Publications by authors named "Adem Turk"

34 Publications

The clinical use of ultra - Wide field imaging and intravenous fluorescein angiography in infants with retinopathy of prematurity.

Photodiagnosis Photodyn Ther 2022 Mar 26;37:102658. Epub 2021 Nov 26.

Department of Ophthalmology, Karadeniz Technical University, Faculty of Medicine, Tip Fakultesi, Goz Hastaliklari Klinigi, Farabi Caddesi, Trabzon 61080, Turkey.

Purpose: To investigate the potential benefits and practicality of ultra - wide field (UWF) imaging and intravenous UWF fluorescein angiography (IV UWF - FA) in infants with retinopathy of prematurity (ROP) using an Optos® California device.

Methods: This retrospective study involved 46 infants with a history of ROP who underwent UWF imaging with or without IV UWF - FA. ROP characteristics were identified using UWF color imaging. Retinal vascular findings following treatment were also assessed at IV UWF - FA analysis. All imaging sessions were performed under topical anesthesia without sedation. Main outcomes were the appearance of ROP at UWF color imaging and IV UWF-FA analysis, including status of ROP, neovascularizations, presence of plus disease, retinal vascular details, and resolution after treatment.

Results: Seven (three girls) of the 46 infants (22 girls) underwent IV UWF-FA. Twelve IV UWF-FA sessions were performed in total. The oldest infant during IV UWF-FA analysis was at 55 postmenstrual weeks. Clinical characteristics of disease were easily identified at UWF color imaging. IV UWF-FA images also clearly revealed non-perfused retinal areas, fluorescein leakage, macular edema, retinal vascular abnormalities, and the status of the peripheral vascular termini. Complications of IV UWF-FA occurred in one infant in the form of patchy yellow skin discoloration around the injection site which completely disappeared on the first day following the procedure.

Conclusions: Providing a high resolution panoramic view of the retina in a single image capture with no need for contact with the cornea appear to represent potential advantages of UWF imaging in infants with ROP. IV UWF-FA also seems to be a safe procedure which can be performed under topical anesthesia and that shows detailed retinal vascular alterations in patients with ROP.
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http://dx.doi.org/10.1016/j.pdpdt.2021.102658DOI Listing
March 2022

Infliximab therapy provides beneficial effects for choroidal thickness increase in patients with active ankylosing spondylitis: A possible mechanism mediating the suppressing of uveitis attacks.

Arch Rheumatol 2021 Mar 4;36(1):56-62. Epub 2020 Sep 4.

Department of Ophthalmology, Karadeniz Technical University Medical School, Trabzon, Turkey.

Objectives: This study aims to quantitatively assess the profile of the choroidal thickness (ChT) in patients with ankylosing spondylitis (AS) using optical coherence tomography (OCT), and to examine whether the posterior eye segment abnormalities in active AS patients are reversible by infliximab therapy.

Patients And Methods: October 2014 and March 2016 Thirty-one patients with AS (22 males, 9 females; mean age 39.6±12.3 years; range, 22 to 68 years) and 24 healthy controls (16 males, 8 females; mean age 40.8±8.9 years; range, 35 to 61 years) were enrolled. Patients' clinical and demographic characteristics were recorded. Using OCT, we performed retinal nerve fiber layer (RNFL) thickness, ganglion cell complex, and ChT measurements in AS patients before and six months after the initiation of infliximab therapy, and in healthy controls.

Results: At baseline, patients with AS had higher ChT (mean±standard deviation: 347.5±114.4 μm) compared to healthy controls (322.1±62.8 μm), although this did not reach statistical significance level (p=0.283). At six months after the first measurement, the mean ChT was significantly decreased (under infliximab therapy: 326.5±99.7 μm vs. before: 347.5±114.4 μm, p=0.018) in AS group, while no significant change was observed in the control group (p=0.102). RNFL thickness in the AS group was significantly decreased after six months of treatment with infliximab (p=0.008).

Conclusion: By evaluating the posterior eye segment of patients with AS using OCT, this study has demonstrated that active AS patients had higher ChT. The significant reduction in this ChT after infliximab therapy may be mediating the established effective suppressing action of infliximab on uveitis attacks.
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http://dx.doi.org/10.46497/ArchRheumatol.2021.7806DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140873PMC
March 2021

Effect of Body Position on Intraocular Pressure Measured by Rebound Tonometer in Healthy Children.

Turk J Ophthalmol 2020 10;50(5):271-274

University of Health Sciences Turkey, Fethi Sekin City Hospital, Clinic of Ophthalmology, Elazığ, Turkey.

Objectives: To evaluate the effect of body position on intraocular pressure (IOP) measurement in the pediatric age group.

Materials And Methods: Children whose general condition was healthy and ophthalmic examination was within normal limits were included. Forty-nine eyes of 49 pediatric patients were included in the study. IOP was measured with an ICARE rebound tonometer (ICARE PRO; ICARE, Helsinki, Finland) while patients were in standing, sitting, and supine positions. Differences between the consecutive measurements were compared statistically.

Results: Twenty-two of the 49 patients were female, 27 were male. The mean age was 9.61±2.66 (5-15) years. Mean IOP values in the standing, sitting, and supine positions were 18.81±2.97 (11.6-26.2) mmHg, 18.88±3.44, (12-28.2) mmHg, and 19.01±2.8 (13.5-25.9) mmHg, respectively. There were no statistically significant differences in pairwise comparisons of the measurements taken in the different positions (p=0.846, p=0.751, p=0.606). There was a statistically significant correlation between corneal thickness and intraocular pressure values in all measurements (p=0.001, r=0.516).

Conclusion: IOP values measured with the ICARE rebound tonometer in healthy children are not affected by body position.
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http://dx.doi.org/10.4274/tjo.galenos.2020.57702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610053PMC
October 2020

A comparison of three different tonometric methods in the measurement of intraocular pressure in the pediatric age group.

Int Ophthalmol 2020 Aug 23;40(8):1999-2005. Epub 2020 Apr 23.

Fethi Sekin City Hospital, Ophthalmology Clinic, University of Health Sciences, Elazig, Turkey.

Introduction And Aim: To compare intraocular pressure (IOP) measurements obtained with non-contact tonometry (NCT), Icare rebound tonometry (IRT) and Goldmann applanation tonometry (GAT) in pediatric cases and to examine the effect of topical anesthesia on measurements obtained using IRT.

Materials And Methods: Pediatric cases in a healthy general condition and with ophthalmic examination findings within normal limits were included in the study. IOP measurements were taken with NCT and IRT devices in all cases. Topical anesthesia was subsequently applied, and IOP measurements were then repeated using IRT and GAT tonometer devices. Differences between measurements were subjected to statistical analysis.

Results: One hundred ten eyes of 55 patients, 27 male, with a mean age of 11.44 ± 2.31 years (7-17) were included. Mean pre-anesthesia IOP values were 16.47 ± 2.89 mmHg with NCT and 17.49 ± 2.57 mmHg with IRT. Mean IOP values after topical anesthesia were 16.91 ± 2.17 mmHg with IRT and 15.51 ± 2.41 mmHg with GAT. IOP measurement values obtained with all three devices exhibited positive correlation with central corneal thickness values. Statistically significant correlation was present in terms of IOP measurement values between all three devices. However, IOP values obtained with the three devices exhibited statistically significant differences. The application of topical anesthesia caused a statistically significant decrease in IRT measurements; however, statistically significant this small change (0.58 mmHg) in recorded IOP would not be considered clinically significant.

Conclusion: IOP measurements obtained with NCT, IRT and GAT devices in the pediatric age group correlate with one another, but differ from one another in a statistically significant manner. Application of topical anesthesia affects IRT measurements; however, these small changes would not be considered clinically significant.
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http://dx.doi.org/10.1007/s10792-020-01375-8DOI Listing
August 2020

Repeatability and Agreement of Macular Thickness Measurements Obtained with Two Different Scan Modes of the Optovue RTVue Optical Coherence Tomography Device

Turk J Ophthalmol 2019 Apr;49(2):78-83

Karadeniz Technical University Faculty of Medicine, Department of Ophthalmology, Trabzon, Turkey

Objectives: To evaluate the repeatability and agreement of macular thickness measurements obtained with E-MM5 and MM6, two different scan modes, on the Optovue RTVue optic coherence tomography (OCT) device.

Materials And Methods: Three consecutive macular thickness measurements in 30 healthy volunteers were taken using the OCT device E-MM5 and MM6 scan modes. The repeatability and agreement of these measurements obtained from the two scan modes and divided into nine anatomical regions based on early treatment diabetic retinopathy study were subjected to statistical analysis.

Results: The mean age of the participants was 29.7±6.39 years. Intraclass correlation (all ICC values ≥0.86) and coefficient of variation (all coefficient of variation values ≤2%) analyses of consecutive OCT measurements in the nine regions of the macula obtained in both E-MM5 and MM6 scan modes gave high repeatability rates. Mean macular thickness values in the foveal region were 243.76±21.79 μm in E-MM5 mode and 247.04±19.83 μm in MM6 mode (p=0.543). Values for measurements obtained in E-MM5 and MM6 scan modes in parafoveal macular regions were also statistically similar (p>0.05 for all). However, a statistically significant difference was observed between the two modes in perifoveal macular measurements, except in the superior region.

Conclusion: The Optovue RTVue OCT device gives highly repeatable measurement results for macular thicknesses in both E-MM5 and MM6 scan modes. However, it should be considered that measurements performed in E-MM5 and MM6 modes give different results in perifoveal regions.
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http://dx.doi.org/10.4274/tjo.galenos.2018.88972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517858PMC
April 2019

The Relation of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio with High Axial Myopia.

Ocul Immunol Inflamm 2020 Apr 17;28(3):396-401. Epub 2019 Apr 17.

Faculty of Medicine, Department of Ophthalmology, Karadeniz Technical University, Trabzon, Turkey.

: To investigate the relation between high axial myopia and neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values.: Seventy-nine cases were enrolled, 50 myopic and 29 emmetropic. All participants were assigned into three groups: Group I (high myopia with no retinal involvement), Group II (high myopia with retinal involvement) and Group III (control). NLR and PLR values calculated from blood tests were compared among the groups.: Mean NLR levels were 2.23 ± 0.78 in Group I, 2.36 ± 1.06 in Group II, and 1.57 ± 0.33 in Group III. Mean PLR levels were 114.62 ± 23.21 in Group I, 145.16 ± 52.36 in Group II, and 91.42 ± 18.73 in Group III. NLR and PLR values in the high myopia groups were significantly higher than in the control group.: NLR and PLR values in cases with high axial myopia were higher than in the emmetropic group. Higher inflammation in the degenerative myopic group in particular may be related to pathological chorioretinal changes.
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http://dx.doi.org/10.1080/09273948.2019.1588334DOI Listing
April 2020

An investigation of the ocular toxic effects of levetiracetam therapy in children with epilepsy.

Childs Nerv Syst 2019 05 20;35(5):769-774. Epub 2019 Feb 20.

Faculty of Medicine, Department of Child Neurology, Karadeniz Technical University, Trabzon, Turkey.

Objective: To investigate the potential toxic effects of levetiracetam monotherapy on ocular tissues in cases of pediatric epilepsy using optical coherence tomography (OCT).

Methods: Thirty epileptic children (group 1) receiving levetiracetam monotherapy at a dosage of 20-40 mg/kg/day for at least 1 year with a first diagnosis of epilepsy and 30 age- and gender-matched healthy children (group 2) were included in the study. In addition to a detailed eye examination, peripapillary retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, foveal thickness (FT), and central corneal thickness (CCT) were measured in all children by means of spectral domain OCT. The data obtained from the two groups were then subjected to statistical analysis.

Results: The mean age of both groups was 12 ± 3.64 years [1-12]. The mean duration of levetiracetam in group 1 was 24.07 ± 12.82 months. Mean RNFL values in groups 1 and 2 were 106.1 ± 10.42 and 104.98 ± 10.04 μm, mean GCC values were 94.72 ± 6.26 and 94.4 ± 6 μm, mean FT values were 240.73 ± 17.94 and 240.77 ± 15.97 μm, and mean CCT values were 555.1 ± 44.88 and 540.97 ± 32.65 μm, respectively. No significant difference was determined between the two groups in terms of any parameter. Best corrected visual acuity values of the subjects in both groups were 10/10, and no color vision or visual field deficit was determined.

Conclusion: Levetiracetam monotherapy causes no significant function or morphological change in ocular tissues in pediatric epilepsies.
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http://dx.doi.org/10.1007/s00381-019-04076-5DOI Listing
May 2019

A comparison of the effects of perindopril arginine and amlodipine on choroidal thickness in patients with primary hypertension

Turk J Med Sci 2018 Dec 12;48(6):1247-1254. Epub 2018 Dec 12.

Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

Background/aim: This study aimed to investigate the effects of two different medical treatment options on choroidal thickness (CT) in patients with primary hypertension.

Materials And Methods: Forty newly diagnosed primary hypertension patients and 21 healthy volunteers were included. The patients were randomly divided into two subgroups. Group I started on perindopril arginine and Group II started on amlodipine. Submacular CT using optical coherence tomography (OCT) was measured before treatment and at the third and sixth months after treatment.

Results: Initial mean arterial pressure (MAP) values in Groups I and II and the control group were 113.4, 109.8, and 89.4 mmHg, respectively, and mean CT values were 257.9, 286.5, and 300.9 μm. Mean MAP values in Groups I and II and the control group at the sixth month after treatment were 99.7, 99.6, and 90.2 mmHg, respectively, and mean CT values were 293.1, 286, and 297.4 μm. Analysis of the changes occurring during the study revealed significant variation in MAP in Groups I and II, and in CT in Group I only.

Conclusion: A gradual increase in CT developed with perindopril arginine therapy in patients with primary hypertension, while no significant change occurred in CT in the amlodipine group.
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http://dx.doi.org/10.3906/sag-1803-171DOI Listing
December 2018

ACCIDENTAL DUPLICATION: Investigation of the effect of hemoglobin F and A levels on development of retinopathy of prematurity.

J AAPOS 2017 Jun 3. Epub 2017 Jun 3.

Karadeniz Technical University, Faculty of Medicine, Department of Pediatric Disease, Trabzon, TURKEY.

The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jaapos.2017.03.006. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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http://dx.doi.org/10.1016/j.jaapos.2017.02.007DOI Listing
June 2017

The Relationship between Serum Carbonic Anhydrase I-II Autoantibody Levels and Diabetic Retinopathy in Type 1 Diabetes Patients.

Turk J Ophthalmol 2017 Apr 1;47(2):85-88. Epub 2017 Apr 1.

Karadeniz Technical University Faculty of Medicine, Department of Ophthalmology, Trabzon, Turkey.

Objectives: To investigate the relationship between serum carbonic anhydrase I-II (CA-I and II) autoantibody levels and diabetic retinopathy (DRP) in cases with type 1 diabetes.

Materials And Methods: A total of 37 type-1 diabetic patients, 17 with DRP (group 1) and 20 without (group 2), and 38 healthy control subjects (group 3) were included. CA-I and CA-II autoantibody levels were measured in serum samples obtained from each of the three groups and compared statistically. Additionally, the correlation between CA-I and CA-II autoantibody levels and the presence of diabetic macular edema was examined.

Results: Mean measured CA-I autoantibody levels were 0.145±0.072, 0.117±0.047, and 0.138±0.061 ABSU in group 1, group 2, and group 3, respectively (p=0.327). The average CA-II autoantibody levels achieved in the same groups were 0.253±0.174, 0.155±0.137, and 0.131±0.085 ABSU, respectively (p=0.005). No significant difference was obtained between the subgroups of group 1, with macular edema (n=8) and without (n=9), in terms of both CA-I and CA-II autoantibody levels (p=0.501, p=0.178, respectively).

Conclusion: A significant correlation was observed between the development of DRP and serum CA-II autoantibody levels in type 1 diabetic cases. However, there was no correlation between the autoantibody levels and the presence of diabetic macular edema in cases with DRP.
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http://dx.doi.org/10.4274/tjo.99233DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384125PMC
April 2017

Evaluation of the effects on choroidal thickness of bimatoprost 0.03% versus a brinzolamide 1.0%/timolol maleate 0.5% fixed combination.

Cutan Ocul Toxicol 2017 Dec 25;36(4):397-403. Epub 2017 Apr 25.

a Faculty of Medicine , Department of Ophthalmology, Karadeniz Technical University , Trabzon , Turkey.

Objective: To investigate the effects of two different medical treatment options on choroidal thickness (CT) in cases of open-angle glaucoma (OAG).

Methods: Sixty-seven eyes newly diagnosed with OAG and 52 healthy eyes constituting the control group were included in the study. Glaucomatous eyes were randomly divided into two subgroups; Group I was started on bimatoprost 0.03% and Group II on a brinzolamide 1.0%/timolol maleate 0.5% fixed combination (BTFC). Intraocular pressure (IOP), ocular pulse amplitude (OPA) and subfoveal CT measurements were performed in all eyes in the study before treatment and on weeks 2, 4 and 8 after treatment.

Results: Mean initial IOP values in groups I and II and the control group were 25.5 ± 4.7, 25.1 ± 5.2 and 16.1 ± 2.9 mmHg, mean OPA values were 3.7 ± 1, 3.6 ± 1.4 and 2.4 ± 0.6 mmHg and mean CT values were 269.4 ± 83, 264.5 ± 84.4 and 320.1 ± 56.6 μm, respectively. Eight weeks after treatment, mean IOP values in Groups I and II and the control group were 18.3 ± 2.6, 18.1 ± 3.4 and 15.7 ± 2.9 mmHg, mean OPA values were 2.9 ± 1.2, 2.8 ± 1.5 and 2.3 ± 0.8 mmHg and mean CT values were 290.2 ± 87.3, 271.8 ± 82.5 and 319.3 ± 56.8 μm, respectively. No significant difference was determined in terms of the decrease in IOP and OPA obtained after treatment in Group I and Group II. However, a significant difference was observed between the two groups in terms of choroidal thickening after treatment.

Conclusion: The use of topical ocular hypotensive medication in eyes with OAG results in an increase in CT. This increase is relatively greater with bimatoprost 0.03% therapy compared to BTFC.
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http://dx.doi.org/10.1080/15569527.2017.1315128DOI Listing
December 2017

Investigation of the effect of hemoglobin F and A levels on development of retinopathy of prematurity.

J AAPOS 2017 Apr 10;21(2):136-140. Epub 2017 Mar 10.

Department of Pediatric Disease, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: To investigate the effect of hemoglobin F (HbF) and hemoglobin A (HbA) levels on development of retinopathy of prematurity (ROP) in premature infants.

Methods: In this prospective study, blood samples were collected from the side of the heel of 49 premature infants at postnatal months 0, 1, 2, and 3. HbF and HbA levels were measured in all samples and analyzed statistically. Furthermore, correlation analysis was performed regarding development of ROP, blood transfusion, and HbF and HbA levels.

Results: A total of 49 infants were included. The mean gestational age of the premature infants was 30.9 ± 2.7 weeks (range, 25-35 weeks); mean birth weight, 1542 ± 582 g (range, 520-3240 g). Of the 49 premature infants, stage 1 ROP or above developed in 26 (53%). Mean HbF levels were lower at postnatal months 1 and 2 in premature infants with ROP compared to those without ROP (P = 0.013 and 0.02, respectively); however, mean HbA levels were higher in the infants with ROP than the others (P = 0.034 and 0.029, respectively). Analysis of covariance that ignored transfusion revealed no difference between the means of Hb variants in the infants with and without ROP (P = 0.572 and 0.486).

Conclusions: Blood transfusion significantly altered the levels of HbF and HbA in premature infants, and Hb variants have no direct effect on development of ROP.
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http://dx.doi.org/10.1016/j.jaapos.2017.03.006DOI Listing
April 2017

Evaluation of Retinal Changes Using Optical Coherence Tomography in a Pediatric Case of Susac Syndrome.

Turk J Ophthalmol 2017 Jan 17;47(1):59-62. Epub 2017 Jan 17.

Karadeniz Technical University Faculty of Medicine, Department of Ophthalmology, Trabzon, Turkey.

Susac syndrome is a rare occlusive vasculopathy affecting the retina, inner ear and brain. The cause is unknown, although it generally affects young women. This syndrome can be difficult to diagnose because its signs can only be revealed by detailed examination. These signs are not always concomitant, but may appear at different times. This report describes a pediatric case who was diagnosed with Susac syndrome when retinal lesions were identified in the inactive period with the help of optical coherence tomography (OCT). The purpose of this case report is to emphasize the importance of OCT in clarifying undefined retinal changes in Susac syndrome.
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http://dx.doi.org/10.4274/tjo.27482DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282545PMC
January 2017

Bilateral acute angle closure developing due to use of ipratropium bromide and salbutamol.

Int Ophthalmol 2018 Feb 6;38(1):385-388. Epub 2017 Feb 6.

Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey.

Acute angle closure can be seen as a side effect of some medications that can be used systemically. In this article, clinical characteristics of 54-year-old female patient who applied to our clinic with bilateral acute angle closure and has been received nebulized form of salbutamol and ipratropium bromide due to asthma for 4 days was evaluated. Right and left eye IOP were measured as 50 and 48 mmHg. IOP was reduced with anti-glaucomatous treatment. and peripheral iridectomy was done, and then the patient was discharged. It is necessary to be careful to prevent contact with the eye of nebulized form of these drugs which may result in angle closure glaucoma when used systemically.
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http://dx.doi.org/10.1007/s10792-017-0458-xDOI Listing
February 2018

Determination of regional screening criteria for retinopathy ofprematurity in the Eastern Black Sea region of Turkey.

Turk J Med Sci 2016 Feb 17;46(2):381-7. Epub 2016 Feb 17.

Department of Pediatric Disease, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Background/aim: To establish a regional screening protocol for retinopathy of prematurity (ROP).

Materials And Methods: Data were analyzed from the hospital records of 1241 infants with gestational age (GA) at birth ≤36 weeks and birth weight (BW) of ≤3600 g.

Results: The mean GA of the infants was 32.05 ± 2.7 weeks and the mean BW was 1780.5 ± 576 g. ROP at any stage was detected in 703 of the 1241 infants (555 female). Eleven infants with type 1 ROP were treated with 810 nm diode laser photocoagulation. No treatment was needed in infants born after 33 weeks of gestation and weighing over 1760 g. Logistic regression analysis showed a significant relationship between the development of ROP and GA, BW, number of deliveries, respiratory distress syndrome, and treatment with oxygen or mechanical ventilation. Receiver operating characteristic curve analysis showed that a GA of 33 weeks or a BW of 1770 g appears to be an appropriate criterion for identifying infants who may require ROP treatment.

Conclusion: GA ≤ 33 weeks and BW ≤ 1770 g can be used as screening criteria in terms of ROP in infants for the Eastern Black Sea region.
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http://dx.doi.org/10.3906/sag-1410-97DOI Listing
February 2016

Comparison of brimonidine-timolol and dorzolamide-timolol in the management of intraocular pressure increase after phacoemulsification.

Int J Ophthalmol 2015 18;8(5):945-9. Epub 2015 Oct 18.

Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.

Aim: To compare the effectiveness of brimonidine/timolol fixed combination (BTFC) and dorzolamide/timolol fixed combination (DTFC) in the management of short-term intraocular pressure (IOP) increase after phacoemulsification surgery.

Methods: Eighty eyes of 80 patients undergoing phacoemulsification and intraocular lens (IOL) implantation were randomly assigned into three groups. Group 1 consisted of 28 eyes and represented the control group. Group 2 consisted of 25 eyes undergoing phacoemulsification surgery and BTFC was instilled at the end of surgery. Group 3 consisted of 27 eyes undergoing phacoemulsification surgery and DTFC was instilled at the end of surgery. IOP was measured preoperatively and 6, 24h and 1wk postoperatively.

Results: There was no statistically significant difference in preoperative baseline IOP among the three groups (P=0.84). However, IOP was significantly lower in groups 2 and 3 compared to the control group (P<0.05 for all comparisons) at all postoperative visits. There was no significant difference between groups 2 and 3 at any visit. Eight eyes (28.6%) in the control group, two (8%) in Group 2 and one (3.7%) in Group 3 had IOP >25 mm Hg at 6h after surgery (P=0.008). However, IOP decreased and was >25 mm Hg in only one eye in each group at 24h after surgery.

Conclusion: BTFC and DTFC have similar effects in reducing increases in IOP after phacoemulsification surgery and can both be recommended for preventing IOP spikes after such surgery.
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http://dx.doi.org/10.3980/j.issn.2222-3959.2015.05.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631018PMC
November 2015

The effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide injection in branch retinal vein occlusion-related macular edema.

Cutan Ocul Toxicol 2016 Sep 12;35(3):185-9. Epub 2015 Aug 12.

a Department of Ophthalmology, Faculty of Medicine , Karadeniz Technical University , Trabzon , Turkey.

Objective: To investigate the effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide (PSTA) application in branch retinal vein occlusion (BRVO)-related macular edema.

Methods: Patients with confirmed BRVO-related macular edema were enrolled in the study. Patients were injected with a single, therapeutic dose of 40 mg PSTA. Detailed ophthalmic examination was performed at baseline and at 1, 3 and 6 months after the treatment. Best corrected visual acuity (BCVA), intraocular pressure (IOP), cataractogenic change (CC) and macular optical coherence tomography (OCT) analysis results were evaluated. The results were compared statistically.

Results: Forty-one eyes of 41 patients with a mean age of 63.49 ± 10.99 (55-86) years, 15 (36.6%) females, were included in the study. BCVA in LogMAR values at 1 and 3 months were significantly better than at baseline, while no significant difference from baseline was observed in sixth month values (p < 0.001, p < 0.001 and p = 0.846, respectively). Central macular thickness values obtained using OCT were significantly lower at the first, third and sixth months compared to baseline (p < 0.001 for all). IOP elevation was determined in only two eyes (4.8%) at the end of the study period, and no CC was detected in any case.

Conclusion: PSTA application is an effective and safe option in BRVO-related macular edema.
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http://dx.doi.org/10.3109/15569527.2015.1074586DOI Listing
September 2016

Regarding Comments by Yolcu et al. on "Evaluation of Choroidal Thickness in Ankylosing Spondylitis Using Optical Coherence Tomography".

Ocul Immunol Inflamm 2015 11;23(6):465-6. Epub 2015 Mar 11.

c Department of Physiology , Karadeniz Technical University, Faculty of Medicine , Trabzon , Turkey.

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http://dx.doi.org/10.3109/09273948.2014.999379DOI Listing
March 2016

Pulsatile ocular blood flow changes after panretinal photocoagulation treatment in patients with proliferative diabetic retinopathy.

Turk J Med Sci 2014 ;44(3):524-9

Department of Ophthalmology, Karadeniz Technical University, Trabzon, Turkey.

Background/aim: To prospectively assess the effects of panretinal photocoagulation (PRP) treatment on pulsatile ocular blood flow (POBF) in patients with proliferative diabetic retinopathy (PDRP).

Materials And Methods: The study included 40 eyes with PDRP in 27 patients. The PRP treatments were completed in 3 sessions with 3-week intervals. The intraocular pressure (IOP), pulse amplitude (PA), pulse volume (PV), and POBF changes that arose during the sessions were recorded using a blood flow analyzer.

Results: The average age of the patients was 57.37 ± 11.14 years. The pre-PRP basal IOP, PA, PV, and POBF values were 20.44 ± 4.13 mmHg, 4.23 ± 1.73 mmHg, 6.89 ± 2.28 μL, and 21.86 ± 5.83 μL/s, respectively. One month after the completion of the PRP sessions, the values were 18.49 ± 4.44 mmHg, 2.78 ± 1.13 mmHg, 5.27 ± 2.08 μL, and 15.89 ± 5.05 μL/s, respectively, and the differences were significant (P = 0.001, P < 0.0001, P < 0.0001, and P < 0.0001, respectively).

Conclusion: PRP treatment reduces the choroidal blood flow and consequently causes significant decreases in IOP, PA, PV, and POBE .
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http://dx.doi.org/10.3906/sag-1303-87DOI Listing
March 2015

Effects of 1% cyclopentolate hydrochloride on anterior segment parameters obtained with Pentacam in young adults.

Arq Bras Oftalmol 2014 Aug;77(4):228-32

Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.

Purpose: To investigate the effects of topically applied 1% cyclopentolate hydrochloride on anterior segment parameters obtained with a Pentacam rotating Scheimpflug camera in healthy young adults.

Methods: Anterior segment analyses of 25 eyes from 25 young adults (Group 1), before and after 45 min of 1% cyclopentolate hydrochloride application, were performed. For a control group (cycloplegia-free, Group 2), 24 eyes of 24 age- and sex-matched healthy cases were evaluated twice at 45 min intervals. The results obtained from the groups were compared statistically.

Results: The mean ages of the groups were 23.04 ± 3.42 (range, 18-29) and 22.4 ± 2.05 (range, 18-27) years for Groups 1 and 2, respectively (p=0.259). In Group 1, measurements between the two analyses were significantly different for the values of anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (ACV) (p<0.05), whereas no statistical difference was found for the central corneal thickness (CCT) and keratometry (K1, K2) measurements. In Group 2, none of these parameters were statistically different between the two analyses.

Conclusions: Topically applied 1% cyclopentolate hydrochloride caused an increase in the ACD and ACV values, and a decrease in the ACA value. However, it had no significant effect on the CCT and keratometry measurements. It is important to consider these effects when using the Pentacam device on young adults with cycloplegia and when applying it for various reasons.
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http://dx.doi.org/10.5935/0004-2749.20140059DOI Listing
August 2014

The effect of topical 1% cyclopentolate on IOLMaster biometry.

Optom Vis Sci 2014 Nov;91(11):1343-7

*MD Department of Ophthalmology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey (CA); Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey (AT, MK); and Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey (OMC).

Purpose: To investigate the effects of topical cyclopentolate on ocular biometry parameters in healthy young adults.

Methods: Ocular biometry measurements were performed twice with 45-minute intervals by use of the IOLMaster. Effects of topical application of 1% cyclopentolate were examined in 25 eyes from 25 young adults (group 1) before and after its application. As a control (cyclopentolate-free, group 2), 30 eyes from 30 age- and sex-matched healthy subjects were evaluated within the same period.

Results: There was no difference between the groups with respect to mean (±SD) ages (group 1: 23 [±3.19] years [range, 18 to 28 years] vs. group 2: 22.6 [±2.7] years [range, 18 to 28 years], p = 0.616). In group 1, the anterior chamber depth and horizontal iris width (white-to-white distance) measurements between the two sessions were significantly different, whereas the axial length was not. In group 2, none of these parameters were different between the two sessions.

Conclusions: Topical application of 1% cyclopentolate caused an increase in the anterior chamber depth and white-to-white distance values without any significant effect on axial length measurement. It is necessary to consider these effects on measurements taken with an IOLMaster in young adults in whom 1% cyclopentolate has been applied.
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http://dx.doi.org/10.1097/OPX.0000000000000388DOI Listing
November 2014

Evaluation of the Repeatability and the Reproducibility of AL-Scan Measurements Obtained by Residents.

J Ophthalmol 2014 22;2014:739652. Epub 2014 Jul 22.

Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey.

Purpose. To assess the repeatability and reproducibility of ocular biometry and intraocular lens (IOL) power measurements obtained by ophthalmology residents using an AL-Scan device, a novel optical biometer. Methods. Two ophthalmology residents were instructed regarding the AL-Scan device. Both performed ocular biometry and IOL power measurements using AL-Scan, three times on each of 128 eyes, independently of one another. Corneal keratometry readings, horizontal iris width, central corneal thickness, anterior chamber depth, pupil size, and axial length values measured by both residents were recorded together with IOL power values calculated on the basis of four different IOL calculation formulas (SRK/T, Holladay, and HofferQ). Repeatability and reproducibility of the measurements obtained were analyzed using the intraclass correlation coefficient (ICC). Results. Repeatability (ICC, 0.872-0.999 for resident 1 versus 0.905-0.999 for resident 2) and reproducibility (ICC, 0.916-0.999) were high for all biometric measurements. Repeatability (ICC, 0.981-0.983 for resident 1 versus 0.995-0.996 for resident 2) and reproducibility were also high for all IOL power measurements (ICC, 0.996 for all). Conclusions. The AL-Scan device exhibits good repeatability and reproducibility in all biometric measurements and IOL power calculations, independent of the operator concerned.
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http://dx.doi.org/10.1155/2014/739652DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129666PMC
August 2014

Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography.

Ocul Immunol Inflamm 2014 Dec 2;22(6):434-8. Epub 2014 Jul 2.

Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University , Trabzon , Turkey .

Unlabelled: Abstract Purpose: To investigate posterior segment (PS) findings in the eye in patients with ankylosing spondylitis (AS).

Methods: Eighty-four patients with AS and 63 healthy controls were enrolled. PS evaluations were performed using optical coherence tomography (OCT). Foveal thickness, peripapillary retinal nerve fiber layer thickness, macular volume, ganglion cell complex, and choroidal thickness (CT) values were compared between the groups.

Results: Mean CT was higher in patients with AS (326.5 ± 71.5 µm) than in the healthy controls (286.2 ± 59.5 µm) (p = 0.001). There was no significant difference between patients with AS and the healthy control group in terms of other OCT parameters. There was also no significant correlation between CT, AS activity index, and disease duration.

Conclusions: This is the first study to evaluate effects of AS on CT. CT was high in patients with AS compared to healthy controls.
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http://dx.doi.org/10.3109/09273948.2014.928734DOI Listing
December 2014

Serum anti-carbonic anhydrase antibodies and oxidant-antioxidant balance in patients with acute anterior uveitis.

Ocul Immunol Inflamm 2014 Apr 24;22(2):127-32. Epub 2013 Sep 24.

Department of Ophthalmology, Karadeniz Technical University, School of Medicine , Trabzon , Turkey .

Purpose: To study the existence of anti-carbonic anhydrase antibodies (anti-CA-I&II) in acute anterior uveitis (AAU) patients and to analyze the relationship between the levels of these antibodies and the total antioxidant capacity (TAC), total oxidant capacity (TOC), oxidative stress index (OSI), and malondialdehyde (MDA) level.

Methods: Forty-five AAU cases and 43 healthy controls were enrolled in this prospective study.

Results: The average anti-CA I and II antibody levels were 0.433 ± 0.306 and 0.358 ± 0.261 IU/mL, respectively, in the AAU group and 0.275 ± 0.147 and 0.268 ± 0.108 IU/mL, respectively, in the control group (p = 0.004 and p = 0.036, respectively). In addition, it was found that the TOC, OSI, and MDA levels in the AAU subjects were statistically significantly higher than those of the control subjects.

Conclusions: These results suggest that autoimmune responses against CA I and CA II and an altered serum oxidant-antioxidant balance may be involved in the pathogenesis of AAU.
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http://dx.doi.org/10.3109/09273948.2013.830753DOI Listing
April 2014

Effects of phacoemulsification surgery on ocular hemodynamics.

Int J Ophthalmol 2013 18;6(4):537-41. Epub 2013 Aug 18.

Department of Ophthalmology, School of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.

Aim: To evaluate the possible effects of phacoemulsification cataract surgery on ocular hemodynamics.

Methods: In this prospective study, intraocular pressure (IOP), pulsatile ocular blood flow (POBF), and ocular pulse amplitude (OPA) were measured pre-operatively (baseline) and at 1 week and 3 weeks postoperation in 52 eyes of 26 patients (mean age 63.15±10.25 years) scheduled for unilateral phacoemulsification cataract surgery with intraocular lens implantation. In all of the eyes, a blood flow analyzer (Paradigm DICON; Paradigm Medical Industries Inc.; USA) was used to obtain measurements of IOP, POBF, and OPA. The data obtained from operated eyes were compared statistically to untreated fellow phakic eyes of the patients.

Results: For operated eyes, the mean baseline IOP, POBF, and OPA values were 15.9±4.64mmHg, 17.41±4.84µL/s, and 2.91±1.12mmHg, respectively. The IOP, POBF, and OPA values were 17.19±4.34mmHg, 17.56±6.46µL/s, and 3.12±1.1mmHg, respectively, in the nonoperated control eyes. Statistically significant differences from baseline measurements were not observed 1 week and 3 weeks postoperation for the operated or nonoperated eyes. There were also no statistically significant differences in any measurements between the operated and nonoperated eyes in all the examination periods (P>0.05 for all).

Conclusion: Uncomplicated phacoemulsification surgery does not affect ocular hemodynamics in normotensive eyes with cataracts.
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http://dx.doi.org/10.3980/j.issn.2222-3959.2013.04.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755318PMC
August 2013

Consecutive exotropia: risk factor analysis and management outcomes.

Eur J Ophthalmol 2014 Mar-Apr;24(2):153-8. Epub 2013 Aug 1.

1 Department of Ophthalmology, Gulhane Military Medical Faculty, Ankara - Turkey.

Purpose: To report the frequency of risk factors and outcomes of consecutive exotropia (XT) following bimedial rectus recession (BMR) for the treatment of childhood esotropia (ET).

Methods: Ninety-eight patients with ET, who underwent only BMR between 1996 and 2007, were included in this study. Predictors of the development of consecutive XT and treatment outcomes were compared between groups (group 1, cases with consecutive XT; group 2, cases without consecutive XT).

Results: Mean follow-up time after BMR surgery was 7.23 ± 3.62 years. There was no significant difference between the groups in terms of age, preoperative angle of near deviation, follow-up time, or refraction for both eyes (p>0.05 for all). The differences regarding preoperative angle of distance deviation (p = 0.009), presence of inferior oblique overaction (p = 0.023), amount of BMR (p = 0.028), and postoperative adduction limitation (p<0.0001) between the groups were statistically significant. However, only preoperative angle of distance deviation and presence of postoperative adduction limitation were independent risk factors for the development of consecutive XT (p = 0.043, p = 0.007, respectively).

Conclusions: Postoperative adduction limitation should alert physicians to the increased risk of developing consecutive XT in the long-term follow-up after BMR for the treatment of childhood ET.
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http://dx.doi.org/10.5301/ejo.5000344DOI Listing
July 2014

Evaluation of the nerve fiber layer and macula in the eyes of healthy children using spectral-domain optical coherence tomography.

Am J Ophthalmol 2012 Mar 22;153(3):552-559.e1. Epub 2011 Oct 22.

Department of Ophthalmology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.

Purpose: To determine the normative values of the peripapillary retinal nerve fiber layer (RNFL), macular thickness, and macular volume in healthy children using spectral-domain optical coherence tomography (SD-OCT) and analyze the correlation of such values with age, refraction error, and biometric measurements.

Design: Observational case series.

Methods: This institutional study involved 107 eyes from 107 healthy pediatric patients (54 female, 53 male) with ages between 6 and 16 years. After the biometric measurements and refractive error values (in spherical equivalent) of the cases were obtained, the peripapillary RNFL, macular thickness, and macular volume values were calculated using the Spectralis OCT device.

Results: Among the study group, with an average age of 10.46 ± 2.94 years, the average axial length (AL) was 23.33 ± 0.89 mm; the average spherical equivalent (SE) value was -0.27 ± 0.99 diopter. The average peripapillary RNFL thickness was 106.45 ± 9.41 μm; the average macular thickness was 326.44 ± 14.17 μm; and the average macular volume was 0.257 ± 0.011 mm(3). The aforementioned OCT measurements were not significantly correlated with age, SE, or AL values (P > .05 for all).

Conclusions: This study reports SD-OCT findings among healthy pediatric cases. SD-OCT can be reliably used for pediatric patients because of its short exposure time and high degree of image resolution.
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http://dx.doi.org/10.1016/j.ajo.2011.08.026DOI Listing
March 2012

Two sisters with Bardet-Biedl syndrome: brain abnormalities and unusual facial findings.

Turk J Pediatr 2011 Jul-Aug;53(4):460-3

Department of Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.

Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder with a wide spectrum of clinical manifestations. BBS is predominantly characterized by dysmorphic distal extremities, obesity, structural abnormalities or functional impairment of the kidney, rod cone dystrophy, and varying degrees of mental retardation. Hypogenitalism is also present, only in males, and in all cases, facial similarities. We present herein two sisters with BBS, one of whom also had cerebellar vermis hypoplasia and cerebral and cerebellar atrophy, and both of whom had ocular abnormalities in the form of epicanthus and telecanthus and metabolic syndrome. It should also be emphasized that the occurrence of cerebellar involvement such as cerebellar vermis hypoplasia and cerebellar atrophy in BBS is very unusual. The association of abnormalities in brain development and other facial features in children with BBS is not seen frequently; thus, these abnormalities should be searched carefully.
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November 2011

The relationship between diabetic retinopathy and serum levels of ischemia-modified albumin and malondialdehyde.

Retina 2011 Mar;31(3):602-8

Department of Ophthalmology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Purpose: To establish the correlation between ischemia-modified albumin (IMA) and malondialdehyde (MDA) and the development of diabetic retinopathy (DRP) in patients with diabetes mellitus.

Methods: Seventy Type 2 diabetic patients, 35 with DRP, and 36 healthy controls were enrolled in this study. Serum IMA and MDA levels were compared statistically. Receiver operating characteristic curve analysis was also performed to calculate the value of IMA and MDA in distinguishing DRP.

Results: Mean serum IMA levels were 0.658 ± 0.128 absorbance units in the non-DRP group, compared with 0.767 ± 0.074 absorbance units in the DRP group and 0.619 ± 0.044 absorbance units in the control group. Mean serum MDA levels were 0.325 ± 0.172 nmol/mL, 0.244 ± 0.152 nmol/mL, and 0.178 ± 0.131 nmol/mL, respectively. The differences in IMA and MDA levels were statistically significant for all groups (P < 0.05 for all). The areas under the receiver operating characteristic curves for the determination of DRP in diabetic patients were 0.789 (95% confidence interval, 0.682-0.896) for IMA and 0.3 (95% confidence interval, 0.175-0.426) for MDA.

Conclusion: Both serum IMA and serum MDA levels were higher in the diabetic patients compared with the control group. In particular, the high sensitivity of IMA toward DRP showed that it reflected retinal vascular complication better than MDA. Ischemia-modified albumin may be a useful marker in monitoring the risk of DRP development.
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http://dx.doi.org/10.1097/IAE.0b013e3181ed8cd1DOI Listing
March 2011

Comparison of Oculus Pentacam and Stratus optical coherence tomography for measurement of central corneal thickness.

Cornea 2011 Jun;30(6):670-4

Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.

Purpose: Measurement of central corneal thickness (CCT) plays an essential role in the diagnosis and treatment of many ocular diseases. In this study, we aimed to compare the CCT measurements obtained using the Scheimpflug system (Pentacam; Oculus, Inc) with a retinal optical coherence tomography device (Stratus OCT; Carl Zeiss Meditec, Inc) to examine healthy corneas.

Methods: CCT measurements of 80 eyes belonging to 40 male patients (mean age: 24.48 ± 6.01 years) were evaluated with the Pentacam and the Stratus OCT. The relationship between the CCT values obtained with these 2 devices was examined with a Pearson correlation analysis, a paired t test, and a Bland-Altman analysis.

Results: The average CCT value obtained with Pentacam was 546.11 ± 34.15 μm and that obtained with Stratus OCT was 567.76 ± 35.02 μm. Although the average difference between the devices was 21.65 ± 8.59 μm (P < 0.0001), the measurements obtained with both devices were significantly correlated (r = 0.969, P < 0.0001). In Bland-Altman analysis, there was a high consistency between measurements obtained with either Pentacam or Stratus OCT devices.

Conclusions: Corneal thickness measurements differ depending on the device used. Corneal thicknesses that have been calculated with Pentacam were lower than the values obtained with Stratus OCT. Both devices used for CCT measurement are easily applied, noninvasive, and effective. However, the devices are not interchangeable. Stratus OCT is not optimal for CCT measurement because of the important limitations of using manual measurements, but it can be used if other measurement devices designed for the purpose are not available.
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http://dx.doi.org/10.1097/ICO.0b013e31820128a4DOI Listing
June 2011
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