Fakülteler / Faculties
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Item 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-4360-2021Objectives: 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.Item Choroidal vascularity index changes with phacovitrectomy for vitreoretinal interface disorders(2022) Ercan, Zeynep Eylul; Gokgoz, Gulsah; Yilmaz, Gursel; 35918960Purpose: Vitreomacular interface disorders have long been argued to change choroidal structure. The aim of this study was to determine the choroidal vascularity index (CVI) changes following internal limiting membrane peeling for epiretinal membrane (ERM) and full thickness macular hole (FTMH). Methods: Fifty-nine patients with unilateral ERM and 56 with unilateral FTMH were induded in the study. Axial length, pre- and post-surgery intraocular pressure, baseline and post-phacovitrectomy CVI were calculated and compared with the normal fellow eyes. To compare the baseline and the final measurements, Wilcoxon test was used. Mann-Whitney U test was used for independent data comparisons. Median and standard deviations were compared. Results: Axial length, pre- and post-surgery intraocular pressure differences were insignificant between study and fellow eyes within all groups. CVI were significantly lower in post-vitrectomy study eyes of all groups compared with pre-surgery (P < 0.001). There were no significant changes before and after the surgeries in fellow eyes. Baseline CVI of ERM study eyes (median 65.90%) and FTHM study eyes (median 65.59%) did not differ significantly between groups (U = 1336, P = 0.07, r = 0.16). Conclusion: There are conflicting results of vitreoretinal interface disorders CVI in the literature. In this study, both FTMH and ERM eyes showed reduced CVI postoperatively compared with the baseline. Preoperatively, there were no difference between study eyes and the fellow eyes.Item Clinical Characteristics And Outcomes Of Ocular Injuries In Pediatric Patients(2022) Bayar, Sezin Akca; Ozturker, Zeynep Kayaarasi; Yilmaz, Gursel; 35485471BACKGROUND: Childhood eye injuries are one of the most common causes of acquired unilateral blindness. In this study, our purpose was to investigate the demographics, etiology, and outcome of pediatric patients with ocular injury. METHODS: The charts of children with ocular trauma who presented to Baskent University Hospitals, between January 1, 2017 and December 31, 2019 were retrospectively reviewed. All patients who were under 16 years of age were included. Data were collected on age, sex, time of trauma, injury type, associated injuries, treatments, visual impairment, intraocular pressure (IOP), and ophthalmic sequelae. Ocular traumas were classified according to the Birmingham Eye Trauma Terminology (BETT) system. RESULTS: A total of 21 patients were identified. Male-female ratio was 13/8. The mean age of the patients was 8.5??3.4 years. Mean post-treatment follow-up was 8.2??4.3 months. Injury was unilateral in all cases (10 right eye, 11 left eye). Fifteen patients (71.4%) had open globe, and 6 (28.5%) had closed globe injury. Type of injury was rupture in 7 cases, perforation in 5, penetration in 4, and intraocular foreign body in 4. A total of 5 cases were documented to have retinal detachment during the follow-up. Sharp injuries were documented in 11 (64.7%) cases, and blunt in 6 (35.2%). The most frequent finding was hyphema in blunt injury, and corneal laceration in perforating injury. Five patients had choroidal hemorrhage, 3 had commotio retinae, 2 had intravitreal hemorrhage, 1 had subhyaloidal hemorrhage, 1 had macular hole, and 1 had optic nerve avulsion. Lens aspiration was performed in 12 (57.1%) cases, and 2 of them had intraocular lens implantation. In children whose initial vision was able to be taken, 4 had no light perception, 7 had light perception-counting fingers, and 5 had best-corrected visual acuity of 0.05???0.3. At final visit, 61.9% of patients had a VA of 0.05???0.8. Corneal scar or leucoma was observed in 14 (66.6%) cases at last visit. One eye was enucleated due to post-traumatic endophthalmitis that did not respond to treatment. At final visit, IOP 6 mmHg was identified in 2 cases and 21 mmHg in 4. CONCLUSION: Anterior segment damage is the main cause of visual morbidity in pediatric ocular trauma. Injuries with sharp objects occur twice as often as blunt trauma and reduce vision with residual corneal scarring in about two-thirds of patients. Understanding the pattern of eye injuries is useful in determining the strategies required to protect children???s eye health.Item Clinical Features of Untreated Type 2 Macular Telangiectasia and Efficacy of Anti-Vascular Endothelial Growth Factor Therapy in Macular Neovascularization(2022) Karatas, Muge Coban; Yilmaz, Gursel; Sezen, Aslihan Yuce; Sariturk, Cagla; 35196839Objectives: To compare best corrected visual acuity (BCVA), central macular thickness (CMT), and central choroidal thickness (CCT) in patients with type 2 macular telangiectasia (MacTel 2) and a control group and to evaluate the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in MacTel 2 patients with macular neovascularization (MNV). Materials and Methods: We conducted a retrospective chart review of consecutive MacTel 2 patients who underwent a full ophthalmologic examination including BCVA and dilated fundus examination with slit-lamp biomicroscopy, fluorescein angiography, and optical coherence tomography imaging at baseline and follow-up visits. BCVA, CMT, and CCT were compared between all identified patients (n=26) and a control group (n=30). A subgroup analysis was performed among eyes with MNV (n=7) before and after treatment. Results: CMT and CCT were significantly lower in the MacTel 2 group compared to the control group. Forty-one treatment-naive eyes without MNV proliferation showed no significant change in BCVA, CMT, or CCT during follow-up. Eight eyes of 7 MacTel 2 patients developed MNV during follow-up. All of the patients were treated with intravitreal anti-VEGF. Conclusion: It is important to closely follow MacTel 2 patients for MNV development. To avoid adverse effects, we prefer to monitor patients who have not yet developed MNV. Patients with proliferative MacTel 2 with decreasing visual function may benefit from intravitreal anti-VEGF treatment.Item Relation of anatomy with function following the surgical treatment of idiopathic epiretinal membrane: a multicenter retrospective study (Nov, 10.1007/s00417-020-05002-1, 2020)(2021) Ozdek, Sengul; Zeydanli, Ece Ozdemir; Karabas, Levent; Teke, Mehmet Yasin; Yilmaz, Gursel; Citirik, Mehmet; Kocak, Nilufer; Durukan, Hakan; 0000-0002-2589-7294; 33625567; AAK-6987-2021Item Impact of Platelet Count in Retinopathy of Prematurity(2020) Keskek, Nedime Sahinoglu; Gulcan, Hande; Yilmaz, Gursel; Akkoyun, Imren; 0000-0001-8544-103X; 33389935; T-4258-2017Objectives: The aim of the study was to investigate the risk factors for retinopathy of prematurity (ROP), including platelet count. Materials and Methods: This retrospective study analyzed 137 infants in 3 subgroups: no ROP; mild RAP, and severe ROP requiring laser treatment (type 1 ROP). A retrospective review of records was performed and statistical analysis of possible risk factors for ROP including platelet count was evaluated by using logistic regression. Results: Birth weight (BW), gestational age (GA), and low platelet count in the first week after birth were significant risk factors for developing ROP (p=0.038, 0.02, and 0.004, respectively). BW, GA, ventilation, and lower platelet count were associated with progression to type 1 ROP (p=0.004; 0.027, and 0.021, respectively). Conclusion: Lower platelet count in the first week after birth is a risk factor for ROP development in addition to the previously established factors of ventilation need, low BW, and low GA.Item 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 Visual outcome of intravitreal ranibizumab for exudative age-related macular degeneration: timing and prognosis(2014) Canan, Handan; Sizmaz, Selcuk; Altan-Yaycioglu, Rana; Sariturk, Cagla; Yilmaz, GurselPurpose: To describe 1-year clinical results of intravitreal ranibizumab treatment in patients with choroidal neovascularization secondary to exudative age-related macular degeneration (AMD) and to evaluate whether early treatment is a predictive value for prognosis of the disease. Materials and methods: Clinical records were retrospectively reviewed of 104 eyes that underwent intravitreal ranibizumab therapy for exudative AMD. Patients were divided into two groups according to their symptom duration: group 1,,1 month; and group 2, 1-3 months. After three monthly injections, patients were examined monthly, and subsequent injections were performed as needed. Results: There were 43 female (48.9%) and 45 males (51.1%). The follow-up time was 13.7 +/- 1.9 (12-19) months. The mean logarithm of minimum angle of resolution best-corrected visual acuity (BCVA) improved significantly, from 0.45 +/- 0.639 at baseline to 0.08 +/- 0.267 at 12 months in group 1, and from 1.06 +/- 0.687 at baseline to 0.75 +/- 0.563 at 12 months in group 2. The increase in BCVA was statistically significant in group 1 (P=0.009). The mean central retinal thickness (CRT) decreased significantly, from 355.13 +/- 119.93 mu m at baseline to 250.85 +/- 45.48 mu m at 12 months in group 1, and from 371.88 +/- 91.047 mu m at baseline to 268.61 +/- 53.51 mu m at 12 months in group 2. The decrease in CRT was statistically significant in group 1 (P=0.001). Conclusion: Intravitreal ranibizumab therapy was effective in significantly increasing mean BVCA and reducing CRT. Shorter duration of AMD, as measured by the subjective duration of visual symptoms, is associated with better visual outcome after treatment.Item Comparison of intravitreal bevacizumab and triamcinolone acetonide theraphies for diffuse diabetic macular edema(2015) Aksoy, Sibel; Yilmaz, Gursel; Akkoyun, Imren; Yazici, Ayse Canan; 26086006AIM: To compare therapeutic effects of intravitreal triamcinolone acetonide (IVTA) versus intravitreal bevacizumab (IVB) injections for bilateral diffuse diabetic macular edema (DDME). METHODS: Forty eyes of 20 patients with bilateral DDME participated in this study. For each patient, 4 mg/0.1 mL IVTA was injected to one eye and 2.5 mg/0.1 mL IVB was injected to the other eye. The effects of injection for diabetic macular edema (DME) were evaluated using best -corrected visual acuity (BCVA), central macular thickness (CMT) by optical coherence tomography (OCT) and intraocular pressure (IOP) by applanation tonometer. Patients underwent eye examinations, including BCVA, CMT, and IOP at pre-injection, 1, 4, 8, 12 and 24wk after injection. During the follow -up, second injections were performed to eyes which have CMT greater than 400 pm at 12wk for salvage therapy. RESULTS: BCVA (logarithm of the minimum angle of resolution) at pre -injection, 1, 4, 8, 12 and 24wk after injection was 0.71 +/- 0.19, 0.62 +/- 0.23, 0.63 +/- 0.12, 0.63 +/- 0.13, 0.63 +/- 0.14 and 0.61 +/- 0.24 in the IVTA group and 0.68 +/- 0.25, 0.61 +/- 0.22, 0.60 +/- 0.24, 0.62 +/- 0.25, 0.65 +/- 0.26 and 0.59 +/- 0.25 in the IVB group, respectively. CMT (mu m) at pre-injection, 1, 4, 8, 12 and 24wk after injection was 544 +/- 125, 383 +/- 96, 335 +/- 87, 323 +/- 87, 333 +/- 92, 335 +/- 61 in the IVTA group and 514 +/- 100, 431 +/- 86, 428 +/- 107, 442 +/- 106, 478 +/- 112, 430 +/- 88 in the IVB group respectively. Reduction ratios of mean CMT were 29% at 1wk, 38% at 4wk, 40% at 8wk, 38% at 12wk, and 38% at 24wk in the IVTA group. Second IVTA injections were performed to the 6 eyes (30%) at 12wk. Reduction ratios of mean CMT were 16% at 1wk, 17% at 4wk, 14% at 8wk, 7% at 12wk, and 16% at 24wk in the IVB group. Second IVB injections were performed to the 15 eyes (75%) at 12wk. CONCLUSION: This study showed earlier and more frequent macular edema recurrences in the eyes treated with bevacizumab compared with the ones treated with triamcinolone acetonide. Triamcinolone acetonide was found to provide more efficient and long-standing effect in terms of reducing CMT compared with the bevacizumab.Item Evaluation of choroidal and retinal thickness measurements in adult hemodialysis patients using spectral-domain optical coherence tomography(2016) Kal, Ali; Kal, Oznur; Eroglu, Fatma Corak; Omer, Ozlem; Kucukdonmez, Cem; Yilmaz, Gursel; 0000-0002-2589-7294; 0000-0003-3003-0756; 27626146; AAK-6987-2021; D-5308-2015Purpose: To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods: In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (lambda=840 mm; 26.000 A-scans/s; 5 mu m resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 mu m and 1000 mu m nasal to the fovea and 500 mu m, 1000 mu m, and 1500 mu m temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared. Results: The median choroidal thicknesses before and after hemodialysis were 182 mu m (range, 103-374 mu m) and 161 mu m (range, 90-353 mu m), respectively (P<0.001). The median retinal thicknesses were 246 mu m (range, 179-296 mu m) before and 248 mu m (range, 141-299 mu m) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540). Conclusion: Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.