Fakülteler / Faculties

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    Epicardial Adipose Tissue Thickness and Carotid Intima-Media Thickness in Hemodialysis Patients
    (2017) Aydin, Elcin; Altin, Cihan; Sakalhoglu, Onur; Yilmaz, Mustafa; Gezmis, Esin; Sade, Leyla Elif; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-0907-3647; 0000-0002-1001-6028; 0000-0003-3737-8595; 28559657; AAG-8233-2020; AAI-8276-2021; AAE-8301-2021; AAQ-7583-2021; HGC-1839-2022
    Background: It is well-known that cardiovascular risk and all-cause mortality is increased in hemodialysis patients. Epicardial fat thickness (EFT), which reflects visceral adiposity, has been suggested as a new cardiometabolic risk factor. The purpose of this study was to investigate EFT in hemodialysis patients. Methods: A total of 144 consecutive patients (60 hemodialysis patients and 84 controls) were enrolled into the study, and patients with diabetes mellitus and cardiovascular diseases (CVD) were excluded. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography. Results: The groups were similar in terms of sex distribution, age, blood pressure, heart rate and frequencies of CAD risk factors including smoking status, family history of CAD and hypertension. There were no significant differences between the hemodialysis patients and controls in 2D echocardiographic parameters, including ejection fraction and biochemical parameters except low-density lipoprotein, high-density lipoprotein and c-reactive protein. Despite having lower body mass index, EFT levels were significantly higher in hemodialysis patients compared to the controls (8.0 +/- 2.2 mm vs. 5.8 +/- 1.9 mm; p < 0.01). In multivariate linear regression analysis we determined that hemodialysis patient status was found to be an independent predictor for both EFT ((3 = 0. 700, p = 0.014) and carotid intima-media thickness (CIMT, beta = 0. 614, p = 0.047). Conclusions: Hemodialysis patients are independently associated with high EFT and CIMT.
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    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-4623-2021
    Background. 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.
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    Factors affecting the surgical success of trabeculectomy performed as the first surgery in primary pediatric glaucoma
    (2022) Demirok, Gulizar; Ozkan, Guner; Kaderli, Ahmet; Guvenc, Umay; Yakin, Mehmet; Eksioglu, Umit; 0000-0002-3061-7162; 35353293; ABG-2501-2020
    Purpose To present the outcomes and factors affecting the success of trabeculectomy performed as the first surgery in primary pediatric glaucoma. Methods Pediatric patients with primary glaucoma who underwent trabeculectomy as the first surgery were retrospectively reviewed. Age, gender, preoperative intraocular pressure (IOP), operation age, axial length, corneal diameter, anterior segment findings, antimetabolite used, complications, and 1-month, 3-months, 1-year, and most recent postoperative findings were recorded. Postoperative IOP with/without medication of 18 mmHg or less was considered successful. Factors that may have affected surgical success were also evaluated using multivariate analysis. Results Included in the study were 48 patients, of whom 30 had primary congenital glaucoma and 18 had juvenile glaucoma. The mean preoperative IOP was 36.84 +/- 6.30 mmHg, and the mean follow-up time was 7.95 +/- 6.93 years. The median operation age value was 100.00 +/- 100.83 (median: 60; IQR: 153) months. The postoperative IOP at the 1-month, 3-months, 1-year, and most recent follow-ups were 15.39 +/- 6.88, 15.70 +/- 7.36, 16.28 +/- 7.86, and 17.48 +/- 8.44 mmHg, respectively (p = 0.565). While there were no postoperative complications in 24 of the patients (50.0%), the most common complications were choroidal detachment and hypotony. Postoperative complication development was found to be significant as a factor affecting surgical success in the multivariate logistic regression analysis. Surgical success rates for all of the patients were 71.7%, 65.9%, 65.0%, and 61.4% at the 1-month, 3-months, 1-year, and most recent follow-ups, respectively. A significant difference was found between the congenital and juvenile groups in terms of surgical success only at 3 months (p = 0.953, p = 0.042,p = 0.191, p = 0.218; respectively). Discussion/Conclusion The fact that surgical success was partially higher in the juvenile group confirmed the idea that the results of trabeculectomy will be more favorable in patients of older age and without anterior segment anomalies.
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    Assessing risk factors for postoperative hypotony in Ahmed glaucoma valve implantation surgery
    (2021) Kaderli, Ahmet; Demirok, Gulizar; Uney, Guner; Yakin, Mehmet; Gunal, Berku; Eksioglu, Umit; 34019191
    Purpose To assess the risk factors associated with the development of hypotony after Ahmed glaucoma valve (AGV) implantation. Methods One hundred and ninety-three eyes of 177 patients with various types of glaucoma that were treated with AGV implantation were retrospectively evaluated. Intraocular pressure lower than 6 mmHg related to the surgery is defined as postoperative hypotony. Patients' demographic characteristics, type of glaucoma, preoperative and postoperative visual acuity, necessity of antiglaucoma treatments, lens status, previous ocular surgeries, intraocular pressure (IOP) measurements before and after surgeries, the need for additional procedures and postoperative complications were recorded from the patients' charts. Results Hypotony was seen in 68 of 193 eyes (35.2%) postoperatively. In 45 eyes (23.3%), it has occurred in first postoperative day and in 23 eyes (11.9%) after the first day within the first week. There was no difference in intraocular pressures between two groups in the first year follow-up. Pre- and postoperative best-corrected visual acuities, age and gender were not statistically different between hypotony and no hypotony groups (p > 0.05). Also, lens status, history of previous ocular surgery, type of glaucoma and number of preoperative glaucoma medication usage were not found to be different between groups (p > 0.05). Conclusions Potential risk factors such as age, sex, lens status, history of previous ocular surgeries, preoperative glaucoma medication usage or glaucoma type are not found to influence upon postoperative hypotony prevalence for AGV surgery. Surgery type and personal ocular factors, which could not be determined beforehand, could be more important than demographic features.
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    A FMEA based novel intuitionistic fuzzy approach proposal: Intuitionistic fuzzy advance MCDM and mathematical modeling integration
    (2021) Yener, Yelda; Can, Gulin Feryal
    This study proposes a novel three-stage intuitionistic fuzzy risk assessment (RA) approach based on Failure Modes and Effects Analysis (FMEA). In this study, it was paid attention for considering real constraints of firms such as capital, time etc. to prevent nan-fatal failure modes (FMs), interactions between FMs and risk level similarities created by risk factors (RFs). At the first stage of the proposed approach, RFs' weights are computed by a new intuitionistic fuzzy weighting method considering similarities between RFs for risk levels that they can create. At the second stage, Modified Intuitionistic Fuzzy Multi Attribute Border Approximation Area (MIF-MABAC) including interactions between FMs is used to determine the rankings of FMs by using Extended Haussdorff distance function. At the third stage, two intuitionistic fuzzy mathematical models are established to show the effect of the real constraints of the firm to identify the risk types (RTs) that must be avoided primarily. It was seen that the first model gives the same ranking results with the MIF-MABAC. Additionally, when including the real constraints, the first model can give the more suitable results than the second model. The results obtained from the first model show that experts' assessments and mathematical modeling identify the same FMs for preventing primarily. This study is the first one to suggest a new RA approach that reflects the real constraints of the firms to RA. Additionally, this is the first study that models' interactions between FMs and risk level similarities created by RFs.