Publications by authors named "Mehmet Fatih Kağan Değirmenci"

9 Publications

  • Page 1 of 1

Efficacy of the subthreshold micropulse yellow wavelength laser photostimulation in the treatment of chronic central serous chorioretinopathy.

Int J Ophthalmol 2020 18;13(9):1404-1410. Epub 2020 Sep 18.

Department of Ophthalmology, Harran University Faculty of Medicine, Şanlıurfa 63000, Turkey.

Aim: To evaluate the efficacy and safety of subthreshold micropulse yellow laser (SMYL) in the treatment of chronic central serous chorioretinopathy (CCSC).

Methods: The medical records of 58 eyes of 58 patients with CCSC were reviewed. A 577-nm SMYL system was used for the treatment. Fundus fluorescein angiography was used as the primary method of identifying CCSC, and resolution of subretinal fluid (SRF) evaluated by optical coherence tomography (OCT) and fundus autofluorescence. Central macular thickness (CMT), central macular volume (CMV), total macular volume (TMV), subfoveal choroidal thickness (SFCT), subretinal fluid height (SRFH), and subfoveal fluid basement diameter values were measured by spectral domain-OCT (SD-OCT) for all eyes.

Results: The mean age of the patients was 42.4±9.9 (range: 20-72)y. The mean follow-up was 11.4±8.5 (range: 6-37)mo. Median BCVA at at the final follow up after treatment was statistically significant from the baseline. Complete SRF resolution was 12.1% of the eyes in the 1 month, 67.2% of the eyes in the 3 month and 67.2% of the eyes in the last follow up. The initial median CMT, CMV, TMV, and SFCT values before treatment was significantly higher than 3 month visit values (<0.001). In the multivariate analysis performed, age and disease duration were found to be a risk factor for persistent SRF (=0.017, =0.016, respectively).

Conclusion: SMYL treatment provides a significant anatomical and functional improvement and is effective in eliminating SRF in eyes with CCSC.
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http://dx.doi.org/10.18240/ijo.2020.09.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459231PMC
September 2020

Quantitative Evaluation of the Retinal Vascular Parameters With OCTA in Patients With Behçet Disease Without Ocular Involvement.

Ophthalmic Surg Lasers Imaging Retina 2019 12;51(1):31-34

Background And Objective: To evaluate the optical coherence tomography angiography (OCTA) features of patients with Behçet disease (BD) without ocular involvement.

Patients And Methods: Twenty-three patients with BD without ocular involvement and 29 healthy age/sex-matched control subjects were involved. The authors measured foveal avascular zone (FAZ) area, vessel density in the parafoveal region, and flow area (fovea-centered 3-mm radius area) in the superficial and deep capillary plexuses evaluated by OCTA.

Results: FAZ area was significantly larger in eyes with BD in both the superficial and deep capillary plexuses (0.331 vs. 0.240 mm [P = .004] and 0.352 vs. 0.257 mm [P = .003], respectively). Although mean capillary vessel density in parafoveal region and mean flow area were lower in eyes with BD for both superficial and deep capillary plexuses, these findings were not statistically significant.

Conclusion: Microvascular changes in macular region can be identified in patients with BD without ocular manifestation. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:31-34.].
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http://dx.doi.org/10.3928/23258160-20191211-04DOI Listing
December 2019

The Clinical Characteristics of Pediatric Non-Infectious Uveitis in Two Tertiary Referral Centers in Turkey.

Ocul Immunol Inflamm 2019 Nov 5:1-8. Epub 2019 Nov 5.

Department of Ophthalmology, Ankara University, Ankara, Turkey.

: To report the manifestations, patterns of disease, treatment strategies and outcomes in pediatric patients with noninfectious uveitis.: Demographic information of 76 cases was recorded. Symptoms, anatomic location, laterality, visual acuity (VA), intraocular pressure, associated systemic diseases, therapeutic strategies, side effects, complications were reviewed.: Thirty-one patients were diagnosed as uveitis on routine surveillance because of underlying systemic disease. The most common anatomic location was intermediate uveitis (34.2%). Juvenile idiopathic arthritis (JIA) was the most common underlying systemic disease (25%). Glaucoma was the most common complication (7.7%). The patients with refractory uveitis received adalimumab (26.5%), infliximab (4.6%) and tocilizumab (3.1%). The mean first-year VA was between 20/32 and 20/20 in 116/140 eyes.: Most pediatric noninfectious uveitis cases have bilateral intermediate uveitis. JIA was the most common systemic association. The first-year VA was good in most eyes which may be due to early use of corticosteroid-sparing agents.
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http://dx.doi.org/10.1080/09273948.2019.1674890DOI Listing
November 2019

Evaluation of the choroidal features in pachychoroid spectrum diseases by optical coherence tomography and optical coherence tomography angiography.

Eur J Ophthalmol 2021 Jan 4;31(1):184-193. Epub 2019 Nov 4.

Vehbi Koç Eye Hospital and Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey.

Purpose: To evaluate choroidal area, stroma/lumen ratio, choriocapillaris vessel density, and choriocapillaris flow area in eyes with central serous chorioretinopathy, uncomplicated pachychoroid, and pachychoroid pigment epitheliopathy using enhanced depth imaging-optical coherence tomography and optical coherence tomography angiography.

Materials And Methods: This retrospective study analyzed enhanced depth imaging-optical coherence tomography and optical coherence tomography angiography scans of 142 eyes of 92 patients with central serous chorioretinopathy, uncomplicated pachychoroid, and pachychoroid pigment epitheliopathy. The choroidal area and stroma/lumen ratio were measured by binarization of enhanced depth imaging-optical coherence tomography images. Choriocapillaris vessel density and choriocapillaris flow area were measured at the choriocapillaris level by manual segmentation of optical coherence tomography angiography scans.

Results: The mean stroma/lumen ratio results were 0.361, 0.345, and 0.354 in central serous chorioretinopathy, uncomplicated pachychoroid, and pachychoroid pigment epitheliopathy groups, respectively ( > 0.05). The mean whole image choriocapillaris vessel density in uncomplicated pachychoroid group was higher compared with central serous chorioretinopathy and pachychoroid pigment epitheliopathy groups ( < 0.0001). The mean foveal, parafoveal, and perifoveal choriocapillaris vessel densities were lower in central serous chorioretinopathy group than in uncomplicated pachychoroid group ( < 0.0001). The mean choriocapillaris flow area was lower in central serous chorioretinopathy group than in uncomplicated pachychoroid and pachychoroid pigment epitheliopathy groups ( < 0.0001 and  = 0.01, respectively).

Conclusion: Our findings suggest that both choroidal vessels and stroma are equally involved in central serous chorioretinopathy, uncomplicated pachychoroid, and pachychoroid pigment epitheliopathy. The choriocapillaris segment seems to be more affected in central serous chorioretinopathy compared to uncomplicated pachychoroid and pachychoroid pigment epitheliopathy. However, the reduced optical coherence tomography angiography signal in central serous chorioretinopathy group could be due to shadowing artifact or choriocapillaris hypoperfusion and further studies with higher quality imaging tools are needed.
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http://dx.doi.org/10.1177/1120672119887095DOI Listing
January 2021

Comparison of United States and International Ophthalmic Drug Pricing.

Ophthalmology 2019 10 27;126(10):1358-1365. Epub 2019 May 27.

Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York. Electronic address:

Purpose: To compare United States and international drug pricing for commonly prescribed intravitreal and topical ophthalmic medications.

Design: Cross-sectional observational study.

Methods: For 25 commonly used ophthalmic medications (3 intravitreal, 22 topical), we obtained 2017 third quarter United States average wholesale price (AWP), drug acquisition cost, or consumer pricing through United States government health insurance plans (Veterans Affairs [VA], Medicaid, Medicare Part B, and Medicare Part D) and commercial drug plans (CVS Caremark and Navitus Health Solutions), online pricing without insurance through a large United States warehouse retailer (Costco), and international drug pricing through government-sponsored health plans in Italy, Spain, Turkey, Canada, and Japan.

Main Outcome Measures: Drug acquisition costs and consumer pricing of ophthalmic drugs through various payment systems. All prices were converted to United States dollars.

Results: For intravitreal medications in the United States, aflibercept and ranibizumab were priced similarly to each other and were more expensive than dexamethasone implants. Pricing of aflibercept and ranibizumab through government health insurance plans in Italy, Spain, Turkey, Canada, and Japan were less expensive by as much as 84.3% compared with the United States. For topical medications in the United States, pricing varied significantly both across different classes of medications and also between nonbranded and branded medications. Drug acquisition costs through the VA and Medicaid were inexpensive on average, but pricing through a hospital-employee drug insurance plan offered the smallest range (between $2.35 and $60.00). In all 5 non-United States countries studied, each topical medication with the exceptions of cyclosporine emulsion and difluprednate was less than $100, and 94.4% of topical medications in these countries had a nonbranded or branded option that was less than $50.

Conclusions: In the United States, for topical more than intravitreal medications, significant price variation exists across both different drug pricing systems and different medications. Price differentials between nonbranded and branded medications can be significant. Internationally, topical medications exhibited a more limited and lower price range compared with drug pricing in the United States.
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http://dx.doi.org/10.1016/j.ophtha.2019.04.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756974PMC
October 2019

Short-term Efficacy of Micropulse Yellow Laser in Non-center-involving Diabetic Macular Edema: Preliminary Results.

Turk J Ophthalmol 2018 Oct 31;48(5):245-249. Epub 2018 Oct 31.

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

Objectives: The aim of this study was to evaluate the efficacy of micropulse yellow laser (MPL) on best corrected visual acuity (BCVA) and retinal thickness in patients with non-center-involving diabetic macular edema (DME).

Materials And Methods: We retrospectively reviewed 9 eyes of 8 patients with non-center-involving DME who underwent MPL treatment between January 2015 and December 2016. BCVA (logMAR) and retinal thickness were evaluated before and 3 months after treatment. Maximum retinal thickness was determined manually from simultaneous spectral-domain optical coherence tomography images and recorded. The change in the measurements from before to after treatment was analyzed statistically.

Results: Of the 8 patients, 3 were female and 5 were male. The mean age was 52.8 years. Two of the 9 eyes had received previous intravitreal anti-vascular endothelial growth factor injection(s). Median BCVA was improved 3 months after treatment, although the difference was not statistically significant (0.34 logMAR before and 0.29 logMAR after treatment). BCVA was improved in 4 eyes while it showed no change in the remaining 5 eyes. The mean retinal thickness was 470.6 μm at baseline and 416 μm at 3 months after MPL treatment (p=0.01). Retinal thickness decreased in all eyes after treatment.

Conclusion: In this study, parafoveal retinal thickness showed significant decrease after MPL treatment in patients with DME. The limited increase in BCVA may be due to the inclusion of a low number of patients and only those with non-center-involving macular edema. MPL may be used as an alternative to conventional argon laser in non-center-involving DME.
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http://dx.doi.org/10.4274/tjo.04657DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6216533PMC
October 2018

Role of a mydriasis-free, full-field flicker ERG device in the detection of diabetic retinopathy.

Doc Ophthalmol 2018 12 17;137(3):131-141. Epub 2018 Oct 17.

Department of Ophthalmology, Faculty of Medicine, Vehbi Koç Eye Hospital, Ankara University, Mamak Street, Dikimevi, Ankara, Turkey.

Purpose: To determine if the RETeval system can be used for the screening of diabetic retinopathy (DR) to provide early diagnosis.

Methods: The subjects were 42 diabetic patients selectively recruited by examination of their medical records to have varying severities of DR. The severity of DR was classified into four groups according to the International Clinical Diabetic Retinopathy Disease Severity Scale. Full-field electroretinograms (ERG) without mydriasis were obtained by the DR assessment protocol of the RETeval system. Macular retinal nerve fiber layer (RNFL) thickness was measured by optical coherence tomography. We compared the DR assessment protocol results and the macular RNFL thickness among four groups. Moreover, an analysis was conducted on whether there was any correlation among the DR assessment protocol results, duration of diabetes mellitus, and RNFL thickness individually for each group of patients.

Results: The mean ages and mean duration of diabetes mellitus of the four groups were similar. The DR assessment protocol results in the moderate-severe nonproliferative DR, and proliferative DR groups were significantly higher than those in the other groups (p < 0.001). The mean macular RNFL thickness was similar in all groups. No significant correlation was found between the DR assessment protocol results and duration of DM and the RNFL thickness.

Conclusions: Our results suggest that the RETeval full-field ERG system can be used as an adjunctive tool for the mass screening of DR, while macular RNFL thickness would not be useful.
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http://dx.doi.org/10.1007/s10633-018-9656-8DOI Listing
December 2018

Optic Nerve Avulsion and Retinal Detachment After Penetrating Ocular Trauma: Case Report.

Turk J Ophthalmol 2018 Apr 25;48(2):89-91. Epub 2018 Apr 25.

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

Optic nerve avulsion is a rare pathology with poor prognosis usually seen after blunt trauma. The optic nerve is separated from the sclera by indirect forces due to the relatively weak structure of the lamina cribrosa area. Here we describe an 11-year-old boy who experienced optic nerve avulsion and retinal detachment after penetrating ocular trauma.
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http://dx.doi.org/10.4274/tjo.31549DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938483PMC
April 2018

The Recovery of Microvascular Status Evaluated by Optical Coherence Tomography Angiography in Patients after Successful Macular Hole Surgery.

Ophthalmic Res 2018 29;59(1):53-57. Epub 2017 Nov 29.

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

Purpose: The aim of this study was to evaluate the optical coherence tomography angiography (OCTA) features of patients who underwent successful macular hole (MH) surgery.

Methods: Nineteen patients who underwent surgery in a single eye due to MH and 13 healthy subjects as a control group were included in the study. Vascular densities, flow indexes, and the foveal avascular zone (FAZ) area in superficial and deep retinal capillary plexuses were evaluated by OCTA in the right eyes of the control group, and both the surgical and healthy fellow eyes of the patients.

Results: The mean vascular densities of the superficial and deep capillary plexuses were significantly lower in the surgical eyes than in the control group (44.1 vs. 49.6%, p = 0.002, and 47.3 vs. 59.1%, p = 0.009, respectively). The mean superficial and deep capillary flow indexes were significantly lower in the surgical eyes than in the control group (0.85 vs. 1.35, p = 0.003, and 0.57 vs. 1.45, p = 0.001, respectively), while the mean superficial and deep FAZ area were significantly greater in the surgical eyes in comparison to the control group (0.55 vs. 0.32, p < 0.001, and 0.64 vs. 0.37, p = 0.001, respectively). There was no difference between the flow indexes of both layers of the healthy fellow eyes and the control group.

Conclusions: These preliminary results may be an explanation for unsatisfactory visual gain after surgery, despite the successful anatomical closure of the MH.
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http://dx.doi.org/10.1159/000484092DOI Listing
March 2018