Fakülteler / Faculties
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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 Evaluation of Choroidal Thickness Using Spectral-Domain Optical Coherence Tomography in Patients with Migraine: A Comparative Study(2015) Karalezli, Aylin; Celik, Guner; Koktekir, Bengu Ekinci; Kucukerdonmez, Cem; 25633615; GOE-6067-2022; HTO-3612-2023Purpose: To assess choroidal thickness in patients with migraine and compare them with healthy controls, using spectral-domain optical coherence tomography (OCT). Methods: In this prospective case-control study, choroidal thicknesses of 20 newly diagnosed migraine patients and 20 age-and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain (FD) OCT device (lambda = 840 nm, 26.000 A-scans/s, 5 mu m axial resolution). All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (9: 00 AM), in order to minimize the effects of diurnal variation. Results: There was a statistically significant difference in median choroidal thickness between the migraine patients (277.00 [interquartile range (IQR) 85.75] mu m) and controls (301.00 [IQR 90.50] mu m) (p = 0.012). There were significant differences at all measurement points (p<0.05 for all). Conclusions: The decreased choroidal thickness of patients with migraine might be related to the vascular pathology of the disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and migraine.Item Retinal and Choroidal Thickness Changes After Single Anti-VEGF Injection in Neovascular Age-Related Macular Degeneration: Ranibizumab vs Bevacizumab(2014) Sizmaz, Selcuk; Kucukerdonmez, Cem; Kal, All; Pinarci, Eylem Yaman; Canan, Handan; Yilmaz, Gursel; https://orcid.org/0000-0002-5877-6536; https://orcid.org/0000-0002-2589-7294; 24803153; AAB-6394-2021; AAK-6987-2021Purpose: To evaluate and compare the effects of single intravitreal injection of ranibizumab and bevacizumab on central retinal and choroidal thickness in patients with neovascular age-related macular degeneration (AMD). Methods: Forty eyes of 40 patients with neovascular AMD that underwent intravitreal injection of vascular endothelial growth factor inhibitors (anti-VEGFs) were included. Patients were randomized into 2 groups: 20 eyes received ranibizumab and 20 eyes received bevacizumab injection. Central retinal and choroidal thicknesses of all eyes at baseline and 1 month postinjection scans were measured with Fourier-domain optical coherence tomography (OCT). Student t test and Mann-Whitney U test were used to compare the data. Results: The mean central retinal thickness (CRT) showed significant decrease after single injection of ranibizumab (from 345.0 mu m to 253.5 mu m, p<0.01) and bevacizumab (from 329.5 mu m to 251.0 mu m, p<0.01) at the first month, respectively. There was no significant difference regarding the CRT change between groups (p = 0.39). The mean choroidal thickness decreased from 158.6 mu m (115-317) to 155.5 mu m (111-322) in the ranibizumab group and from 211.5 mu m (143-284) to 201.5 mu m (93-338) in bevacizumab group. The decrease was not significant between groups (p = 0.35). Conclusions: Intravitreal injection of both ranibizumab and bevacizumab provided a significant decrease in CRT; however, the agents caused no significant change in choroidal thickness. Additionally, no difference between ranibizumab versus bevacizumab was observed related to macular edema inhibition.Item Evaluation of Retrobulbar Blood Flow and Choroidal Thickness in Patients with Rheumatoid Arthritis(2018) Kal, Ali; Duman, Enes; Sezenoz, Almila Sariguel; Ulusoy, Mahmut Oguz; Kal, Oznur; https://orcid.org/0000-0001-7544-5790; https://orcid.org/0000-0002-7030-5454; https://orcid.org/0000-0002-7751-4961; 28730400; AAJ-4936-2021; AAJ-4860-2021; AAJ-7586-2021PurposeTo evaluate whether retrobulbar blood flow and choroidal thickness (CT) are affected in patients with rheumatoid arthritis (RA), and the relationship between these values.MethodsWe evaluated 40 eyes of 20 RA patients and 40 eyes of 20 healthy controls. The enhanced depth imaging optical coherence tomography, color Doppler imaging, was held. Statistical analysis was performed.ResultsPeak systolic velocity (PSV) of ophthalmic (OA) and central retinal artery (CRA) were significantly higher in RA. No significant difference was observed when end-diastolic velocity (EDV) of OA and CRA was compared between the groups. The resistivity index (RI) of OA and CRA was higher in RA. Perifoveal/subfoveal CT was lower in RA. Negative correlation was detected between the RI of OA and the perifoveal CT, and a positive correlation was detected between RI of CRA and CT.ConclusionsOcular hemodynamics is effected by RA and can exaggerate ocular complications of various vascular diseases such as diabetes mellitus, hypertension, retinal vascular occlusions.Item Microperimetry, Humphrey field analyzer, and optical coherence tomography in detecting glaucoma: a comparative performance study(2022) Akar, Serpil; Tekeli, Oya; Ozturker, Zeynep Kayaarasi; 35023012Purpose To evaluate and compare the diagnostic performance of microperimetry (MP), visual field (VF) 10-2 and 24-2 tests, and spectral-domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG). Methods The study consisted of 35 POAG and 42 control eyes were enrolled in this prospective study. Eligible participants were >= 50 years old. VF assessments were carried out using the Humphrey field analyzer (HFA) and Macular Integrity Assessment. Optic nerve head (ONH), retinal nerve fiber layer thickness (RNFLT), and ganglion cell inner-plexiform-layer thickness (GCIPLT) were measured by SD-OCT. Areas under the receiver operating characteristic curves (AUC) and sensitivities at 95% specificity were calculated for each parameter. Results HFA 24-2 had the largest AUC value among the functional parameters to differentiate POAG from control eyes [AUC: 0.950 (0.906-0.994), sensitivity at 95%:60]. HFA 24-2 showed a significantly better performance than the 10-2 test (p = 0.036). Among the SD-OCT structural parameters, minimum GCIPLT had the largest AUC value to differentiate POAG from control eyes [AUC: 0.952 (0.905-0.999), sensitivity at 95%:80]. In comparison of the functional and structural parameters, HFA 24-2 showed a significantly better performance than the 10-2 test (p = 0.036). In macular parameters, minimum GCPLT performed significantly better than HFA 10-2 (p = 0.015) in detecting POAG. There was no statistically significant difference between the comparative diagnostic performance of the RNFL, ONH, HFA, and MP (p > 0.05 for all comparisons). Conclusion The structural and functional test results revealed that GCIPLT measurements had the highest diagnostic performance in detecting POAG. HFA 24-2 test performed better than 10-2 test in distinguishing glaucoma from healthy eyes. MP showed a similar performance with HFA 10-2 and may be considered a complementary diagnostic tool.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.Item Evaluation of the acute effect of haemodialysis on retina and optic nerve with optical coherence tomography(2016) Emre, Sinan; Ozturkeri, Anil; Ulusoy, Mahmut Oguz; Cankurtaran, Cem; 28003781; T-5643-2019Purpose: The primary objective of haemodialysis (HD) was to correct the composition and volume of body fluids. The aim of this study was to evaluate the acute effect of HD on mean arterial pressure changes and on retina and optic nerve with optical coherence tomography (OCT). Methods: Fifty-three eyes of 28 patients were enrolled in this study. The patients' retinal and RNFL thicknesses were measured by OCT and mean arterial pressure alterations were recorded before and immediately after HD session. Results: The results show that while there was a reduction at central foveal thickness and ganglion cell layer thickness, central sub-field and RNFL thickness were increased with HD session. But none of them were statistically significant (p = 0.320, p = 0.792, p = 0.744, p = 0.390). The mean arterial pressure of the patients decreased significantly (p < 0.05) but it was not correlated with retinal and RNFL values. Conclusion: The changes in retinal and RNFL findings were not significant. But these alterations may effect the long term follow-up of the patients with retinal and optic nerve disease. Therefore it is important to pay attention HD session time for these patients' measurements.Item Prevalence of Split Nerve Fiber Layer Bundles in Healthy People Imaged with Spectral Domain Optical Coherence Tomography(2016) Gungor, Sirel Gur; Akman, Ahmet; Sezenoz, Almila Sarıgul; Tanriasik, Gulsah; 0000-0001-6178-8362; 0000-0002-7030-5454; 28050324; AAD-5967-2021; AAJ-4860-2021Objectives: The presence of retinal nerve fiber layer (RNFL) split bundles was recently described in normal eyes scanned using scanning laser polarimetry and by histologic studies. Split bundles may resemble RNFL loss in healthy eyes. The aim of our study was to determine the prevalence of nerve fiber layer split bundles in healthy people. Materials and Methods: We imaged 718 eyes of 359 healthy persons with the spectral domain optical coherence tomography in this cross-sectional study. All eyes had intraocular pressure of 21 mmHg or less, normal appearance of the optic nerve head, and normal visual fields (Humphrey Field Analyzer 24-2 full threshold program). In our study, a bundle was defined as 'split' when there is localized defect not resembling a wedge defect in the RNFL deviation map with a symmetrically divided RNFL appearance on the RNFL thickness map. The classification was performed by two independent observers who used an identical set of reference examples to standardize the classification. Results: Inter-observer consensus was reached in all cases. Bilateral superior split bundles were seen in 19 cases (5.29%) and unilateral superior split was observed in 15 cases (4.16%). In 325 cases (90.52%) there was no split bundle. Conclusion: Split nerve fiber layer bundles, in contrast to single nerve fiber layer bundles, are not common findings in healthy eyes. In eyes with normal optic disc appearance, especially when a superior RNFL defect is observed in RNFL deviation map, the RNLF thickness map and graphs should also be examined for split nerve fiber layer bundles.Item Corneal, Scleral, Choroidal, and Foveal Thickness in Patients with Rheumatoid Arthritis(2017) Akman, Ahmet; Gungor, Sirel Gur; Gokmen, Onur; Yesilirmak, Nilufer; Yucel, Ahmet Eftal; Yesil, Hilmi; Yildiz, Fatih; Sise, Adam; Diakonis, Vasilios; 29326847; I-6542-2012Objectives: To investigate corneal, scleral, choroidal, and foveal thicknesses in female patients with rheumatoid arthritis (RA) and compare them with healthy subjects. Materials and Methods: This prospective study included consecutive female patients diagnosed with RA and healthy subjects. Corneal, scleral, choroidal, and retinal (foveal) thicknesses were obtained by using optical coherence tomography and a comparison was performed between groups for all outcome measures. Results: Thirty-six eyes of 36 female patients diagnosed with RA (group 1) and 36 eyes of 36 healthy female volunteers (group 2) were included. Mean corneal, scleral, choroidal thicknesses and retinal thickness at the fovea of group 1 were 543.3 +/- 33.7 mu m, 343.7 +/- 42.2 mu m, 214.6 +/- 50, and 213.5 +/- 18.9 mu m, respectively; in group 2, these values were 549.9 +/- 29.6 mu m, 420.9 +/- 42.4 mu m, 206.4 +/- 41.9 mu m, and 222 +/- 15.5 mu m, respectively. The comparison between group 1 and 2 with respect to corneal, choroidal, and foveal thicknesses did not reveal statistical significant differences (p>0.05). On the contrary, there was a statistically significant difference with respect to scleral thickness between the groups, with the RA patients demonstrating a thinner scleral layer (p<0.001). Conclusion: Female patients with RA seem to demonstrate statistically significant scleral thinning when compared with healthy subjects, while there was no difference concerning corneal, choroidal, and foveal thickness.