Publications by authors named "Hidayet Erdol"

34 Publications

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 2021 Nov 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
November 2021

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

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

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

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

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

Developments and current approaches in the treatment of pterygium.

Int Ophthalmol 2017 Aug 23;37(4):1073-1081. Epub 2016 Sep 23.

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

Purpose: To assess and compare the studies conducted in the literature with recurrence rates and the summary of the justified treatment approaches be presented.

Method: Pterygium, a fibrovascular tissue that proceeds from the bulbar conjunctiva towards the cornea, is quite a commonly seen ocular surface deterioration. The treatment is performed through a surgical excision, and the frequent recurrence of this disorder, despite the developments of today, is the major problem experienced in the wake of the surgery. There are various treatment methods applied for the prevention of recurrence; yet, there is no definite view as to what treatment is the most effective one. Since the recurrent pterygium cases are more aggressive than the primary pterygium, it is of great importance to determine the treatment method in which recurrence rate is the lowest. In different studies seen in the literature, there is difficulty in comparing the results due to the fact that the follow-up periods, recurrence criteria and the doses and durations of the medications administered differ from one another.

Conclusion: When the literature is reviewed, the bare sclera technique is not used due to the high rate of recurrence, whereas successful results can be achieved through the conjunctival autograft technique. Lower recurrence rates have been reported along with the administration of mitomycin C, 5-FU and other agents that were used as an adjuvant treatment.
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http://dx.doi.org/10.1007/s10792-016-0358-5DOI Listing
August 2017

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

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

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

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

Identification of suitable fundus images using automated quality assessment methods.

J Biomed Opt 2014 Apr;19(4):046006

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

Retinal image quality assessment (IQA) is a crucial process for automated retinal image analysis systems to obtain an accurate and successful diagnosis of retinal diseases. Consequently, the first step in a good retinal image analysis system is measuring the quality of the input image. We present an approach for finding medically suitable retinal images for retinal diagnosis. We used a three-class grading system that consists of good, bad, and outlier classes. We created a retinal image quality dataset with a total of 216 consecutive images called the Diabetic Retinopathy Image Database. We identified the suitable images within the good images for automatic retinal image analysis systems using a novel method. Subsequently, we evaluated our retinal image suitability approach using the Digital Retinal Images for Vessel Extraction and Standard Diabetic Retinopathy Database Calibration level 1 public datasets. The results were measured through the F1 metric, which is a harmonic mean of precision and recall metrics. The highest F1 scores of the IQA tests were 99.60%, 96.50%, and 85.00% for good, bad, and outlier classes, respectively. Additionally, the accuracy of our suitable image detection approach was 98.08%. Our approach can be integrated into any automatic retinal analysis system with sufficient performance scores.
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http://dx.doi.org/10.1117/1.JBO.19.4.046006DOI Listing
April 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

Simple methods for segmentation and measurement of diabetic retinopathy lesions in retinal fundus images.

Comput Methods Programs Biomed 2012 Aug 14;107(2):274-93. Epub 2011 Jul 14.

Department of Computer Engineering, Faculty of Engineering, Karadeniz Technical University, 61080 Trabzon, Turkey.

Diabetic retinopathy (DR) is one of the most important complications of diabetes mellitus, which causes serious damages in the retina, consequently visual loss and sometimes blindness if necessary medical treatment is not applied on time. One of the difficulties in this illness is that the patient with diabetes mellitus requires a continuous screening for early detection. So far, numerous methods have been proposed by researchers to automate the detection process of DR in retinal fundus images. In this paper, we developed an alternative simple approach to detect DR. This method was built on the inverse segmentation method, which we suggested before to detect Age Related Macular Degeneration (ARMDs). Background image approach along with inverse segmentation is employed to measure and follow up the degenerations in retinal fundus images. Direct segmentation techniques generate unsatisfactory results in some cases. This is because of the fact that the texture of unhealthy areas such as DR is not homogenous. The inverse method is proposed to exploit the homogeneity of healthy areas rather than dealing with varying structure of unhealthy areas for segmenting bright lesions (hard exudates and cotton wool spots). On the other hand, the background image, dividing the retinal image into high and low intensity areas, is exploited in segmentation of hard exudates and cotton wool spots, and microaneurysms (MAs) and hemorrhages (HEMs), separately. Therefore, a complete segmentation system is developed for segmenting DR, including hard exudates, cotton wool spots, MAs, and HEMs. This application is able to measure total changes across the whole retinal image. Hence, retinal images that belong to the same patients are examined in order to monitor the trend of the illness. To make a comparison with other methods, a Naïve Bayes method is applied for segmentation of DR. The performance of the system, tested on different data sets including various qualities of retinal fundus images, is over 95% in detection of the optic disc (OD), and 90% in segmentation of the DR.
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http://dx.doi.org/10.1016/j.cmpb.2011.06.007DOI Listing
August 2012

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

The results of intravitreal bevacizumab injections for persistent neovascularizations in proliferative diabetic retinopathy after photocoagulation therapy.

Retina 2010 Apr;30(4):570-7

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

Purpose: The purpose of this study was to evaluate the effectiveness of intravitreal bevacizumab on persistent retinal neovascularizations in proliferative diabetic retinopathy.

Methods: Thirty-three eyes of 24 patients (mean age, 52.75 +/- 8.2 years) with proliferative diabetic retinopathy showing recurrences or no regressions in neovascularizations were evaluated in this study. After the intravitreal injection of 1.25 mg/0.05 mL of bevacizumab, the first examination was performed within 3 days and repeated at 1 week, 1 month, 3 months, and 6 months. In these examinations, localization and dimensions of neovascularizations were evaluated with red-free photographs and/or fluorescein angiography.

Results: All patients had type II diabetes for a period of 12 +/- 4.4 years (range, 2-20 years). After a single dose of bevacizumab, complete resolution rate of neovascularizations was 78.8% at 1 month, 63.6% at 3 months, and 45.4% at 6 months. When evaluated together with 9 eyes that had a second injection at 3 months, the complete resolution rate was 60.6% at 6 months. Mean best-corrected visual acuity and macular volume were 1.06 logarithm of the minimum angle of resolution (20/225 in Snellen) and 11.65 mm3 before treatment. Six months after treatment, these were 0.73 logarithm of the minimum angle of resolution (20/108 in Snellen) and 8.92 mm3 (P = 0.048 and 0.003, respectively).

Conclusion: Bevacizumab can be used safely and successfully in patients with proliferative diabetic retinopathy who do not experience any resolution or experience recurrences after panretinal photocoagulation.
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http://dx.doi.org/10.1097/IAE.0b013e3181bf5ff0DOI Listing
April 2010

Bilateral Optic Nerve Aplasia in a Child.

J Pediatr Ophthalmol Strabismus 2009 Jun 25. Epub 2009 Jun 25.

An 3-month-old female infant was admitted to the authors' clinic because of abnormal gaze position. On examination, the eyes were in the down gaze position. The left eye had a partial iris and lens coloboma. On funduscopic examination, the optic nerve and retinal vessels could not be detected. Optic nerve and optic chiasm were not observed on magnetic resonance imaging.
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http://dx.doi.org/10.3928/01913913-20090616-02DOI Listing
June 2009

Lacrimal sac removal made easy by methylene blue in endoscopic dacrocystorhinostomy.

Eur Arch Otorhinolaryngol 2008 Sep 26;265(9):1071-4. Epub 2008 Feb 26.

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

Endonasal dacrocystorhinostomy (DCR) has gained interest in the last decade. Especially when a novice surgeon is performing the surgery, difficulty in identification of the lacrimal apparatus may complicate the procedure. We investigated the efficacy of methylene blue (MB) solution as a marker for lacrimal sac (LS) in endoscopic DCR. A total of 24 endoscopic DCR cases were performed (16 primary and 8 revision cases). During surgery, LS was irrigated with MB solution. Following lacrimal bone removal, medial wall of the LS is seen with a bluish hue. When the sac is dissected, the epithelium of the LS, which is heavily stained with MB contrasts with the surrounding nasal mucosa and therefore tailoring of the extent of the LS mucosa removal is facilitated. The follow-up period of the patients was 23 +/- 7.5 months. Of the 24 cases operated, only one case needed a re-operation. Use of MB solution is effective in both identifying LS and distinguishing it from surrounding nasal mucosa in DCR.
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http://dx.doi.org/10.1007/s00405-008-0612-1DOI Listing
September 2008

MYO15A (DFNB3) mutations in Turkish hearing loss families and functional modeling of a novel motor domain mutation.

Am J Med Genet A 2007 Oct;143A(20):2382-9

Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Myosin XVA is an unconventional myosin which has been implicated in autosomal recessive nonsyndromic hearing impairment (ARNSHI) in humans. In Myo15A mouse models, vestibular dysfunction accompanies the autosomal recessive hearing loss. Genomewide homozygosity mapping and subsequent fine mapping in two Turkish families with ARNSHI revealed significant linkage to a critical interval harboring a known deafness gene MYO15A on chromosome 17p13.1-17q11.2. Subsequent sequencing of the MYO15A gene led to the identification of a novel missense mutation, c.5492G-->T (p.Gly1831Val) and a novel splice site mutation, c.8968-1G-->C. These mutations were not detected in additional 64 unrelated ARNSHI index patients and in 230 Turkish control chromosomes. Gly1831 is a conserved residue located in the motor domains of the different classes of myosins of different species. Molecular modeling of the motor head domain of the human myosin XVa protein suggests that the Gly1831Val mutation inhibits the powerstroke by reducing backbone flexibility and weakening the hydrophobic interactions necessary for signal transmission to the converter domain.
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http://dx.doi.org/10.1002/ajmg.a.31937DOI Listing
October 2007

Long-term follow-up of external dacryocystorhinostomy and the factors affecting its success.

Orbit 2005 Jun;24(2):99-102

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

Aim: To evaluate the long-term follow-up results of external dacryocystorhinostomy (Ex-DCR) and to assess the role of some factors in its success.

Patients And Methods: Between January 1990 and November 2002, 437 nasolacrimal systems of 387 patients were operated on and included in the study. The success rates were determined on the basis of the last examinations of the patients, and the correlations between success rates and factors such as age, gender, the duration of obstruction, history of acute dacryocystitis, the side of obstruction, and the postoperative follow-up period were calculated.

Results: The mean follow-up period was 5.9 +/- 2.5 years. Fifty cases (12.9%) were operated bilaterally. The initial success rate was 91.5% and the last success rate was 98.4% after reoperations. We found meaningful correlations between success and duration of obstruction, age of the patient, and the duration of postoperative follow-up (r = 0.18, 0.17 and -0.14, p = 0.036, 0.001 and 0.002, respectively).

Discussion: In comparison to newly developed surgical techniques for the treatment of nasolacrimal duct obstruction, Ex-DCR still appears to offer higher success rates, even after long-term follow-up. In addition to being a cost-effective procedure, it requires no sophisticated instruments. In our opinion, the high success rates may be explained by the nature of the operation, which creates a fistula between the sac and the nasal mucosa.
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http://dx.doi.org/10.1080/01676830590926693DOI Listing
June 2005

Nephropathy and retinopathy in type 2 diabetic patients living at moderately high altitude and sea level.

Ren Fail 2005 ;27(1):67-71

Medical Faculty, Department of Internal Medicine, Yuzuncu Yil University, Van, Turkey.

Background: High-altitude-induced hypoxia results in various diseases, such as chronic mountain sickness and high altitude retinal edema, and may affect severity and incidence of some cardiovascular diseases. In order to evaluate the effects of moderately high altitude on diabetic nephropathy and retinopathy, a cross-sectional study was planned.

Material Method: Long-term type II diabetic residents of sea level (n=75, 38 male, 37 female, mean age 51.9+/-10.5 in Trabzon and Zonguldak cities) and moderately high altitude (h = 1,727 m, n = 73, 28 male, 45 female, mean age 48.3+/-12.1, Van city) were compared.

Results: No difference was observed in terms of age, gender, diabetes duration, body mass index, smoking, systolic, diastolic, and mean arterial blood pressure values, serum glucose levels, cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, hemoglobin, HbA1C, hypertension control, or blood pressure medications and retinopathy incidence. Mean 24 h protein excretion (210.0+/-139.9, 127.8+/-112.1 mg; P=0.00), proteinuria prevalence (57.5% versus 33.3%, p=0.003), and serum creatinine levels (1.04+/-0.22 versus 0.84+/-0.21, p = 0.00) were significantly higher in the highlanders, glomerular filtration rate (GFR) was significantly lower in sea level (SL) patients (90.9+/-26.5 versus 83+/-21.1, p=0.05).

Conclusion: Tendency to diabetic nephropathy as indicated by higher proteinuria and creatinine levels is increased among type 2 diabetic patients living at moderately high altitude. Prospective studies are needed to confirm these findings.
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June 2005

The effect of the aspiration of pericardial effusion on intraocular pressure.

Acta Cardiol 2003 Oct;58(5):385-8

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

Objective: To assess the effect of pericardial effusion on intraocular pressure (IOP).

Patients And Methods: Twenty-two patients with pericardial effusion were enrolled into the study. The average pericardial effusion was 2245 +/- 257 cc, and the mean IOP was 26.1 +/- 2.1 mm Hg in the initial examination. Pericardial effusion was aspirated via canula under topical anaesthesia at two or three-day intervals. IOP was measured after every aspiration of pericardial fluid. We statistically compared the changes in the mean IOP after every aspiration (one-way ANOVA), and calculated the correlation (regression analysis) between the amount of fluid and the changes in IOP.

Results: An average of 400 ml of fluid was aspirated at two or three-day intervals. The mean IOP decreased to 23.3, 21.2, 19.1 and 16.3 mm Hg after aspirations, respectively. These decreases in the mean IOP were statistically significant (p < 0.01). In regression analysis, we observed a meaningful relationship between the changes in IOP and the amount of pericardial effusion (p < 0.001).

Conclusion: We found that pericardial effusion affected IOP due to increased episcleral venous pressure. Therefore, patients with pericardial effusion should be referred for an ophthalmological examination with IOP measurement. IOP-lowering medication can eventually be started or adjusted by the ophthalmologist.
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http://dx.doi.org/10.2143/AC.58.5.2005301DOI Listing
October 2003
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