Publications by authors named "Sengul Ozdek"

93 Publications

Relation of anatomy with function following the surgical treatment of idiopathic epiretinal membrane: a multicenter retrospective study.

Graefes Arch Clin Exp Ophthalmol 2021 Apr 13;259(4):891-904. Epub 2020 Nov 13.

Department of Ophthalmology, Gulhane Education and Research Hospital, Ankara, Turkey.

Purpose: To investigate the prognostic factors associated with functional and anatomical outcomes and to assess the longitudinal course of visual acuity and retinal morphology after vitreoretinal surgery for idiopathic epiretinal membrane (ERM).

Methods: This multicenter, retrospective study included a total of 634 eyes who underwent surgery for idiopathic ERM in 22 academic centers nationwide in Turkey. Data on best-corrected visual acuity (BCVA) and optical coherence tomography features (central foveal thickness (CFT), ERM and foveal contour morphology, ellipsoid zone (EZ) integrity) were collected and compared at baseline, 6-month, 12-month, and 24-month follow-ups. Prognostic factors for functional (having ≥ 20/25 Snellen BCVA) and anatomical (having normal/shallow foveal contour) recoveries after surgery were investigated by means of multivariate regression analyses. A cutoff value of preoperative BCVA optimizing functional recovery was calculated using receiver operating characteristic curve analysis.

Results: At a median follow-up of 24 months, 37.4% of the eyes achieved ≥ 20/25 BCVA and 54% regained normal or shallow foveal contour. Functional recovery was more likely in eyes with better baseline BCVA and intact EZ (R = 0.356, p < 0.001). The cutoff baseline BCVA value for good visual prognosis was 0.35 logarithm of the minimum angle of resolution (Snellen 20/44) (sensitivity 60%, specificity 85%, p < 0.001). Anatomical recovery was negatively associated with advanced age, higher baseline CFT, foveal herniation-type ERM morphology, and internal limiting membrane (ILM) peeling (R = 0.225, p < 0.001). The negative effect of ILM peeling on anatomical recovery was not significant after the first postoperative year (p = 0.05). Mean BCVA values and foveal morphology progressively improved at each visit. Cases with convex baseline foveal contour continued to change towards normal foveal depression over 24 months of follow-up, which took longer than the eyes with shallow/flat contoured cases. One-third of eyes with severe baseline EZ defects showed recovery at follow-up and achieved significantly greater visual acuity gains than the remaining eyes with persistent defects (p < 0.001).

Conclusions: Functional and anatomical restoration of the eyes appears to be a slow process after ERM surgery. This process may take much longer in eyes with worse foveal morphology at baseline. Although photoreceptor disruption may be reversible in some eyes, full functional recovery is unlikely when it persists.
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http://dx.doi.org/10.1007/s00417-020-05002-1DOI Listing
April 2021

Outcomes of Gonioscopy-assisted Transluminal Trabeculotomy in Vitrectomized Patients With Secondary Glaucoma After Silicone Oil Removal.

J Glaucoma 2021 Mar;30(3):e114-e118

Department of Ophthalmology, Gazi University School of Medicine, Ankara.

Prcis: The present study demonstrates that surgical success rates of gonioscopy-assisted transluminal trabeculotomy (GATT) with a target intraocular pressure (IOP)≤21 mm Hg are 93.3% (for qualified success) and 26.7% (for complete success) in vitrectomized patients exhibiting secondary open-angle glaucoma (SOAG) after silicone oil (SO) removal, for an average follow-up of 37.5 months.

Purpose: To report the long-term outcomes of GATT in vitrectomized patients exhibiting SOAG after SO removal.

Setting: Retrospective case-series study.

Patient Population: This retrospective case-series study enrolled vitrectomized patients who underwent uneventful GATT surgery between May 2014 and May 2019 at Gazi University Hospital for the treatment of medically uncontrolled SOAG after SO removal.

Main Outcome Measures: At baseline and at each postoperative visit, a detailed ophthalmic examination consisting of slit-lamp biomicroscopy, indirect ophthalmoscopy, macular optical coherence tomography, and Goldmann applanation tonometry was performed in all patients. Baseline demographic and clinical characteristics, duration between pars plana vitrectomy and SO removal, duration between SO removal and onset of SOAG, follow-up time, need for antiglaucoma medication, visual acuity, and IOP measurements were noted. Surgical success was defined as an IOP≤21 and ≥6 mm Hg with (qualified success) and without (complete success) IOP-lowering medication.

Results: A total of 15 patients had a history of pars plana vitrectomy with 1000 centistoke SO tamponade before the GATT surgery. GATT was performed in all patients with SOAG after SO removal. The mean age and follow-up of the patients were 53.6±11.8 years (range, 34 to 72 y) and 37.5±15.1 months (range, 12 to 61 mo), respectively. The average duration of SO tamponade in the vitreous cavity was 7.5±1.6 months (range, 5 to 10 mo). The average duration between the SO removal and the development of SOAG was 14.1±13.2 months (range, 2 to 46 mo). The mean IOP decreased from 31.0±4.1 mm Hg at baseline to 15.6±4.6 mm Hg at final visit. The mean final logMAR BCVA was 0.92±0.58 (range, 2 to 0.045). Qualified surgical success was achieved in 14 (93.3%) patients, whereas complete success was achieved in only 4 (26.7%) patients (P<0.001).

Conclusions: GATT seems to be safe and successful procedure for controlling IOP in patients exhibiting SOAG after SO removal. However, most patients may require antiglaucoma medication during the follow-up, particularly within the first 2 postoperative years.
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http://dx.doi.org/10.1097/IJG.0000000000001738DOI Listing
March 2021

Effect of Fundus Fluorescein Angiography on Semiautomated Aqueous Flare Measurements.

Ocul Immunol Inflamm 2020 Sep 23:1-4. Epub 2020 Sep 23.

Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA.

Purpose: To evaluate the effects of fluorescein fundus angiography (FFA) on semiautomated aqueous flare measurements.

Methods: Laser flare photometer (LFP) measurements was performed at baseline, 30 min, and 4 h after the intravenous administration of sodium fluorescein dye. FFA was performed immediately after the baseline LFP measurement. LFP values at 30 min and 4 h after FFA were compared to baseline values. Mean change in LFP measurements at 30 min and 4 hafter baseline was compared between FFA arm and controls.

Results: The mean flare measurement in the FFA and control arm dropped 6% ( value = 0.002) and 9% ( value = 0.04), respectively. Mean change in LFP measurement at 30 min and 4 h after baseline was not significant between FFA arm and controls.

Conclusions: Administration of fluorescein dye does not increase LFP values. The decrease in the LFP measurement following FFA may be attributed to dilation drops.
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http://dx.doi.org/10.1080/09273948.2020.1799036DOI Listing
September 2020

PREOPERATIVE ANATOMICAL FEATURES ASSOCIATED WITH IMPROVED SURGICAL OUTCOMES FOR STAGE 5 RETINOPATHY OF PREMATURITY.

Retina 2021 Apr;41(4):718-725

Ophthalmology Department, Gazi University School of Medicine, Ankara, Turkey.

Purpose: To describe preoperative anatomical features of Stage 5 retinopathy of prematurity with results of surgery and patient-related and surgery-related factors affecting postoperative success.

Methods: Forty eyes of 33 infants who underwent vitrectomy with lensectomy or lens-sparing vitrectomy for Stage 5 retinopathy of prematurity were enrolled. Stage 5 cases were divided into different groups according to their preoperative anatomical features as follows: A: for eyes with ophthalmoscopically observable total retinal detachment; B: for eyes with total leucocoria associated with funnel retinal detachment; and C: for eyes with very shallow anterior chamber and corneal opacity. Only A and B eyes underwent surgery. The effect of the presence of vascular dilation and tortuosity, preoperative treatment status, surgically induced posterior hyaloid detachment, and sparing the lens on anatomical and functional results was evaluated.

Results: Thirty-five percentage of the eyes were in Group A and 65% were in Group B. The mean follow-up was 30.6 months (12-68). Anatomical success was 55.5% for Group A and 15.4% for Group B (P: 0.047), and functional success was 33.3% for Group A and 7.7% for Group B at the third year (P: 0.125). The presence of vascular dilation and tortuosity and postoperative vitreous hemorrhage were found to have negative effects; preoperative treatment and surgical induction of posterior hyaloid detachment were found to have positive effects on anatomical and functional results.

Conclusion: Surgery for ophthalmoscopically observable retinopathy of prematurity-associated retinal detachment resulted in better anatomical and functional outcomes, and the results are even better in eyes with preoperative treatment, lens-sparing vitrectomy, and surgically induced posterior hyaloid detachment.
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http://dx.doi.org/10.1097/IAE.0000000000002948DOI Listing
April 2021

Non-neovascular age-related macular degeneration with subretinal fluid.

Br J Ophthalmol 2020 Sep 12. Epub 2020 Sep 12.

Ophthalmology, University of Bonn, Bonn, Germany.

Purpose: To evaluate the various patterns of subretinal fluid (SRF) in eyes with age-related macular degeneration (AMD) in the absence of macular neovascularisation (MNV) and to assess the long-term outcomes in these eyes.

Methods: This retrospective study included only eyes with non-neovascular AMD and associated SRF. Eyes with evidence of MNV were excluded. Spectral-domain optical coherence tomography (SD-OCT) was obtained at baseline and at follow-up, and qualitative and quantitative SD-OCT analysis of macular drusen including drusenoid pigment epithelial detachment (PED) and associated SRF was performed to determine anatomic outcomes.

Results: Forty-five eyes (45 patients) were included in this analysis. Mean duration of follow-up was 49.7±36.7 months. SRF exhibited three different morphologies: crest of fluid over the apex of the drusenoid PED, pocket of fluid at the angle of a large druse or in the crypt of confluent drusen or drape of low-lying fluid over confluent drusen. Twenty-seven (60%) of the 45 eyes with fluid displayed collapse of the associated druse or drusenoid PED and 24 (53%) of the 45 eyes developed evidence of complete or incomplete retinal pigment epithelial and outer retinal atrophy.

Conclusion: Non-neovascular AMD with SRF is an important clinical entity to recognise to avoid unnecessary anti-vascular endothelial growth factor therapy. Clinicians should be aware that SRF can be associated with drusen or drusenoid PED in the absence of MNV and may be the result of retinal pigment epithelial (RPE) decompensation and RPE pump failure.
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http://dx.doi.org/10.1136/bjophthalmol-2020-317326DOI Listing
September 2020

External Drainage Alone Versus External Drainage With Vitrectomy in Advanced Coats Disease.

Am J Ophthalmol 2021 02 9;222:6-14. Epub 2020 Sep 9.

Ophthalmology Department, Gazi University School of Medicine, Besevler, Ankara, Turkey.

Purpose: To evaluate the efficacy of transscleral drainage of subretinal fluid (TDSRF) with and without pars plana vitrectomy (PPV), which are performed as an adjunct to ablative therapies in advanced Coats disease.

Design: Retrospective, comparative case series.

Patient Population: A total of 31 eyes from 31 consecutive patients with advanced Coats disease at an average age of 47.8 ± 34.2 (2-156) months at the time of the surgery, who underwent TDSRF alone or in combination with PPV.

Methods: Main outcome measurements were LogMAR visual acuity values, anterior and posterior segment findings, need for further surgery, laser photocoagulation, and anti-vascular endothelial growth factor (anti-VEGF) treatment. Anatomical success was defined as the maintenance of retinal reattachment without any further surgery during follow-up.

Results: Sixteen patients underwent TDSRF alone, and 15 patients underwent combined TDSRF and PPV. Mean follow-up time was 34.8 ± 32.9 months (6-128). Anatomical success rate of combined TDSRF and PPV was higher than that of TDSRF alone (93.8% vs 75%, respectively). The incidence of epiretinal membrane formation, number of laser photocoagulation procedures, and anti-VEGF treatments were statistically significantly higher in the group that underwent TDSRF alone than in those who had combined TDSRF and PPV in the long term. There was an improvement in vision in only 4 eyes (12.9%) (all >3 years old at presentation) during the follow-up.

Conclusions: Combined TDSRF and PPV appears to be more effective in controlling the disease than TDSRF alone, as an adjunct to ablative procedures for the treatment of advanced Coats disease. The need for additional treatment is much less with the addition of PPV.
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http://dx.doi.org/10.1016/j.ajo.2020.09.006DOI Listing
February 2021

Inherited eye diseases in Turkey: Current approaches and future directions.

Am J Med Genet C Semin Med Genet 2020 09 30;184(3):773-781. Epub 2020 Aug 30.

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

The aim of this review is to reveal Turkey's current status of medical practice in inherited eye diseases and the necessary steps to improve healthcare services and research activities in this area. Since consanguinity rate is high, disease burden is estimated to be high in Turkey. Universal health insurance system, easily accessible medical specialists, increasing genetic test, and counseling opportunities are the key advantages of Turkey's healthcare system. However, specialized clinics for inherited eye diseases, low-vision rehabilitation services, training of ophthalmologists about the recent developments in ocular genetics, and multidisciplinary translational research are the main headlines needed to be focused for better health services and successful research in Turkey.
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http://dx.doi.org/10.1002/ajmg.c.31829DOI Listing
September 2020

Sustained Elevation of Intraocular Pressure After Administration of Intravitreal Anti-Vascular Endothelial Growth Factor Agents in Patients With and Without Pseudoexfoliation Syndrome.

J Glaucoma 2020 10;29(10):981-988

Department of Ophthalmology, Gazi University Medical School, Ankara.

PRéCIS:: Intravitreal anti-vascular endothelial growth factor therapy resulted in sustained elevation of intraocular pressure (IOP) in 18.6% of patients with coexisting age-related macular degeneration and pseudoexfoliation (PXF) syndrome. The development of sustained elevation of IOP after ~19 injections reflected the cumulative effect of anti-vascular endothelial growth factor injections on IOP.

Purpose: The purpose of this study was to compare the long-term effect of intravitreal ranibizumab (IVR) and intravitreal bevacizumab (IVB) therapies on IOP in patients with and without PXF syndrome.

Design: This was a retrospective comparative study.

Patients And Methods: Data from 412 eyes of 206 patients diagnosed with unilateral neovascular age-related macular degeneration, treated with IVR or IVB, and followed-up for at least 6 months, were retrospectively reviewed. Seventy treated and 70 untreated fellow eyes of 70 patients with bilateral PXF syndrome, and 136 treated and 136 untreated fellow eyes of 136 patients without PXF syndrome were included in this study. Demographic information, clinical findings, total number of IVR and IVB injections, and IOP values at each visit were recorded. Sustained elevation of IOP (SE-IOP) was defined as either an IOP >21 mm Hg or a ≥5 mm Hg increase in IOP from baseline for at least 2 consecutive visits. Baseline and final IOP values in each group were compared using the paired sample t test, and IOP changes in the groups were compared using split-plot analysis of variance. Multivariate logistic regression analysis was used to evaluate the influence of variables on the development of SE-IOP.

Results: The mean (±SD) age of the patients was 77.53±3.78 years (range, 70 to 83 y), and the mean follow-up was 28.50±16.51 months (range, 6 to 58 mo). The mean number of injections was 15.56±8.01 (range, 5 to 36). The mean baseline and final IOP in treated eyes were 14.82±3.08 and 16.50±3.11 mm Hg, respectively (P<0.001). A higher incidence of SE-IOP and higher final IOP values were observed in PXF-positive eyes receiving IVB compared with the other groups. Seven of the patients required antiglaucomatous treatment. Multivariate logistic regression analysis revealed an increased odds ratio (4.90; P=0.016) of SE-IOP in PXF-positive eyes compared with PXF-negative eyes.

Conclusion: IVB therapy may cause greater increases in IOP in patients with PXF syndrome. The co-accumulation of PXF material and bevacizumab particles on the trabecular meshwork should be further investigated.
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http://dx.doi.org/10.1097/IJG.0000000000001600DOI Listing
October 2020

VISUAL OUTCOME OF EARLY VITRECTOMY AND INTRAVITREAL ANTIBIOTICS IN ACUTE POSTSURGICAL AND POSTINTRAVITREAL INJECTION ENDOPHTHALMITIS: European Vitreo-Retinal Society Endophthalmitis Study Report Two.

Retina 2021 Feb;41(2):423-430

Jones Eye Institute, University of Arkansas for Medical Sciences, Arkansas.

Purpose: To evaluate the visual outcome associated with intravitreal antibiotics (IVA) and pars plana vitrectomy (PPV) for acute postprocedure endophthalmitis.

Methods: Data from 237 eyes presenting with acute postprocedure endophthalmitis were collected from 57 retina specialists in 28 countries. All eyes were treated with IVA on the day of presentation. We classified eyes according to the method of treatment used as IVA and early PPV (IVA + PPV within 1 week of presentation) groups.

Results: After exclusion of ineligible eyes, data from 204 eyes were analyzed. The mean (SD) age of patients was 62.7 (21.8) years and 69.3 (12.7) years in the IVA and PPV groups, respectively (P = 0.18). Endophthalmitis secondary to cataract, intravitreal injections, PPV, and other intraocular procedures represented 64.2%, 16.2%, 13.7%, and 5.9% of cases, respectively. Intravitreal antibiotics alone were administered in 55 eyes (27.0%), and early PPV was performed in 149 eyes (73.0%). No difference was found between groups in the final visual acuity of ≥20/60 (43.6%, 65 eyes vs. 34.5%, 19 eyes) and ≤counting fingers (30.9%, 46 eyes vs. 36.4%, 20 eyes) for IVA versus early PPV groups, respectively. Vision of light perception (odds ratio = 12.2; 95% confidence interval: 2.0-72.6) and retinal detachment (odds ratio = 7.7; 95% confidence interval: 1.5-409) at baseline were predictive of vision of ≤counting fingers. Retinal detachment at baseline (odds ratio = 20.4; 95% confidence interval: 1.1-372.1) was predictive of final retinal detachment status.

Conclusion: The current retrospective multicenter cohort of eyes with acute postprocedure endophthalmitis reports similar outcomes after treatment with IVA alone when compared with IVA and early PPV within 1 week of presentation.
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http://dx.doi.org/10.1097/IAE.0000000000002856DOI Listing
February 2021

Management of vitreous floaters: an international survey the European VitreoRetinal Society Floaters study report.

Eye (Lond) 2020 05 20;34(5):825-834. Epub 2020 Apr 20.

Department of Public Health, Gazi University School of Medicine, 06500, Ankara, Turkey.

Background/objectives: To evaluate the efficacy and safety of pars plana vitrectomy for symptomatic floaters.

Subjects/methods: Forty-eight vitreoretinal surgeons from 16 countries provided information on 581 eyes who underwent vitrectomy for floaters in this retrospective survey study conducted by European VitreoRetinal Society. Percentage symptomatic improvement, incidence of retinal tears/detachment and post-vitrectomy cataract surgery, and the factors associated with satisfaction and complications were investigated.

Results: Ninety-two percent were satisfied with the results, with 86.3% reporting complete resolution of daily-life symptoms. Overall satisfaction was lower in patients with smaller vitreous opacities at presentation (OR:0.4). Iatrogenic retinal breaks occurred in 29 eyes (5%). Core vitrectomy and cut rates of 1500-4000 or >4000 cuts/min were associated with lower risk of retinal breaks than complete vitrectomy (OR:0.05) and cut rates < 1500 cuts/min (OR: 0.03, 0.12, respectively). Fourteen eyes (2.4%) developed retinal detachment at a median of 3 months; and 84 (48.6%) developed cataract at a median of 16 months post-vitrectomy.

Conclusions: Pars plana vitrectomy resulted in high patient satisfaction with relatively low rate of severe complications in a large group of patients. The procedure may be safer when core vitrectomy and cut rates > 1500 cuts/min are favoured. Proper patient selection and informed consent are the most important aspects of surgery.
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http://dx.doi.org/10.1038/s41433-020-0825-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182575PMC
May 2020

Rhegmatogenous retinal detachment secondary to isolated retinal metastasis from small cell lung carcinoma: An uncommon complication.

Eur J Ophthalmol 2020 Jan 21:1120672120902022. Epub 2020 Jan 21.

Department of Ophthalmology, Gazi University School of Medicine, Ankara, Turkey.

Purpose: To report a case of rhegmatogenous retinal detachment associated with isolated retinal metastasis from lung carcinoma.

Methods: Multimodal imaging, including wide-field retinal imaging, ultrasonic imaging, and magnetic resonance imaging.

Results: Systemic chemotherapy and cranial prophylactic radiotherapy resulted in shrinkage of these lesions and retinal breaks making them much smaller and preventing progression of retinal detachment transiently.

Conclusion: This is the first reported case of rhegmatogenous retinal detachment secondary to retinal metastasis from a lung cancer.
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http://dx.doi.org/10.1177/1120672120902022DOI Listing
January 2020

Effectiveness of Intravitreal Dexamethasone Implant Treatment for Diabetic Macular Edema in Vitrectomized Eyes

Turk J Ophthalmol 2019 12;49(6):323-327

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

Objectives: To report the effectiveness and long-term outcomes of intravitreal dexamethasone implantation for diabetic macular edema (DME) in vitrectomized eyes.

Materials And Methods: Medical records of patients were retrospectively reviewed. Time of pars plana vitrectomy (PPV), PPV indications, interval between DEX injection and PPV, other intravitreal treatment prior to DEX application, best corrected visual acuity (BCVA), intraocular pressure (IOP), and central retinal thickness (CRT) measured by optical coherence tomography were recorded.

Results: Seventeen eyes of 17 patients were included in the study. The mean follow-up after DEX injection was 21±2.4 months (12-43 months). The female/male ratio was 11/6. Mean age was 60.7 years (46-70 years). Sixteen eyes (94.1%) were pseudophakic at the time of DEX treatment. The most common indication for PPV was tractional retinal detachment (8 eyes, 47.1%). Ten eyes (58.8%) received a single injection and a total of 30 DEX implantations were performed. Mean BCVA was 0.77 logarithm of the minimum angle of resolution (logMAR) units before the first injection and improved to 0.64, 0.68 and 0.66 logMAR after 1, 3 and 6 months, respectively (p<0.01). CRT decreased significantly from 452 µm at baseline to 310, 368±34 and 375 µm after 1, 3 and 6 months, respectively (p<0.04). Mean IOP was 16±1.2 mmHg at baseline and 18.2, 18.8 and 18.5 mmHg after 1, 3, and 6 months (p>0.05). Two eyes (%8) received topical anti-glaucoma medication (IOP≥25 mmHg). Similar results were observed in eyes receiving repeated DEX injections.

Conclusion: Intravitreal DEX injection treatment seems to be effective for improving BCVA and decreasing CRT in vitrectomized eyes with DME. This effect seemed to last for 6 months in most eyes, but maximized at 3 months. Patients with repeated injections often require injection before 6 months.
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http://dx.doi.org/10.4274/tjo.galenos.2019.95226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961074PMC
December 2019

Defining Cystoid Macular Degeneration in Diabetic Macular Edema: An OCT-Based Single-center Study

Turk J Ophthalmol 2019 12;49(6):315-322

Gazi University Faculty of Medicine, Department of Public Health, Ankara, Turkey

Objectives: To describe cystoid macular degeneration (CMD), which has no clear definition in diabetic macular edema (DME), and examine its features in optical coherence tomography (OCT) and fundus fluorescein angiography (FFA).

Materials And Methods: This study was conducted using OCT images of patients who were followed in Gazi University between November 2011 and March 2015. A total of 259 eyes (187 patients) found to have cystic changes on OCT were included. Macular ischemia, peripheral ischemia, and type of edema were identified on FFA. Vitreomacular interface abnormalities, foveal contour integrity, internal reflectivity of the cysts, and outer retinal layer defects were analyzed from OCT images. The horizontal and vertical diameters of the largest cyst within 1000 μm of the foveal center were measured for the definition of CMD. Cut-offs for these values were determined by receiver operating characteristic curve analysis. Cystoid macular edema (CME) and CMD groups were created and their characteristics were analyzed.

Results: The horizontal and vertical diameters of the largest cyst were moderately positively correlated with visual acuity (rs=0.349, r=0.419, respectively). Eyes with horizontal diameter of the largest cyst ≥450 μm were classified as CMD; in this group, sensitivity in the prediction of visual acuity ≤20/60 was 58%. Eyes with horizontal diameter of the largest cyst <450 μm were classified as CME; in this group, specificity in the prediction of visual acuity >20/60 was 73%. For the threshold of 300 μm determined for vertical diameter of the largest cyst, sensitivity was 62% and specificity was 69%. The CME and CMD groups were formed according to these cut-off values. Compared to the CME group, the CMD group had greater central subfield thickness and higher prevalence of outer retinal damage, severe disruption of foveal contour, macular ischemia, and diffuse/mixed type edema.

Conclusion: In eyes with DME, CMD can be defined as the largest cyst within 1000 μm of the foveal center having a horizontal diameter of ≥450 μm and vertical diameter ≥300 μm, especially if associated with macular ischemia, outer retinal damage, loss of foveal contour, and diffuse/mixed type edema.
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http://dx.doi.org/10.4274/tjo.galenos.2019.22687DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961082PMC
December 2019

Intravitreal Dexamethasone Implant in the Treatment of Non-infectious Uveitis

Turk J Ophthalmol 2019 Oct;49(5):250-257

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

Objectives: To evaluate the long-term results of intravitreal dexamethasone implant (DEX) for noninfectious uveitis.

Materials And Methods: The study included 62 eyes of 44 patients treated with DEX implant due to noninfectious uveitis and followed up for at least a year. Best-corrected visual acuity (BCVA), central foveal thickness, intraocular pressure (IOP), vitreous haze score, indications, immunomodulatory therapy and steroid usage before/after injection, number of injections, and adverse events were analyzed retrospectively.

Results: Average follow-up was 20 months (range 12-64 months). The female/male ratio was 29/15. Mean age was 50 years (range 22-75 years). The most frequent uveitis etiologies were idiopathic (25 patients, 40.3%) and Behçet’s uveitis. (17 patients, 27.4%) The most common indication for DEX injection was cystoid macular edema together with resistant vitreous haze (26 eyes, 41.9%). Twenty-two eyes (30%) received more than one DEX injection. Mean BCVA was improved from 0.55 logMAR at baseline to 0.38, 0.32, and 0.35 after 1, 3, and 6 months, respectively (p<0.001 for each). Mean CFT was decreased from 386 μm at baseline to 288, 311, and 302 μm after 1, 3, and 6 months, respectively (p<0.001 for each). Mean IOP did not change significantly during follow-up. Five eyes (8%) received topical anti-glaucoma medication (IOP ≥25 mmHg). Eighteen (46%) of 39 phakic eyes underwent cataract surgery during follow-up. Similar efficacy of the DEX implant was observed in eyes that received multiple injections. Systemic immunomodulatory therapy did not change significantly during follow-up.

Conclusion: Intravitreal DEX injection does not alter systemic immunomodulatory therapy, but may facilitate the management of noninfectious uveitis by suppressing local intraocular inflammation. Multiple injections yielded comparable visual and anatomical outcomes to single injections. Follow-up for ocular hypertension and cataract formation are important, especially in eyes receiving multiple injections.
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http://dx.doi.org/10.4274/tjo.galenos.2019.81594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823586PMC
October 2019

Effects of Congenital Ocular Toxoplasmosis on Peripheral Retinal Vascular Development in Premature Infants at Low Risk for Retinopathy of Prematurity

Turk J Ophthalmol 2019 09;49(4):230-234

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

Congenital toxoplasmosis and retinopathy of prematurity (ROP) are two devastating clinical entities of the newborn. There is little information in the literature about the interaction between congenital infections and retinal vascular development at the fetal stage, and none regarding the relationship between ROP and congenital toxoplasmosis. In this report, we present two premature newborns diagnosed with congenital toxoplasmosis with ocular involvement, accompanied by ROP with interrupted retinal vascularization, peripheral avascular regions, and retinal detachment. The aim of this paper is to emphasize the possibility of ROP and congenital toxoplasmosis coexistence wherein one condition may mask the other and make it difficult to distinguish the cause of retinal detachment. Timely management with medical and surgical treatment of congenital toxoplasmosis and ROP could save eyes and vision in those cases.
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http://dx.doi.org/10.4274/tjo.galenos.2019.74484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761382PMC
September 2019

Pneumatic Vitreolysis for the Treatment of Vitreomacular Traction Syndrome

Turk J Ophthalmol 2019 09;49(4):201-208

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

Objectives: To evaluate the posterior vitreous release rates after a single injection of expansile gas in patients with vitreomacular traction (VMT) syndrome with or without associated full-thickness macular hole (FTMH).

Materials And Methods: Thirteen eyes of 12 consecutive patients with VMT (11 eyes) or VMT+FTMH (2 eyes) were reviewed retrospectively. Intravitreal injection of 0.3 mL of pure sulfur hexafluoride (SF6) (9 eyes) or perfluoropropane (C3F8) (4 eyes) was performed. Bobbing the head forward and backward similar to ‘drinking bird’ head movements was instructed until VMT release. Full ophthalmic examination and optical coherence tomography was performed at each visit.

Results: VMT was released in all patients (100%) and mean release time was 5.2 days (1-19 days). Macular hole closure was not achieved in either of the two eyes with FTMH. Mean central subfield thickness decreased significantly from 361 μm to 263 μm (p=0.007). The mean pretreatment visual acuity was 0.44 LogMAR, which significantly improved to 0.25 LogMAR at the last visit (p=0.003). One of 13 eyes had retinal tear after the procedure which was successfully treated with laser retinopexy. Gas migration to the anterior chamber occurred in one patient. No other complications were observed.

Conclusion: Pneumatic vitreolysis with C3F8 and SF6 gases is a relatively safe, low-cost, and minimally invasive treatment modality for VMT. However, FTMH closure could not be achieved with pneumatic vitreolysis.
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http://dx.doi.org/10.4274/tjo.galenos.2019.00400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761384PMC
September 2019

The Relationship Between Macular Cyst Formation and Ischemia in Diabetic Macular Edema

Turk J Ophthalmol 2019 09;49(4):194-200

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

Objectives: To evaluate the relationship between cyst characteristics and macular and peripheral ischemia in diabetic macular edema (DME).

Materials And Methods: We retrospectively reviewed eyes with DME and included those with clinically significant macular edema as defined by ETDRS (Early Treatment Diabetic Retinopathy Study) and cystoid spaces in optical coherence tomography scans in this study. Central subfield thickness (CSFT), horizontal and vertical diameters of the largest cyst, cyst area, and the remaining retinal thickness outside the cyst were determined. The presence and number of hyperreflective foci in the cyst wall and the internal reflectivity of the cyst were analyzed. Outer retinal damage was graded. Fluorescein angiography was used to determine the areas of macular and peripheral ischemia, which were graded as mild or severe. Correlations between macular and peripheral ischemia and cyst-related measurements and structural changes in the retina were evaluated.

Results: This retrospective study included 250 eyes of 186 patients with DME. Mean CSFT was significantly greater in eyes with macular ischemia (510.4±144.7 μm) compared to eyes without macular ischemia (452.1±114.6 μm) (p=0.001). Horizontal and vertical diameter of the largest cyst increased with the presence and severity of macular ischemia (p=0.045 and p=0.016, respectively). Remaining retinal thickness increased with the presence and severity of peripheral ischemia (p=0.009). There was a statistically significant relationship between the number of the hyperreflective foci in the cyst wall and internal reflectivity of the cyst (p=0.007). Patients with greater CSFT had a 1.04-times higher odds of having macular ischemia and 0.25-times higher odds of having outer retinal damage.

Conclusion: The likelihood of macular ischemia increases with larger cyst diameter, CSFT, and extent of outer retinal damage. Thickness of the noncystic area is increased in the presence of peripheral ischemia.
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http://dx.doi.org/10.4274/tjo.galenos.2018.19616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761383PMC
September 2019

Turkish Neonatal and Turkish Ophthalmology Societies consensus guideline on the retinopathy of prematurity.

Turk Pediatri Ars 2018 25;53(Suppl 1):S151-S160. Epub 2018 Dec 25.

Department of Ophthalmology, Osmangazi University, Faculty of Medicine, Eskişehir, Turkey.

Retinopathy of prematurity is a pathophysiological condition that occurs in relation to abnormal proliferation in the retinal vessels in premature babies. Its exact pathogenesis is not known. In Turkey, the increased chance of survival in premature babies with much younger gestational age and much lower birth weight in parallel with the developments in neonatal care causes retinopathy of prematurity, which has led to vision problems and blindness to emerge as a more frequent problem. Early diagnosis and timely and appropriate treatment of retinopathy of prematurity contributes to the developmental process and increases the quality of life by preventing vision loss. It should be kept in mind that retinopathy of prematurity may also lead to serious medicolegal problems.
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http://dx.doi.org/10.5152/TurkPediatriArs.2018.01815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6568303PMC
December 2018

Results of surgery for late sequelae of cicatricial retinopathy of prematurity.

Indian J Ophthalmol 2019 06;67(6):908-911

Department of Ophthalmology, Gazi University, School of Medicine, Ankara, Turkey.

Purpose: To report anatomical and functional results of vitreoretinal surgery in our case series of late cicatricial retinopathy of prematurity (ROP) patients with subtotal retinal detachment.

Methods: This is a retrospective, consecutive case series. Eleven eyes of 10 patients presented with partial tractional retinal detachment secondary to late cicatricial ROP (cicatricial stage 4B) who underwent vitreoretinal surgery were retrospectively reviewed. Anatomical and functional outcomes were evaluated.

Results: The mean gestational age at birth was 28.6 (26-32) weeks. The mean age at surgery was 79 (4-213) months. Patients were followed up for 21.7 (6-40) months. Six eyes (55%) had lens-sparing vitrectomy and five eyes (45%) had lensectomy + vitrectomy. Anatomical success was achieved in 10 eyes (91%). Improvement in visual acuity was noted in nine eyes (82%).

Conclusion: Eye grows but fibrotic tissue does not grow with age, and during this period retinal traction may get worse. Relieving these tractions may lead to good anatomical and visual outcomes in selected late cicatricial ROP cases.
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http://dx.doi.org/10.4103/ijo.IJO_1083_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552626PMC
June 2019

International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis: European Vitreo-Retinal Society Endophthalmitis Study Report 1.

Ophthalmol Retina 2019 06 21;3(6):461-467. Epub 2019 Mar 21.

Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address:

Purpose: To study the practice patterns for the management of acute postoperative and postinjection endophthalmitis.

Design: Retrospective, interventional, nonrandomized, multicenter study.

Participants: Data on 237 eyes diagnosed with acute endophthalmitis occurring after intraocular surgery or procedures provided by 57 retina specialists from 28 countries.

Main Outcome Measures: Rates of pars plana vitrectomy (PPV), repeat intravitreal injection, and adjunctive therapeutic regimens (local and systemic antibiotics and steroids).

Results: Of 237 analyzed eyes, acute endophthalmitis secondary to cataract surgery or secondary lens implantation represented 64.6% of cases (153 eyes), whereas the remaining were secondary to intravitreal injections (35 eyes [14.8%]), PPV (29 eyes [12.2%]), and other intraocular surgeries (20 eyes [8.4%]). All eyes received intravitreal antibiotics on the same day of diagnosis. Overall, early PPV was used within the first week of presentation in 176 eyes (74.3%). There was no statistical difference in the proportion of eyes requiring a second intravitreal injection of antibiotics whether the eye was managed primarily with intravitreal antibiotics alone versus early PPV plus intravitreal antibiotics (29.5% [18 eyes] vs. 25.0% [44 eyes], respectively). Adjunctive therapies in the form of intravitreal steroids, systemic steroids, and systemic antibiotics were used in 25.3%, 21.9%, and 66.6% of eyes, respectively. The absence of disc or macular view and absence of endophthalmitis after cataract surgery were associated with an increased likelihood for early PPV (odds ratios 4.1 and 5.1, respectively).

Conclusions: Pars plana vitrectomy was frequently performed regardless of the presenting vision in eyes with endophthalmitis after cataract surgery and intravitreal injections. Increased vitreous opacification was associated with a higher probability for performing PPV.
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http://dx.doi.org/10.1016/j.oret.2019.03.009DOI Listing
June 2019

Anterior elongation of the retina in persistent fetal vasculature: emphasis on retinal complications.

Eye (Lond) 2019 06 6;33(6):938-947. Epub 2019 Feb 6.

Gazi University School of Medicine, Ankara, 06500, Turkey.

Purpose: To identify the characteristics of peripheral retinal anomalies associated with persistent fetal vasculature (PFV) and evaluate the complications and outcomes.

Methods: Retrospective, noncomparative case series of patients with PFV who underwent surgery. Type of PFV, presence of peripheral retinal anomalies, extent of the retrolental membrane, complications, and functional and anatomical results were evaluated.

Results: Twenty-nine eyes of 28 patients were enrolled in the study: 14 eyes (48.3%) with anterior PFV, 10 eyes (34.5%) with posterior PFV, and 5 eyes (17.2%) with combined PFV. The retina was found to elongate anteriorly as finger-like projections beyond the ora serrata, incorporating into retrolental fibrovascular tissue in 81.8% of the anterior PFV cases. Cases with more extensive retrolental tissue had a higher risk of retinal complications (p = 0.009) and anterior segment complications (p = 0.026) than those with localized disease. Leaving the peripheral part of the fibrovascular tissue in place led to complications by later contraction. A total of 35.7% of the anterior PFV cases had 20/200 or better vision at the final follow-up versus 6.7% of the cases with posterior involvement. Retinal attachment was achieved in 12 eyes (80%) with posterior involvement. Four eyes (13.7%) resulted in total retinal detachment at final follow-up.

Conclusions: The high incidence of peripheral retinal anomalies that are found in anterior PFV patients and their relation to retinal complications warrant careful examination of the ora serrata-ciliary body area. Limbal approach may be preferred as a safer method in cases with an extensive fibrovascular membrane obscuring the view. Leaving the peripheral part of the fibrovascular tissue may result in severe postoperative complications, which should be avoided.
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http://dx.doi.org/10.1038/s41433-019-0345-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707181PMC
June 2019

Parameters affecting postoperative success of surgery for stage 4A/4B ROP.

Br J Ophthalmol 2019 11 18;103(11):1624-1632. Epub 2019 Jan 18.

Gazi University School of Medicine, Ankara, Turkey.

Purpose: To describe the long-term anatomical and functional results of surgery for retinal detachment (RD) associated with stage 4 retinopathy of prematurity (ROP) and patient and surgery-related factors affecting postoperative success.

Design: Retrospective case series at a single tertiary referral paediatric vitreoretinal practice.

Methods: One hundred and twenty-one eyes of 82 infants (40 female/42 male) who underwent lens-sparing vitrectomy (LSV) or lensectomy with vitrectomy surgery for stage 4A and 4B ROP at Gazi University Department of Ophthalmology between 2011 and 2016 were enrolled in this study. Patient characteristics including gestational age, birth weight, gender, stage of ROP at presentation, preoperative treatment (laser, anti-vascular endothelial growth factor (VEGF) or combined), anatomical and functional outcome and complications were recorded. The effect of birth weight, gestational age, presence of plus disease, preoperative treatment status, surgically induced posterior hyaloid detachment, postoperative vitreous haemorrhage and iatrogenic retinal tear formation on anatomical and functional results was evaluated.

Results: 61.2% of the eyes were stage 4A and 38.8% were stage 4B ROP. The mean follow-up was 24.5 months. 18.2% of the eyes had no preoperative treatment. Anatomical success was 86.5% for stage 4A and 68.1% for stage 4B at the first year, 91.7% for stage 4A and 69.4% for stage 4B at the second year, and 95.8% for stage 4A and 57.9% for stage 4B at the third year. Functional success was 85.1% for stage 4A and 65.9% for stage 4B at the first year, 89.6% for stage 4A and 61.1% for stage 4B at the second year, and 87.5% for stage 4A and 57.8% for stage 4B at the third year. The mean visual acuity was 1.12±0.34 logarithm of the minimum angle of resolution (logMAR) for stage 4A and 1.34±0.32 logMAR at the 3-year follow-up duration (p>0.05). There was preoperative plus disease in 59.5% of the eyes. Subsequent retinal surgeries were required in 17.4% of the eyes. Presence of plus disease and absence of preoperative treatment, iatrogenic retinal tear formation and postoperative vitreous haemorrhage were found to have significant negative effects, while surgical induction of posterior hyaloid detachment and sparing the lens intraoperatively affected the anatomical and functional results positively.

Conclusions: Surgery for stage 4 ROP-associated RD resulted in encouraging anatomical and functional outcomes and the results are even better in eyes with preoperative (laser/anti-VEGF) treatment, LSV and surgically induced posterior hyaloid detachment.
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http://dx.doi.org/10.1136/bjophthalmol-2018-312922DOI Listing
November 2019

Single-Nucleotide Polymorphisms in IL23R-IL12RB2 (rs1495965) Are Highly Prevalent in Patients with Behcet's Uveitis and Vary Between Populations.

Ocul Immunol Inflamm 2019 24;27(5):766-773. Epub 2018 May 24.

b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.

: To test the frequency of single-nucleotide polymorphisms in the genes in patients with Behcet's uveitis. : Blood samples were collected from 89 Israeli and Turkish patients, and from healthy control subjects of different origins. Genomic DNA was extracted from peripheral blood leukocytes and genotyped. : The risk allele, A, in rs1800871, of gene was highly prevalent in Behcet's uveitis and healthy control samples alike; highest among the Turkish groups. Prevalence of G allele, in rs1495965, in the gene was high in Behcet's uveitis patients, and among healthy Turkish and Israelis of Middle Eastern origin, while lower among the other Israeli control group (77.9%, 78.9%, 27.8%, respectively, < 0.001). : Our findings highlight the differences between populations and may account for the increased prevalence of the disease among Turkish and Israelis of Middle Eastern origin. Further studies are required to map other healthy and affected populations.
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http://dx.doi.org/10.1080/09273948.2018.1467463DOI Listing
January 2020

Intravitreal dexamethasone implant as an option for anti-inflammatory therapy of tuberculosis uveitis.

Int Ophthalmol 2019 Feb 29;39(2):485-490. Epub 2018 Jan 29.

Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey.

Introduction: Tuberculosis-associated uveitis remains a diagnostic and therapeutic challenge. After diagnosis of tuberculosis and initiation of anti-tuberculosis therapy for tuberculosis uveitis, the clinical responses are favorable. However, at 4-6 weeks of the therapy, there commonly occurs paradoxical deterioration due to an increase in inflammation which is often accompanied by cystoid macular edema. Thus, adjuvant administration of anti-inflammatory regimen should be considered. For this purpose, systemic and periocular steroids, systemic and intravitreal immunosuppressive agents have been tested. Nevertheless, there is no report in the literature about intravitreal dexamethasone slow-release implants for the treatment of this inflammatory condition.

Methods: Case presentation.

Results: We presented a tuberculosis uveitis case whose ocular inflammation is partially modified by systemic and periocular steroid injections and then well controlled by the intravitreal dexamethasone implant.

Conclusion: Intravitreal dexamethasone implant injection seems to be a safe and potent option for the treatment of macular edema secondary to tuberculosis uveitis.
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http://dx.doi.org/10.1007/s10792-018-0831-4DOI Listing
February 2019

RECURRENT OPENING AND CLOSURE OF MACULAR HOLE AFTER PARS PLANA VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT.

Retin Cases Brief Rep 2020 ;14(4):331-333

Gazi University, School of Medicine, Besevler, Ankara, Turkey.

Purpose: To report a case of full-thickness macular hole formation and closure twice after pars plana vitrectomy for macula-off rhegmatogenous retinal detachment.

Methods: Case report.

Results: A 45-year-old woman with a macula-off rhegmatogenous retinal detachment underwent uncomplicated pars plana vitrectomy with silicone oil tamponade, which was removed 3 months postoperatively. A full-thickness macular hole developed spontaneously 18 months after silicone oil removal, concurrently with the formation of epiretinal membrane and perifoveal cystoid changes. The hole was noted to close spontaneously within 2 months with normal foveal contour formation and improved vision, but then reopened for the second time after 10 months. A second spontaneous closure was observed within 2 months.

Conclusion: Dynamic course of macular hole formation and resolution in a previously vitrectomized eye may justify a more conservative approach with observation for some time before surgical intervention is favored.
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http://dx.doi.org/10.1097/ICB.0000000000000699DOI Listing
January 2020

PARACENTRAL ACUTE MIDDLE MACULOPATHY IN PRIMARY CONGENITAL GLAUCOMA.

Retin Cases Brief Rep 2020 ;14(2):163-165

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

Purpose: To report a case of primary congenital glaucoma associated with paracentral acute middle maculopathy.

Methods: A case report.

Results: A 14-year-old girl with undiagnosed primary congenital glaucoma was referred for the evaluation of sudden vision loss a week after the initial symptoms. Visual acuity was counting fingers at 2 m in the right eye. Examination of her right eye revealed corneal stromal scar like Haab striae, splinter hemorrhage at the temporal border of the optic disk, perivenular hemorrhage, and fern-like white area at the macula. On optical coherence tomography of the right eye, hyperreflective plaques at the level of the inner nuclear layer/outer plexiform layer were present, corresponding to the opaque areas in fundoscopy. On optical coherence tomography angiography of the right eye, ischemic areas in deep capillary plexuses were present. These findings in optical coherence tomography angiography and optical coherence tomography were consistent with paracentral acute middle maculopathy.

Conclusion: This is the first case of primary congenital glaucoma associated with paracentral acute middle maculopathy in the literature, and primary congenital glaucoma might be a predisposing factor.
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http://dx.doi.org/10.1097/ICB.0000000000000652DOI Listing
February 2021

A Modified Perfluoro-n-octane-Assisted Autologous Internal Limiting Membrane Transplant for Failed Macular Hole Reintervention: A Case Series.

Ophthalmic Surg Lasers Imaging Retina 2017 05;48(5):416-420

The authors describe a modified perfluoro-n-octane (PFO)-assisted autologous internal limiting membrane (ILM) transplantation technique for macular hole (MH) reintervention and present results from a series of 11 patients. The authors harvested a free ILM flap and transplanted it into the MH under a PFO bubble. The time at which PFO is injected, the extent of coverage of PFO, and the sequence of fluid-air exchange (FAE) are crucial to overcome previously described technical difficulties of relieving the flap from forceps, stabilizing the flap into the MH, and prevention of flap dislodgement during FAE. A successful U-shaped closure was observed in 10 of 11 cases (90.9%). One case (9.1%) showed flat open closure. The postoperative visual gain was statistically significant (P = .01). [Ophthalmic Surg Lasers Imaging Retina. 2017;48:416-420.].
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http://dx.doi.org/10.3928/23258160-20170428-08DOI Listing
May 2017

Clinical Characteristics of Patients with Newly Diagnosed Diabetic Macular Edema in Turkey: A Real-Life Registry Study-TURK-DEM.

J Ophthalmol 2017 19;2017:3596817. Epub 2017 Feb 19.

Bayer Türk, Istanbul, Turkey.

To evaluate the clinical and diagnostic characteristics of patients with newly diagnosed diabetic macular edema (DME) in Turkey in a real-life setting. A total of 945 consecutive patients (mean (SD) age: 61.3 (9.9) years, 55.2% male) with newly diagnosed DME were included. Data on patient demographics, comorbidities, ocular history, ophthalmic examination findings including type of DME, central macular thickness (CMT) via time domain (TD) and spectral domain (SD) optical coherence tomography (OCT), and planned treatments were recorded. OCT (98.8%) and fundoscopy (92.9%) were the two most common diagnostic methods. Diffuse and focal DMEs were detected in 39.2% and 36.9% of cases, respectively. Laser photocoagulation (32.1%) and antivascular endothelial growth factors (anti-VEGF; 31.8%) were the most commonly planned treatments. The median CMT in the right eye was significantly greater in untreated than in treated patients [376.5 m (range: 160-840) versus 342 m (range: 146-999) ( = 0.002)] and in the left eye [370 m (range: 201-780) versus 329 m (range: 148-999) ( < 0.001)]. This study is the first large-scale real-life registry of DME patients in Turkey. SD-OCT and fundoscopy were the most common diagnostic methods. Laser photocoagulation and anti-VEGF therapy were the most common treatments.
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http://dx.doi.org/10.1155/2017/3596817DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337790PMC
February 2017

Pediatric Traumatic Retinal Detachments: Clinical Characteristics and Outcomes.

Ophthalmic Surg Lasers Imaging Retina 2017 02;48(2):143-150

Background And Objective: To compare clinical characteristics and surgical outcomes of retinal detachment (RD) after open globe injuries (OGIs) and closed globe injuries (CGIs).

Patients And Methods: One hundred ten eyes of 110 patients aged 17 years or younger who underwent primary RD repair after OGI and CGI between 2010 and 2013 were reviewed retrospectively.

Results: Cataract (59.8% vs. 21.7%; P = .002) and vitreous hemorrhage (54% vs. 13%; P < .001) were significantly higher in OGIs than CGIs. Anatomical success rates were 75.9% in OGI and 82.6% in CGI (P = .586). Final visual acuity of 20/200 or greater was obtained in 23% of OGIs and 47.8% of CGIs (P = .035). Advanced proliferative vitreoretinopathy was associated with poor anatomical and visual outcome in both OGIs and CGIs. In OGIs, macular detachment was associated with poor visual outcome, and in CGIs, vitrectomy and macular detachment were associated with poor visual outcome.

Conclusion: Visual outcomes were not compatible with anatomical success in both groups. Advanced PVR seems to be the most prominent factor that influences the anatomical and functional success rates in both OGI and CGI. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:143-150.].
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http://dx.doi.org/10.3928/23258160-20170130-08DOI Listing
February 2017