Fakülteler / Faculties

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Choroidal Osteoma and Secondary Choroidal Neovascularization Treated with Ranibizumab
(2017) Bayar, Sezin Akca; Sezenoz, Almila Sarıgul; Yilmaz, Gursel; 0000-0002-2589-7294; 0000-0001-5109-755X; 0000-0002-7030-5454; 28845332; AAK-6987-2021; AAJ-2406-2021; AAJ-4860-2021
A 47-year-old female patient presented with a complaint of decreased vision in the right eye. Her visual acuity was 0.16 in the right eye and 1.0 in the left eye. Fundus examination revealed a slightly elevated, yellowish-white lesion with regular borders at the macula of the right eye. Early and late hyperfluorescence related with choroidal neovascularization (CNV) was detected in the right eye on fundus fluorescein angiography. B-scan ultrasonography revealed a hyperechoic choroidal lesion with acoustic shadowing. The lesion was diagnosed as choroidal osteoma. The patient received 3 injections of intravitreal ranibizumab. After 4 months, the visual acuity of the right eye was 0.9 and the CNV had regressed. Follow-up at about 7 months revealed reduced visual acuity in the right eye with an increase in subretinal fluid. An additional ranibizumab injection was administered. In this case report, we discuss the findings and treatment of a rare case of choroidal osteoma with secondary CNV.
Clinical Spectrum of Ocular and Visual Dysfunction in Children with Periventricular Leukomalacia: A Need for an Interdisciplinary Approach
(2021) Ozturker, Zeynep Kayaarasi; Bayar, Sezin Akca; Oto, Sibel; Aksoy, Sibel; Akkoyun, Imren; Sezer, Taner; 0000-0001-5109-755X; 0000-0003-0171-4200; 0000-0003-1395-6207; 0000-0002-2860-7424; AAJ-2406-2021; AAJ-4668-2021; AAK-7713-2021
The study aimed to evaluate the ocular motility and visual and optic disc abnormalities in children diagnosed with periventricular leukomalacia (PVL). A retrospective analysis was performed on 51 consecutive children who had ophthalmic symptoms and were diagnosed with PVL by using magnetic resonance imaging. The patients were assessed for visual function, strabismus, cycloplegic refraction, fundus examination, and if appropriate, spectral-domain optical coherence tomography and visual field testing were applied. The primary outcome measures were the prevalence and visual and ocular motility dysfunctions. Mean age was 5.72 +/- 2.6 years (range = 1-12), median birth weight was 2,740 g (range =1,240-3,460), and median gestational age was 34 weeks (range = 28-38). In total, 21 patients (39.6%) had neurological deficit, 11 (21.5%) had intellectual disability, and 19 (37.2%) had no neurological symptom. In the spherical equivalent refractive error and cylinder power analysis, 10 patients had >= 3.0 D myopia, 15 had >= 3.0 D hyperopia, and eight had >= 2.50 D astigmatism. Thirteen (25.4%) children had a best-corrected visual acuity between 20/40 and 20/20 for Snellen card, while 9 (17.6%) had strabismic amblyopia and 6 (11.7%) had anisometropic amblyopia. Manifest strabismus was present in 35 patients (68.6%); of whom 12 had esotropia (23.5%), 16 had exotropia (31.3%) and 6 had vertical deviation (11.7%). Manifest or latent nystagmus was detected in 14 patients (27.4%). In 28 patients (54.9%), there was optic nerve abnormality. Two patients had hypoplastic disc, 14 had optic disc pallor, 7 had large cupping, and 5 had total optic atrophy. Six subjects underwent reliable visual field (VF) examinations, and all six had abnormal VFs, with inferior fields being most affected. Ocular motility disorders, optic nerve abnormalities, VF defects, and low visual acuity are common findings in this cohort of PVL patients and maybe the only presenting signs of the disease. The recognition of the visual disabilities and implementation of early rehabilitation may have a significant benefit in these children.
Contrast Sensitivity in Microtropic and Anisometropic Eyes of Successfully Treated Amblyopes
(2017) Bayar, Sezin Akca; Oner, Ozlem; Oto, Sibel; Gokmen, Onur; Tekindal, Mustafa Agah; 0000-0003-0171-4200; 0000-0002-6058-4226; 0000-0002-4060-7048; 0000-0001-5109-755X; 28405480; AAJ-4668-2021; AAB-1096-2021; U-9270-2018; AAJ-2406-2021
Objectives: To assess and compare contrast sensitivity function in the previously amblyopic and non-amblyopic "normal" eyes of patients with microtropia and anisometropia who achieved 20/20 visual acuity after occlusion therapy. Materials and Methods: Contrast sensitivity was tested monocularly on both eyes of 34 successfully treated microtropic and 15 anisometropic subjects (visual acuity 20/20 in both eyes). Contrast sensitivity function was evaluated by CSV-1000E and age-matched nomograms were used (spatial frequencies of 3, 6, 12, and 18 cycles per degree [cpd]) for comparison. Results: The mean age of subjects was 11.2 +/- 1.3 years in the microtropic group, 9.8 +/- 1.7 years in the anisometropic group (7-12 years); the mean follow-up time was 16.4 +/- 3.2 months (12 to 92) in the microtropic group and 27.7 +/- 1.8 months (12-84) in the anisometropic group. Statistical comparison of the microtropic amblyopic eyes versus non-microtropic eyes showed significant differences at spatial frequencies of 3, 12 and 18 cpd (3 cpd, t= 2.8, p= 0.007; 6 cpd, t= 1.1 p= 0.261; 12 cpd, t= 2.2, p= 0.033; 18 cpd, t= 2.2, p= 0.030). When anisometropic eyes were compared with non-anisometropic eyes, there was a significant difference only at 12 cpd (t= 2.1 p= 0.049). The comparison of non-amblyopic eyes versus age-matched nomograms revealed no differences at any of the spatial frequencies (p> 0.05 for all). Conclusion: Contrast sensitivity was decreased in patients with amblyopia, especially in the microtropic group. The assessment of contrast sensitivity function may serve as a new parameter for termination of occlusion therapy.
Effects of Intracameral Drugs and Dyes on Corneal Endothelial Cell Apoptosis in a Rat Model: An In Vivo and In Vitro Analysis
(2022) Bayar, Sezin Akca; Ozturker, Zeynep Kayaarasi; Akova, Yonca Aydin; Bilezikci, Banu; Karabay, Gulten; 0000-0001-5109-755X; 36578186; AAJ-2406-2021
Objectives: To evaluate the effects of intracameral drugs and dyes on rat corneal endothelial apoptosis and cell morphology. Materials and Methods: The right eyes of 72 rats were injected intracamerally with 1% lidocaine, 0.01% adrenaline, triamcinolone acetonide (TA) 4 mg/mL, 1% trypan blue (TB), 0.5% indocyanine green (ICG), and fortified balanced salt solution as control. Corneal samples were taken 1 day and 1 week post-injection. Corneal endothelial apoptosis was assessed by the TUNEL technique, and the ratio of apoptotic cells in each group was compared with the control. Corneal endothelial cell morphology was evaluated in each specimen by transmission electron microscopy. Results: The mean apoptotic endothelial cell ratio was significantly higher at 1 day and 1 week after intracameral adrenaline injection when compared to controls (p=0.03 and 0.021, respectively). TB caused a significantly higher apoptotic cell ratio when compared to controls at 1 week after injection (p=0.043). Lidocaine caused a higher apoptotic cell ratio compared to TA and ICG at 1 week, although not statistically significant (p=0.058, 0.09, 0.69, respectively). In all experimental specimens, transmission electron microscopy showed morphological changes associated with apoptosis. Conclusion: This study showed that intracameral adrenaline, TB, and lidocaine injections may have toxic effects on corneal tissue, as indicated by ultrastructural and histopathological alterations. Therefore, these agents should be used with caution in intraocular surgery.
Macular Imaging Characteristics in Children with Myelinated Retinal Nerve Fiber and High Myopia Syndrome
(2023) Sezenoz, Almila Sarigul; Oto, Sibel; Akkoyun, Imren; Bayar, Sezin Akca; Yilmaz, Gursel; Colak, Meric Yavuz; 0000-0003-0171-4200; 0000-0002-2860-7424; 0000-0001-5109-755X; 0000-0002-7030-5454; 0000-0002-0294-6874; 37602641; AAJ-4668-2021; AAK-7713-2021; AAJ-2406-2021; AAJ-4860-2021; AAA-4360-2021
Objectives: To investigate the macular imaging features in patients with unilateral myelinated retinal nerve fiber (MRNF) and high myopia syndrome. Materials and Methods: Six patients with unilateral MRNF and high myopia syndrome and 13 myopic controls were enrolled in this study. Spectral domain (SD) optical coherence tomography (OCT), SD enhanced depth imaging OCT, and OCT angiography (OCTA) imaging results of MRNF-affected eyes were compared with the fellow eyes and myopic controls. Results: All patients had abnormal foveal reflex and/or ectopia. No significant difference in retinal thickness parameters were noted between the groups. In OCT scans, posterior vitreous detachment (PVD) was observed in 4 out of the 6 MRNF-affected eyes. Regarding OCTA parameters, only a significant increase in acircularity index was noted in myelinated eyes (p=0.01). Conclusion: All patients demonstrated normal foveal contours, macular structure, and OCTA features except for a higher acircularity index. The incidence of PVD was notably increased in the myelinated eyes.
Spontaneous Regression of Optic Disc Pit Maculopathy in a Six-Year-Old Child
(2017) Bayar, Sezin Akca; Sezenoz, Almila Sarıgul; Pinarci, Eylem Yaman; Yilmaz, Gusel; 0000-0001-5109-755X; 0000-0002-7030-5454; 28182177; AAJ-2406-2021; AAJ-4860-2021
A 6-year-old boy with a complaint of blurred vision for two months was referred to our clinic. His visual acuity was 20/32 in the right eye and 20/20 in the left eye. Optical coherence tomography (OCT) revealed optic disc pit maculopathy in the right eye. The patient was followed for 6 months without any treatment. At the end of the 6-month period, the patient's visual acuity was 20/20 in both eyes. The OCT imaging showed spontaneous regression of the optic disc pit maculopathy. In this case report, it is concluded that in children, spontaneous regression of the optic pit maculopathy with full recovery of visual acuity is possible. The development of optic pit maculopathy in childhood is rare and there are not enough studies on the treatment methods. Therefore, our case report may be helpful in the management of similar cases of pediatric optic disc maculopathy.