Publications by authors named "Kemal Örnek"

72 Publications

Evaluation of Nasopharyngeal and Conjunctival Swab Samples of Hospitalised Patients with Confirmed COVID-19.

Ocul Immunol Inflamm 2021 Mar 4:1-4. Epub 2021 Mar 4.

Department of Emergency Medicine, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey.

Purpose: To evaluate the results of conjunctival and nasopharyngeal swab tests in patients with confirmed COVID-19.

Methods: This prospective study included 45 patients who were hospitalized for confirmed COVID-19. Nasopharyngeal swab samples were obtained from the patients before hospitalization. Only one eye of each patient was randomly selected for-conjunctival sampling. All participants underwent a complete slit-lamp examination. Conjunctival and nasopharyngeal swab samples were analyzed by reversetranscriptase-polymerase-chain reaction (RT-PCR).

Results: Twenty seven (60%) of the patients were male and 18 (40%) were female. Conjunctival swab was positive in only one (2.22%) patient. None of the COVID-19 patients showed ocular changes and symptoms. There were no abnormalities of the ocular surface, anterior chamber or posterior segment at slit-lamp examination.

Conclusions: The RT-PCR was not high positive in the conjunctiva as in nasopharyngeal swabs. Ocular changes were not common in COVID-19 patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09273948.2020.1838558DOI Listing
March 2021

Retinal Vessel Diameter Changes in COVID-19 Infected Patients.

Ocul Immunol Inflamm 2021 Jan 26:1-7. Epub 2021 Jan 26.

Department of Medical Microbiology, Amasya University School of Medicine , Amasya, Turkey.

: To evaluate the longitudinal changes in retinal vessel diameters in patients with coronavirus disease 2019 (COVID-19). : This study included 25 patients with COVID-19 (Group 1) and 25 healthy subjects (Group 2). The diameters of peripapillary temporal and nasal retinal arteries and veins were measured at baseline and at 4 months after remission. : The baseline diameters of the inferior temporal vein and the artery were increased in group 1 compared to controls ( = .007 and = .041, respectively). There was also an increase in the diameters of the inferior and superior nasal veins and arteries in group 1 at baseline ( = .001, = .019, = .037, and = .008, respectively). Retinal vessel diameters decreased after remission in all quadrants in comparison to baseline measurements (all < .05). : Increased retinal vessel diameters were measured in COVID-19 patients during the disease. Measurement of retinal vessel diameters may be a noninvasive method of estimating the vascular risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09273948.2020.1853783DOI Listing
January 2021

Localized retinal nerve fiber layer defect in patients with COVID-19.

Arq Bras Oftalmol 2020 Nov-Dec;83(6):562-563

Department of Opthalmology, Kırşehir Ahi Evran University School of Medicine, Kırşehir, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5935/0004-2749.20200109DOI Listing
January 2021

Evaluation of choroidal thickness and choroidal vascularity index during pregnancy.

Can J Ophthalmol 2021 Jan 6. Epub 2021 Jan 6.

Kırşehir Ahi Evran University School of Medicine, Department of Gynecology and Obstetrics, Kırşehir, Turkey.

Objective: To assess the choroidal structural characteristics in the first and third trimesters in pregnant women using enhanced depth imaging optical coherence tomography and binarization method.

Design: Prospective study.

Participants: Twenty-five eyes of 25 pregnant women in the first trimester (group 1) and 25 eyes of 25 pregnant women in the third trimester (group 2) were examined. Healthy age-matched 25 participants were enrolled as a control group (group 3).

Methods: The choroidal thickness (CT) was measured at 3 points; subfoveal, 1500 μm nasal to the fovea, and 1500 μm temporal to the fovea. Total choroidal area, luminal area, stromal area, stroma/lumen ratio, and choroidal vascularity index (CVI) were measured by Image-J software.

Results: The mean subfoveal and nasal CT were statistically significantly increased in group 1 compared with controls (p = 0.005 and p = 0.004, respectively). The mean temporal CT was statistically significantly increased in group 1 compared with groups 2 and 3 (group 1 vs group 2, p = 0.043; group 1 vs group 3, p = 0.011). The mean total choroidal area, stromal area, and luminal area were significantly increased in groups 1 and 2 compared with control group (p < 0.001, p < 0.001, p < 0.001, and p < 0.001, p = 0.002, p = 0.002, respectively). There were no statistically significant differences among groups in terms of mean stroma/lumen ratio and CVI (p = 0.148 and p = 0.312, respectively).

Conclusions: There was a significant increase in subfoveal, temporal, and nasal CT in the first trimester. Total choroidal, stromal, and luminal areas were significantly increased in the first and third trimesters.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcjo.2020.12.002DOI Listing
January 2021

Comparison of the Neodymium-doped Yttrium Aluminum Garnet Capsulotomy Rate with Viscoimplantation and the Hydroimplantation Intraocular Lens Technique.

Korean J Ophthalmol 2019 Jun;33(3):222-227

Kudret Eye Hospital, Kırıkkale, Turkey.

Purpose: To investigate the rate of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy in the hydroimplantation intraocular lens (IOL) technique.

Methods: This retrospective study was comprised of 6,192 eyes in 3,790 patients who underwent surgery from January 2013 to September 2017 and then were followed up for at least 1 year. The eyes of these patients were divided into two groups: either viscoimplantation or hydroimplantation. The follow-up examinations were carried out on the 1st day, 4th day, 1st month, and 3 months to 1 year postoperatively. The Nd:YAG capsulotomy rates were evaluated by the different IOL implantation techniques and IOL materials.

Results: The mean follow-up duration of the patients was in the viscoimplantation group 14.85 ± 2.43 and 15.05 ± 1.93 months in the hydroimplantation group. The Nd:YAG capsulotomy rate was significantly lower in the hydroimplantation group compared with the viscoimplantation group for the entire hydrophilic IOL model ( < 0.001). In addition, the Nd:YAG rate was lower in the hydroimplantation group that used a hydrophilic IOL than it was in the viscoimplantation group, which used a hydrophobic IOL.

Conclusions: The hydroimplantation technique reduced the Nd:YAG capsulotomy rate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3341/kjo.2018.0122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557793PMC
June 2019

Limbal stem cell defficiency associated with primary adrenocortical insufficiency.

GMS Ophthalmol Cases 2019 6;9:Doc02. Epub 2019 Feb 6.

Department of Ophthalmology, School of Medicine, Kırıkkale University, Yahşihan, Turkey.

To report a female patient with bilateral limbal stem cell deficiency (LSCD) due to primary adrenocortical insufficiency (PAI). Case report A 40-year-old female patient had blurry vision, foreign body sensation, tearing, and photophobia for several years. On examination, corneal epithelial haze, surface irregularity, and superficial neovascularization were observed. There was a dull and irregular reflex from the conjunctivalized corneal surface. Medical history revealed that she had a diagnosis of PAI for 11 years and received hormone replacement (fludrocortisone acetate) therapy. With the clinical presentation and examination, the diagnosis was compatible with LSCD. Frequent ocular lubricant and topical steroid drops were initially started and topical cyclosporine treatment was planned for the long term. After 3 weeks, there was no corneal superficial neovascularization and epithelial haze, peripheral stromal haze was still observed. LSCD may rarely be associated with PAI. In patients with LSCD, systemic evaluation should be made to rule out PAI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3205/oc000091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381395PMC
February 2019

Choroidal thickness changes in non-treated acute and ranibizumab-treated chronic central serous chorioretinopathy.

Medicine (Baltimore) 2018 Oct;97(43):e12885

Kudret Eye Hospital, Ankara, Turkey.

To evaluate the changes in subfoveal retinal, and choroidal thicknesses (CT) in the non-treated acute and the ranibizumab-treated chronic central serous chorioretinopathy (CSCR) patients.This retrospective study included 32 eyes of 32 consecutive patients with CSCR. There were 12 patients who presented with a spontaneous resolution of CSCR (Group 1) and 20 patients who were treated with ranibizumab for persistent subretinal fluid (SRF) (Group 2). Optical coherence tomography (OCT) imaging of subfoveal retinal thickness and enhanced depth imaging OCT of CT at subfoveal; at nasal and temporal 500 μm (T500); at nasal and temporal 1500 μm (T1500) were analyzed. The Student t test and multivariate analysis were used to compare variables within and between groups, respectively and correlations were analyzed using Pearson correlation coefficient. A P value of P < .05 was accepted as significant.The mean patient age was 38.94 ± 8.41 years (range, 20-53 years). Female/male ratio was 4/28. The mean duration of follow-up was 21.6 ± 8.2 months in the chronic CSCR group. Visual acuity improved and central foveal thickness (FT) decreased significantly in both groups. CT decreased significantly only at nasal 1500 μm (N1500) in the acute group and at all measured points in the chronic group compared with baseline, except at T500 (P = .07). No significant difference in central FT was detected between the 2 groups. Compared with the acute group, baseline subfoveal CT was significantly higher in chronic patients. There was a significant difference between the groups in baseline and final CT at T500. No significant difference was found at T1500. At nasal 500 μm and N1500, the difference between the groups was significant only for final CT values.Chronic CSCR was associated with higher baseline CT values in the subfoveal region and at T500. CT significantly decreased at most of the measured points in ranibizumab-treated chronic CSCR patients, whereas it significantly decreased only at 1 point in spontaneously resolved acute CSCR patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000012885DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221658PMC
October 2018

Effect of dexamethasone intravitreal implant (Ozurdex®) on corneal endothelium in retinal vein occlusion patients : Corneal endothelium after dexamethasone implant injection.

BMC Ophthalmol 2018 Sep 4;18(1):235. Epub 2018 Sep 4.

Department of Ophthalmology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.

Background: To assess corneal endothelial cell changes after intravitreal dexamethasone (DEX) implant (Ozurdex®) injection in patients with macular edema secondary to retinal vein occlusion (RVO).

Methods: Twenty-two eyes of 22 patients were assessed prospectively after intravitreal 0.7 mg DEX implant injection. Twenty-two eyes of 22 healthy volunteers served as control group. Corneal endothelial cell parameters including endothelial cell density (ECD), coefficient of variation of cell size (CV), percentage of hexagonality (Hex) and central corneal thickness (CCT) were analyzed before and 1 and 3 months after injection by specular microscopy. The results of the study were compared statistically.

Results: There were 17 (77.3%) patients with branch RVO and 5 (22.7%) patients with central RVO. Mean intraocular pressure (IOP) was 14.73 mmHg before injection, 17.05 mmHg at 1 month and 17.15 mmHg at 3 months after injection. Mean IOP at 1 and 3 months were significantly higher than pre-injection value (p = 0.002 and p = 0.003, respectively). There was a statistically significant reduction in mean ECD at 3 months after injection compared to pre-injection and 1 month (p = 0.013, p = 0.009, respectively) in the injected eyes. Mean ECD showed no significant difference in the uninjected fellow eyes during the follow up (p>0.05). Mean CV and Hex did not reveal a statistically significant difference in injected and uninjected fellow eyes (p > 0.05). No significant change was observed in mean CCT values during the follow up (p = 0.8).

Conclusion: Intravitreal dexamethasone implant may cause a transient reduction in corneal endothelial cell density in short term without changing cell morphology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12886-018-0905-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122223PMC
September 2018

Cystoid macular edema following selective laser trabeculoplasty in a patient with ocular hypertension.

Int Ophthalmol 2019 Aug 13;39(8):1891-1893. Epub 2018 Aug 13.

Department of Ophthalmology, Faculty of Medicine, Kırıkkale University, Yahşihan, Kırıkkale, Turkey.

Purpose: Presentation of a case with ocular hypertension who developed cystoid macular edema (CME) following selective laser trabeculoplasty (SLT).

Case Report: A 62-year-old male patient who had undergone phacoemulsification surgery for traumatic cataract 9 years ago was on ocular hypertension treatment for the last 5 years. Due to uncontrolled intraocular pressure and side effect of medications, a 360° SLT was performed. The patient returned with decrased visual acuity 1 week after the procedure. There was CME in the treated eye. It healed completely after topical prednisolone acetate QID and nepafenac QID for 1 week, and no recurrence was observed during follow-ups.

Conclusion: Cystoid macular edema may occur following SLT treatment in patients with previous traumatic cataract surgery which responds to topical treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10792-018-1000-5DOI Listing
August 2019

0.1% Nepafenac reduces pain and increases patient comfort during cataract surgery.

Cont Lens Anterior Eye 2018 10 26;41(5):448-451. Epub 2018 May 26.

Kırıkkale University Medical Faculty, Dept. of Ophthalmology, Kırıkkale University Campus, Ankara Road 6. Km, Yahsihan, 71100, Kırıkkale, Turkey.

Purpose: To evaluates analgesic effectiveness of 0.1% nepafenac during cataract surgery.

Methods: This prospective randomized randomized double-masked, placebo-controlled study comprised 80 eyes of 40 consecutive patients who underwent bilateral cataract surgery and implantation of foldable intraocular lens with topical anesthesia with and without topical nepafenac drops. Each eye of patients was assigned to group 1 and group 2. Topical anesthesia combined with 0.1% nepafenac used three times a day the day before the surgery and once half an hour just before the surgery was group 1, consisting of 40 eyes, and topical anesthesia with using placebo was group 2 consisting of 40 eyes. Patients were asked to score their pain using a visual analog scale (VAS) and verbal pain scale (VPS) immediately following the surgery. When the patient moved or squeeze the eye during surgery, the surgical comfort was evaluated as bad and otherwise, it was evaluated as good.

Results: When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild or no pain in group 1 was %825 and in group 2 was %45. Mean VAS pain score and mean VPS pain score in group 1 was significantly lower than that in group 2(p = 0.024, p < 0.001). Surgical comfort in group 1 was %825 and in group 2%65(P = 0.075).

Conclusion: 0.1% nepafenac reduces pain of patients who undergone routine clear corneal phacoemulsification with topical anesthesia and may increase patient comfort during the surgery when used preoperatively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clae.2018.05.003DOI Listing
October 2018

FULL-THICKNESS MACULAR HOLE WITH MACULAR INTRACHOROIDAL CAVITATION IN A PATIENT WITH PATHOLOGIC MYOPIA.

Retin Cases Brief Rep 2020 ;14(4):328-330

Department of Ophthalmology, Kudret Eye Hospital, Ankara, Turkey.

Purpose: To describe a full-thickness macular hole (MH) opening to macular intrachoroidal cavitation in a patient with pathologic myopia.

Methods: Full ophthalmologic examination, fundus camera (Topcon TRC; Topcon Co, Tokyo, Japan), optical coherence tomography (RetinaScan Advanced RS-3000; NIDEK, Gamagori, Japan) imaging, and cataract surgery.

Results: A 61-year-old woman admitted with decreased vision in the left eye. Visual acuity was counting fingers from 30 cm. Anterior segment examination showed advanced cataract. Fundus examination revealed pathologic myopia. There was full-thickness MH opening to macular intrachoroidal cavitation in contact with the anterior surface of the sclera subfoveally. Except for the communicating part of MH and macular intrachoroidal cavitation, outer retina, ellipsoid zone, and retinal pigment epithelium were intact. Choroid was intact except for a small part at subfoveal area. The patient received an uncomplicated cataract surgery. Visual acuity improved to 5/10. Because she was satisfied, MH surgery was postponed to a later date.

Conclusion: Full-thickness MH may occur within the area of macular intrachoroidal cavitation in pathologic myopia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICB.0000000000000720DOI Listing
January 2020

Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma.

Int Ophthalmol 2018 Dec 13;38(6):2327-2333. Epub 2017 Oct 13.

Department of Ophthalmology, Kudret Eye Hospital, Kavaklıdere, Ankara, Turkey.

Purpose: To evaluate corneal endothelial cell parameters after a single session of selective laser trabeculoplasty (SLT) in pseudoexfoliative glaucoma (PEG) patients.

Methods: Corneal endothelial cell parameters of 18 PEG patients were compared with 18 healthy subjects following SLT treatment. All patients underwent SLT treatment to 180 degrees of inferior trabecular meshwork. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical, Hyogo, Japan). Endothelial cell density (ECD), hexagonal cell ratio (HEX), coefficient of variation (CV) of the corneal endothelial cell layer and central corneal thickness of the patients were measured at each visit.

Results: There was a statistically significant decrease in ECD (p = 0.004) and a statistically significant increase in CV (p = 0.041) at superior cornea 1 week after SLT. They returned to pre-SLT values at 1 month. One hour post-SLT HEX of inferior cornea was statistically significantly reduced (p = 0.01). At central cornea, there was a significant increase in HEX after 1 week (p = 0.001). Post-SLT IOP showed a significant positive correlation with CV and significant negative correlation with HEX at superior and inferior cornea. There was no correlation between total laser energy used and endothelial cell parameters.

Conclusion: Effect of a single session of SLT on corneal endothelium of PEG patients appears to be transient, and superior cornea was more affected than central and inferior cornea. All parameters returned to pre-SLT values at 1 month after treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10792-017-0730-0DOI Listing
December 2018

Safety of hydroimplantation in cataract surgery in patients with pseudoexfoliation syndrome.

Int J Ophthalmol 2017 18;10(5):723-727. Epub 2017 May 18.

Department of Ophthalmology, Kirikkale University School of Medicine, Kirikkale University Campus, Ankara 71100, Yahsihan, Turkey.

Aim: To evaluate the safety of hydroimplantation in cataract surgery in patients with pseudoexfoliation syndrome.

Methods: This prospective randomized study comprised 100 eyes of 100 consecutive patients who underwent cataract surgery and implantation of foldable intraocular lens (IOL). Each eye was assigned to group 1 or group 2. Hydroimplantation without using viscoelastic agent as group 1 (=50), and hydroxypropylmethylcellulose (Eyevisc, Biotech, India) was used in group 2 (=50).

Results: There were no statistically significant differences in central corneal thickness (CCT) and corneal endothelial cell count (ECC) between both groups at each visit and percentage change in CCT and ECC (>0.05). The mean intraocular pressure (IOP) at postoperative 5h increased statistically significantly in group 2 (<0.001). There was no statistically significant difference in IOP between two groups, before and after surgery excluding the 24h postoperative IOP, but patients in group 2 had higher IOP than that in the group 1 at 24h after surgery (=0.035). No case in either group experienced posterior capsular rupture, or zonular dialysis. Fixation of the globe during IOL implantation was better in group 1 than that in group 2.

Conclusion: Hydroimplantation has advantages in terms of IOP changes and duration of the surgery and seems to be safe in patients with pseudoexfoliation syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18240/ijo.2017.05.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437458PMC
May 2017

Evaluation of Optic Nerve with Strain and Shear Wave Elastography in Patients with Behçet's Disease and Healthy Subjects.

Ultrasound Med Biol 2017 07 24;43(7):1348-1354. Epub 2017 Apr 24.

Department of Ophtalmology, Faculty of Medicine, Kirikkale University, Yahsihan, Kirikkale, Turkey.

The objective of this study was to investigate the elasticity characteristics of the optic nerve using strain and shear wave elastography in patients with Behçet's disease and to compare the results with those of healthy volunteers. Forty-six optic nerves from patients with Behçet's disease and 54 optic nerves from healthy volunteers were investigated prospectively in this study using strain and shear wave elastography. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p < 0.001). Elastographic images of healthy volunteers revealed most optic nerves to be type 3 (51.8%); however, type 2 (40.7%) and type 1 (7.5%) were also observed. Elastographic examination of Behçet's disease patients revealed type 2 in 52.2%, type 1 in 43.5% and type 3 in 4.3% of patients. Statistically significant differences were observed between patients and healthy volunteers in the analysis of shear wave elastography values (p < 0.001). Receiver operating characteristic curve analysis was perfect (0.933) (95% CI = 0.885-0.980), and a cutoff value of 16.5 kPa shear had very high sensitivity and specificity for the patient group. Strain and shear wave elastography findings for the optic nerves of patients with Behçet's disease were significantly different from those for healthy volunteers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ultrasmedbio.2017.03.008DOI Listing
July 2017

Evaluation of the optic nerve using strain and shear wave elastography in patients with multiple sclerosis and healthy subjects.

Med Ultrason 2017 Jan;19(1):39-44

Department of Ophtalmology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey.

Aims: Our aim was to evaluate the elasticity features of the optic nerve using strain (SE) and shear wave elastography (SWE) in multiple sclerosis (MS) patients in comparison with healthy subjects.

Material And Methods: One hundred and seven optic nerves from 54 MS patients and 118 optic nerves from 59 healthy subjects were examined prospectively by SE and SWE. Optic nerves were divided into three types in accordance to the elasticity designs, as follows: type 1 predominantly blue (hardest tissue); type 2 predominantly blue/green (hard tissue); and type 3 predominantly green (intermediate tissue). Quantitative measurements of optic nerve hardness with SWE were analyzed in kilopascals.

Results: Elastographic images from healthy volunteers showed mostly type 3 optic nerves (61.9%); type 2 was also found (38.1%), but type 1 was not observed. Elastographic examination of MS patients showed mostly type 2 optic nerves (88%), while some type 1 (4.6%) and type 3 optic nerves (6.5%) were rarely observed. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p<0.001). Statistically significant differences were observed between patients and healthy volunteers in the analysis of SWE values (10.381±3.48 kPa and 33.87±11.64 p<0.001). The receiver operating characteristic curve analysis was perfect (0.993; 95% confidence interval [CI]=0.971-0.999), and a cut-off value of 18.3 kPa shear had very high sensitivity and specificity for the patient group. No significant differences were observed between patients with and without previous optic neuritis.

Conclusion: SE and SWE examination findings concerning the optic nerve in MS patients demonstrated remarkable differences according to the healthy group.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11152/mu-939DOI Listing
January 2017

Corneal Endothelial Cell Density and Morphology in Different Trimesters of Pregnancy.

Eye Contact Lens 2018 Sep;44 Suppl 1:S125-S130

Departments of Ophthalmology (N.O., K.O.), and Gynecology and Obstetrics (Z.O.D.), School of Medicine, Kirikkale University, Kirikkale, Turkey.

Objectives: To evaluate corneal endothelial cell density (CD) and morphology in different trimesters of pregnancy.

Methods: This prospective study included 66 (66 eyes) pregnant women. The patient group was divided into three subgroups comprised of 22 women in the first, second, and third trimesters of pregnancy. An age-matched group of 22 (22 eyes) volunteers served as controls. Corneal measurements were performed using specular microscopy (Noncon Robo SP8000, Konan Medical). Central corneal thickness (CCT) and CD, hexagonal cell ratio (HEX), and coefficient of variation (CV) of the corneal endothelial cell layer of the patients were measured at each trimester.

Results: Central corneal thickness did not change significantly during the pregnancy compared to controls (P>0.05). Endothelial CD was decreased in the first trimester and increased in the second and third trimesters, but the difference was not significant (P>0.05). Hexagonal cell ratio was decreased significantly in the first trimester (P<0.05). There was an increase in the second and third trimesters, which was not statistically significant (P>0.05). Coefficient of variation was increased significantly in the first trimester and showed a significant decrease in the second and third trimesters (P<0.05, respectively). Endothelial CD had a significant positive correlation with CV and HEX had a negative correlation with CV in the second trimester (r=0.438, P=0.041 and r=-0.822, P<0.001, respectively).

Conclusion: Central corneal thickness and endothelial CD did not change significantly throughout the pregnancy. Hexagonal cell ratio and CV showed a significant but transient increase in the first trimester.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICL.0000000000000354DOI Listing
September 2018

Intravitreal Dexamethasone Implant (Ozurdex) for Refractory Macular Edema Secondary to Retinitis Pigmentosa.

Turk J Ophthalmol 2016 Aug 15;46(4):179-181. Epub 2016 Aug 15.

Kırıkkale University Faculty of Medicine, Department of Ophthalmology, Kırıkkale, Turkey.

Macular edema (ME) in retinitis pigmentosa (RP) often impairs central vision dramatically. A 41-year-old woman diagnosed with RP was referred to our outpatient clinic due to severe visual deterioration in both eyes. The patient was treated with topical carbonic anhydrase inhibitors, topical corticosteroids and intravitreal triamcinolone acetonide injections, but her ME recurred. Intravitreal 0.7 mg dexamethasone implant (Ozurdex, Allergan) was administered into both eyes without complications. On the fourth day after both injections, visual acuity improved and ME almost totally resolved. No recurrence was observed at follow-up six months later.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjo.60437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5200824PMC
August 2016

Comparison of choroidal thickness changes following intravitreal dexamethasone, ranibizumab, and triamcinolone in eyes with retinal vein occlusion.

Eur J Ophthalmol 2016 Nov 3;26(6):627-632. Epub 2016 Feb 3.

Department of Ophthalmology, Kırıkkale University School of Medicine, Kırıkkale - Turkey.

Purpose: To evaluate short-term choroidal thickness changes following intravitreal dexamethasone implant (DEX), ranibizumab (RAN), and triamcinolone acetonide (TA) in eyes with retinal vein occlusion (RVO) and macular edema (ME).

Methods: In this prospective study, 35 eyes of 35 patients with RVO and ME who were treated with intravitreal injections of DEX, RAN, and TA were included. Choroidal thickness was measured using semiautomated segmentation of enhanced depth imaging with optical coherence tomography at fovea and parafoveal areas. Changes in choroidal thickness following treatment were compared statistically.

Results: Choroidal thickness decreased following DEX, RAN, and TA treatments (all p>0.05). In the DEX group, at the first month nasal 1,500 µm (N11,500) and at the third month subfoveal (SF3) and nasal 500 µm (N3500) choroidal thickness revealed a significant reduction compared to RAN and TA groups (all p<0.05). In the TA group, choroidal thickness showed a significant reduction only at nasal 1,500 µm (N31,500) at the third month (p<0.05).

Conclusions: Choroidal thickness was decreased in all 3 groups. The DEX and TA groups showed a significant reduction at some areas. Ranibizumab had the smallest effect on choroidal thickness after 3 months among all groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5301/ejo.5000734DOI Listing
November 2016

Comparison of Perioperative Ranibizumab Injections for Diabetic Macular Edema in Patients Undergoing Cataract Surgery.

J Ophthalmol 2016 14;2016:7945619. Epub 2016 Jul 14.

Department of Ophthalmology, Kırıkkale University Faculty of Medicine, 71450 Kırıkkale, Turkey.

Purpose. To compare the efficacy of perioperative ranibizumab injections on diabetic macular edema (DME) in patients undergoing cataract surgery. Methods. This study included 59 eyes of 59 patients. All patients had advanced cataract with DME and underwent an uneventful phacoemulsification surgery. There were 3 subgroups. The first group received intravitreal ranibizumab injection 2 weeks preoperatively, the second group received intraoperatively, and the third group received 2 weeks postoperatively. Follow-up examinations were performed at 1 week as well as at 1 and 3 months. Results. Baseline visual acuity showed a significant increase in all groups at 1 month. In group 1, compared to baseline value, foveal thickness (FT) increased significantly at 1 month and showed a significant decrease up to month 3. In group 2, FT increased at month 1 and this continued up to month 3. In group 3, FT increased at month 1 and was almost stable up to month 3. There were not any significant differences for visual acuity and FT between the groups. Conclusions. Although intrapostoperative ranibizumab injection for DME seems to be more effective than preoperative injections in patients undergoing cataract surgery, the treatment still needs to be continued following surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2016/7945619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4963569PMC
August 2016

Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis.

Case Rep Ophthalmol 2016 May-Aug;7(2):341-5. Epub 2016 Jun 13.

Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey.

A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK) in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000446602DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943299PMC
July 2016

Correspondence.

Retina 2016 08;36(8):e85-6

Department of Ophthalmology, School of Medicine, Kırıkkale University, Kırıkkale, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IAE.0000000000001185DOI Listing
August 2016

Serum vascular endothelial growth factor receptor-2 and adropin levels in age-related macular degeneration.

Int J Ophthalmol 2016 18;9(4):556-60. Epub 2016 Apr 18.

Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale 71450, Turkey.

Aim: To investigate the serum levels of vascular endothelial growth factor receptor-2 (VEGFR-2) and adropin in age-related macular degeneration (AMD) patients.

Methods: Ninety-eight AMD patients were included in the study. Seventy-eight age- and sex-matched healthy volunteers were recruited as the control group. Fundus florescein angiography and optical coherence tomography were performed to assess the posterior segment details. Serum VEGFR-2 and adropin levels were measured using enzyme-linked immunosorbent assays and compared between the study groups.

Results: AMD group had significantly increased foveal retinal thickness, serum LDL and HDL levels and significantly decreased subfoveal choroidal thickness (P =0.01, 0.047, 0.025 and <0.001, respectively). Serum VEGFR-2 level revealed a significant decrease in AMD patients compared to controls (26.48±6.44 vs 30.42±7.92 ng/mL, P<0.001). There was an insignificant increase in serum adropin level in AMD patients (6.17±3.19 vs 5.79±2.71 ng/mL, P=0.4). Serum level of VEGFR-2 in AMD patients had a significant negative correlation with foveal retinal thickness (r=-0.226, P=0.025) and a significant positive correlation with subfoveal choroidal thickness (r=0.2, P=0.048).

Conclusion: The current study demonstrated that the decreased serum VEGFR-2 level may be considered in the development of AMD. Adropin does not seem to play a role in the pathogenesis of AMD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18240/ijo.2016.04.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853351PMC
May 2016

Choroidal thickness in obese women.

BMC Ophthalmol 2016 May 4;16(1):48. Epub 2016 May 4.

Department of Internal Medicine, Kırıkkale University School of Medicine, Kırıkkale, Turkey.

Background: Excessive weight is a well-known risk factor for microvascular diseases. Changes in thickness in a vascular tissue, such as the choroid, can be useful to evaluate the effect of obesity on the microvascular system. The aim of this study was to evaluate the choroidal thickness (CT) changes in obese women, using optical coherence tomography (OCT).

Methods: The prospective clinical study included examination of the right eyes of 72 patients. The right eyes of 68 patients were examined and served as the controls. A complete ophthalmological examination and OCT imaging were performed for each group studied. The CT in each eye was measured using OCT.

Results: The obese group consisted of 72 female patients with a mean age of 37.27 ± 1.18 years. The control group included 68 female subjects with a mean age of 37.85 ± 7.98 years (p > 0.05). There was no statistical significant difference for the foveal retinal thickness measurements between the two groups (p > 0.5). Our study revealed significant choroidal tissue thickening subfoveally and at areas 500 μm temporal, 500 μm nasal, and 1500 μm nasal to the fovea in the obese group (all p < 0.05). There was a positive correlation between body mass index (BMI) and CT changes.

Conclusions: CT may increase in obese women and a positive correlation was found between BMI and CT. The trial protocol was approved by the Local Ethical Committee of the Kırıkkale University, date of registration: April 27, 2015 (registration number: 10/11).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12886-016-0227-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855894PMC
May 2016

Corneal and conjunctival sensitivity in rosacea patients.

Saudi J Ophthalmol 2016 Jan-Mar;30(1):29-32. Epub 2015 Sep 11.

Department of Opthalmology, Kırıkkale University, School of Medicine, Kırıkkale, Turkey.

Purpose: To assess corneal and conjunctival sensitivity in rosacea patients.

Methods: A total of 55 patients with rosacea and 37 control subjects participated in the study. Corneal and conjunctival sensitivity was determined by Cochet-Bonnet esthesiometer. Subjective symptoms of ocular dryness were evaluated using Ocular Surface Disease Index (OSDI). Schirmer's I test (ST), tear breakup time (tBUT) and ocular surface staining with fluorescein were carried out to measure objective signs.

Results: The mean corneal and conjunctival sensitivity did not differ significantly between rosacea patients and controls (all p > 0.05). Schirmer's I test and tBUT were significantly reduced (p = 0.004 for OD and p < 0.001 for OS) and grade of ocular surface staining was significantly high (p = 0.018 for OD and p = 0.038 for OS) in rosacea patients. Corneal and conjunctival sensitivity did not show significant correlation with ST, tBUT, ocular surface staining (Oxford Schema), duration of rosacea and OSDI score.

Conclusions: Corneal and conjunctival sensitivity did not change significantly in rosacea.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.sjopt.2015.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759513PMC
March 2016

Plasma adropin level in patients with pseudoexfoliation.

Int Ophthalmol 2016 Oct 10;36(5):737-42. Epub 2016 Feb 10.

Department of Ophthalmology, Kırıkkale University Medical Faculty, Kırıkkale University Campus, Ankara Road 6. Km, Yahsihan, 71100, Kirikkale, Turkey.

The aim of this study was to evaluate plasma adropin levels in patients with pseudoexfoliation (PEX). This retrospective case-control study included 35 patients with PEX and 35 individuals without PEX who served as controls. Plasma adropin levels with triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and haemoglobin A1c (HGBA1C) concentrations were measured in both groups. The mean serum adropin levels were 3.24 ± 0.95 ng/mL (range, 1.90-7.88 ng/mL) in patients with PEX syndrome and 5.78 ± 2.85 ng/mL (range, 2.08-5.41 ng/mL) in PEX glaucoma patients. There was no statistically significant difference in mean adropin levels between PEX syndrome and PEX glaucoma patients. However, similar adropin levels were found in the PEX glaucoma patients and the control group (P > 0.05). The mean serum adropin levels were 3.34 ± 0.89 ng/mL (range, 1.90-5.39 ng/mL) in the PEX group and 5.78 ± 2.85 ng/mL (range, 3.08-11.06 ng/mL) in the control group. The mean serum adropin level of the PEX group was significantly lower than that of the control group (P < 0.001). There were no significant differences between the two groups in terms of serum glucose, total cholesterol, LDL, HDL, HGBA1C, triglycerides levels, or body mass index (all P > 0.05). Adropin level is lower in patients with PEX.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10792-016-0185-8DOI Listing
October 2016

Changes in the choroidal thickness in reproductive-aged women with iron-deficiency anemia.

BMC Ophthalmol 2015 Dec 29;15:186. Epub 2015 Dec 29.

Department of Ophthalmology, Kırıkkale University School of Medicine, Kırıkkale, Turkey.

Background: The aim of this study was to investigate the potential significance of the central macular thickness (foveal thickness-FT) and choroidal thickness (CT) in the eyes of patients with iron-deficiency anemia, the most common form of the anemia, via enhanced-depth imaging optical coherence tomography (EDI-OCT). We also investigated whether such changes might serve as an early indicator of underlying hematological disease.

Methods: This prospective clinical study compared 96 female patients with iron-deficiency anemia and 60 healthy female control subjects. The macular and choroidal thicknesses in the temporal and nasal subfoveal areas were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) at 500 and 1500 microns and in five different regions (FCT, T1500, T500, N500, and N1500).

Results: The mean ages of the patients and healthy controls were 34.08 ± 10.39 years and 32.29 ± 8.28 years, respectively (P =0.232). There were no significant changes in macular thickness between the groups (225.58 ± 19.76 vs. 222.45 ± 13.51, P =0.2). The choroidal thickness was significantly reduced in the patient group relative to the controls at all measured points (foveal choroidal thickness, P = 0.042; nasal-500 microns, P = 0.033; temporal-500 microns, P = 0.033; and temporal-1500 microns, P = 0.019). At some points, the choroidal thickness findings correlated with the hemoglobin values (temporal-500 microns, r = -0.287, P = 0.001; nasal-500 microns, r = -0.287, P = 0.005; nasal-1500 microns, r = -0.245, P = 0.016; and temporal-1500 microns, r = -0.280, P = 0.06).

Conclusions: Patients with iron-deficiency anemia had a significantly reduced choroidal thickness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12886-015-0163-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696148PMC
December 2015

Early results of dexamethasone implant, ranibizumab, and triamcinolone in macular edema due to branch retinal vein occlusion.

Eur J Ophthalmol 2016 Jan-Feb;26(1):54-9. Epub 2015 Jun 11.

Department of Ophthalmology, Kırıkkale University Faculty of Medicine, Kırıkkale - Turkey.

Purpose: To compare the short-term results of the efficacy and safety of dexamethasone intravitreal implant (DEX), ranibizumab (RAN), and intravitreal triamcinolone acetonide (IVTA) in macular edema secondary to branch retinal vein occlusion (BRVO).

Methods: One eye each of 32 patients who were treated with intravitreal injections for macular edema secondary to BRVO was studied. This retrospective study included 3 groups. The patients received DEX in group 1 (n = 11), RAN in group 2 (n = 11), and IVTA in group 3 (n = 10). Data were collected before and after the injections at the first and third months. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were analyzed statistically.

Results: The median duration of the follow-up was 3.0 months in overall groups. The BCVA increased significantly in all groups (p = 0.018, p = 0.034, p = 0.014, respectively). The CMT increased significantly in groups 1 and 3 (p = 0.02, p<0.001, respectively), but not in group 2 (p = 0.14). The IOP increased significantly in groups 1 and 3 (p = 0.05, p<0.001, respectively). Antiglaucomatous treatment was required only in group 3. Cataract developed in 2 patients (20%) in group 3 and surgery was required.

Conclusions: Although RAN was the safest among the 3 agents, DEX and IVTA reduced CMT more than RAN, while significant improvement was achieved in BCVA in all groups. All 3 agents can be effectively used in the treatment of macular edema due to BRVO.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5301/ejo.5000637DOI Listing
April 2016

Endophthalmitis after tooth extraction in a patient with previous perforating eye injury.

Pan Afr Med J 2015 27;20:72. Epub 2015 Jan 27.

Kirikkale University Medical Faculty, Department of Ophthalmology, Kirikkale, Turkey.

The aim of this stuty is to describe a case of endophthalmitis after tooth extraction in a patient with previous perforating eye injury. 50 years old male patient attempted to our clinic with complaints of sudden severe pain, reduced vision, light sensitivity and redness in the right eye. The patient stated that severe pain in his eye began approximately 12 hours following tooth extraction. The patient's ocular examination revealed a visual acuity of hand motion in the right eye. Anterior segment examination of the right eye showed intense conjunctival hyperemia, chemosis, a fine keraticprespitat and corneal edema. Dental procedures of the patients who had recently underwent ocular surgery or trauma should be done in a more controlled manner under anti -infective therapy or should be postponed in elective procedures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11604/pamj.2015.20.72.6080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450044PMC
May 2016

Effect of intravitreal bevacizumab on retrobulbar blood flow of patients with diabetic macular edema.

Eur J Ophthalmol 2015 Nov-Dec;25(6):539-45. Epub 2015 Apr 21.

Department of Ophthalmology, Kırıkkale University School of Medicine, Kırıkkale - Turkey.

Purpose: To determine the effect of intravitreal bevacizumab on retrobulbar blood flow of patients with diabetic macular edema.

Methods: Peak systolic velocity, end-diastolic velocity, resistance, and pulsatility indices of central retinal artery (CRA), nasal posterior ciliary artery (NPCA), temporal posterior ciliary artery (TPCA), and ophthalmic artery (OA) were assessed by color Doppler ultrasonography in injected and uninjected eyes of 37 patients at baseline and at day 1 and day 7 after the injection.

Results: At day 1 after the injection, peak systolic and end diastolic velocities of the CRA and NPCA in the injected eyes and peak systolic velocity of NPCA in the uninjected eyes decreased significantly (p<0.05, p = 0.025, respectively). Peak systolic and end diastolic velocities were not significantly different in the injected and uninjected eyes at day 7 after the injection (p>0.05). In the injected eyes, there was no significant change in resistance and pulsatility indices (p>0.05), but a decrease in resistance index of NPCA and resistance and pulsatility indices of TPCA occurred in uninjected eyes at day 7 after the injection (p = 0.016, p = 0.023, and p = 0.025, respectively).

Conclusions: Intravitreal bevacizumab affects retrobulbar blood flow in injected and uninjected eyes of patients with diabetic macular edema.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5301/ejo.5000617DOI Listing
February 2016

Effect of intravitreal bevacizumab on macular and peripapillary choroidal thickness in injected and fellow eyes of patients with diabetic macular oedema.

Acta Ophthalmol 2015 Dec 15;93(8):e684-6. Epub 2015 Feb 15.

Department of Ophthalmology, Kırıkkale University School of Medicine, Kırıkkale, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/aos.12700DOI Listing
December 2015