Publications by authors named "Özge Yanık"

23 Publications

  • Page 1 of 1

A comparative study on the choroidal vascularity index and the determination of cut-off values in the pachychoroid spectrum diseases.

Jpn J Ophthalmol 2021 Mar 6. Epub 2021 Mar 6.

Department of Ophthalmology, Ankara University School of Medicine, Mamak Street Vehbi Koç Eye Hospital, Dikimevi, Ankara, Turkey.

Purpose: To determine the cut-off levels for choroidal thickness and choroidal vascularity index (CVI) to differentiate among pachychoroid spectrum diseases.

Study Design: A retrospective comparative study METHODS: A total of 143 eyes were included. Of these 29 had uncomplicated pachychoroid (UCP), 29 had pachychoroid pigment epitheliopathy (PPE), 25 had pachychoroid neovasculopathy (PNV), 30 had central serous chorioretinopathy (CSC), and 30 had polypoidal choroidal vasculopathy (PCV). The choroidal areas were measured with ImageJ software. The CVI, the proportion of the luminal area to the total choroidal area, was assessed.

Results: The cut-off points of central choroidal thickness were determined as 360 µm for the PPE and PCV group pair (p < 0.001), 422 µm for the PNV and CSC group pair (p = 0.026), 271 µm for the PNV and PCV group pair (p < 0.001), and 341 µm for the CSC and PCV group pair (p < 0.001). The cut-off points of CVI were 72.7 for the PPE and PCV group pair (p < 0.001), 74.7 for the PNV and CSC group pair (p = 0.005), 72.6 for the PNV and PCV group pair (p = 0.001), and 73.6 for the CSC and PCV group pair (p < 0.001).

Conclusion: Pachychoroid spectrum may be composed of a combination of distinct choroidal diseases with different vascular and structural characteristics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10384-021-00829-5DOI Listing
March 2021

Natural course of acquired vitelliform lesions associated with pigment epithelial detachments in dry age related macular degeneration.

Eur J Ophthalmol 2021 Jan 28:1120672121990566. Epub 2021 Jan 28.

Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.

Purpose: To describe the natural history of acquired vitelliform lesions (AVLs) associated with different types of pigment epithelial detachments (PEDs) in dry age-related macular degeneration.

Methods: A retrospective review of clinical examination and multimodal imaging data of patients with AVLs associated with PED(s) was performed.

Results: This study included 25 eyes of 17 patients. The mean age of patients was 67.2 ± 9.7 (47-83) years. The mean follow-up time was 32.6 ± 16.2 (12-66) months, excluding four patients (five eyes) that were lost to follow-up. The mean logMAR BCVA was 0.21 ± 0.16 at baseline and 0.38 ± 0.28 at final visit ( = 0.016). At the end of the follow-up period, PEDs enlarged in eight eyes (40%) and were unchanged in two eyes (10%). Spontaneous resolution of the central PED(s) with AVLs was seen in four (20%) eyes. Rupture of the PED(s) occurred in four eyes (20%), with two developing central foveolar atrophy afterwards. Overall, central foveolar atrophy was seen ultimately in four eyes (20%).

Conclusion: It seems that high PED size may be a risk factor for PED rupture during follow-up. 1/3 of the eyes ended up with unfavorable anatomical outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1120672121990566DOI Listing
January 2021

Pseudophakic macular edema involving epiretinal proliferation associated with macular hole.

Indian J Ophthalmol 2020 Nov;68(11):2599-2601

Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey.

This case report describes an unusual course of an impending macular hole (MH) throughout a 72-month follow-up period. A 53-year-old female presented with impending MH associated with epiretinal proliferation (EP) which showed unusual progress including full thickness MH, spontaneous closure, reopening as lamellar MH, and full anatomical closure with EP tissue. After cataract surgery, cystoid spaces occurred involving both EP tissue and neuroretina. Due to full recovery following a single dose of aflibercept, the source of the cystoid spaces was thought to be associated with postoperative inflammation leading to pseudophakic macular edema involving not only but also EP tissue.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_602_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774124PMC
November 2020

Multimodal Imaging Characteristics and Functional Test Findings in a Case of Acute Macular Neuroretinopathy Accompanied by Behçet Disease.

Ocul Immunol Inflamm 2020 Jun 8:1-7. Epub 2020 Jun 8.

Department of Ophthalmology, Ankara University School of Medicine , Ankara, Turkey.

Purpose: To report a case of acute macular neuroretinopathy (AMN) in Behçet Disease.

Case: A 23-year-old male presented with a complaint for central scotoma in his right eye. He had been diagnosed with Behçet Disease 3 years ago. Best-corrected visual acuity (BCVA) was 20/20. Anterior chamber and fundus examinations were unremarkable. Optical coherence tomography revealed a paracentral area of outer nuclear layer thinning. Infrared reflectance showed a well-defined, circular, hyporeflective area. Optical coherence tomography angiography revealed an area of capillary dropout in deep retinal capillary plexus corresponding to that hyporeflective lesion. Microperimetry test showed decreased macular sensitivity on the lesion area and the loss of the macular integrity. In multifocal electroretinogram, diminished amplitudes of the central cone responses were detected nasal to fixation.

Conclusion: Behçet disease is a cause of occlusive retinal vasculitis. Accompanied retinal microvascular disease may be a possible risk factor of AMN suggesting ischemic etiopathogenesis for AMN.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09273948.2020.1751857DOI Listing
June 2020

The Use of Optical Coherence Tomography Angiography in the Diagnosis of Inflammatory Type 1 Choroidal Neovascularization Secondary to Tuberculosis: A Case Report.

Ocul Immunol Inflamm 2020 May 27:1-7. Epub 2020 May 27.

Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

: To report a case of choroidal neovascularization (CNV), which was not obvious with dye angiography but was detected with optical coherence tomography angiography (OCTA).: A 50-year-old female presented with decreased vision in her right eye. Funduscopic examination revealed a swollen hyperemic disc, peripapillary exudation, and choroidal infiltration.: Optical coherence tomography revealed intraretinal cysts, subretinal fluid in the macular region, and subretinal hyperreflective material in the papillomacular area. Fluorescein angiography revealed early hypofluorescence in the areas of choroidal infiltrations, and indocyanine green angiography (ICGA) also showed hypocyanescence corresponding to these infiltrations and revealed a faint hypocyanescence in the papillomacular region, further corresponding to the subretinal hyperreflective material on OCT scan. Two weeks after the initiation of systemic therapy with the diagnosis of tuberculosis, OCTA scans detected Type 1 CNV in the peripapillary area.: OCTA may be superior to ICGA in the detection of CNV secondary to inflammatory situations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09273948.2020.1754862DOI Listing
May 2020

A comparative study of the choroidal vascularity indexes in the fellow eyes of patients with pachychoroid neovasculopathy and central serous chorioretinopathy by binarization method.

Graefes Arch Clin Exp Ophthalmol 2020 Aug 15;258(8):1649-1654. Epub 2020 May 15.

Department of Ophthalmology, Ankara University School of Medicine, Vehbi Koç Eye Hospital, Mamak Street, Dikimevi, Ankara, Turkey.

Purpose: To evaluate the choroidal vascularity index (CVI) in the fellow eyes of patients with pachychoroid neovasculopathy (PCN) and central serous chorioretinopathy (CSC).

Methods: Fifty-eight asymptomatic fellow eyes from 58 patients diagnosed with PCN or CSC and 26 eyes from 26 healthy participants were included. The total choroidal area (CA), luminal area (LA), and stromal area (SA) were measured with ImageJ software and Niblack threshold method. The CVI, which was the proportion of the LA to the CA, was assessed.

Results: The CA, LA, and SA were widest in the fellow eyes of the CSC group. The differences between the fellow eyes of the CSC group and the control group and the differences between the fellow eyes of the PCN group and the CSC group were significant (p < 0.001). The CVI of the fellow eyes of the CSC group was significantly higher than the control group (74.93 ± 3.58 vs. 73.38 ± 3.09, p = 0.023).

Conclusion: The differences in the CA, LA, and SA in particular pachychoroid diseases were evident in the asymptomatic fellow eyes. Pachychoroid diseases are characterized by thick choroid or vessels as a common feature, but they may have different structural choroidal features, which might result in different consequences.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00417-020-04740-6DOI Listing
August 2020

Viral nucleic acid analysis with PCR in lacrimal tissue and nasal swab samples of primary acquired nasolacrimal duct obstruction cases.

Eur J Ophthalmol 2021 Jan 21;31(1):138-143. Epub 2019 Oct 21.

Ürgüp State Hospital, Nevşehir, Turkey.

Purpose: To evaluate the role of viral infections in the pathogenesis of primary acquired nasolacrimal duct obstruction.

Methods: The study included 48 patients diagnosed with primary acquired nasolacrimal duct obstruction undergoing dacryocystorhinostomy surgery. Prior to dacryocystorhinostomy surgery, nasal swab sample was taken from the inferior meatus at the same side. During dacryocystorhinostomy, tissue biopsy sample (2 × 2 mm) was taken from the junction area of the lacrimal sac and nasolacrimal duct. Following nucleic acid extraction, polymerase chain reaction was performed.

Results: The patients consisted of 9 (18.8%) men and 39 (81.2%) women with a mean age of 51.0 ± 14.3 years. Qualitative polymerase chain reaction showed viral genome in the nasal swabs of 10 (20.8%) patients, including coronavirus 229E (three cases), coronavirus HKU1 (two cases), respiratory syncytial virus (two cases), coronavirus OC43 (one case), coronavirus NL63 (one case), and adenovirus (one case). In the dacryocystorhinostomy samples, viral genomes were detected in four (8.3%) cases, including respiratory syncytial virus (two cases), coronavirus HKU1 (one case), and adenovirus (one case). There was a statistically significant agreement between nasal mucosal swab and dacryocystorhinostomy biopsy samples in terms of respiratory syncytial virus positivity (kappa = 1.000,  = 0.001).

Conclusion: Although the viral genome was detected in the samples, a direct relationship between viruses and pathogenesis of primary acquired nasolacrimal duct obstruction could not be revealed because of the low number of positive results. However, considering the profibrotic characteristics of specific viruses such as respiratory syncytial virus and adenovirus, viral infections may be one of the many predisposing factors of primary acquired nasolacrimal duct obstruction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1120672119882331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140976PMC
January 2021

A Case of Best Disease Accompanied by Pachychoroid Neovasculopathy

Turk J Ophthalmol 2019 09;49(4):226-229

Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey

The aim of this case presentation is to describe ocular findings of a 22-year-old patient with Best vitelliform macular dystrophy accompanied by pachychoroid neovasculopathy. Color fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) images were reviewed. Funduscopic examination showed bilateral yellowish vitelliform-like submacular deposits. FAF revealed these deposits as hyperautofluorescent spots. OCT showed flat irregular pigment epithelial detachments corresponding to these submacular deposits. OCT showed choroidal thickening and dilatation of the large outer oval choroidal vessels. Fundus fluorescein angiography could not be performed because the patient was pregnant. En face OCTA images of the choriocapillaris illustrated the choroidal neovascular network. In this case report, we describe for the first time the coexistence of Best vitelliform macular dystrophy and pachychoroid neovasculopathy with OCTA images enabling visualization of the neovascular network in a patient with contraindication for fluorescein angiography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjo.galenos.2019.38073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761379PMC
September 2019

Investigation of the Presence of Glaucoma in Patients with Obstructive Sleep Apnea Syndrome Using and Not Using Continuous Positive Airway Pressure Treatment

Turk J Ophthalmol 2019 06;49(3):134-141

Ankara University, Faculty of Medicine, Department of Chest Diseases, Ankara, Turkey

Objectives: To evaluate the frequency of glaucoma in patients with obstructive sleep apnea syndrome (OSAS) using and not using continuous positive airway pressure treatment.

Materials And Methods: This prospective study included 59 patients diagnosed with OSAS based on the Apnea-Hypopnea Index (AHI). OSAS patients were divided into 3 groups according to their AHI scores: 5-15 was considered mild (19 patients), 16-30 was considered moderate (16 patients), and >30 (24 patients) was considered severe. Twenty-eight (47.5%) of the OSAS patients had been using continuous positive airway pressure treatment. The control group included 19 healthy subjects. Retinal nerve fiber layer and ganglion cell complex (GCC) thickness analyses were performed.

Results: Average GCC thickness in left eyes was significantly lower in the mild OSAS group than in the control group (p=0.013). The GCC was significantly thinner in the inferior and inferonasal sectors of both eyes in the mild OSAS group compared to the control group (p=0.029, p=0.022, p=0.037, and p=0.019 respectively). Minimum GCC thickness in the left eyes of all OSAS groups was significantly lower than in the control group (p<0.05).

Conclusion: In OSAS patients, there may be changes in retinal nerve fiber layer and ganglion cell complex thickness before alterations in the visual field emerge.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjo.galenos.2018.88614DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6624468PMC
June 2019

Vascular and structural alterations of the choroid evaluated by optical coherence tomography angiography and optical coherence tomography after half-fluence photodynamic therapy in chronic central serous chorioretinopathy.

Graefes Arch Clin Exp Ophthalmol 2019 May 7;257(5):905-912. Epub 2019 Jan 7.

Department of Ophthalmology, Ankara University Faculty of Medicine Ankara, Mamak Street, Dikimevi, Ankara, Turkey.

Purpose: To concurrently evaluate the effect of half-fluence photodynamic therapy (hf PDT) on choriocapillaris (CC) perfusion and choroidal structure in chronic central serous chorioretinopathy (CSC).

Methods: This prospective study included 48 eyes of 41 patients with chronic CSC. Enhanced depth imaging optical coherence tomography and optical coherence tomography angiography (OCTA) images were analyzed. Choroidal area (CA), luminal area (LA), and stromal area (SA) were computed using Image J software.

Results: One month after hf-PDT, total CA decreased to 1.312 mm from 1.490 mm (p < 0.001), LA decreased to 0.981 mm from 1.097 mm (p < 0.001), and SA decreased to 0.331 mm from 0.393 mm (p < 0.001). In OCTA, the CC flow in the eyes with CSC (17.75 mm) was statistically significantly lower than the fellow eyes (18.93 mm) at the baseline visit (p < 0.001). After hf-PDT, the flow in the choriocapillaris statistically significantly increased to 18.81 mm at the first month (p = 0.02).

Conclusions: OCTA proves that after hf-PDT a significant increase in CC perfusion occurred at first month. The decrease of the luminal areas in enhanced depth imaging optical coherence tomography is mainly due to a decrease in large-caliber vessels, which indicates that hf-PDT has an effect on larger choroidal vessels and spares CC flow.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00417-018-04226-6DOI Listing
May 2019

Optical coherence tomography angiography in pachychoroid spectrum diseases.

Graefes Arch Clin Exp Ophthalmol 2018 08 1;256(8):1559-1560. Epub 2018 Jun 1.

Department of Ophthalmology, Ankara University Faculty of Medicine, Mamak Street, Dikimevi, Ankara, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00417-018-4019-4DOI Listing
August 2018

The Recovery of Microvascular Status Evaluated by Optical Coherence Tomography Angiography in Patients after Successful Macular Hole Surgery.

Ophthalmic Res 2018 29;59(1):53-57. Epub 2017 Nov 29.

Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

Purpose: The aim of this study was to evaluate the optical coherence tomography angiography (OCTA) features of patients who underwent successful macular hole (MH) surgery.

Methods: Nineteen patients who underwent surgery in a single eye due to MH and 13 healthy subjects as a control group were included in the study. Vascular densities, flow indexes, and the foveal avascular zone (FAZ) area in superficial and deep retinal capillary plexuses were evaluated by OCTA in the right eyes of the control group, and both the surgical and healthy fellow eyes of the patients.

Results: The mean vascular densities of the superficial and deep capillary plexuses were significantly lower in the surgical eyes than in the control group (44.1 vs. 49.6%, p = 0.002, and 47.3 vs. 59.1%, p = 0.009, respectively). The mean superficial and deep capillary flow indexes were significantly lower in the surgical eyes than in the control group (0.85 vs. 1.35, p = 0.003, and 0.57 vs. 1.45, p = 0.001, respectively), while the mean superficial and deep FAZ area were significantly greater in the surgical eyes in comparison to the control group (0.55 vs. 0.32, p < 0.001, and 0.64 vs. 0.37, p = 0.001, respectively). There was no difference between the flow indexes of both layers of the healthy fellow eyes and the control group.

Conclusions: These preliminary results may be an explanation for unsatisfactory visual gain after surgery, despite the successful anatomical closure of the MH.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000484092DOI Listing
March 2018

The Diagnostic Role of Multimodal Imaging Techniques in Isolated Foveal Hypoplasia.

Turk J Ophthalmol 2017 Oct 27;47(5):306-308. Epub 2017 Oct 27.

Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.

To report a case of bilateral isolated foveal hypoplasia in which multimodal imaging was used to confirm the diagnosis. Fundus autofluorescence imaging, optical coherence tomography (OCT), and fundus fluorescein angiography were used to describe the typical findings of a patient with isolated foveal hypoplasia. Spectral domain OCT showed absence of foveal depression and persistent inner retinal layers in the fovea. Fundus autofluorescence did not reveal foveal hypoautofluorescence in the presumed foveal area. Clinical diagnosis of foveal hypoplasia may be difficult due to the subtle nature of fundus findings. Fundus autofluorescence imaging may help to diagnose these patients. Foveal hypoplasia should be considered in the differential diagnosis of absence of foveal hypoautofluorescence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjo.43799DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661184PMC
October 2017

The use of optical coherence tomography angiography in pachychoroid spectrum diseases: a concurrent comparison with dye angiography.

Graefes Arch Clin Exp Ophthalmol 2017 Dec 11;255(12):2317-2324. Epub 2017 Sep 11.

Department of Ophthalmology, Ankara University Faculty of Medicine, Vehbi Koç Göz Hastanesi, Mamak Caddesi, Dikimevi, Ankara, Turkey.

Purpose: The study objective was to compare dye angiography and optical coherence tomography angiography (OCTA) in detecting choroidal neovascuarization (CNV) in patients presenting with pachychoroid features and flat irregular pigment epithelial detachment (PED).

Methods: Nineteen eyes of 17 patients, presenting with flat PED and pachychoroid features, and without age-related macular degeneration or any other degenerative change, were analyzed. Fuorescein angiography (FA)/Indocyanine green angiography (ICGA) and OCTA were performed during the same visit. Subfoveal choroidal thickness was measured by enhanced depth imaging using spectral domain optical coherence tomography.

Results: The mean age of the patients was 59.1 years. Mean subfoveal choroidal thickness was 388 μm. FA revealed non-patognomic features including RPE alterations, window defects, leaking points and leakage from an undetermined source. ICGA revealed choroidal vascular plaque in eight eyes (42%) and suspicious plaque in five eyes (26%). Nonneovascular features, such as hyperpermeability or dilated choroidal vessels, were observed in six eyes (32%). OCTA showed choroidal neovascularization in 14 (74%). For all of the eyes, which ICGA was positive for presence of CNV, OCTA also showed CNV, and in one case it also revealed polypoidal characteristics of the neovascular network. OCTA was also able to detect CNV in all of the eyes with suspicious plaque, and in one eye without CNV appearance using ICGA.

Conclusions: OCTA demonstrated greater sensitivity in detecting type 1 CNV than conventional dye angiography in cases with pachychoroid spectrum disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00417-017-3793-8DOI Listing
December 2017

Evaluation of Ganglion Cell-Inner Plexiform Layer Thickness after Vitreoretinal Surgery with Internal Limiting Membrane Peeling in Cases with Idiopathic Macular Hole.

Turk J Ophthalmol 2017 Jun 1;47(3):138-143. Epub 2017 Jun 1.

Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.

Objectives: To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness after vitrectomy with internal limiting membrane (ILM) peeling for idiopathic macular holes using spectral domain optical coherence tomography (SD-OCT).

Materials And Methods: Eighteen eyes of 18 patients with unilateral idiopathic macular hole who underwent vitrectomy with ILM peeling were retrospectively analyzed. Healthy fellow eyes of the patients and 18 eyes of 18 age-matched healthy individuals constituted the control group. The patients were evaluated at 1 day, 1 week, 1 month, and 3 months after surgery. The best corrected visual acuity (BCVA) measurements, biomicroscopic examination findings and SD-OCT measurements were recorded. Ganglion cell-inner plexiform layer thickness was evaluated with ganglion cell analysis software of Cirrus HD-OCT before surgery and at 1 month and 3 months after surgery and compared with control groups. Presence of dissociated optic nerve fiber layer (DONFL) was evaluated with C-scan mode.

Results: Of the 18 patients, 9 were male and 9 were female with a mean age of 65.6±5.6 (55-77) years. Preoperative BCVA was 0.75±0.19 logMAR, while it was 0.44±0.17 logMAR and 0.36±0.15 logMAR at postoperative 1 and 3 months, respectively (p<0.001). Postoperative mean GCIPL thickness was 66.33±17.28 µm. There was a correlation between mean GCIPL thickness and BCVA at postoperative 3 months (p<0.01). When compared with the control group, GCIPL thickness was significantly thinner in all quadrants of all patients at postoperative 3 months. Dissociated optic nerve fiber layer appearance was observed on C-scan in 13 of 18 eyes postoperatively. There was no correlation between the presence of DONFL and BCVA (p>0.05).

Conclusion: Internal limiting membrane peeling during macular hole surgery may cause functional and/or structural changes that may be associated with visual acuity. Significant GCIPL thinning and DONLF appearance may occur postoperatively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjo.34545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468526PMC
June 2017

Assessment of the Anterior Chamber Flare and Macular Thickness in Patients Treated with Topical Antiglaucomatous Drugs.

J Ocul Pharmacol Ther 2017 04 6;33(3):170-175. Epub 2017 Feb 6.

Department of Ophthalmology, Faculty of Medicine, Ankara University , Ankara, Turkey .

Purpose: To determine the changes in the anterior chamber flare and central macular thickness (CMT) under topical antiglaucomatous therapy.

Methods: This study included 121 eyes of 73 patients and 36 eyes of 18 controls. Glaucoma patients were divided into 3 groups (timolol maleate, latanoprost, and bimatoprost). Control eyes did not receive any medications. Flare and CMT measurements were performed at baseline and follow-up visits (15th day, and 1st, 3rd, 6th, and 12th month).

Results: Statistically significant increases were detected in the flare values in the bimatoprost and latanoprost groups (P < 0.001, P = 0.011, respectively). Significant increases were also found in CMT values measured in these 2 groups (P < 0.001, P = 0.002, respectively). However, increased flare and CMT values were not clinically manifested as uveitis and macular edema. Flare and CMT values did not change statistically in the timolol maleate and control groups.

Conclusions: Although the use of prostaglandin (PG) analogs was found to be associated with increased flare and CMT, these increases were not clinically significant. PG analog monotherapy may be safely and effectively used in the treatment of glaucoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/jop.2016.0128DOI Listing
April 2017

Chemotherapy in Retinoblastoma: Current Approaches.

Turk J Ophthalmol 2015 Dec 5;45(6):259-267. Epub 2015 Dec 5.

Ankara University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey.

Retinoblastoma (RB) is the most common childhood malignant intraocular tumor. Although enucleation and external beam radiotherapy have been historically used, today the most commonly used eye-sparing approach is chemotherapy. Chemotherapy can be used in both intraocular and extraocular RB cases. Chemotherapeutic agents may be applied in different ways, including systemic, subconjunctival, intra-arterial and intravitreal routes. The main purposes of application of systemic therapy are to reduce the tumor size for local treatment (chemoreduction), or to reduce the risk of metastasis after enucleation surgery (adjuvant therapy). Intra-arterial chemotherapy with the current name "super-selective intra-arterial infusion therapy" could be applied as primary therapy in tumors confined to the retina or as a secondary method in tumor recurrence. The most important advantage of intra-arterial therapy is the prevention of systemic chemotherapy complications. Intravitreal chemotherapy is administered in the presence of persistent or recurrent vitreous seeding. The term "extraocular RB" includes orbital invasion and metastatic disease. Current treatment for orbital invasion is neoadjuvant chemotherapy followed by surgical enucleation and adjuvant chemotherapy and radiotherapy after surgery. In metastatic disease, regional lymph node involvement, distant metastases, and/or central nervous system (CNS) involvement may occur. Among them, CNS involvement has the worst prognosis, remaining at almost 100% mortality. In metastatic disease, high-dose salvage chemotherapy and autologous hematopoietic stem cell rescue therapy are the possible treatment options; radiotherapy could also be added to the protocol according to the side of involvement.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjo.06888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082265PMC
December 2015

The Use of Bandage Contact Lenses in Adenoviral Keratoconjunctivitis.

Eye Contact Lens 2016 11;42(6):388-391

Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

Purpose: To evaluate the safety and efficacy of the use of the bandage contact lenses (BCLs) in adenoviral keratoconjunctivitis-related ocular surface problems.

Methods: Fifteen eyes of 15 consecutive patients presenting at the Ankara University Medical Center, Cornea and Contact Lens Service, and requiring BCL use for adenoviral keratoconjunctivitis-related ocular surface problems were enrolled. Visual acuity, slitlamp examination findings, indication and duration of the BCL use, the total follow-up, and any adjuvant medication were recorded. All patients were followed regarding the success of treatment and adverse effects associated with BCL use.

Results: The average age at the time of presentation was 26.8±15.5 years. The major reasons for BCL use included epithelial defect (7 eyes), filamentous keratopathy (5 eyes), epithelial edema (1 eyes), and filamentous keratopathy together with epithelial defect (2 eyes). After the first appearance of conjunctivitis symptoms, the mean time to BCL application was 9.0±3.9 days. The mean duration of contact lens wear was 9.9±6.5 days, and the mean follow-up was 26.4±15.8 days. Preservative-free artificial tears and topical antibiotics were used in all cases. Besides, topical ganciclovir 0.15% gel (8 eyes), topical 0.4% povidone-iodine solution (9 eyes), and topical steroids (11 eyes) were used in various combinations. At the end of the follow-up period, the mean visual acuity improved from 0.23±0.32 logMAR units (∼0.6 Snellen line) to 0.0l±0.04 logMAR units (∼1.0 Snellen line) (P=0.042). No sight-threatening complication related to contact lens wear was encountered.

Conclusion: Adjuvant use of BCLs seems to be safe and effective in the treatment of adenoviral keratoconjunctivitis-related ocular surface problems. Close follow-up and prophylactic use of topical antibiotics are rationalistic for prevention of secondary infections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICL.0000000000000206DOI Listing
November 2016

Low-Fluence Photodynamic Therapy versus Subthreshold Micropulse Yellow Wavelength Laser in the Treatment of Chronic Central Serous Chorioretinopathy.

J Ophthalmol 2016 15;2016:3513794. Epub 2016 Aug 15.

Department of Ophthalmology, Faculty of Medicine, Ankara University, 06620 Ankara, Turkey.

Purpose. To compare the efficacy and safety of subthreshold micropulse yellow wavelength laser (SMYL) and low-fluence photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC). Methods. Thirty-three eyes of 30 patients with chronic CSC received either PDT (18 eyes) or SMYL (15 eyes) therapy. Best corrected visual acuity (BCVA), subretinal fluid (SRF) height, and central macular thickness (CMT) were evaluated at the baseline visit and one, three, six, nine, and 12 months after the therapy. Results. After 12 months, mean BCVA improved from 67.3 ± 14.2 to 71.5 ± 21.4 ETDRS letters in SMYL group and from 60.7 ± 16.3 to 64.4 ± 24.9 ETDRS letters in PDT group (p = 0.285 and p = 0.440, resp.). Mean CMT decreased from 242.8 ± 80 μm to 156.9 ± 60 μm in the PDT group and from 287.3 ± 126 μm to 138.0 ± 40 μm in the SMYL group (p = 0.098 and p = 0.003, resp.). SRF resolved completely in 72.2% and 80.0% of the eyes in the PDT and SMYL groups, respectively. Mean SRF height decreased from 117.2 ± 58 μm to 31.3 ± 56 μm in the PDT group and from 130.0 ± 104 μm to 12.5 ± 21 μm in the SMYL group (p = 0.031 and p = 0.014, resp.). Conclusions. Subthreshold micropulse yellow wavelength laser seems to be effective in the treatment of chronic CSC without any side effect and results in the resorption of SRF without causing visible retinal scarring.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2016/3513794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002482PMC
September 2016

Myths in the Diagnosis and Management of Orbital Tumors.

Middle East Afr J Ophthalmol 2015 Oct-Dec;22(4):415-20

Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

Orbital tumors constitute a group of diverse lesions with a low incidence in the population. Tumors affecting the eye and ocular adnexa may also secondarily invade the orbit. Lack of accumulation of a sufficient number of cases with a specific diagnosis at various orbital centers, the paucity of prospective randomized studies, animal model studies, tissue bank, and genetic studies led to the development of various myths regarding the diagnosis and treatment of orbital lesions in the past. These myths continue to influence the diagnosis and treatment of orbital lesions by orbital specialists. This manuscript discusses some of the more common myths through case summaries and a review of the literature. Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future. This will enable targeted treatments even for diseases with the same histopathologic diagnosis. Phenotypic variability within the same disease will be addressed using targeted treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0974-9233.167823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660525PMC
May 2016

Aqueous Flare as an Indicator of Response to Dexamethasone Treatment in Retinal Vein Occlusions: A Pilot Study.

Curr Eye Res 2016 05 3;41(5):700-7. Epub 2015 Aug 3.

a Department of Ophthalmology, Faculty of Medicine , Ankara University , Ankara , Turkey.

Purpose: To investigate aqueous flare change patterns in retinal vein occlusions (RVO) following intravitreal application of dexamethasone implant. To evaluate the correlations between central macular thickness (CMT), best corrected visual acuity (BCVA) and aqueous flare values.

Methods: This prospective, interventional pilot study included 40 eyes of 40 patients with macular edema associated with RVO. All patients received intravitreal injection of dexamethasone implant at baseline visit. Full ophthalmologic examination, CMT and aqueous flare measurements were performed prior to injection and repeated at months 1, 3, and 5. Aqueous flare, BCVA and CMT changes between visits were assessed. Further statistical analysis was performed to investigate correlations between these three parameters.

Results: The patients consist of 23 (57.5%) men and 17 (42.5%) women with a mean age of 65.7 ± 6.2 years. Of the 40 eyes, 24 (60%) had branch retinal vein occlusion and 16 (40%) had central retinal vein occlusion. BCVA (log MAR) was significantly correlated with aqueous flare at each visit (r = 0.436, p  = 0.005; r = 0.349, p = 0.027; r = 0.357, p = 0.024; r = 0.551, p = 0.000, respectively). Flare values were also correlated with CMT measurements in 3rd and 5th months (r = 0.324, p = 0.042; r = 0.556, p = 0.000, respectively). Comparing the percentage change in CMT and flare values over time, the change in CMT from baseline to 3rd and 5th months (r = 0.441, p = 0.004, r = 0.448, p = 0.004), from 1st month to 3rd and 5th months (r = 0.441, p = 0.004; r = 0.461, p = 0.003) and from 3rd month to 5th month were directly correlated with aqueous flare changes (r = 0.584, p = 0.000). Twenty-two eyes (55%) required second dexamethasone implant application at 5th month.

Conclusion: Considering the inflammatory base of RVO, dexamethasone implants effectively decreased the flare values in the anterior chamber. The CMT change was directly correlated with aqueous flare values.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/02713683.2015.1050740DOI Listing
May 2016

Intraocular pressure changes related to intravitreal injections of ranibizumab: analysis of pseudophakia and glaucoma subgroup.

Int Ophthalmol 2015 Aug 31;35(4):541-7. Epub 2014 Jul 31.

Department of Ophthalmology, Ankara University Faculty of Medicine, Mamak Caddesi, Vehbi Koç Göz Hastanesi, Dikimevi, Ankara, Turkey,

The purpose of this study was to determine intraocular pressure (IOP) changes following intravitreal ranibizumab injections and to investigate the effect of pre-existing glaucoma and pseudophakia. Two hundred and two eyes of 175 patients who received repeated intravitreal ranibizumab injections were included in this study. IOP measurements were obtained at both 30 min and 24 h after each injection. IOP changes after the first, third, sixth, ninth, and twelfth injections were analyzed. Data gotten from subgroups with pre-existing glaucoma and pseudophakia were also analyzed. The mean number of injections was 4.81 ± 2.7 (range: 3-18), while the mean IOP prior to the first intravitreal ranibizumab injection was 15.11 ± 2.8 (9-25) mmHg. At the last visit, IOP was 14.66 ± 2.8 (9-22) mmHg. There was no cumulative increase in IOP at either 30 min or 24 h values throughout repeated injections. Pseudophakic patients had significantly lower mean IOP values at 30 min after all injections except for twelfth. The number of eyes with an IOP higher than 21 mm Hg and the mean IOP values were significantly higher in patients with pre-existing glaucoma at 30 min after the first and third injections. Pseudophakic eyes are less prone to immediate IOP spikes than phakic eyes. Pre-existing glaucoma may be a potential risk factor for uncontrolled IOP spikes immediately after intravitreal injection; nonetheless, this effect is usually transient and does not cause long-term problems. Also, ranibizumab injections can be administered safely under close monitoring.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10792-014-9981-1DOI Listing
August 2015