Publications by authors named "Gamze Ucan Gunduz"

9 Publications

  • Page 1 of 1

A rare case of recurrence presenting with bilateral exudative retinal detachment in a child with acute lymphoblastic leukemia.

Pediatr Blood Cancer 2021 Dec 16;68(12):e29291. Epub 2021 Aug 16.

Department of Pediatric Hematology, Bursa Uludag University School of Medicine, Bursa, Turkey.

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http://dx.doi.org/10.1002/pbc.29291DOI Listing
December 2021

SD-OCT assessment of macular and optic nerve alterations in patients recovered from COVID-19.

Can J Ophthalmol 2021 Jul 5. Epub 2021 Jul 5.

Bursa Uludag University School of Medicine, Department of Chest Diseases, Bursa, Turkey.

Objective: To quantify microstructutal alterations in the macula and peripapillary retinal nerve fibre layer (RNFL) in patients recovered from coronavirus disease 2019 (COVID-19) using spectral domain optic coherence tomography (SD-OCT).

Design: Retrospective, observational.

Participants: This comparative, cross-sectional study included patients who recovered from COVID-19 (Group 1) and age- and sex-matched normal controls (Group 2).

Methods: A comprehensive ophthalmic examination, including best-corrected visual acuity and biomicroscopic anterior and posterior segment examination was performed. SD-OCT analysis of the macula and peripapillary RNFL was obtained for each participant. In addition, patient demographics and comorbidities were recorded.

Results: 238 eyes of 122 subjects (Group 1: n = 63; Group 2: n = 59) were included. The incidence of coexisting comorbidity was higher in Group 1 (n = 26/63, 41.3%) compared with Group 2 (n = 12/59, 20.3%) (p = 0.013). The central foveal thickness (CFT) was significantly higher in Group 1 (271.0±26.8 µm) than Group 2 (263.2±22.0 µm) (p = 0.015). The average outer nuclear layer (ONL) thickness at central fovea in Group 1 (85.4±13.3 µm) was significantly thicker than that in Group 2 (81.4±15.2 µm) (p = 0.035). The mean peripapillary RNFL thickness of Group 1 (102.6±8.8 µm) and Group 2 (100.9±8.3 µm) were similar (p = 0.145). The mean choroidal thickness of groups at the fovea and at 1500 µm nasal and temporal to the fovea were not significantly different (p > 0.05 for all).

Conclusion: Significant thickness alterations in individual retinal layers and CFT was detected in post-COVID-19 patients. The increase in CFT and ONL thickness might be attributed to direct infection or viral-induced inflammatory response of retina.
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http://dx.doi.org/10.1016/j.jcjo.2021.06.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255111PMC
July 2021

Anti-Tumor Necrosis Factor Treatment in the Management of Pediatric Noninfectious Uveitis: Infliximab Versus Adalimumab.

J Ocul Pharmacol Ther 2021 05 28;37(4):236-240. Epub 2021 Jan 28.

Uludag University School of Medicine, Pediatric Immunology and Rheumatology, Bursa, Turkey.

Management of uveitis displays a particular challenge in childhood. This study aims to compare the efficacy and safety of infliximab (IFX) and adalimumab (ADA) in pediatric noninfectious uveitis that were refractory to conventional immunosuppresives. This retrospective single-center study included 33 patients who were treated with anti-tumor necrosis factor (TNF) agents (16 with IFX and 17 with ADA). Patients had diverse etiologies, including juvenile idiopathic arthritis, idiopathic uveitis, and Behçet's disease. Demographic characteristics, systemic diagnosis, findings of the ophthalmological examination, control of ocular inflammation, response to treatment, and the rate of clinical remission were studied. Fourteen (87.5%) patients receiving IFX and 10 (58.8%) patients receiving ADA achieved response to treatment during the follow-up ( = 0.118). The agents were discontinued with complete clinical remission in 6 (37.5%) patients receiving IFX and in 2 (11.8%) patients receiving ADA ( = 0.118). Baseline visual acuities and parameters of inflammation improved significantly in both groups after anti-TNF therapy. Both IFX and ADA are safe and effective for pediatric noninfectious uveitis.
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http://dx.doi.org/10.1089/jop.2020.0081DOI Listing
May 2021

Laser photocoagulation, intravitreal anti-VEGF, and vitreous surgery for the treatment of juxtapapillary retinal capillary hemangioma.

Indian J Ophthalmol 2019 12;67(12):2104-2106

Department of Ophthalmology, Ozel Jimer Hastanesi, Bursa, Turkey.

Juxtapapillary retinal capillary hemangiomas (JRCHs) are benign vascular tumors located on or adjacent to the optic nerve head. A 19-year-old girl presented with epiretinal membrane (ERM) associated with an elevated and round vascular tumoral mass located in the juxtapapillary region of her left eye. She was subsequently diagnosed with isolated JRCH. A combined approach with laser photocoagulation and intravitreal bevacizumab injection was used to facilitate shrinkage of the tumor preoperatively and pars plana vitrectomy was used to remove the tumor and ERM. A small remnant of tumoral mass remained intact and did not show any growth for 7 years.
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http://dx.doi.org/10.4103/ijo.IJO_1799_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896561PMC
December 2019

Isolated and Transient Nuclear Midbrain Blepharoptosis in a Young and Healthy Adult.

Neuroophthalmology 2020 Apr 22;44(2):111-113. Epub 2019 Mar 22.

Department of Ophthalmology, Uludag University, Bursa, Turkey.

A 32-year-old otherwise healthy man presented with acute-onset bilateral blepharoptosis of 6 days' duration. On examination, he had severe ptosis bilaterally and mildly restricted abduction in the left eye. Brain magnetic resonance imaging showed a 10-mm-diameter lesion in the dorsal midbrain. The ptosis resolved spontaneously within two weeks. Systemic investigation did not uncover any aetiological factor. During 70 months' follow-up, neither any systemic disease nor ptosis relapse developed. Isolated nuclear midbrain ptosis has been previously reported in a few patients and these had neoplastic or inflammatory causes. In this patient, spontaneous resolution of the nuclear ptosis within weeks suggested that the underlying cause might be isolated ischaemic damage to the central caudal nucleus.
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http://dx.doi.org/10.1080/01658107.2019.1588336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202413PMC
April 2020

Efficacy of Dexamethasone Implants in Uveitic Macular Edema in Cases with Behçet Disease.

Ophthalmologica 2019 21;241(4):190-194. Epub 2018 Sep 21.

Department of Ophthalmology, Uludag University School of Medicine, Bursa, Turkey.

Purpose: Investigation of the efficacy of intravitreal dexamethasone implants (0.7 mg) in patients with Behçet disease (BD) who had cystoid macular edema (CME) despite immunomodulatory treatment.

Materials And Methods: Twenty-seven eyes of 20 patients who had intravitreal dexameth-asone implant injections and follow-up for more than 6 months were included in this study. Best corrected visual acuities (BCVA), intraocular pressures (IOP), and central macular thicknesses (CMT) were recorded. Systemic immunomodulatory treatment was noted. Injection-related complications and the need for recurrent injections were recorded.

Results: Statistically significant anatomical and functional success was achieved with a single injection. BCVA increased from 0.85 ± 0.72 to 0.45 ± 0.52 logMAR, while the mean CMT decreased from 406 ± 190 to 243 ± 101 µm at the sixth month. The peak of visual acuity gain was reached within the first 2 months and a substantial proportion of the patients gained 3 or more lines. There was no complication other than transient IOP elevation in 4 eyes and cataract surgery in 2 eyes.

Conclusion: Adjuvant intravitreal dexamethasone implant injections offer promising results in cases of BD with CME. It is effective in preserving the macular anatomy and vision particularly in transition to biological agents.
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http://dx.doi.org/10.1159/000490674DOI Listing
May 2019

How Does Usage of Serotonin Noradrenaline Reuptake Inhibitors Affect Intraocular Pressure in Depression Patients?

J Ocul Pharmacol Ther 2018 05 15;34(4):354-359. Epub 2018 Feb 15.

4 Department of Psychiatry, Muammer Agım Gemlik State Hospital , Bursa, Turkey .

Purpose: To evaluate anterior segment parameters and intraocular pressure (IOP) modifications in patients using serotonin noradrenaline reuptake inhibitors (SNRIs) due to major depressive disorder.

Methods: This cross-sectional study included 170 eyes of 85 subjects. All subjects were divided into three groups: group 1 included 44 healthy control subjects, group 2 included 22 patients receiving antidepressants for 1 week to 6 months, and group 3 included 19 patients receiving antidepressants for >6 months. All subjects underwent a detailed ophthalmologic examination, including gonioscopy. Anterior segments of all subjects were evaluated with the Scheimpflug system and pupil diameter (PD), central corneal thickness, anterior chamber depth (ACD), anterior chamber volume, and anterior chamber angle (ACA) measurements were enrolled.

Results: The median IOP was significantly lower in patients using antidepressants [16.0 (11.0-21.0) mmHg] than the control group [17.5 (12.0-21.0) mmHg] (P = 0.041). The PD was significantly larger in patients using antidepressants [3.56 (2.29-5.60) mm] than the control group [2.95 (2.00-4.40) mm] (P = 0.000). In the study group, PD was also significantly larger in patients using SNRIs for ≥6 months [3.67 (2.38-5.08) mm] than <6 months [3.31 (2.29-5.60) mm] (P = 0.000). The median ACD was significantly lower in patients using antidepressants for ≥6 months [3.21 (2.52-4.06) mm] than the control group [3.44 (2.63-4.29) mm] (P = 0.000). ACAs were measured between 25° and 55° by Scheimpflug imaging.

Conclusions: Treatment of SNRIs causes mydriasis and decrease in width of ACD. These changes may not increase IOP as long as the patient has an open angle. SNRIs lead to decrease in IOP particularly in long-term usage.
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http://dx.doi.org/10.1089/jop.2017.0133DOI Listing
May 2018

Effects of selective serotonin reuptake inhibitors on intraocular pressure and anterior segment parameters in open angle eyes.

Cutan Ocul Toxicol 2018 Mar 1;37(1):36-40. Epub 2017 Jun 1.

c Department of Psychiatry , Muammer Ağım Gemlik State Hospital , Bursa , Turkey.

Purpose: To evaluate the short- and long-term effects of selective serotonin reuptake inhibitors (SSRIs) on intraocular pressure (IOP) and anterior segment parameters in open angle eyes.

Materials And Methods: This cross-sectional study included 325 eyes of 166 subjects. Subjects were divided into three groups: Group 1 included 116 eyes of 58 patients receiving SSRIs for 1 week-6 months, Group 2 included 102 eyes of 53 patients receiving SSRIs for longer than 6 months and Group 3 included 107 eyes of 55 healthy subjects not receiving any drugs. All of the patients receiving SSRIs were diagnosed as major depressive disorder. All groups were chosen to be similar in terms of age and gender. All patients underwent a detailed ophthalmologic examination including IOP measurement by Goldmann applanation tonometer and gonioscopy. Anterior segment parameters including pupil diameter (PD), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) were assessed by a Scheimpflug system.

Results: Pupil diameter was significantly larger in patients receiving SSRIs for <6 months and ≥6 months than the control subjects (3.53 ± 0.71 mm, 3.48 ± 0.60 mm versus 3.11 ± 0.72 mm, p < 0.05) but this effect was independent from the duration of SSRI treatment. IOP was significantly lower in patients receiving SSRIs for <6 months and ≥6 months than the control group (16.04 ± 2.17 mm Hg, 16.11 ± 2.13 mm Hg versus 17.34 ± 2.15 mmHg, p < 0.05), but there were no statistically significant differences between the patients receiving SSRIs for <6 months and ≥6 months. There were no statistically significant differences between the patient and the control group in values of CCT, ACD, ACV and ACA. The ACAs were measured between 25° and 55° with Scheimpflug system and also classified as grade 3-4 (Shaffer system) by gonioscopy.

Conclusions: Selective serotonin reuptake inhibitors cause mydriasis which is persistent during the treatment. In depression patients with open angle eyes, short- and long-term use of SSRIs leads to decrease in IOP.
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http://dx.doi.org/10.1080/15569527.2017.1330270DOI Listing
March 2018

Herpes zoster ophthalmicus and lateral rectus palsy in an elderly patient.

Case Rep Ophthalmol 2011 Sep 28;2(3):333-7. Epub 2011 Oct 28.

Department of Ophthalmology, Uludağ University School of Medicine, Bursa, Turkey.

Acquired palsy of the lateral rectus presents with horizontal diplopia and has a broad differential. Herpes zoster ophthalmicus- (HZO) related cranial nerve palsy is a transient and self-limiting condition. Systemic antiviral treatment is administered in order to prevent sight-threatening complications. In suspected cases, zosteriform rash should be questioned. One should keep in mind that acquired esotropia in the elderly may sometimes present following HZO.
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http://dx.doi.org/10.1159/000334236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224518PMC
September 2011
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