609-2021Background: Although studies report a high prevalence rate of restless legs syndrome (RLS) among patients with multiple sclerosis (PwMS) ranging from 13.3 to 65.1%, little is known about the causes of this relationship. Methods: To ascertain the prevalence, features and impact of RLS among PwMS a nation-wide, multicenter, prospective and a cross-sectional survey, designed to reflect all of the PwMS throughout Turkey, was conducted in 13 centers. Exploring the relationship of the two conditions could possibly contribute to the understanding of the causes of the high and wide-ranging prevalence rates and the pathophysiology of both diseases. Results: Of the 1068 participants 173 (16,2%) found to have RLS [RLS(+)] and 895 (83,8%) did not [RLS(-)]. Among the RLS(+) 173, all but 8 patients (4,6%) were underdiagnosed in terms of RLS. More than half of the patients with RLS had 'severe' or 'very severe' RLS. The onset of RLS was before or synchronous with the onset of MS in about a half of our patients. Conclusion: We conclude that RLS should be meticulously investigated in PwMS and MS can be a direct cause of RLS at least in part of PwMS. Our data about the timing of the onset of MS and RLS, along with the high prevalence of RLS in PwMS suggest that the pathologic changes in the initial phases of MS can possibly trigger RLS symptoms.