Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Peripapillary and Macular Vessel Density Measurement With Optical Coherence Tomography Angiography in Exfoliation Syndrome(2021) Gur Gungor, Sirel; Gokgoz, Gulsah; Sarigul Sezenoz, Almila; Ozturk, Caner Caner; Akman, Ahmet; 0000-0002-4837-7937; 0000-0002-7030-5454; 32976289; AAY-7932-2021; AAJ-4860-2021Precis: Although peripapillary retinal nerve fiber layer thickness (RNFLTs) and vessel density (VD) values were similar to healthy group, eyes with exfoliation syndrome had significantly lower superficial macular VDs and minimum ganglion cell analysis values. Purpose: To compare peripapillary and macular perfused capillary densities with optical coherence tomography angiography (OCT-A) between patients with eyes having exfoliation syndrome (XFS) and normal age-matched healthy controls. Patients and Methods: This cross-sectional study included patients diagnosed with XFS from December 2017 to January 2020 at the Glaucoma Department. Peripapillary and parafoveal superficial VDs were obtained using OCT-A. The RNFLTs and ganglion cell analysis values were compared. Results: Thirty-nine eyes of 39 XFS patients (26 women; mean age, 69.0 +/- 8.1 y) and 39 eyes of 39 healthy patients (25 women; mean age, 68.0 +/- 8.6 y) were enrolled. There were no statistically significant differences in sex or age distribution, central corneal thickness measurements, refractive errors, or intraocular pressures between both groups (all P>0.05). There were no statistically significant differences in the peripapillary VD or peripapillary RNFLT between XFS eyes and healthy eyes (P>0.05 for all). In the macular region, most superficial VD parameters were significantly reduced in the XFS group (P=0.02 for parafoveal VD, P=0.04 for both hemifields). While the average ganglion cell and internal plexiform layer (GCL+IPL) values were similar between groups (P=0.19), the minimum GCL+IPL value was lower in the XFS group than in the healthy group (P=0.03). Conclusion: Although structural test results, especially peripapillary RNFLT and mean GCL+IPL, were similar between the healthy and XFS groups, macular VD values were lower in XFS eyes. Our findings implicate microvascular damage can be the mechanism underlying XFS-related changes and indicate that it precedes significant structural damage.Item 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-5967-2021Objectives: 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 valueItem Comparison of intracameral dexamethasone and intracameral triamcinolone acetonide injection at the end of phacoemulsification surgery(2014) Gungor, Sirel Gur; Bulam, Begum; Akman, Ahmet; Colak, Meric; 25230962Purpose: To compare the results of intracameral dexamethasone and intracameral triamcinolone acetonide injection in patients that underwent cataract surgery with phacoemulsification. Materials and Methods: Sixty eyes of 60 patients that underwent cataract surgery with phacoemulsification were randomized into two groups. Preoperative visual acuity of all patients was 0.5 or lower and intraocular pressures were under 21mmHg. After surgery, eyes in group 1 (30 eyes) were injected with 0.4 mg/0.1 ml dexamethasone into the anterior chamber, and eyes in group 2 (30 eyes) were injected with 2 mg/0.05 ml triamcinolone acetonide into the anterior chamber. All eyes received standard postoperative prednisolone acetate and moxifloxacin eye drops. The biomicroscopic evaluation, visual acuity, and intraocular pressure measurements were done at baseline (preoperatively) and on postoperative days 1, 7 and 30. Results: There were no statistically significant differences in mean visual acuity, the amount of anterior cells and flare between the two groups (P >= 0.05). Mean intraocular pressure values at postoperative first day were significantly higher in group 2 than in group 1 (P = 0.009). The mean intraocular pressures on days 7 and 30 after surgery were not statistically different between the two groups (P >= 0.05). Conclusions: Intracameral dexamethasone and intracameral triamcinolone acetonide were similarly effective in controlling postoperative inflammation following phacoemulsification. However, the intraocular pressures on postoperative first day were higher in patients receiving intracameral triamcinolone acetonide. The highest intraocular pressure in triamcinolone acetonide group was 24 mmHg, and stabilized in a few days, therefore using triamcinolone acetonide may impose a minimal risk to patients. Nevertheless, intracameral dexamethasone seems to be a better alternative to apply at the end of surgery to suppress the inflammation during the first 24 hours.Item Atypical Intrapapillary Hemorrhage in a Patient with Glaucoma(2015) Gungor, Sirel Gur; Ozisik, Gulce Gokgoz; Akman, Ahmet; Asena, LeylaA 73-year-old man presented for routine follow-up. There were primary open-angle glaucoma, diabetes mellitus, and usage of acetylsalicylic acid in patient's history. Dilated fundus examination demonstrated cup hemorrhage in the right eye. Because of the progression of the superotemporal retinal nerve fiber layer defect in the last seven months, we think that the disk hemorrhage could be associated with glaucoma. (Turk J Ophthalmol 2015; 45: 77-8)Item Comparison of intracameral dexamethasone and intracameral triamcinolone acetonide injection at the end of phacoemulsification surgery Reply(2015) Gungor, Sirel Gur; Bulam, Begum; Akman, Ahmet; Colak, MericItem Herpetic Keratouveitis and Trabeculectomy Failure during Infliximab Therapy in a Patient with Behcet's Disease(2016) Gungor, Sirel Gur; Asena, Leyla; Akman, Ahmet; Gokmen, Onur; 27800267A 51-year-old man was diagnosed with Behcet's disease in 2001. The patient was resistant to all immunosuppressive therapies. After 6 months of infliximab therapy, he presented to our clinic with pain and blurred vision in his right eye. The visual acuity was 20/200 and the intraocular pressure was 35 mmHg in the right eye. Biomicroscopic examination revealed corneal dendritic ulcers and 2+ cells in the anterior chamber in the right eye. The herpetic keratouveitis attack was controlled with antiviral therapy but the patient needed another glaucoma surgery. Trabeculectomy with mitomycin C was performed about halfway through an eight-week interval between two doses of infliximab.Item Retinal Nerve Fiber Layer Thicknesses in Three Different Optic Nerve Head Size Groups Measured by Cirrus Spectral Domain Optical Coherence Tomography(2016) Gungor, Sirel Gur; Akman, Ahmet; Kucukoduk, Ali; Colak, Meric; 27800261Objectives: To compare the retinal nerve fiber layer (RNFL) thicknesses in three different optic nerve head (ONH) size groups measured by Cirrus spectral domain optical coherence tomography (OCT). Materials and Methods: Between January and March 2013, 253 eyes of 253 healthy subjects were enrolled in this study (mean age: 42.7 perpendicular to 7.4 years [28-62 years]; 121 men and 132 women). The patients were divided into 3 groups according to ONH size: 77 patients in the "small ONH" group (ONH area < 1.63 mm(2)), 90 patients in the " medium ONH" group (ONH area 1.63-1.97 mm(2)), and 86 patients in the "large ONH" group (ONH area > 1.97 mm(2)). Results: There were significant differences in superior (p=0.008), inferior (p=0.004) and average RNFL thickness (p=0.001) between the small, medium and large ONH groups. Positive correlations between ONH size and inferior/ average RNFL thicknesses were significant but very weak (r=0.150, p=0.017 and r=0.157, p=0.013 respectively). Conclusion: RNFL thickness as measured by Cirrus OCT is positively correlated with ONH size and the differences in RNFL thickness were statistically significant between groups. This correlation and difference may be the result of a varying distance between the circular scan and the ONH margin.Item Evaluation and comparison of the new swept source OCT-based IOLMaster 700 with the IOLMaster 500(2016) Akman, Ahmet; Asena, Leyla; Gungor, Sirel Gur; 0000-0001-6178-8362; 0000-0002-6848-203X; 26674777; AAD-5967-2021; E-5914-2016Purpose To compare the measurements and failure rates obtained with a new swept source optical coherence tomography (OCT)-based biometry to IOLMaster 500. Setting Eye Clinic, Baskent University Faculty of Medicine, Ankara, Turkey. Design Observational cross-sectional study and evaluation of a new diagnostic technology. Methods 188 eyes of 101 subjects were included in the study. Measurements of axial length (AL), anterior chamber depth (ACD), corneal power (K1 and K2) and the measurement failure rate with the new Zeiss IOLMaster 700 were compared with those obtained with the IOLMaster 500. The results were evaluated using Bland-Altman analyses. The differences between both methods were assessed using the paired samples t test, and their correlation was evaluated by intraclass correlation coefficient (ICC). Results The mean age was 68.3212.71years and the male/female ratio was 29/72. The agreements between two devices were outstanding regarding AL (ICC=1.0), ACD (ICC=0.920), K1 (ICC=0.992) and K2 (ICC=0.989) values. IOLMaster 700 was able to measure ACD AL, K1 and K2 in all eyes within high-quality SD limits of the manufacturer. IOLMaster 500 was able to measure ACD in 175 eyes, whereas measurements were not possible in the remaining 13 eyes. AL measurements were not possible for 17 eyes with IOLMaster 500. Nine of these eyes had posterior subcapsular cataracts and eight had dense nuclear cataracts. Conclusions Although the agreement between the two devices was excellent, the IOLMaster 700 was more effective in obtaining biometric measurements in eyes with posterior subcapsular and dense nuclear cataracts.Item Prevalence of Split Nerve Fiber Layer Bundles in Healthy People Imaged with Spectral Domain Optical Coherence Tomography(2016) Gungor, Sirel Gur; Akman, Ahmet; Sezenoz, Almila Sarıgul; Tanriasik, Gulsah; 0000-0001-6178-8362; 0000-0002-7030-5454; 28050324; AAD-5967-2021; AAJ-4860-2021Objectives: The presence of retinal nerve fiber layer (RNFL) split bundles was recently described in normal eyes scanned using scanning laser polarimetry and by histologic studies. Split bundles may resemble RNFL loss in healthy eyes. The aim of our study was to determine the prevalence of nerve fiber layer split bundles in healthy people. Materials and Methods: We imaged 718 eyes of 359 healthy persons with the spectral domain optical coherence tomography in this cross-sectional study. All eyes had intraocular pressure of 21 mmHg or less, normal appearance of the optic nerve head, and normal visual fields (Humphrey Field Analyzer 24-2 full threshold program). In our study, a bundle was defined as 'split' when there is localized defect not resembling a wedge defect in the RNFL deviation map with a symmetrically divided RNFL appearance on the RNFL thickness map. The classification was performed by two independent observers who used an identical set of reference examples to standardize the classification. Results: Inter-observer consensus was reached in all cases. Bilateral superior split bundles were seen in 19 cases (5.29%) and unilateral superior split was observed in 15 cases (4.16%). In 325 cases (90.52%) there was no split bundle. Conclusion: Split nerve fiber layer bundles, in contrast to single nerve fiber layer bundles, are not common findings in healthy eyes. In eyes with normal optic disc appearance, especially when a superior RNFL defect is observed in RNFL deviation map, the RNLF thickness map and graphs should also be examined for split nerve fiber layer bundles.Item 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-5967-2021Objectives: 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.