Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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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 A diagnostic dilemma in a patient with delayed onset endophthalmitis(2019) Ercan, Zeynep Eylul; Akkoyun, Imren; Gungor, Sirel Gur; Yilmaz, Gursel; 0000-0001-6178-8362; 0000-0002-9915-3781; 30930672; AAD-5967-2021; AAQ-3136-2020We report a case of nonpainful uveitis nine months after an uncomplicated phacoemulsification cataract surgery. Chronic postoperative endophthalmitis was suspected. Diagnostic vitrectomy and partial capsular bag removal was performed, but the specimens cultured in microbiology laboratory showed no pathogens. Systemic workup came positive for skin Tuberculosis test, and presumed intraocular tuberculosis treatment was started accordingly. Inflammation persisted, so a repeat vitrectomy was performed with removal of the lens implant with the capsule, and this time bedside culture inoculation was performed in operating room, revealing Pseudomonas infection. Delayed-onset postoperative endophthalmitis typically progresses slowly and therefore can be confused with uveitis and treated with steroid and immunosuppressant treatment regimes. Our case confirms both the value of immediate bacterial inoculation and the necessity of aggressive surgical treatment in chronic postoperative endophthalmitis cases.Item 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 Evaluation of anterior chamber inflammation Reply(2015) Gungor, Sirel Gur; 26171477Item 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 A Case of Lyme Disease Accompanied by Uveitis and White Dot Syndrome(2016) Gungor, Sirel Gur; Muftuoglu, Ilkay Kilic; Akova, Yonca Aydin; 0000-0001-6178-8362; 28058168; AAD-5967-2021In this case report we aimed to present a case of Lyme disease presenting as peripheral retinal vasculitis, intermediate uveitis and multifocal white dots in the posterior pole. The patient exhibited vitritis and snowball opacities in both eyes. A diagnosis of Lyme disease was made based on clinical, angiographic and laboratory findings. Fundus fluorescein angiography revealed optic nerve and retinal venous leakage as well as multiple hyperfluorescent foci in both eyes. The patient's symptoms and ocular findings significant improved after treatment with a combination of systemic antibiotics and steroids. Ophthalmologists should bear in mind that conditions presenting with uveitis and multifocal white dots may be related to Lyme disease.