Publications by authors named "Hasan Oncul"

14 Publications

  • Page 1 of 1

Solar retinopathy from sun gazing under the influence of ecstasy: A longitudinal analysis of OCT and OCTA findings.

Photodiagnosis Photodyn Ther 2021 May 25;35:102359. Epub 2021 May 25.

Department of Ophthalmology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

This report presents the clinical and optical coherence tomography (OCT) and OCT angiography (OCTA) findings from a case of acute and chronic solar retinopathy (SR) caused by sun gazing while under the influence of the hallucinogenic drug methylenedioxymethamphetamine, which is commonly known as ecstasy. This retrospective and observational case report involves a 16-year-old male patient who developed disruption of all foveolar layers two days after using ecstasy and subsequently gazing at the sun. The patient underwent visual acuity testing, dilated fundus examination, visual field analysis, OCT, and OCTA imaging. He exhibited visual recovery with the permanent disruption of the photoreceptor outer layers, and demonstrated enlargement in the deep foveal avascular zone areas during later follow-up periods, from one month to two years. This report aims to draw attention to SR that may occur after sun gazing while using hallucinogenic drugs and the importance of OCT and OCTA imaging in follow-up exams in such cases.
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http://dx.doi.org/10.1016/j.pdpdt.2021.102359DOI Listing
May 2021

Evaluation of corneal densitometry changes in patients with lichen planus.

Int J Clin Pract 2021 Apr 19:e14234. Epub 2021 Apr 19.

Department of Ophthalmology, University of Health Scıences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Purpose: To investigate the corneal topography and densitometry changes in patients with lichen planus (LP).

Methods: Anterior segment parameters and corneal densitometry of patients with LP and age- and gender-matched individuals with healthy eyes were evaluated using Scheimpflug corneal topography. A 12 mm corneal area was divided into 4 annular zones and 3 regions-in-depth anterior, central and posterior-for densitometry evaluation.

Results: The study included 45 patients with LP and 50 individuals with healthy eyes. The two groups were similar in age and gender, and they showed no significant differences in anterior segment corneal topography parameters. Schirmer's I test results were significantly lower in the patients with LP than in the control group (P ˂ .001). The total corneal densitometry was higher in patients with LP than in the control group (P = .030). The anterior, central and posterior corneal densitometry in the 0-2 mm and 2-6 mm annular zones was higher in the LP group than in the control group. Correlation analysis between disease duration and corneal densitometry values showed a strong positive correlation in the anterior segment and a moderate positive correlation in the central and posterior segments (r = 0.632, P ˂ .001; r = 0.572, P ˂ .001; and r = 0.562, P ˂ .001, respectively).

Conclusions: Corneal densitometry values were higher in patients with LP than in individuals with healthy eyes, even if the patients had a clinically transparent cornea. More studies are needed to evaluate the changes that may occur in corneal transparency in patients with LP and other autoimmune dermatologic diseases that may affect the eye.
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http://dx.doi.org/10.1111/ijcp.14234DOI Listing
April 2021

Investigation of corneal topographic and densitometric properties of Wilson's disease patients with or without a Kayser-Fleischer ring.

Eye Vis (Lond) 2021 Mar 11;8(1). Epub 2021 Mar 11.

Department of Internal Medicine, University of Health Sciences, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakır, Turkey.

Background: To investigate the topographic measurements and densitometry of corneas in Wilson's disease (WD) patients with or without a Kayser-Fleischer ring (KF-r) compared to healthy individuals.

Methods: This cross-sectional study included 20 WD patients without a KF-r (group I), 18 WD patients with a KF-r (group II), and 20 age-matched controls (group III). The Pentacam high resolution imaging system is used to determine corneal topographic measurements and densitometry.

Results: Mean age for groups I, II and III was 25.40 ± 6.43 years (14-36 years), 25.38 ± 6.96 years (16-39 years), 23.60 ± 6.56 years (17-35 years), respectively (P = 0.623). There was no significant difference between the groups in terms of the anterior corneal densitometry values (P > 0.05), while the 6-10 mm and 10-12 mm mid stroma and the 2-6 mm, 6-10 mm, and 10-12 mm posterior corneal densitometry values in group II were significantly higher than those in groups I and III (for all values, P <  0.05). However, the 10-12 mm posterior corneal densitometry values in group I were also significantly higher than those in group III (P = 0.038). The central corneal thickness (CCT), thinnest corneal thickness (tCT), and corneal volume (CV) values in groups I and II were significantly lower than those in group III (for CCT values, P = 0.011 and P = 0.009; for tCT values, P = 0.010 and P = 0.005; for CV values, P = 0.043 and P = 0.029).

Conclusion: In WD patients with a KF-r, corneal transparency decreased in the peripheral posterior and mid stromal corneal layers; for these patients, corneal transparency may be impaired not only in the peripheral cornea but also in the paracentral cornea.
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http://dx.doi.org/10.1186/s40662-021-00231-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948376PMC
March 2021

Evaluation of corneal safety in systemic lupus erythematosus patients undergoing long-term hydroxychloroquine treatment.

Cutan Ocul Toxicol 2021 Mar 23;40(1):21-25. Epub 2020 Dec 23.

Ophthalmology Clinic, Gazi Yaşargil Diyarbakir Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey.

Purpose: The aim of this study was to examine the effects of long-term use of hydroxychloroquine (HQ) on the pachymetric, aberrometric, and densitometric values of the cornea and corneal endothelium in lupus patients.

Method: Twenty-two eyes (study group) of 22 patients using HQ for treatment of lupus and 25 eyes (control group) of 25 healthy individuals were included in this prospective study. A specular microscopy was used to measure corneal endothelial cell density (ECD), percentage of hexagonal cells (HEX%), coefficient of variation of the cell size (CV). Then, a Pentacam® HR corneal tomography system was used to measure central corneal thickness (CCT), corneal aberrometry values in 6-mm pupil diameters and corneal densitometry values in 6-mm corneal zones (0-2 mm and 2-6 mm).

Results: While ECD was significantly lower in the study group than in the control group ( = 0.034), CCT was significantly higher in the study group ( = 0.032). The higher-order aberrations values and the anterior corneal densitometry values in the 0-2 mm and 2-6 mm corneal zones in the study group were found to be significantly higher than the control group ( = 0.021,  = 0.007 and  = 0.013).

Conclusion: Prolonged use of HQ may cause some changes in the cornea. In the follow-up of these cases, detailed examination of the cornea as well as the macula may be important for the protection of corneal health.
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http://dx.doi.org/10.1080/15569527.2020.1861003DOI Listing
March 2021

Corneal and lens densitometry with Pentacam HR in children with vernal keratoconjunctivitis.

Clin Exp Optom 2021 Mar;104(2):156-161

Department of Ophthalmology, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Clinical Relevance: Corneal and lens densitometry measurements provide clinically important information for the evaluation and monitoring of corneal and lens health in patients with vernal keratoconjunctivitis.

Background: To compare the corneal and lens densitometry values between paediatric patients with vernal keratoconjunctivitis (VKC) and healthy individuals.

Methods: This study included 72 eyes of 72 patients with VKC (25 with mild VKC [Group 1], 22 with moderate VKC [Group 2], and 25 with severe VKC [Group 3]), and 25 eyes of 25 healthy subjects (Group 4). Corneal and lens densitometry values were measured using Pentacam HR as follows: for corneal densitometry in two different corneal zones (0-2 and 2-6-mm) and four different corneal depths (at the total thickness, anterior, central, and posterior layers), and lens densitometry in three different lens zones (Zone 1: 2.0-mm, Zone 2: 4.0-mm, and Zone 3: 6.0-mm).

Results: In the 0-2-mm corneal zone for the total thickness and all three layers, corneal densitometry values in Group 3 were significantly higher than those in Groups 1, 2, and 4 (for all values p < 0.012). There was no significant difference in the mean corneal densitometry values between Groups 1 and 2 (for all values p > 0.05). In these groups, the mean corneal densitometry values were significantly higher than those in Group 4 for the anterior layer in the 0-2 and 2-6-mm corneal zones (for all values p < 0.012). The mean values for Zone 3 and average lens densitometry values in Groups 2 and 3 were significantly higher than those in Group 4 (p = 0.001 and p = 0.001, respectively).

Conclusion: The current study showed corneal clarity changes in patients with mild, moderate, and especially severe VKC. An increase in the lens densitometry values was also observed in patients with moderate and severe VKC than in healthy individuals.
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http://dx.doi.org/10.1111/cxo.13144DOI Listing
March 2021

Changes in choroidal thickness after vitamin D supplementation in patients with vitamin D deficiency.

Can J Ophthalmol 2020 12 18;55(6):486-491. Epub 2020 Aug 18.

Department of Internal Medicine, University of Health Scıences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Objective: To determine the relationship between vitamin D (vit D) deficiency and choroidal thickness and to investigate changes in choroidal thickness after vit D treatment.

Methods: Sixty-five patients diagnosed with vit D deficiency (group 1) and 60 healthy individuals with normal vit D levels (group 2) were included in the study. The choroidal thickness in the subfoveal, nasal, and temporal regions of the fovea were measured manually using enhanced depth imaging optical coherence tomography. The choroidal thickness in the patients in group 1 was re-evaluated after treatment with vit D.

Results: The groups were similar in terms of age and sex (p = 0.138 and p = 0.198, respectively). The subfoveal, temporal (500 and 1.500 µm), and nasal (500 and 1.500 µm) choroidal thickness values in group 1 were statistically significantly lower than those in group 2 (p < 0.001 for all). After vit D replacement therapy, there was a significant increase in the choroidal thicknesses compared with the pretreatment measurements (p < 0.001 for all). There was a positive correlation between vit D values and subfoveal, temporal (500 and 1.500 µm), and nasal (500 and 1.500 µm) choroidal thickness values (r = 0.558 and p < 0.001, r = 0.415 and p < 0.001, r = 0.352 and p < 0.001, r = 0.349 and p < 0.001, and r = 0.294 and p = 0.001, respectively).

Conclusion: The choroidal thickness decreased in patients with vit D deficiency. The choroidal thickness values increased after vit D replacement therapy. Serum vit D levels should be assessed in studies evaluating choroidal thickness.
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http://dx.doi.org/10.1016/j.jcjo.2020.06.014DOI Listing
December 2020

Ocular findings in patients with coronavirus disease 2019 (COVID-19) in an outbreak hospital.

J Med Virol 2021 02 21;93(2):1126-1132. Epub 2020 Aug 21.

Department of Ophthalmology, University of Health Scıences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Purpose: The aim of this study was to investigate the ocular findings observed in patients with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 and to present the relationship between ocular involvement, systemic findings, and laboratory results.

Material And Methods: This cross-sectional study was carried out between 1 May and 30 June 2020. The study included 359 patients diagnosed with COVID-19 and assessed by clinical evaluation, nasopharyngeal polymerase chain reaction, and lung computed tomography.

Results: One hundred ninety-seven (54.9%) of the patients were male and 162 (45.1%) were female. The mean age of the patients was 58.5 years (20-91). Two hundred ninety-four (81.9%) patients were treated in the inpatient clinic and 65 (18.1%) patients were treated in the intensive care unit. Various ocular diseases were observed in 16 (4.5%) of the patients. Although the rate of ocular disease was 12 out of 294 (4.1%) in patients followed up in the inpatient clinic, this rate was 4 out of 65 (6.2%) in intensive care patients. There was no systemic problem in one patient, in whom conjunctival hyperemia was the first and only reason for admission to the hospital. Four patients followed up in the inpatient clinic had conjunctivitis at the time of admission, and conjunctivitis occurred in three patients during hospitalization. Subconjunctival hemorrhage occurred in five patients and vitreous hemorrhage in one patient.

Conclusion: Ocular diseases are uncommon in COVID-19 patients but may occur during the first period of the disease or during follow-up. Ocular diseases may be the initial or only sign of COVID-19 infection.
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http://dx.doi.org/10.1002/jmv.26412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436579PMC
February 2021

Central serous chorioretinopathy associated with high-dose follistatin-344: a retrospective case series.

Int Ophthalmol 2020 Nov 15;40(11):3155-3161. Epub 2020 Jul 15.

Department of Ophthalmology, University of Health Sciences, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir, Turkey.

Purpose: To present 11 bodybuilding athletes who developed central serous chorioretinopathy (CSCR) following high-dose subcutaneous follistatin-344, a peptide-based performance and image enhancing drug, injections to increase muscle mass.

Methods: This is a retrospective case series from one institution. Demographic and clinical data of 11 patients who were admitted to our clinic with decreased visual acuity after high-dose follistatin-344 injections and optical coherence tomography (OCT) findings consistent with CSCR were analyzed.

Results: All 11 patients were male, and the mean age was 36.8 ± 8.1 years. All patients had a history of injecting complete 1 mg vials of follistatin-344 subcutaneously in the abdomen. There was a history of a single previous high-dose follistatin-344 injection in eight patients and multiple previous injections in three patients. At the time of diagnosis, ten patients had unilateral CSCR findings and one had bilateral CSCR findings. In all eight patients with a history of only one injection, subretinal fluid completely disappeared after an average of 2.3 ± 0.7 months and symptoms regressed. Recurrent CSCR developed in three patients with a history of multiple follistatin-344 injections.

Conclusion: Follistatin-344 injection can be considered as a risk factor for CSCR. To take medical history from CSCR patients including follistatin-344 use may be important to reveal the CSCR etiology.
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http://dx.doi.org/10.1007/s10792-020-01501-6DOI Listing
November 2020

Evaluation of the subfoveal choroidal and outer retinal layer thickness in obese women.

Clin Exp Optom 2021 Mar;104(2):178-186

Obesity Clinic, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakır, Turkey.

Clinical Relevance: Obesity has become one of the most important health problems of today with its increasing prevalence. With the development of retinal imaging systems, obesity has been observed to be associated with changes in outer retinal layers and choroid in women.

Background: The aim of this study was to examine retinal layer parameters and their relationship with body mass index in obese women.

Methods: The study included 197 eyes of 197 women, of whom 44 were normal-weight, 40 were overweight, 40 were class 1 obese, 38 were class 2 obese, and 35 were morbidly obese. The thickness of the choroid was measured manually using an enhanced-depth imaging optical coherence tomography scanning program.

Results: The mean choroidal thickness values in five locations were lower than those of normal-weight, overweight, class 1, and class 2 obese women, in morbidly obese women (p < 0.05 for all). Subfoveal outer retinal layer thickness and specific sublayer thickness of the photoreceptor layer values were significantly lower in morbidly obese women than in normal-weight women, but there were no statistically significant differences between the groups in retinal pigment epithelium thickness and Bruch's membrane thickness (p = 0.001, p < 0.001, p = 1.00, and p = 0.101, respectively). Furthermore, there were significant negative relationships between body mass index and subfoveal choroidal thickness, subfoveal outer retinal layer thickness, and specific sublayer thickness of the photoreceptor layer values (r = -0.327, p < 0.001; r = -0.259, p < 0.001; and r = -0.281, p < 0.001, respectively).

Conclusions: Morbid obesity was associated with a thinner choroid, subfoveal outer retinal layer, and specific sublayer thickness of the photoreceptor layer in women. Furthermore, retinal hypoxia associated with morbid obesity may be related to a decrease in photoreceptor layer thickness. Thinning of the outer retinal layer may also lead to atrophy of the cone sheath.
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http://dx.doi.org/10.1111/cxo.13108DOI Listing
March 2021

Retinal nerve fiber layer, retinal pigment epithelium, and choroidal thickness in vitiligo patients.

J Cosmet Dermatol 2020 Nov 9;19(11):3032-3037. Epub 2020 Jun 9.

Department of Dermatology, University of Health Sciences Gazi Yaşargil Education Research Hospital, Diyarbakir, Turkey.

Background: Vitiligo is one of the common pigmentary disorders affecting the ocular structures.

Aim: To determine the retinal nerve fiber layer (RNFL), retinal pigment epithelium (RPE), and choroidal thickness (CT) in vitiligo patients and to evaluate the relationship between choroidal thickness and vitiligo subtypes.

Methods: The right eyes of 106 participants (51 vitiligo, 55 nonvitiligo) were included in the study. All of the participants underwent detailed eye examinations and spectral-domain optical coherence tomography (SD-OCT) examinations. CT was measured manually with enhanced depth imaging optical coherence tomography (Edi-OCT) (subfoveal [SubF], nasal n500 µm [N1], n1500 µm [N2]), and temporal (t500 µm [T1], t1500 µm [T2]).

Results: In vitiligo patients, CT values were significantly lower in the SubF, N1, N2, T1, and T2 areas compared to the control group (P = .001, P = .011, P = .002, P = .005, P ˂ .001, respectively). Periorbital involvement did not affect CT (P = .355, P = .746, P = .443, P = .633, P = .558, respectively). However, in patients with periorbital region involvement, the CT was significantly reduced if the lesion had a universal character (P ˂ .001, P = .001, P = .011, P ˂ .001, P = .002, respectively). It was observed that RPE thickness decreased in vitiligo, but this difference was not statistically significant (P = .140). RNFL thickness was unaffected in all quadrants. A positive correlation (r = .286, r = .280, respectively) was observed between the Vitiligo Area Severity Index (VASI) and age and disease duration. A negative correlation (r = -.360, r = -.316, r = -.315, r = -.313, respectively) was found in the CT of the SubF, N1, N2, T1, and T2 areas.

Conclusion: Vitiligo patients should be closely monitored for possible posterior ocular segment disorders.
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http://dx.doi.org/10.1111/jocd.13367DOI Listing
November 2020

A rare complication of combined oral contraceptives (COCs): optic neuritis.

J Obstet Gynaecol 2021 Feb 8;41(2):319-320. Epub 2020 Feb 8.

Department of Ophhtalmology, Health Sciences University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.

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http://dx.doi.org/10.1080/01443615.2019.1706462DOI Listing
February 2021

Successful Treatment of Conjunctival Kaposi Sarcoma in a Human Immunodeficiency Virus-Negative Kidney Transplant Recipient: A Case Report.

Transplant Proc 2020 Mar 6;52(2):622-624. Epub 2020 Feb 6.

Department of Ophthalmology, University of Health Sciences, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.

Kaposi sarcoma (KS) is the most common tumor in patients with human immunodeficiency virus (HIV), and its frequency is increasing after organ transplantation in HIV-negative patients. A 28-year-old woman had preemptive kidney transplantation from her 48-year-old mother. In the postoperative ninth month, an exophytic mass was found in the upper medial conjunctiva of the right eye. The lesion was excised under local anesthesia, and cryotherapy was applied to the surgical area. The biopsy result was reported as KS. Treatment with tacrolimus was switched to everolimus (EVO), but EVO was discontinued because of pneumonitis. The patient was followed without any recurrences after the excision of the conjunctival lesion. No local or systemic recurrence was observed in the 14th month after surgical excision and local cryotherapy. Local treatment and the reduction of immunosuppressive therapy may be effective in the treatment of conjunctival KS.
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http://dx.doi.org/10.1016/j.transproceed.2019.12.005DOI Listing
March 2020

Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery?

Eur J Ophthalmol 2020 Nov 19;30(6):1228-1231. Epub 2019 Nov 19.

Department of Endocrinology and Metabolic Diseases, Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey.

Purpose: The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction.

Method: The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth.

Results: The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group.

Conclusion: Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.
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http://dx.doi.org/10.1177/1120672119889522DOI Listing
November 2020