Publications by authors named "Dilek Uzlu"

11 Publications

  • Page 1 of 1

Effects on Intravitreal Anti-vascular Endothelial Growth Factor Injections during the COVID-19 Pandemic in the Eastern Black Sea Region of Turkey.

Beyoglu Eye J 2022 18;7(1):47-53. Epub 2021 Feb 18.

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

Objectives: To compare the number of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections performed during 2020 with that in the same period in 2019.

Methods: The study investigated anti-VEGF injections performed in 2019 and 2020. Injections performed on 923 eyes of 858 patients were evaluated. The patients were treated for diabetic macular edema (DME), age-related macular degeneration (AMD), and retinal vein occlusion (RVO). Injections, new cases, and patients who either completed or did not complete three loading doses in 2019 and 2020 were first compared. The same comparisons were then performed between the pandemic period in 2020 and the same period in 2019.

Results: While 2070 injections were performed on 670 eyes in 2019, 1478 injections were applied to 253 eyes in 2020 (p=0.001). The number of naive eyes was 163 in 2019 and 83 in 2020. During the pandemic period in 2020, 967 injections were performed on 181 eyes, compared with 1721 injections on 532 eyes in the same period in 2019 (p=0.001). While 86.5% of patients completed three injections in 2020, the rate was 78.9% for the same period in 2019 (p=0.025).

Conclusion: The COVID-19 pandemic caused a significant decrease in the number of patients presenting to the hospital, and delays occurred in treatment protocols. However, patients admitted to the hospital during this period adapted better to the loading doses. In conclusion, the pandemic caused significant disruption to treatment, and this will inevitably result in anatomical and functional worsening in the eye.
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http://dx.doi.org/10.14744/bej.2021.59244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874256PMC
February 2021

Psoriasis and uveitis.

Int Ophthalmol 2022 Jan 19. Epub 2022 Jan 19.

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

Purpose: Psoriasis, which is a chronic, immune-mediated skin disease of unknown etiology, not only affects the skin, but also is linked to many systemic conditions such as arthritis, cardiovascular disease, depression, and malignancy. Although many types of eye involvement are encountered in psoriasis patients, dry eye is the first among them. Uveitis is an entity that can be associated with psoriasis and can cause severe vision loss as a result of late diagnosis, inadequate and inappropriate treatment. In this review, we aimed to shed light on the diagnosis, type, prognosis and treatment of uveitis in psoriasis patients by compiling current datas obtained from published studies and to guide the follow-up and treatment of these patients.

Methods: A systematic literature search was done on PubMed using key words including "psoriasis", "psoriatic arthritis", "uveitis", "TNF- inhibitors", "HLA B27".

Results: In the literature, the frequency, type and treatment of uveitis developing in the course of psoriatic arthritis are clearly defined. However, the coexistence of psoriasis and uveitis has not yet been clarified due to few numbers published studies and designs of these studies. Since we examined the existing studies, we determined that the coexistence of psoriasis and uveitis could be acute or insidious, and the probability and severity of uveitis increased as the severity of skin and joint involvement increased. In addition, we found that psoriasis-associated uveitis can be bilateral, chronic, severe progression and with a high recurrence rate.

Conclusion: The relations between non-arthritic psoriasis and uveitis have not yet been fully elucidated. Physicians who treat these diseases must be cautious, and refer their patients who have psoriasis to an ophthalmologist for periodic examination, even if they do not have eye symptoms. On the other hand, ophthalmologists must be careful in uveitis patients in terms of skin and joint involvement, and must not overlook the underlying disease.
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http://dx.doi.org/10.1007/s10792-022-02225-5DOI Listing
January 2022

The evaluation of the efficacy of adalimumab in refractory non-infectious uveitis with ultra-widefield fundus fluorescein angiography.

Int Ophthalmol 2022 Jan 5. Epub 2022 Jan 5.

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

Aim: To investigate the efficacy of adalimumab in the cases with refractory non-infectious uveitis and evaluate retinal vascular leakage changes on ultra-widefield fundus fluorescein angiography.

Methods: Twenty-three patients with refractory uveitis were included in study.

Results: Forty-four eyes of 23 patients with non-infectious uveitiswere evaluated. Clinically active inflammation was present in 19 eyes (43.18%), while 25 (56.8%) were inactive. The mean drug burden was a 9.91 ± 3.78 (5-21) in baseline, 7.3 ± 4.25 at third and 8.0 ± 4.71 at sixth month (p = 0.022). The mean choroidal thickness was 256.65 ± 43.63 μm in baseline, 240.49 ± 36.73 μm at third and 224.81 ± 34.91 μm at sixth month (p ≤ 0.05). In terms of leakage extend, leakage was initially present in a mean of 2.95 ± 4.55 clock hours, 2.41 ± 3.91 at third and 1.76 ± 3.44 at sixth month (p < 0.001).

Conclusion: Adalimumab was found to be effective in establishing inflammation control by reducing drug burden, controlling retinal vascular leakage and choroidal inflammation in refractory uveitis.
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http://dx.doi.org/10.1007/s10792-021-02209-xDOI Listing
January 2022

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

Long-Term Follow-Up Results of a Patient Undergoing Acute Retinal Necrosis: A Case Report and Literature Review.

Case Rep Ophthalmol Med 2021 10;2021:9997155. Epub 2021 Jul 10.

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

Purpose: To describe the follow-up and treatment approach of a patient with acute retinal necrosis. . A 44-year-old male patient, who had complaints of pain in the right eye and blurred vision, was referred to our clinic. Best-corrected visual acuity (BCVA) was 0.4. There was 2+ anterior chamber reaction and diffuse smooth-rounded keratic precipitates. Fundus examination revealed optic nerve and vascular involvement. Fundus fluorescein angiography revealed extensive ischemia in the periphery. Oral antiviral therapy was preferred. In addition, systemic steroid and laser photocoagulation were applied. Nonetheless, retinal detachment developed 2 months later. Detachment, silicon removal, and cataract surgery were performed sequentially. It was observed that the patient was followed for 4.5 years and did not have contralateral eye involvement. Best-corrected visual acuity remained stable at 0.3.

Conclusion: Early diagnosis, appropriate treatment, accurate complication management, and frequent follow-up may provide useful vision in patients with acute retinal necrosis.
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http://dx.doi.org/10.1155/2021/9997155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289596PMC
July 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

The role of simple inflammatory blood parameters in idiopathic epiretinal membrane patients.

Int Ophthalmol 2021 Jan 26;41(1):107-112. Epub 2020 Aug 26.

The State Hospital of Bayburt, Bayburt, Turkey.

Aim: To evaluate the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in idiopathic epiretinal membrane (IERM) patients, and their relations with visual acuity.

Method: Fifty-seven IERM and 51 control patients were included. All patients underwent comprehensive ophthalmological examination and complete blood count tests, and NLR and PLR values were calculated. Patients with IERM were compared with the control group, and associations with visual prognosis were evaluated. These ratios' cut-off values for IERM were also calculated RESULTS: NLR values were statistically significantly higher in the IERM group than in the control group (p = 0.001). No significant difference was observed between the IERM and control groups in terms of PLR (p = 0.43). No significant correlation was determined between visual acuity and NLR or PLR (r = 0.05, p = 0.66; and r = 0.18, p = 0.16, respectively). The cut-off value for NLR was 1.91.

Conclusion: Patients with IERM showed significantly increased NLR compared to control subjects suggesting that IERM patients may be prone to have high NLR values.
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http://dx.doi.org/10.1007/s10792-020-01557-4DOI Listing
January 2021

The efficacy of subthreshold micropulse yellow laser (577 nm) in chronic central serous chorioretinopathy.

Lasers Med Sci 2021 Jul 19;36(5):981-988. Epub 2020 Aug 19.

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

Central serous chorioretinopathy (CSC) is a disease characterized by a well-defined serous detachment of the neurosensory retina. Therapeutic options in chronic cases are limited, and side effects can result in a limited response. The aim of this article is to assess the efficacy of subthreshold micropulse laser therapy in patients with chronic central serous chorioretinopathy. The study included 20 eyes of 19 patients who had a history of chronic or chronic recurrent CSC and who underwent subthreshold micropulse laser therapy between January 2015 and June 2018. Twenty eyes of 19 patients with a mean age of 48.9 ± 9.40 years were included. The mean visual acuity was 0.24 ± 0.28 logMAR before laser, 0.19 ± 0.25 logMAR 3 months after laser, and 0.18 ± 0.27 logMAR after 6 months. A statistically significant difference was determined in terms of visual acuity before and after treatment (p = 0.0001). The mean central retinal thickness was 308.10 ± 95.25 μm before laser, 233.65 ± 81.17 μm 3 months after laser, and 203.88 ± 72.79 μm at 6 months. A statistically significant relationship was present between visual acuity and the duration of disease (p = 0.001), between visual acuity and the outer nuclear layer thickness (p = 0.005), and between the outer nuclear layer thickness and the duration of disease in chronic cases (p = 0.008). There was no evidence of retinal pigment epithelium or retinal damage on optical coherence tomography or fundus autofluorescence secondary to subthreshold micropulse laser therapy. Visual acuity appears to be more associated with the duration of disease and with changes in the outer nuclear layer thickness in chronic CSC. Subthreshold micropulse laser therapy seems to be effective at treating chronic CSC, while it increases success during early period of the disease before the development of permanent retinal damage.
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http://dx.doi.org/10.1007/s10103-020-03129-5DOI Listing
July 2021

Ultra-widefield fundus fluorescein angiography findings in patients with ankylosing spondylitis experiencing uveitis.

Int Ophthalmol 2020 Oct 2;40(10):2627-2634. Epub 2020 Jun 2.

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

Aim: To evaluate ultra-widefield fundus fluorescein angiography (FFA) findings in cases of ankylosing spondylitis (AS)-associated uveitis.

Materials And Methods: Forty-five eyes of 23 AS patients followed up with a diagnosis of uveitis were included.

Results: Sixteen (69.6%) men and seven (30.4%) women with a mean age of 46.26 ± 10.87 years were included in the study. Retinal vascular leakage was observed in 19 (42.2%) eyes at FFA, diffuse in six (13.3%) and peripheral in 13 (28.9%) eyes. Active anterior uveitis attack was present in seven (36.8%) eyes with vascular leakage at FFA, while no active uveitis findings were present in 12 (63.15%) eyes. No statistical relation was determined between peripheral and diffuse leakage and active uveitis (p = 0.195). No significant association was also determined between both diffuse and peripheral leakage and visual acuity (p = 0.066).

Conclusion: We observed widespread retinal vascular leakage at UWF angiography in AS patients (in eyes undergoing active uveitis attacks and inactive eyes).
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http://dx.doi.org/10.1007/s10792-020-01443-zDOI Listing
October 2020

Characteristics and Seasonal Variations of Rhegmatogenous Retinal Detachment in the Eastern Black Sea Region of Turkey: 8-Year Results.

Turk J Ophthalmol 2020 04;50(2):94-98

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

Objectives: To assess seasonal variations in the incidence of rhegmatogenous retinal detachment (RRD) in the Eastern Black Sea region of Turkey.

Materials And Methods: Patients presenting due to primary RRD to a university hospital operating as a reference clinic in the region between 2011 and 2018 were evaluated retrospectively. Patients' ages, sex, affected eye, and presentation times were recorded. Years were divided into months, quarters, seasons, and half-year periods, and these periods were analyzed in terms of differences in patient numbers.

Results: Two hundred eighty-one eyes of 276 patients meeting the study criteria were included. The patients' mean age was 60.2 years, and the male:female ratio was 1.35:1. Right and left eye rates were similar. Detachments were most common (49.4%) in the upper temporal quadrant. Eighty-nine patients (31.6%) had undergone uncomplicated phacoemulsification surgery a mean 2.7 years previously. The mean annual case number was 35.13±5.43, and no statistically significant variation was determined in case numbers by year (p=0.558). Analysis of all years revealed a monthly mean case number of 23.42±4.4, with the highest number of cases, 29 (10.3%), being seen in September and the lowest number, 13 (4.7%), in December. No statistically significant monthly variation was determined (p=0.613). Similarly, no statistically significant variation was observed in case numbers analyzed by quarter, season, or half-year (p>0.05).

Conclusion: The incidence of cases of uncomplicated RRD does not exhibit seasonal variation in our region. We also think that since 31.6% had a history of cataract surgery, patients undergoing phacoemulsification surgery, even if uncomplicated, should be periodically assessed for detachment.
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http://dx.doi.org/10.4274/tjo.galenos.2019.59140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204898PMC
April 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
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