Fakülteler / Faculties
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Item Choroidal Vascularity Index Changes in Different Treatments for Vitreomacular Traction(2023) Ercan, Zeynep Eylul; Gokgoz, Gulsah; Akkoyun, Imren; Yilmaz, Gursel; 0000-0002-2860-7424; 37572736; AAK-7713-2021Introduction: The aim of this study was to examine if choroidal vascularity index (CVI) is different in eyes with unilateral vitreomacular traction (VMT) from their healthy fellow eyes; and whether different treatments affect the CVI. Methods: The baseline and 8-week post treatment CVIs of 56 unilateral VMT patients that underwent spontaneous resolution (n = 30), vitreoretinal surgery (n = 16) or pneumatic vitreolysis (n = 10) were compared with fellow eyes using paired samples t-test. Partial correlation analyses correcting age and gender was used for calculations between treatment groups. P values < 0.05 were considered statistically significant. Results: The mean baseline CVI for VMT and control eyes had no statistically significant difference (p = 0.81, r= -0.38). The post traction release follow-up CVI of VMT eyes and contralateral eyes had no significant difference (p = 0.12, r = 0.49). In spontaneous resolution group, vitreoretinal surgery group and pneumatic vitreolysis group the baseline and follow up CVIs of VMT eyes were statistically similar (p = 0.72, p = 0.32 and p = 0.79 respectively).Spontaneous detachment patients' CVIs showed a 0.57 +/- 5.81% increase, vitreoretinal surgery group had a reduction of 1.098 +/- 4.76%, and the pneumatic vitreolysis patients showed a CVI reduction of 0.307 +/- 4.24%. However, none of these changes was found to be statistically significant when compared between the groups (p = 0.21, r = 0.02). Discussion: Previous studies have argued that vitreomacular traction might have a role on the choroidal changes seen in the vitreoretinal interface disorders. This study has shown that VMT alone does not cause any significant changes in choroidal vascular index pre or post traction release.Item The Relationship Between the Degree of Cognitive Impairment and Retinal Nerve Fiber Layer Thickness(2015) Oktem, Ece Ozdemir; Derle, Eda; Kibaroglu, Seda; Oktem, Caglar; Akkoyun, Imren; Can, Ufuk; 0000-0002-2860-7424; 0000-0003-2122-1016; 0000-0001-8689-417X; 0000-0002-3964-268X; 25575807; AAK-7713-2021; AAI-8830-2021; AAJ-2999-2021; AAJ-2956-2021The goal of the present study is to investigate the relationship between the degree of cognitive impairment and retinal nerve fiber layer (RNFL) thickness which is measured by the optical coherence tomography (OCT). Thirty-five patients with Alzheimer's disease (AD), 35 patients with mild cognitive impairment (MCI), and 35 healthy volunteers, between the ages of 60-87, who were examined in the neurology outpatient clinic among 2012-2013 were prospectively involved in our study. Mini mental state examination (MMSE) test, montreal cognitive assessment (MOCA), and also neuropsychological test batteries were used for the neurocognitive evaluation. RNFL thickness was measured by the OCT technique and the differences among groups were studied. The relationship between RNFL thickness and MMSE scores with demographic characteristics was investigated. RNFL thickness was significantly lower in AD and MCI groups compared with the control group (p < 0.01). No significant differences of RNFL were found between the MCI and the AD groups (p > 0.05). Significant correlation was found between MMSE scores and the RNFL values (p < 0.05). Significant thinning in RNFL along with age was detected (p < 0.05). In our study, it is thought that retinal nerve fiber degeneration and central nervous system degeneration may be concurrent according to the thinning of RNFL measured by OCT in AD and MCI groups. RNFL measurement may also be useful for early diagnosis and evaluation of the disease progression. Further studies are needed to optimize the utility of this method as an ocular biomarker in AD.Item Choroidal Thickness in Ocular Sarcoidosis during Quiescent Phase Using Enhanced Depth Imaging Optical Coherence Tomography(2014) Gungor, Sirel Gur; Akkoyun, Imren; Reyhan, Nihan Haberal; Yesilirmak, Nilufer; Yilmaz, Gursel; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-2860-7424; https://orcid.org/0000-0001-9852-9911; https://orcid.org/0000-0002-8632-2873; https://orcid.org/0000-0002-2589-7294; 24912003; AAD-5967-2021; AAK-7713-2021; AAK-4587-2021; AAD-7299-2020; AAK-6987-2021Purpose: To evaluate the choroidal thickness in patients with ocular sarcoidosis during quiescent phase using enhanced depth imaging optical coherence tomography (EDI-OCT) and comparing it with normal subjects. Method: Eighteen eyes of 9 patients with ocular sarcoidosis (8 women, 1 man, mean age: 59.12 +/- 18.49 years) were enrolled in this study. Their subfoveal choroidal thickness was measured using EDI-OCT in the quiescent phase of uveitis, and compared with the age-, sex-, and spherical equivalent-matched normal subjects (6 women, 3 men, mean age: 59.6 +/- 14.22 years). Results: The mean subfoveal choroidal thickness was 281.76 +/- 88.1 mm in patients with sarcoidosis and 342.32 +/- 71.02 mm in controls. Significant differences were found at points between nasal 1500 mm and temporal 1000 mm to the fovea between patients and control group (p = 0.002, at fovea). Conclusions: Patients with ocular sarcoidosis had thinner choroids in the quiescent phases when compared to normal subjects.Item Submacular Allogeneic Ecto-Mesenchymal Stem Cell Transplantation in Retinitis Pigmentosa: One-Year Results(2015) Sobaci, Gungor; Sevinc, Koray; Ovali, Ercument; Ozmert, Emin; Ozdek, Sengul; Yilmaz, Gursel; Durukan, Hakan; Gurelik, Gokhan; Batioglu, Figen; Akkoyun, Imren; 0000-0002-2589-7294; 0000-0002-2860-7424; AAK-6987-2021; AAK-7713-2021Item Macular Vessel Density Measurement in Pediatric Renal and Liver Transplant(2022) Sezenoz, Almila Sarigul; Tortumlu, Gokhan; Akkoyun, Imren; Oto, Sibel; Haberal, Mehmet; 0000-0002-2860-7424; 0000-0002-3462-7632; 0000-0003-0171-4200; 0000-0002-7030-5454; 35570609; AAK-7713-2021; AAJ-8097-2021; AAJ-4668-2021; AAJ-4860-2021Objectives: Microcirculatory dysfunction is known to be associated with organ failure and increased mortality in transplant patients. Noninvasive monitorization of retinal structures of the eye could be a predictor for systemic microvasculature in these patients. Therefore, in this study we aimed to evaluate the retinal microvascular changes in pediatric patients who had undergone liver or renal transplant surgery, using optical coherence tomography angiography. Materials and Methods: The medical records of pediatric patients who had liver or renal transplant in the past 10 years were reviewed. The macular vessel density parameters were obtained by optical coherence tomography angiography (Avanti RTVue XR). The results were compared with the age-matched, sex-matched, and spherical equivalent-matched healthy participants (control group). The IBM SPSS (version 25.0) statistics program was used for data analysis. Results: We included 32 eyes of 16 liver transplant patients, 20 eyes of 10 renal transplant patients, and 64 eyes of 32 healthy participants (control group). Superficial macular whole image, superficial perifoveal, and deep foveal vessel densities were found to be lower in the liver transplant group compared with the healthy control group (P = .02, P = .01, and P = .01, respectively). Superficial foveal, deep macular whole image, deep foveal, and deep perifoveal vessel densities were found to be lower in the renal transplant group compared with the healthy control group (P = .03, P = .04, P = .01, and P = .02, respectively). Conclusions: Macular vessel density measurements are affected in pediatric renal and liver transplant patients. In those patients, retinal optical coherence tomography and optical coherence tomography angiography measurements may provide a noninvasive window to the microcirculation.Item Analysis of Choroidal Thickness in AP-ROP, Threshold Disease and ROP Without Laser Photocoagulation(2016) Gokgoz-Ozisik, G.; Akkoyun, Imren; Oto, S.; Bayar, S. A.; Tarcan, A.; Kayhan, Z.; Yilmaz, G.; https://orcid.org/0000-0001-9037-7394; https://orcid.org/0000-0002-2860-7424; https://orcid.org/0000-0003-0171-4200; https://orcid.org/0000-0001-5109-755X; https://orcid.org/0000-0003-0579-1115; 26142227; ABG-6096-2021; AAK-7713-2021; AAJ-4668-2021; AAJ-2406-2021; AAJ-4623-2021Background. Enhanced depth imaging (EDI) and spectral domain optical coherence tomography (SD-OCT) provide high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after laser photocoagulation (LC) in aggressive posterior retinopathy of prematurity (APROP) and threshold disease (TD) is rare. Patients and methods. A total of 75 eyes were retrospectively analyzed in 4 groups. Groups 1 and 2 included patients with APROP and TD, respectively, who underwent LC. Group 3 included ROP children who did not undergo LC and group 4 included full-term children. Infants aged >= 4 < 7, who had examination of subfoveal (SF) CT with SD-EDI-OCT, visual acuity (VA), spherical equivalent (SE), anterior segment and fundus examination, axial lenght (AXL) were included. The results of SFCT, VA and SE at the age of >= 4 < 7 years, AXL, gestational age (GA), birth weight (BW) and age at examination were compared between the groups. Potential risk factors (GA, BW, SE, AXL and SFCT) influencing visual acuity were evaluated by using multivariate linear regression analysis. Results. The results of SFCT and AXL were not significantly different between groups 2 and 3 or between groups 3 and 4. There was a significant difference between the other groups for SFCT and AXL and VA was significantly different between all groups. The SE was not significantly different between groups 3 and 4 but there was a significant difference for SE, BW and GA between the groups. Age at examination was not significantly different between the groups. Multivariate linear regression analysis revealed SFCT for groups 1 and 2, GA for group 3 and GA, SFCT and AXL for group 4 as independent risk factors influencing visual acuity. Conclusion. The regression model used for groups 1-4 explains the variation of the dependent risk factor LogMar VA for groups 1-4 with 31.2 %, 43.5 %, 9.6 % and 69.4 %, respectively. These values expressed in percentage demonstrate that even more predictors may influence the dependent factor LogMar VA than evaluated in the study.Item Refractive Outcome Comparison Between Vitreomacular Interface Disorders After Phacovitrectomy(2017) Ercan, Zeynep Eylul; Akkoyun, Imren; Pinarci, Eylem Yaman; Yilmaz, Gursel; Topcu, Hulya; https://orcid.org/0000-0002-2860-7424; https://orcid.org/0000-0002-2589-7294; https://orcid.org/0000-0002-5259-0204; 10.1016/j.jcrs.2017.06.034; AAK-7713-2021; AAK-6987-2021Purpose: To compare the refractive accuracy of intraocular lens (IOL) power calculations between patients with vitreomacular interface disorders who had phacovitrectomy for vitreomacular traction (VMT), epiretinal membranes (ERM), and macular holes. Setting: Baskent University Department of Ophthalmology, Ankara, Turkey. Design: Retrospective case series. Methods: Refraction results 8 weeks postoperatively were compared between phacovitrectomy (3 study groups comprising eyes with VMT with intrafoveal pseudocysts, ERM, or medium-to-large macular holes) and phacoemulsification (control group comprising eyes having phacoemulsification only). The IOLMaster 700 partial coherence interferometry (PCI) device and Haigis formula were used for all calculations. Results: This study included 100 eyes (100 patients), 25 in each of the 4 groups. There was no statistically significant difference in axial length (AL) between the groups (P = .305). Differences in the pre-operative macular thickness were statistically significant between all groups except between the macular hole and VMT groups. Most eyes (92%) in the VMT and macular hole groups and all eyes in the VMT and phacoemulsification groups achieved a final refraction within +/- 1.00 diopter of the refractive aim. The mean prediction error and the mean absolute error did not differ significantly between the groups. In all groups, there was no significant correlation between prediction error and age, AL, preoperative refractive error, or preoperative or postoperative macular thickness (P > .05). Conclusions: The IOL power calculation with PCI yielded no difference in postoperative refraction errors between the vitreomacular interface disorders. There was no correlation with preoperative refraction, age, or preoperative or postoperative macular thickness. (c) 2017 ASCRS and ESCRSItem Enhanced Depth Imaging Optical Coherence Tomography in Patients with Different Phases of Behcet's Panuveitis(2017) Yesilirmak, Nilufer; Lee, Wen-Hsiang; GurGungor, Sirel; Yaman Pinarci, Eylem; Akkoyun, Imren; Yilmaz, Gursel; https://orcid.org/0000-0002-8632-2873; https://orcid.org/0000-0001-6178-8362; https://orcid.org/0000-0002-2860-7424; https://orcid.org/0000-0002-2589-7294; 28237149; AAD-7299-2020; AAD-5967-2021; AAK-7713-2021; AAK-6987-2021OBJECTIVE: To evaluate the changes in choroidal thickness (CT) at 13 different points between "active," "remission," and "end-stage" phase of Behcet's panuveitis and compare this with the age, sex, and spherical equivalent matched healthy controls using enhanced depth imaging optical coherence tomography. DESIGN: Prospective study. PARTICIPANTS: Eighty-five eyes of 45 patients with Behcet's panuveitis (19 eyes with active phase, 48 eyes with remission phase, and 18 eyes with end-stage phase) and 84 eyes of 42 controls were enrolled in this study. METHODS: CT measurements were obtained beneath the fovea and at 500-mu m intervals for 3 mm nasal and temporal to the centre of the fovea. Correlation analyses were calculated to assess the relationship of the CT with age and disease duration. RESULTS: At all 13 measurement points, CT was significantly thinnest in end-stage-phase eyes and thickest in active-phase eyes (p < 0.01). CT was thicker in remission-phase eyes compared with control eyes at foveal and perifoveal points, but the trend was not statistically significant. The mean CT at each of the 13 measured points showed a negative correlation with age and disease duration (p < 0.01). CONCLUSIONS: Submacular CT, as measured by enhanced depth imaging optical coherence tomography, was significantly reduced in eyes with Behcet's panuveitis in the end-stage phase and increased in those in the active phase.Item Relationship Between White Matter Hyperintensities and Retinal Nerve Fiber Layer, Choroid, and Ganglion Cell Layer Thickness in Migraine Patients(2018) Iyigundogdu, Ilkin; Derle, Eda; Asena, Leyla; Kural, Feride; Kibaroglu, Seda; Ocal, Ruhsen; Akkoyun, Imren; Can, Ufuk; 0000-0001-7860-040X; 0000-0003-2122-1016; 0000-0002-6848-203X; 0000-0002-4226-4034; 0000-0002-3964-268X; 0000-0002-2860-7424; 0000-0001-8689-417X; 28952336; AAJ-2053-2021; AAI-8830-2021; E-5914-2016; AAL-9808-2021; AAJ-2956-2021; V-3553-2017; AAK-7713-2021; AAJ-2999-2021Aim To compare the relationship between white matter hyperintensities (WMH) on brain magnetic resonance imaging and retinal nerve fiber layer (RNFL), choroid, and ganglion cell layer (GCL) thicknesses in migraine patients and healthy subjects. We also assessed the role of cerebral hypoperfusion in the formation of these WMH lesions. Methods We enrolled 35 migraine patients without WMH, 37 migraine patients with WMH, and 37 healthy control subjects examined in the Neurology outpatient clinic of our tertiary center from May to December 2015. RFNL, choroid, and GCL thicknesses were measured by optic coherence tomography. Results There were no differences in the RFNL, choroid, or GCL thicknesses between migraine patients with and without WMH (p>0.05). Choroid layer thicknesses were significantly lower in migraine patients compared to control subjects (p<0.05), while there were no differences in RFNL and GCL thicknesses (p>0.05). Conclusions The only cerebral hypoperfusion' theory was insufficient to explain the pathophysiology of WMH lesions in migraine patients. In addition, the thinning of the choroid thicknesses in migraine patients suggests a potential causative role for cerebral hypoperfusion and decreased perfusion pressure of the choroid layer.Item The Correlation Of Atrophy, Traction And Neovascularization In Myopic Choroidal Neovascularization According To A Novel Myopic Maculopathy Classification System (Atrophy (A), Traction (T), Neovascularization (N): ATN)(2022) Kurt, Rengin Aslihan; Sezenoz, Almila Sarigul; Akkoyun, Imren; https://orcid.org/0000-0002-2860-7424; 35876940; AAK-7713-2021Purpose To grade myopic choroidal neovascularization (CNV) patients according to the new myopic maculopathy classification (A: atrophy, T: traction, N: neovascularization-ATN) and analyze the correlation in between atrophy, traction and neovascularization. Methods Fifty-one eyes of 41 patients with the diagnosis of pathologic myopia and myopic CNV were included in this clinical practice study. Patients were graded according to the recently described ATN classification. Color fundus photographs were used to grade the atrophy and spectral domain optical coherence tomography scans were used to grade traction and neovascularization. Active myopic CNVs were treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections. Chi-square test was used to test the categorical variants and univariate logistic regression analysis was used to predict the independent risk factors of myopic CNV scar formation. Results Active myopic CNV was observed most frequently in the group with patchy chorioretinal atrophy. Grade of the atrophy and female gender were significantly associated with myopic CNV scar in the univariate logistic regression tests. Multivariate logistic regression showed that atrophy grading is the independent predictor of myopic CNV scar. Conclusion ATN classification is a practical and comprehensive system to grade myopic CNV. Atrophy is an independent predictor for myopic CNV scar and patchy chorioretinal atrophy requires a more careful examination and close follow-up for the risk of CNV development.