Publications by authors named "Mehmet Talay Koylu"

25 Publications

  • Page 1 of 1

A Case of Multiple Optic Disc Pits: 21-Year Follow-up

Turk J Ophthalmol 2021 04;51(2):123-126

University of Health Sciences Turkey Gülhane Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey

Optic disc pits (ODP) are an uncommon congenital abnormality. Patients remain asymptomatic unless they develop maculopathy. The use of optic coherence tomography has critical benefits in the follow-up of patients who are at the amblyogenic age. The aim of this study is to present a case of double ODP in the right eye and single ODP in the left eye in a partially accommodative esotropia patient followed for 21 years. To our knowledge, multiple ODP has never been described in a patient with partially accommodative esotropia.
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http://dx.doi.org/10.4274/tjo.galenos.2020.66909DOI Listing
April 2021

Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma.

Eur J Ophthalmol 2021 Apr 16:11206721211010402. Epub 2021 Apr 16.

Department of Ophthalmology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey.

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.
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http://dx.doi.org/10.1177/11206721211010402DOI Listing
April 2021

Alterations in the Retinal Nerve Fiber Layer Thickness Color Map in Non-Glaucomatous Eyes with Myopia.

Turk J Ophthalmol 2021 Feb;51(1):26-31

University of Health Sciences Turkey, Gülhane Faculty of Medicine, Department of Ophthalmology Ankara, Turkey.

Objectives: To determine the normal values for retinal nerve fiber layer thickness (RNFLT) in myopic patients without glaucoma and analyze the changes in their color map.

Materials And Methods: A total of 245 eyes without glaucoma were included in the study. According to the degree of myopia, the cases were divided into 4 groups: control group (+1.00/-1.00 D; n=70), Group 1 (-1.00/-3.00 D; n=50), Group 2 (-3.00/-6.00 D; n=75), and Group 3 (>-6.00 D; n=50). Intra-group comparisons were performed in terms of superotemporal, superonasal, nasal, inferonasal, inferotemporal, temporal, and global RNFLT (Heidelberg Spectralis, Optic Coherence Tomography, Germany) and the color coding of these quadrants (green: within normal limits, yellow: borderline, red: outside normal limits).

Results: All groups were similar in age and gender (p>0.05). As the degree of myopia increased, RNFLT became thinner in the upper and lower temporal and upper and lower nasal quadrants (p<0.01). The rate of measurements considered borderline and outside normal limit in at least 1 quadrant was higher in groups with higher myopia for all quadrants (p<0.05). This rate was found to be 8/70 (11.4%) for the control group, 9/50 (18.0%) for Group 1, 21/75 (28.0%) for Group 2, and 33/50 (66.0%) for Group 3 (p<0.01).

Conclusion: The high rate of RNFLT classified as borderline or outside normal limits in myopic patients is a finding to which clinicians should pay attention in order not to make a misdiagnosis, especially in cases of suspected glaucoma.
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http://dx.doi.org/10.4274/tjo.galenos.2020.58726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931659PMC
February 2021

Comparative study of retinal nerve fibre layer thickness and retinal peripapillary capillary plexus microvascular vessel density: structure-function relationship analysis in glaucoma.

Eye (Lond) 2021 Jan 19. Epub 2021 Jan 19.

Department of Ophthalmology, Gulhane Medical Faculty, Health Sciences University, Ankara, Turkey.

Background: To investigate whether the retinal peripapillary capillary plexus vessel density (RPCP VD) or the retinal nerve fibre layer thickness (RNFLT) is better in showing the structure-function relationship in glaucoma.

Methods: Sixty-seven patients with primary open-angle glaucoma (POAG) in one eye and no visual field loss in fellow eye were included in this study. The scans of RPCP VD and RNFLT, and the standard automated perimetry data [including mean deviation (MD), pattern standard deviation (PSD), sector-based pattern deviation (PD) values] were analysed and compared.

Results: The global RNFLT was associated with MD (P = 0.035). RNFLTs of the superotemporal, superonasal, inferotemporal and inferonasal quadrants were associated with the corresponding PD (P = 0.004, <0.001, 0.002 and 0.012). The global RPCP VD was found to be associated with MD and PSD (P = 0.030 and 0.049, respectively). RPCP VD of the superotemporal quadrant was associated with PD of the corresponding quadrant, as well as with PSD (P = 0.003 and 0.043, respectively). Remaining RPCP VD values were only associated with the PD values of the corresponding quadrants (P < 0.05). The associations of the RPCP VD with PD were stronger than those of the RNFLT with PD [RPCP VD vs RNFLT: R = 0.624 vs 0.558 (P < 0.001 for both) for the superotemporal, 0.649 vs 0.552 for the superonasal (P < 0.001 for both), 0.598 vs 0.427 for the inferotemporal (P < 0.001 for both), 0.581 vs 0.408 for the inferonasal (P < 0.001 for both), 0.594 vs 0.068 (P < 0.001 vs 0.098) for the temporal, and 0.338 vs 0.195 (P < 0.001 vs 0.004) for the nasal quadrants].

Conclusion: In conclusion, the VD of RPCP was more informative in terms of the structure-function relationship in POAG. Future prospective follow-up studies with larger sample sizes are required to confirm the findings.
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http://dx.doi.org/10.1038/s41433-020-01367-zDOI Listing
January 2021

Agreement Between Standard Optical Coherence Tomography and Optical Coherence Tomography-Based Angiography in Estimating Retinal Nerve Fiber Layer Thickness

Turk J Ophthalmol 2020 10;50(5):264-270

University of Health Sciences Turkey, Gülhane Medical Faculty, Department of Ophthalmology, Ankara, Turkey

Objectives: To investigate the agreement between optical coherence tomography (OCT) and OCT-based angiography (OCT-A) in estimating retinal nerve fiber layer thickness (RNFLT) and evaluate the associations between peripapillary vessel density (VD) and RNFLT measurements obtained with both devices.

Materials And Methods: The AngioVue (Optovue Inc., Fremont, CA, USA) and Spectralis (Heidelberg Engineering, Heidelberg, Germany) images of 325 patients were screened retrospectively. RNFLT values were recorded using both devices. The intraclass correlation coefficient (ICC) and Bland-Altman plots were obtained to investigate the agreement between the devices. Age- and intraocular pressure-corrected associations between VD and RNFLT measured by the two devices were analyzed using linear regression models.

Results: ICC revealed excellent agreement for global, superior, inferior, and temporal RNFLT and good agreement for the nasal quadrant (ICC=0.895, 0.936, 0.923, 0.887, and 0.614, respectively). The Bland-Altman plots showed poor agreement for all measurements with a large span of limits of agreement and significant proportional bias (p<0.05). VD was found to be strongly associated with the RNFLT measurements of both devices (p<0.001).

Conclusion: The disagreement between the devices should be considered in clinical practice, and the data should not be used interchangeably. The association of the peripapillary VD with RNFLT using both devices indicated that RNFLT assessed by the AngioVue could be used in glaucoma management along with VD.
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http://dx.doi.org/10.4274/tjo.galenos.2020.18488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610055PMC
October 2020

Uveitis as a Confounding Factor in Retinal Nerve Fiber Layer Analysis Using Optical Coherence Tomography.

Ocul Immunol Inflamm 2020 Sep 18:1-6. Epub 2020 Sep 18.

Gulhane Medical Faculty, Department of Ophthalmology, Health Sciences University, Ankara, Turkey.

Purpose: To investigate the retinal nerve fiber layer thickness (RNFLT) in uveitic eyes and search for the associations with uveitis activity, etiology and location.

Methods: The files of 76 patients with uveitis and 76 controls were scanned. Associations of RNFLT were analyzed using generalized linear models.

Results: The RNFLT was significantly higher in patients with uveitis ( < .001). Active uveitis patients had a thicker RNFL than the controls and the patients with quiescent uveitis ( < .001). Anterior uveitis was associated with thinner RNFL in global and inferotemporal quadrant ( = .011 and 0.013, respectively). Thickening of RNFL was associated with posterior uveitis and Behçet's disease in all quadrants ( < .001) and idiopathic uveitis in the superonasal and nasal quadrants ( = .001).

Conclusion: Active uveitis, as well as posterior uveitis and Behcet's disease-associated uveitis, is a major confounding factor in RNFL analysis and therefore detection of glaucoma.
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http://dx.doi.org/10.1080/09273948.2020.1811353DOI Listing
September 2020

The agreement between optical coherence tomography angiography and non-mydriatic retinal camera in estimating the optic nerve head parameters and relations with the peripapillary vessel density in primary open-angle glaucoma.

Eye (Lond) 2021 Mar 4;35(3):959-965. Epub 2020 Jun 4.

Department of Ophthalmology, Gulhane Medical Faculty, Health Sciences University, Ankara, Turkey.

Background/objectives: To investigate the agreement between optical coherence tomography angiography (OCT-A) and non-mydriatic retinal camera (NMRC) in estimating the optic nerve head (ONH) parameters and evaluate the associations between peripapillary vessel density (VD) with ONH parameters assessed by both devices.

Methods: The OCT-A and NMRC images of 262 participants (138 eyes were diagnosed with POAG, 63 were glaucoma suspect, and 61 were healthy subjects) were screened retrospectively. The vertical cup-to-disc ratio (VCDR), cup-to-disc area ratio (CDAR), rim area (RA), disc area (DA), and cup volume (CV) were recorded using both devices. Peripapillary VD data were also recorded using OCT-A. The intraclass correlation coefficient (ICC) and Bland-Altman plots were obtained to investigate the agreement between the devices. Age- and intraocular pressure (IOP)-corrected associations between the VD and ONH parameters measured by the two devices were analyzed using linear regression models.

Results: ICC revealed excellent agreement for VCDR and CDAR, but poor agreement for RA, DA, and CV (ICC = 0.801, 0.793, 0.445, 0.298, and 0.527, respectively). The Bland-Altman plots showed poor agreement for VCDR and CDAR with a large span of limits of agreement (0.500 and 0.528, respectively) and significant proportional biases (P < 0.05). VD was found to be strongly associated with the VCDR and CDAR measurements of both devices (P < 0.001), but the associations were stronger for the measurements of NMRC.

Conclusions: The disagreement between the devices should be considered in clinical practice. The associations between the VD and ONH parameters proved once again the importance of the ONH parameters in terms of the management of glaucoma patients.
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http://dx.doi.org/10.1038/s41433-020-1006-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027805PMC
March 2021

Adherence to glaucoma medication, illness perceptions, and beliefs about glaucoma: Attitudinal perspectives among Turkish population.

Eur J Ophthalmol 2021 Mar 4;31(2):469-476. Epub 2020 Feb 4.

Department of Ophthalmology, TOBB ETU Hospital, Ankara, Turkey.

Purpose: To evaluate the topical glaucoma eye drops adherence prevalence and its association with beliefs and illness perceptions about glaucoma in Turkey. We also aimed to explore the factors linked to patients' total, voluntary, and involuntary non-adherence to medication in different patient attitudes.

Material And Methods: A prospective study with cross-sectional design which included a total of 317 glaucoma patients who completed questionnaires. We assessed the adherence to medication, illness perceptions, and the beliefs about the glaucoma treatment by the "Reported Adherence to Medication scale," "the Brief Illness Perception Questionnaire," and "the Beliefs about Medicine-Specific Questionnaire," respectively. According to the RAM scale, voluntary and involuntary non-adherence scores were also distinguished. Different adherence categories in RAM scale were compared with perception and belief measures. Patient attitudes were assessed from the BMQ. We also performed attitudinal type comparisons with different adherence groups.

Results: The full adherence prevelance to glaucoma medication was 40%. The proportion of voluntary and involuntary non-adherence was 26% and 57%, respectively. The adherence groups were similar in terms of belief measures but statistically different according to illness perceptions (consequences (p = 0.002), timeline (p = 0.008), personal control (p = 0.001), identity (p = 0.019), concerns (p = 0.003)), and attitude types (ambivalent (p = 0.030) and accepting (p = 0.029)).

Conclusion: New strategies are required to improve patient adherence to glaucoma medication in Turkey. The beliefs about the glaucoma treatment and illness perceptions are also needed to be enhanced.
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http://dx.doi.org/10.1177/1120672120901687DOI Listing
March 2021

Does Dry Eye Affect Repeatability of Corneal Topography Measurements?

Turk J Ophthalmol 2018 04 25;48(2):57-60. Epub 2018 Apr 25.

University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey.

Objectives: The purpose of this study was to assess the repeatability of corneal topography measurements in dry eye patients and healthy controls.

Materials And Methods: Participants underwent consecutive corneal topography measurements (Sirius; Costruzione Strumenti Oftalmici, Florence, Italy). Two images with acquisition quality higher than 90% were accepted. The following parameters were evaluated: minimum and central corneal thickness, aqueous depth, apex curvature, anterior chamber volume, horizontal anterior chamber diameter, iridocorneal angle, cornea volume, and average simulated keratometry. Repeatability was assessed by calculating intra-class correlation coefficient.

Results: Thirty-three patients with dry eye syndrome and 40 healthy controls were enrolled to the study. The groups were similar in terms of age (39 [18-65] vs. 30.5 [18-65] years, p=0.198) and gender (M/F: 4/29 vs. 8/32, p=0.366). Intra-class correlation coefficients among all topography parameters within both groups showed excellent repeatability (>0.90).

Conclusion: The anterior segment measurements provided by the Sirius corneal topography system were highly repeatable for dry eye patients and are sufficiently reliable for clinical practice and research.
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http://dx.doi.org/10.4274/tjo.10179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938476PMC
April 2018

Association of retinal vein occlusion, homocysteine, and the thrombophilic mutations in a Turkish population: A case-control study.

Ophthalmic Genet 2017 Jul-Aug;38(4):352-356. Epub 2017 Jan 13.

a Department of Ophthalmology , Gulhane Military Medicine Academy , Ankara , Turkey.

Purpose: To compare homocysteine and thrombophilic mutations for the methylenetetrahydrofolate reductase (MTHFR) C677T, factor V Leiden, and prothrombin G20210A between retinal vein occlusion (RVO) and healthy controls in a Turkish population.

Materials And Methods: Forty-nine subjects with RVO were compared for homocysteine status and the MTHFR C677T, prothrombin G20210A, and factor V Leiden mutations with those of 68 healthy controls. Then, the groups were subdivided into two subgroups according to age (less than 50 years old, equal to or more than 50 years old) and were further compared.

Results: Mean plasma level of homocysteine was similar, but the frequency of hyperhomocysteinemia was significantly higher in the RVO group when compared with the control group (22.5% and 8.8%, respectively, p = 0.037). The frequency of all thrombophilic mutations was similar between the groups (p > 0.05). The frequency of all thrombophilic mutations and homocysteine levels was also similar between age subgroups (p > 0.05). Only hyperhomocysteinemia was significantly different between subgroups (p = 0.037); the frequency of hyperhomocysteinemia was significantly different in RVO patients less than 50 years old (22.7%) from that in healthy controls less than 50 years old (11.1%). Two RVO patients (4.1%) with bilateral involvement had MTHFR C677T mutation.

Conclusions: Screening for thrombophilic mutations such as MTHFR C677T, factor V Leiden, and prothrombin G20210A in RVO patients at all ages seems to be unnecessary and not cost-effective. However, thrombophilic disorders should be screened selectively, focusing on young individuals, especially with bilateral involvement, without additional cardiovascular risk factors, or a family history of thrombosis.
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http://dx.doi.org/10.1080/13816810.2016.1235716DOI Listing
December 2017

Efficacy of aflibercept on exudative age-related macular degeneration in patients exhibiting complete ranibizumab resistance and tachyphylaxis.

Arq Bras Oftalmol 2016 Nov-Dec;79(6):384-389

Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey.

Purpose:: The present study compared the efficacy of aflibercept for neovascular age-related macular degeneration (NV-AMD) in patients with complete ranibizumab resistance and tachyphylaxis.

Methods:: Forty-four eyes of 38 neovascular age-related macular degeneration patients were evaluated. Eyes were divided into a complete resistance group (n=23 eyes) and tachyphylaxis group (n=21 eyes).

Results:: After three injections, eight (38.1%) patients in the tachyphylaxis group and nine (39.1%) in the complete resistance group presented with macular dryness. After the first injection of aflibercept, the mean visual acuity improved significantly in the tachyphylaxis group (p=0.018) but remained unchanged in the complete resistance group (p=0.37). There was a non-significant trend towards improved mean visual acuity in both groups after the second and third injections relative to the acuity at the final visit for ranibizumab treatment. In the tachyphylaxis group, the presence of subfoveal pigmented epithelium detachment (PED) decreased significantly after intravitreal aflibercept treatment.

Conclusions:: Although treatment with aflibercept yielded generally positive anatomical results in both groups, no significant increase in visual acuity was achieved.
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http://dx.doi.org/10.5935/0004-2749.20160109DOI Listing
September 2017

Ophthalmic pathologies in female subjects with bilateralcongenital sensorineural hearing loss.

Turk J Med Sci 2016 Jan 5;46(1):139-44. Epub 2016 Jan 5.

Department of Ophthalmology, Gülhane Military Medical School, Ankara, Turkey.

Background/aim: The high prevalence of ophthalmologic pathologies in hearing-disabled subjects necessitates early screening of other sensory deficits, especially visual function. The aim of this study is to determine the frequency and clinical characteristics of ophthalmic pathologies in patients with congenital bilateral sensorineural hearing loss (SNHL).

Materials And Methods: This descriptive study is a prospective analysis of 78 young female SNHL subjects who were examined at a tertiary care university hospital with a detailed ophthalmic examination, including electroretinography (ERG) and visual field tests as needed.

Results: The mean age was 19.00 ± 1.69 years (range: 15 to 24 years). A total of 39 cases (50%) had at least one ocular pathology. Refractive errors were the leading problem, found in 35 patients (44.9%). Anterior segment examination revealed heterochromia iridis or Waardenburg syndrome in 2 cases (2.56%). Dilated fundus examination revealed retinal pathologies in 15 cases (19.23%), including retinitis pigmentosa or Usher's syndrome in 8 cases (10.25%). Most of the Usher's syndrome cases (87.5%) had consanguinity.

Conclusion: Screening for congenital SNHL in the early years of life and routine yearly follow-ups are essential for maximizing the rehabilitation of this disabled group. The high rate of visually debilitating syndromic ocular pathologies associated with high frequency of consanguinity doubles the importance.
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http://dx.doi.org/10.3906/sag-1411-82DOI Listing
January 2016

Retinal Nerve Fiber Layer and Peripapillary Choroidal Thicknesses in Non-Glaucomatous Unilateral Optic Atrophy Compared with Unilateral Advanced Pseudoexfoliative Glaucoma.

Curr Eye Res 2017 02 27;42(2):302-306. Epub 2016 Jun 27.

d Department of Ophthalmology , Kirikkale University , Kirikkale , Turkey.

Purpose: To investigate retinal nerve fiber layer thickness (RNFL-T) and peripapillary choroidal thickness (PC-T) in non-glaucomatous optic atrophy (OA) patients in comparison with unaffected and control eyes, furthermore, to compare thickness profiles with unilateral pseudoexfoliative advanced glaucoma.

Materials And Methods: Thirty-three eyes with OA (Group A), 33 unaffected fellow eyes (Group B), 25 right eyes of 25 control subjects (Group C), and 15 eyes with advanced glaucoma (Group D) were enrolled. RNFL-T was measured in six regions by spectral-domain optical coherence tomography. Enhanced depth imaging optical coherence tomography was obtained to evaluate PC-T in corresponding regions.

Results: RNFL-T was significantly lower in Group A than in Groups B and C globally and at all peripapillary regions (all p < 0.001). P-CT in Group A was significantly lower globally (p = 0.03) and in three regions (temporal, p = 0.001; temporal-superior, p = 0.01; and nasal-inferior, p = 0.037) versus Group C. However, it was significantly thinner than in Group B in all regions (temporal, p = 0.02; temporal-superior, p = 0.013; nasal-superior, p = 0.044; nasal, p = 0.02; nasal-inferior, p < 0.001; and temporal-inferior, p < 0.001) and globally (p < 0.001). In Group A RNFL-T (thicker superiorly and inferiorly; thinner temporally and nasally) and PC-T (superior > temporal > nasal > inferior) profiles were almost identical to that in unaffected fellow eyes and control eyes. However, Group D showed different patterns with less regional differences in RNFL-T, and the greatest value of PC-T in nasal quadrant.

Conclusions: Besides retinal nerve fiber layer thinning, non-glaucomatous OA is associated with choroidal thinning. The RNFL-T and PC-T profiles in advanced glaucoma eyes differed from the common patterns seen among OA eyes, unaffected fellow eyes, and control eyes.
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http://dx.doi.org/10.3109/02713683.2016.1170856DOI Listing
February 2017

A Novel Capsulorhexis Technique in White Cataract Surgery.

Semin Ophthalmol 2017 18;32(5):661. Epub 2016 May 18.

a Department of Ophthalmology , Gulhane Military Medical School , Ankara , Turkey.

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http://dx.doi.org/10.3109/08820538.2015.1123736DOI Listing
June 2018

Fixation Characteristics of Severe Amblyopia Subtypes: Which One is Worse?

Semin Ophthalmol 2017 18;32(5):553-558. Epub 2016 May 18.

b Department of Ophthalmology , Gulhane Military Medical School , Ankara , Turkey.

Purpose: To determine differences in macular sensitivity and fixation patterns in different subtypes of severe amblyopia.

Methods: This case-control study enrolled a total of 73 male adults, including 18 with pure strabismic severe amblyopia, 19 with pure anisometropic severe amblyopia, 18 with mixed (strabismic plus anizometropic) severe amblyopia, and 18 healthy controls. MP-1 microperimetry was used to evaluate macular sensitivity, location of fixation, and stability of fixation.

Results: Mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in all amblyopia subtypes when compared with healthy controls. Intergroup comparisons between amblyopia subtypes revealed that mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in pure strabismic and mixed amblyopic eyes when compared with pure anisometropic amblyopic eyes.

Conclusions: Strabismus seems to be a worse prognostic factor in severe amblyopia than anisometropia in terms of fixation characteristics and retinal sensitivity.
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http://dx.doi.org/10.3109/08820538.2015.1123739DOI Listing
December 2017

Comment on: "Autoimmune uveitis: clinical, pathogenetic, and therapeutic features".

Clin Exp Med 2016 May 6;16(2):137-8. Epub 2016 Apr 6.

Department of Ophthalmology, Tatvan Military Hospital, Bitlis, Turkey.

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http://dx.doi.org/10.1007/s10238-016-0415-4DOI Listing
May 2016

Comparison of peripapillary choroidal thickness measurements via spectral domain optical coherence tomography with and without enhanced depth imaging.

Postgrad Med 2016 May 8;128(4):439-43. Epub 2016 Apr 8.

a Department of Ophthalmology , GATA Medical School , Ankara , Turkey.

Objectives: To compare peripapillary choroidal thickness (PP-CT) measurements using a spectral domain optical coherence tomography (SD-OCT) device with and without enhanced depth imaging (EDI).

Methods: Sixty healthy subjects aged from 18 to 40 years were included in this study. PP-CTs were measured in the right eyes by manual segmentation via SD-OCT both with and without EDI. The intraclass correlation coefficient (ICC) for each technique and comparison of PP-CT measurements between two techniques were evaluated. The correlation between retinal nerve fiber layer (RNFL) thickness and PP-CT was also explored on images of SD-OCT without EDI.

Results: The PP-CT measurements of 55 subjects were evaluated. The ICC was 0.999 (95% CI: 0.998-1.0, p < 0.001) for SD-OCT with EDI and 0.996 (95% CI: 0.995-0.997, p < 0.001) for SD-OCT without EDI. The mean PP-CT measurements in all regions and the overall mean PP-CT measurements between the two techniques were not different (p > 0.05). Additionally, there was no correlation between RNFL thickness and PP-CT (r = -0.109; p = 0.335).

Conclusions: The PP-CT measurements via SD-OCT without EDI were consistent with the measurements via SD-OCT with EDI. Ophthalmologists who do not have access to EDI technology can use images of SD-OCT without EDI to measure the peripapillary choroid for research purposes. However, thicker peripapillary choroids cannot be measured using this technique and require further modifications or newer technologies, such as SD-OCT with EDI.
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http://dx.doi.org/10.1080/00325481.2016.1171119DOI Listing
May 2016

Evaluation of retinal nerve fiber layer thickness and choroidal thickness in pseudoexfoliative glaucoma and pseudoexfoliative syndrome.

Postgrad Med 2016 May 4;128(4):444-8. Epub 2016 Apr 4.

a Department of Ophthalmology , Gulhane Military Medical Academy , Ankara , Turkey.

Objectives: To compare retinal nerve fiber layer thickness (RNFLT) and choroidal thickness (ChT) measurements in eyes with pseudoexfoliative (PEX) glaucoma, PEX syndrome and healthy control eyes.

Methods: Eighteen patients with PEX glaucoma in one eye and PEX syndrome in the fellow eye were included. The right eyes of thirty-nine age- and sex-matched healthy subjects were included as control group. All participants underwent a detailed biomicroscopic and funduscopic examination. RNFLT and ChT measurements were performed with a commercially available spectral-domain optical coherence tomography (SD-OCT). ChT measurements were performed by using enhanced depth imaging (EDI) mode. Patients with PEX underwent diurnal IOP measurements with 4-hour intervals before inclusion in the study. RNFLT results included the average measurement and 6 quadrants (temporal, inferotemporal, inferonasal, nasal, superonasal and supero-temporal). ChT measurements were performed in the subfoveal region and around the fovea (500µm and 1500 µm nasal and temporal to the fovea), as well as around the optic disc (average peripapillary and eight quadrants in the peripapillary region (temporal, inferotemporal, inferior, inferonasal, nasal, superonasal, superior, supero-temporal)).

Results: RNFLT in all quadrants and average thickness were significantly lower in PEX glaucoma eyes compared to PEX syndrome eyes and healthy control eyes (p<0.001 for both). RNFLT comparisons between PEX syndrome and healthy control eyes did not show a significant difference (p>0.05) except the inferotemporal quadrant. ChT measurements were similar between groups (p>0.05).

Conclusions: Thinning of the RNFL in association with unchanged ChT may mean that the presence of PEX material is a much more significant risk factor than choroidal changes in the progression of PEX syndrome to PEX glaucoma.
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http://dx.doi.org/10.1080/00325481.2016.1170579DOI Listing
May 2016

Correspondence.

Retina 2016 Jun;36(6):e47

*Department of Ophthalmology, Gulhane Military Medical School, Ankara, Turkey †Department of Ophthalmology, Kayseri Military Hospital, Kayseri, Turkey ‡Department of Ophthalmology, Tatvan Military Hospital, Bitlis, Turkey.

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http://dx.doi.org/10.1097/IAE.0000000000001006DOI Listing
June 2016

Retina nerve fiber layer and choroidal thickness changes in obstructive sleep apnea syndrome.

Postgrad Med 2016 11;128(3):317-22. Epub 2016 Mar 11.

a Department of Ophthalmology , Gulhane Military Medical Academy , Ankara , Turkey.

Objectives: The purpose of this study was to determine the effects of obstructive sleep apnea syndrome (OSAS) on the submacular and peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness (ChT).

Methods: Eighty-four eyes of 42 male patients with OSAS and 112 eyes of 56 aged-matched and body mass index-matched healthy male subjects were enrolled in this case-control study. The ChT and peripapillary RNFL thickness was measured using enhanced depth imaging optical coherence tomography. The ChT and RNFL thickness measurements of the groups were compared, and correlations among the Apnea Hypopnea Index (AHI) values and these measurements were calculated. Right and left eyes were separately evaluated.

Results: There were no significant differences in the subfoveal and temporal ChT between the groups (p > 0.05). The OSAS group had significantly thicker ChT at 0.5 and 1.5 mm nasal to the fovea in both eyes than the control group (p < 0.05). The peripapillary ChT were significantly thicker in the OSAS group at all segments except for the temporal and superotemporal segments when compared with the control group (p < 0.05 for all quadrants except temporal and superotemporal). When compared with controls, the OSAS group had significantly thinner nasal RNFL thickness in the right eye (p = 0.01) and thinner mean RNFL thickness in both eyes (p < 0.001). Other RNFL thickness measurements were similar between groups (p > 0.05). Between AHI and mean RNFL thickness showed a median negative correlation (r = - 0.411, p = 0.001).

Conclusion: The choroidal thickening in patients with OSAS may be associated with the pathophysiology of the neurodegeneration process of the disease.
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http://dx.doi.org/10.1080/00325481.2016.1159118DOI Listing
August 2016

The effect and safety of intravitreal injection of ranibizumab and bevacizumab on the corneal endothelium in the treatment of diabetic macular edema.

Cutan Ocul Toxicol 2017 Mar 24;36(1):5-8. Epub 2016 Feb 24.

b Department of Ophthalmology , Selcuk University , Konya , Turkey , and.

Objective: To investigate the effect and safety of intravitreal injection (IVI) of bevacizumab and ranibizumab on corneal endothelial cell count and morphology in patients with diabetic macular edema.

Materials And Methods: A total of 60 eyes from 60 consecutive patients who received 0.5 mg/0.05 ml IVIs of bevacizumab (n = 30, IVB group) or 1.25 mg/0.05 ml ranibizumab (n = 30, IVR group) for three consecutive months were investigated prospectively. Specular microscopy was performed to evaluate endothelial cell count, the percentage of hexagonal cells (pleomorphism), and the coefficient of variation of the cell size (polymegathism); optical biometry was performed to evaluate central corneal thickness. Results before injection and 1 month after the first and third injections were compared.

Results: The groups were matched for age (p = 0.11) and gender (p = 0.32). There was no significant difference in endothelial cell count (IVB group, p = 0.66; IVR group, p = 0.74), pleomorphism (IVB group, p = 0.44; IVR group, p = 0.88) and polymegathism (IVB group, p = 0.21; IVR group, p = 0.24) before injection or 1 month after the first and third injections. There was also no difference in central corneal thickness (IVB group, p = 0.15; IVR group, p = 0.58) before injection or 1 month after the first and third injections.

Conclusion: Monthly 1.25 mg/0.05 ml IVIs of bevacizumab or 0.5 mg/0.05 ml of ranibizumab for three consecutive months in the treatment of diabetic macular edema does not affect corneal morphology and has no harmful effects on the endothelium.
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http://dx.doi.org/10.3109/15569527.2016.1140177DOI Listing
March 2017

Letter to the Editor: Appropriate Evaluation of the Effect of Ranibizumab Injections on Retinal Nerve Fiber Layer Thickness.

Curr Eye Res 2016 05 4;41(5):725. Epub 2015 Sep 4.

c Department of Ophthalmology , Tatvan Military Hospital , Tatvan , Turkey.

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http://dx.doi.org/10.3109/02713683.2015.1057853DOI Listing
May 2016

Spontaneous resolution of subretinal hemorrhage secondary to choroidal osteoma unassociated with choroidal neovascularization.

Case Rep Ophthalmol Med 2014 26;2014:823953. Epub 2014 Jun 26.

Gulhane Military Medical School, Ophthalmology Clinic, 06010 Ankara, Turkey.

Choroidal osteoma is a rare benign intraocular tumor composed of calcification throughout the choroid. Various treatment modalities are available according to location of the tumor and the cause of the visual distortion. We report herein a 30-year-old male who was referred to our hospital with acute blurred vision as a result of the subretinal hemorrhage from choroidal osteoma. We ruled out the presence of CNV and observation was preferred and we prevented unnecessary treatment attempts as spontaneous recovery is the easiest and safest way.
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http://dx.doi.org/10.1155/2014/823953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4099108PMC
July 2014

Bilateral symmetrical subepidermal calcified nodules of the eyelids.

Orbit 2014 Aug 15;33(4):295-7. Epub 2014 May 15.

Tatvan Military Hospital Ophthalmology Clinic , Bitlis , Turkey .

A subepidermal calcified nodule is an uncommon variant of calcinosis cutis and only a limited number of cases have been reported about the eyelid nodules in the literature. A 20-year-old male was referred to our department with symmetrical nodules on both upper eyelids enlarging over 3 years. Both nodules were removed by excisional biopsy. After the histopathologic evaluation, the diagnosis was subepidermal calcified nodule. He had a complete recovery with no recurrence and acceptable aesthetic appearance. As a rare entity, subepidermal calcified nodule should be thought in differential diagnosis of eyelid nodular lesions and symmetrical appearance may be seen.
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http://dx.doi.org/10.3109/01676830.2014.902477DOI Listing
August 2014