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Öğe Assessment of inflammation biomarkers in diabetic macular edema treated with intravitreal dexamethasone implant(Mary Ann Liebert, INC, 2021) Vural, Esra; Hazar, LeylaPurpose: To evaluate inflammation biomarkers in diabetic macular edema (DME) treated with intravitreal dexamethasone implant (Ozurdex(R)). Methods: This retrospective single-center study investigated 64 eyes of 64 patients with DME who were nonresponsive to prior antivascular endothelial growth factor and treated with intravitreal Ozurdex. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio were calculated. Visual acuity and optical coherence tomography markers, including hyper-reflective dots and subretinal fluid (SRF), were determined, and central retinal thickness was also evaluated monthly for 3 months. Results: The average age was 64.06 +/- 7.81 (48-84) years. The baseline NLR and MLR were significantly higher in patients with better visual outcomes (P = 0.029 and P = 0.048, respectively). Better anatomical outcomes were observed in the presence of SRF (P = 0.027). No significant differences were observed in the rates of the presence of SRF and hyper-reflective points about the better functional outcome (P > 0.05). Conclusions: SRF as an imaging biomarker, and NLR and MLR as blood biomarkers, stand out as markers of inflammation and were found to be associated with better response to Ozurdex implantation in DME.Öğe Autonomic dysfunction detection by an automatic pupillometer as a non?invasive test in patients recovered from COVID?19(Springer, 2021) Karahan, Mine; Demirtaş, Atılım Armağan; Hazar, Leyla; Erdem, Seyfettin; Ava, Sedat; Dursun, Mehmet Emin; Keklikçi, UğurPurpose To recognize dysfunctions in the autonomic nervous system (ANS) with changes in dynamic and static pupillary responses in patients who recovered from coronavirus disease-2019 (COVID-19) Methods One month after recovery from COVID-19, patients were subjected to eye examinations. Pupillary responses were measured using a pupillometry system. Dynamic pupil parameters (i.e., pupil contraction amplitude, pupil dilatation latency, pupil contraction latency, pupil dilatation duration, pupil dilatation velocity, pupil contraction duration, pupil contraction velocity, resting pupil diameter [PD]) and static pupil parameters (i.e., mesopic PD, scotopic PD, high photopic PD, and low photopic PD) were registered. Results Although high photopic and scotopic PDs were significantly higher in patients recovering from COVID-19 than in healthy controls (P = 0.04 and P = 0.002), no statistically significant difference was found in mesopic and low photopic PD (P = 0.19 and P = 0.41). Regarding dynamic pupillometry parameters, resting PD and pupil contraction velocity (P = 0.04 and P = 0.02, respectively) were significantly higher in patients recovering from COVID-19 than in healthy controls (P < 0.001 and P < 0.001, respectively), whereas pupil dilatation latency and pupil contraction duration were lower in these patients than in healthy controls (P = 0.01 and P = 0.008, respectively). No significant differences in pupil contraction amplitude, pupil dilatation duration, pupil contraction latency, and pupil dilatation velocity were found between the study groups (P = 0.93, P = 0.91, P = 0.42, and P = 0.48, respectively). Conclusion Pupil responses, which are controlled by the ANS, were impaired in patients recovering from COVID-19. Pupillometry shows promise as a non-invasive, easy-to-apply diagnostic technology for detecting autonomic dysfunction in patients recovering from COVID-19.Öğe Bilateral central retinal artery occlusion secondary to SARS-CoV-2 infection in the early and late periods: A case report(Georg Thieme Verlag KG, 2021) Karahan, Mine; Erdem, Seyfettin; Hazar, Leyla; Dursun, Mehmet Emin; Ava, Sedat; Emek, Hüseyin; Keklikçi, UğurThe causative agent of coronavirus disease (COVID-19) is a new virus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the coronavirus family. It was first detected in China in December 2019 and spread rapidly around the world. COVID-19 is highly contagious and mainly transmitted through contact with infected patients or droplets. The most common symptoms are fever, cough, weakness, muscle pain, and shortness of breath [1]. SARS-CoV-2 infects host cells through the renin angiotensin-converting enzyme 2 (ACE2) receptors. The ACE2 receptor is widely expressed in many organs, including the retina, and plays a role in the pathogenesis of systemic vascular diseases, which can lead to ocular symptoms such as diabetic and hypertensive retinopathy [2], [3]. SARS-COV-2 has been reported to be associated with neurological symptoms, including stroke, thromboembolism (e.g., pulmonary embolism), and myocardial infarction. Hypercoagulation associated with COVID-19 has been described as “sepsis-induced coagulopathy” and may predispose patients to the spectrum of thromboembolic events [4], [5], [6]. We present here the first case of bilateral central retinal artery occlusion (CRAO) that developed in the early and late stages secondary to the SARS-CoV-2 infection.Öğe A Case Report of a New Variant Associated with Vici Syndrome in aTurkish Infant; EPG5 Frameshift Variant(Brieflands, 2025) Ipek, Rojan; Cavdartepe, Busra Eser; Hazar, LeylaIntroduction: Vici syndrome is a congenital multisystem disorder characterized primarily by callosal agenesis, cataracts, cardiomyopathy, combined immunodeficiency, and oculocutaneous hypopigmentation, along with additional newly recognized findings. Autosomal recessive variants in the EPG5 gene, which encodes ectopic P-granules autophagy protein 5 (EPG5), a key regulator of autophagy, are known genetic causes of this syndrome. The aim of this case report is to present a novel disease-causing variant identified through EPG5 gene sequence analysis. Case Presentation: We report on a 2-month-old Turkish girl who presented with developmental delay, bilateral congenital cataracts, microcephaly, hypotonia, hypertrophic cardiomyopathy, hypopigmented skin lesions, and agenesis of the corpus callosum. Genetic analysis revealed a homozygous c.7504delC (p.G1n2502Argfs*4) frameshift variant in the EPG5 gene, which has not been previously documented. Conclusions: Adding a new variant to the literature is crucial, as it highlights the feasibility of reaching an accurate diagnosis through well-conducted physical examination findings in patients with early developmental delay. This case also raises awareness about such rare diseases. Moreover, recognizing new mutations is critical for understanding atypical findings, prognosis, treatment responses, and the genetic risks for other family members.Öğe Changes in the dry eye parameters, tear meniscus height and corneal epithelial thickness in long-term computer users over a short-term working week period: Cohort study(Ortadoğu Reklam Tanıtım Yayıncılık, 2022) Vural, Esra; Hazar, LeylaObjective: To investigate the changes in dry eye parameters, tear meniscus height and epithelial thickness over a shortterm period (working week) in long-term computer users. Material and Methods: There were 46 eyes of 23 patients with dry eye symptoms who used computers for at least 6 h per day were included in this study. The Schirmer's test scores, tear break-up time (TBUT), ocular surface disease index (OSDI) score, epithelial thickness and tear meniscus levels by spectral domain-optical coherence tomography were recorded. All measurements of the patients were repeated on Monday morning before starting work (first visit) and on Friday of the same week after work (second visit) without medication. Results: The mean TBUT values were 12.41±2.68 s, 9.69±2.39 s, the Schirmer's test values were 20±5.47 mm, 11.89±3.62 mm (p<0.001); the tear meniscus levels were 158.65±41.18 μm, 118.15±31.99 μm (p<0.001); the OSDI scores were 12.13±4.89, 18±5.50 (p<0.001); and the central corneal epithelium thicknesses were 33.5±5.81 μm, 33.19±6.10 μm (p=0.703) upon the first and second visit, respectively. There was no significant difference in central corneal epithelial thickness (CET) between the two visits (p=0.703). Conclusion: While changes in the OSDI score, the TBUT, the Schirmer's test score and the tear meniscus levels were observed in long-term computer users in the short-term working week period, there was no short-term effect on central CET.Öğe Comparison of Clear Corneal Incision Morphology Changes in Biaxial Microincision Cataract Surgery by Transverse and Torsional Phacoemulsification: Cohort Study(2022) Hazar, Leyla; Çelik, Ekrem; Yaşar, Mustafa; Gönen, TansuObjective: To compare the effects of transverse versus torsional phacoemulsification by using the biaxial microincision cata ract surgery technique on corneal structures and clear corneal incision (CCI) morphology. Material and Methods: We evaluated comparative case series of patients with moderate density nuclear cataracts who un derwent biaxial microincision transverse or torsional phacoemulsifica tion. Seventy patients have included in the study and they were divided into 2 groups: transverse and torsional. The main outcome measures included, corrected distance visual acuity, central corneal thickness, central corneal endothelial cell density, endothelial cell loss (ECL), and changes in the CCI morphology. Results: Each group comprised 35 (35 eyes) patients. Epithelial misalignment on the CCI morphology was highly significantly meaningful with the transverse group on the po stoperative first day (p<0.001). Descemet membrane detachment on the first day postoperatively was high in both groups, especially in the transverse group, but the difference was not statistically significant (p=0.073). In the postoperative 3rd month, the mean ECL was 23.6% in the transverse group, and 19.0% in the torsional group, and there was no statistically significant difference between groups (p=0.187). Con clusion: In biaxial microincision cataract surgery, the corneal damage caused by transverse phacoemulsification seems to be higher compared to the torsional mode.Öğe Comparison of intravitreal bevacizumab responses in different morphologies of macular edema due to branch retinal vein occlusion: Short-term results(2022) Vural, Esra; Hazar, Leyla; Sırakaya, EnderPurpose: The purpose of the study was to compare the results of intravitreal bevacizumab in patients with macular edema (ME) due to branch retinal vein occlusion (BRVO) according to different ME morphologies. Methods: In this retrospective study, 24, 13, and 22 patients with ME type due BRVO were included in the serous retinal detachment group, cystoid ME group, and diffuse ME group, respectively. The best-corrected visual acuity (BCVA) was evaluated with an ETDRS chart, and central macular thickness (CMT) was evaluated by spectral domain optical coherence tomography at the 1st, 2nd, and 3rd months. Results: The mean ages of the patients were 64.25±7.80, 64.84±7.96, and 61.81±6.67 years in the serous, cystoid, and diffuse groups, respectively (p=0.414). While no significant difference was observed in the serous group in terms of BCVA and CMT at the 1st month after injection compared with that in the cystoid group (p=0.201 and p=0.986), BCVA and CMT values at the 2nd and 3rd months were statistically different (p=0.021, p=0.003, p=0.015, and p=0.006, respectively). When the serous group and the diffuse group were compared, only a significant difference was found in CMT at the 2nd month (p=0.016). Conclusion: Intravitreal bevacizumab treatment was more effective in terms of anatomical and visual results in the serous group compared with that in the cystoid group; however, at the end of the 3rd month, it showed similar results with the diffuse group.Öğe Comparison of Intravitreal Dexamethasone Implant and Afl ibercept Therapy in Resistant Diabetic Macular Oedema Patients with an Infl ammatory Phenotype: Short Term Results(2021) Hazar, Leyla; Vural, Esra; Sırakaya, EnderPurpose: To compare the effectiveness of dexamethasone and afl ibercept therapy in diabetic macular oedema (DMO) patients with an infl ammatory phenotype and insuffi cient response to bevacizumab. Methods: Twenty-seven eyes of 27 patients who received a single dose of an intravitreal dexamethasone implant (group 1) and 32 eyes of 32 patients who received three doses of an intravitreal afl ibercept injection (group 2) were included in the study. All the patients had DMO, accompanied by serous retinal detachment (SRD) and hyperrefl ective dots (HRDs), with an insuffi cient response to three doses of bevacizumab. The effi cacy of the intravitreal dexamethasone implant and afl ibercept injection was assessed 1, 2 and 3 mo later by analysing changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: The mean age of the patients in group 1 and 2 was 62.22 ± 7.49 and 63.06 ± 8.20 years. Although there was no signifi cant difference in the BCVA between groups at the 1- and 3-mo follow-ups, there was a statistically signifi cant increase in the BCVA in group 1 at the 2-mo follow-up. There was a statistically signifi cant decrease in CMT at the 2- and 3-mo follow-ups in group 1 as compared to that in group 2. Conclusions: In patients with DMO accompanied by an infl ammatory phenotype and insuffi cient response to bevacizumab, dexamethasone implant was more effective in terms of both visual and anatomical results compared to afl ibercept in a 3-mo follow-up study In refractory cases, switching to appropriate treatment before photodegeneration occurs affects visual results.Öğe Evaluation of blood inflammatory parameters of infants with premature retinopathy treated with intravitreal anti vascular endothelial growth factor(Gazi Göz Vakfı, 2022) Ava, Sedat; Hazar, Leyla; Karahan, Mine; Erdem, Seyfettin; Dursun, Mehmet Emin; Keklikçi, UğurPurpose: This study compared the blood inflammatory parameters between early preterm infants with retinopathy of prematurity (ROP) who were treated with intravitreal anti-vascular endothelial growth factor (VEGF)) and those who did not need treatment. Materials and Methods: One hundred and six infants were included in the study. Early preterm infants with a gestational age (GA) ≤ 32 weeks and birth weight (BW) ≤ 1500 gm were included. These infants were divided into three groups: infants without ROP (group 1), infants with ROP who did not require treatment (group 2) and infants with ROP who were treated with intravitreal anti-VEGF (group 3). In the first week, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) of the groups were calculated and compared. Results: Of 106 infants, 38 (35.8%) were in group 1, 30 (28.3%) were in group 2 and 38 (35.8%) were in group 3. GA was 24.89 ± 1.48 weeks, and BW was significantly lower in group 3, 775.21 ± 175.11 gm. (p < 0.001). There was no significant difference between the groups in terms of NLR, MLR and PLR (p = 0.833, p = 0.918 and p = 0.082, respectively). Logistic regression analysis was performed; BW was a statistically significant independent risk factor (OR: 0,999 %CI: 0,992-0,999 p = 0.022) associated with ROP that required treatment. Conclusion: It was shown that systemic inflammation parameters, including NLR, MLR and PLR, are not a reliable marker in the diagnosis and prognosis of ROP.Öğe Evaluation of choroidal thickness in light-coloured eyes(Sage Publications Ltd, 2022) Vural, Esra; Hazar, Leyla; Caglayan, Mehtap; Celebi, Ali Riza CenkObjective: The aim of this study was to determine whether iris colour is related to the choroidal thickness of healthy individuals. Methods: Healthy participants were divided into two groups. Group 1 had light-coloured eyes (blue and green), and group 2 had dark-coloured eyes (brown). The main outcome measures were iris thickness, subfoveal choroidal thickness and nasal and temporal choroidal thicknesses 500 mu m away from the fovea. Results: Group 1 comprised 31 subjects with light-coloured eyes, and group 2 had 31 subjects with dark eyes. The mean ages of groups 1 and 2 were 26.7 +/- 7.5 years and 24.1 +/- 5.8 years, respectively (p = 0.14). The choroidal thicknesses of the subfoveal, nasal and temporal regions were 336.3 +/- 52.1 mu m, 321.9 +/- 43.6 mu m and 318.4 +/- 49.2 mu m, respectively, in group 1 and 396.5 +/- 76.9 mu m, 372 +/- 79.3 mu m and 379.6 +/- 82.4 mu m, respectively, in group 2. All the values in group 1 were statistically lower than those in group 2 (p = 0.001, p = 0.001 and p = 0.003, respectively). The iris thickness in group 1 (493.73 +/- 95.44 mu m) was thinner than in group 2 (524.61 +/- 69.74 mu m) but not statistically significant (p = 0.141). Conclusion: The results showed that a thinner choroid can be seen in disease-free light-coloured eyes. The iris colour should be considered among the factors affecting the choroidal thickness, such as age, sex, race and refractive error.Öğe Evaluation of choroidal thickness in patients who have recovered from COVID-19(Springer, 2022) Erdem, Seyfettin; Karahan, Mine; Ava, Sedat; Dursun, Mehmet Emin; Dursun, Birgul; Hazar, Leyla; Bozarslan Senol, BerivanPurpose We aimed to evaluate choroidal thickness (CT) in patients who have recovered from COVID-19 by using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods We included fifty-eight patients who have recovered from COVID-19 (group 1) and fifty healthy control subjects (group 2) in this prospective study. Best corrected visual acuity, anterior segment and posterior segment examinations of all subjects were performed. CT scan and measurements were taken with the EDI mode of the Spectral Domain OCT device. Results Of the 108 subjects included in this study, 57 were female and 51 were male. The mean age was similar in both groups (36.10 +/- 7.12 and 35.58 +/- 7.29, respectively, p = 0.276). Group 1 had the following characteristics: the mean time since diagnosis was 53.18 +/- 2.84; it had been 38.48 +/- 4.07 days since the PCR test was negative; and all subjects were outpatients. It was detected that the CT of the patients in group 1 decreased in all areas compared to group 2, and this decrease was significant in subfoveal, temporal and inferior areas (257.48 +/- 32.79, 273.62 +/- 45.04, p = 0.04; 232.96 +/- 41.79, 252.76 +/- 46.09, p = 0.02, and 245.22 +/- 44.58, 271.54 +/- 55.07, p = 0.01, respectively). In the retinal nerve fiber layer analysis for group 1, thickening was detected in all areas, although it was not statistically significant, except in the temporal area where it was (superotemporal, superonasal, nasal, inferonasal, inferotemporal, temporal, and global [p = 0 .08, p = 0.45, p = 0.73, p = 0.64, p = 0.74, p = 0.02, and p = 0.10, respectively]). Conclusion For individuals who had recovered from COVID-19, it was found that CT decreased in all areas in these patients. Therefore, this study in which we have demonstrated the decrease in the thickness of the choroidal tissue, a tissue with high blood flow, may contribute to the understanding of the systemic microvascular waste of this disease.Öğe Evaluation of parafoveal and peripapillary vascular densities using optical coherence tomography angiography in children with thalassemia major(SAGE Publications Ltd., 2023) Dursun, Mehmet Emin; Hazar, Leyla; Karahan, Mine; Erdem, Seyfettin; Ava, Sedat; Üzel, Veysiye Hülya; Dursun, Birgül; Keklikçi, UğurBackground: Thalassemia major (TM) is an inherited anaemia caused by faulty haemoglobin synthesis. Reducing serum iron levels using iron chelating agents is an important step in the treatment of TM, and the effects on the eye of both the disease and these agents can be determined by regular eye examination. Objectives: We evaluated macular and optic nerve vascular densities in children with TM and compared the results with healthy controls using optical coherence tomography angiography (OCTA). Design: This is a prospective study. Methods: A total of 30 children with TM and 30 healthy controls were included in the study. The area of the foveal avascular zone (FAZ) and the vascular densities (VD) of the optic nerve head (ONH), radial peripapillary capillary (RPC) and deep and superficial retinal vascular networks were measured using OCTA. Results: A statistically significant decrease in VD was observed in the whole image and the parafovea, superior hemi, superior and inferior parts of the superficial capillary plexus and in the whole image and the superior regions of the deep capillary plexus in the TM patient group compared with the control group (p < 0.05). A significant decrease in VD was also observed in the whole image and the inside disc, peripapillary, nasal, inferonasal and temporal regions of the ONH and in the whole image and the inside disc, peripapillary and inferonasal regions of the RPC network in patients with TM (p < 0.05). A significant positive correlation was observed between both serum ferritin levels and deferasirox dosage, on one hand, and both the superficial (p = 0.023 and p = 0.002, respectively) and deep FAZs (p = 0.015 and p = 0.045, respectively), on the other hand. A negative correlation was also found between the deferasirox dosage and the VDs of the superficial (p = 0.010) and deep (p = 0.001) foveal plexuses. Conclusion: Retinal VD and FAZ are affected in patients with TM. OCTA, which can noninvasively measure retinal VD in patients with TM, may be a useful tool for the early detection of retinal microvascular changes that may occur during the course of the disease.Öğe Evaluation of parafoveal vascular density using optical coherence tomography angiography in patients with central serous chorioretinopathy(Springer London Ltd, 2022) Dursun, Mehmet Emin; Erdem, Seyfettin; Karahan, Mine; Ava, Sedat; Hazar, Leyla; Dursun, Birgul; Keklikci, UgurUsing optical coherence tomography angiography (OCTA), we sought to evaluate parafoveal vascular density (VD) in patients with central serous chorioretinopathy (CSCR). Our study included 43 patients with a diagnosis of CSCR and 40 healthy controls. Ophthalmologic examination findings and OCTA measurements of the participants were retrospectively analysed. Of the 43 patients with CSCR, 31 were males (72%) and 12 were females (28%); the control group was 30 males (75%) and 10 females (25%) (p = 0.657). There were significant differences between affected eyes, unaffected eyes and healthy control eyes for all parameters in the superficial capillary plexus (SCP) VD and deep capillary plexus (DCP) VD (p < 0.05 for all values). It was also determined that the affected eyes had lower SCP-VD and DCP-VD than the unaffected eyes and that the unaffected eyes had lower SCP-VD and DCP-VD than the healthy control eyes (p < 0.05 for all values). While there were no significant differences in the deep foveal avascular zone (FAZ) area, the superficial FAZ area was larger in affected eyes than in both unaffected eyes and healthy control eyes (p < 0.05). In most areas, the SCP-VD and DCP-VD values were lower and the FAZ larger in the chronic group than in the acute group (p < 0.05). Retinal vascular changes were found in patients with both acute and chronic CSCR, and the fellow eyes of these patients were also affected. OCTA can therefore be considered an easily applicable, non-invasive screening option for evaluating the microvascular structure in these patients.Öğe Evaluation of peripapillary microcirculation in patients with acromegaly(KARE yayıncılık, 2021) Karahan, Mine; Demirtaş, Atılım Armağan; Hazar, Leyla; Ava, Sedat; Pekkolay, Zafer; Keklikçi, UğurObjectives: The aim of this study was to evaluate the radial peripapillary capillary (RPC) and the optic nerve head (ONH) perfusion of patients with acromegaly using optical coherence tomography angiography (OCTA). Methods: Twenty-four eyes of 24 acromegaly patients comprised the study group and 24 eyes of 24 healthy individuals were used as a control group. The ONH and RPC vascular density (VD) was measured for each patient using OCTA. The insulin-like growth factor 1 (IGF-1) levels were also recorded and compared. Results: The VD of the inferior nasal ONH and nasal RPC was significantly lower in the acromegaly group than in the control group (p=0.047 and p=0.001, respectively). There was a significant negative correlation between the VD of the superior nasal ONH and the IGF-1 level (r=-0.283, p=0.038). Conclusion: The ONH and RPC VD values measured using OCTA were segmentally different in the acromegaly group compared with those of the control group. This method of non-invasive quantitative analysis of retinal perfusion using OCTA may be useful for future studies involving patients with acromegaly.Öğe Evaluation of plasma inflammatory markers in patients with nonarteritic retinal artery occlusion(2023) Karahan, Mine; Ava, Sedat; Erdem, Seyfettin; Keklikçi, Uğur; Dursun, Mehmet Emin; Hazar, Leyla; Vural, EsraPurpose: To examine the clinical characteristics, comorbid status and laboratory parameters of patients followed up with a diagnosis of retinal artery occlusion (RAO) and to compare blood inflammation parameters with control subjects. Methods: The medical records of 49 patients who were followed up for RAO at Dicle University Medical Faculty between 2017 and 2020 were retrospectively analysed. The occlusion type was divided into two groups, central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). The demographic characteristics and clinical and laboratory tests of the groups were compared. The blood WBC, neutrophil, lymphocyte, monocyte and platelet counts of the patients were also recorded, and the neutrophil/lymphocyte, monocyte/lymphocyte and platelet/lymphocyte counts were calculated by simple division and compared with 41 age- and gender-matched controls. Results: There was no difference in age and gender between the CRAO and BRAO groups (p = 0.220 and p = 0.303 respectively). Heart disease was significantly more common in CRAO patients (p = 0.004), and hypertension was observed more often, although not significantly (p = 0.084). WBC, neutrophil and monocyte values were found to be significantly higher in those with RAO than in the controls (p = 0.005, p < 0.001, p = 0.035 respectively). The neutrophil-lymphocyte ratio (NLR) was found to be significantly higher in those with RAO (p = 0.007). Conclusion: RAO is associated with significant elevation in WBC and NLR. The association of CRAO with cardiovascular disease is prominent.Öğe Evaluation of Retinal Microvascular Perfusion Changes in Patients with Celiac Disease(Taylor & Francis Inc, 2022) Erdem, Seyfettin; Ucmak, Feyzullah; Karahan, Mine; Ava, Sedat; Dursun, Mehmet Emin; Dursun, Birgul; Hazar, LeylaPurpose We aimed to determine whether there are retinal microvascular changes in patients with celiac disease (CD). Methods A total of 30 patients with CD (group 1) and 30 healthy controls (group 2) were included in this study. AngioVue optical coherence tomography angiography (OCTA) device was used to evaluate the retinal microvascular structure. Results Some of the values of both optic nerve head (ONH) vessel density (VD) and radial peripapillary capillary VDs were found to be significantly lower in group 1 than in group 2. These 2 groups were similar except for one of the parameters of superficial capillary plexus VD (SCP-VD), whereas it was found that deep capillary plexus VD (DCP-VD) was lower in group 1 than in group 2 except for the foveal area. Conclusion It was determined that some VDs obtained from the ONH and DCP-VD obtained from most areas of the macular region were significantly lower.Öğe Evaluation of the effect of obstructive sleep apnea syndrome on retinal microvascularity by optical coherence tomography angiography(Elsevier, 2022) Ava, Sedat; Erdem, Seyfettin; Karahan, Mine; Dursun, Mehmet Emin; Hazar, Leyla; Şen, Hadice Selimoğlu; Keklikçi, UğurPurpose: Using optical coherence tomography angiography (OCTA), we sought to determine whether there are retinal microvascular changes in patients with obstructive sleep apnea syndrome (OSAS). Method: The study included 56 patients diagnosed with OSAS by polysomnography [21 patients with mild OSAS (group 1), 14 with moderate OSAS (group 2) and 21 with severe OSAS (group 3)], and 26 healthy individuals as a control group (group 4). The vascular densities of the superficial capillary plexus and deep capillary plexus of the retinal segmentations, together with the foveal avascular zone (FAZ) width, were measured for all participants, using OCTA.Result: Compared with the control group, vascular densitiy in whole image of superficial capillary plexus were found to be significantly lower in group 2. In addition, vascular densitiy in fovea region of superficial capillary plexus was significantly lower in group 1 than the control group. In deep capillary plexus, vascular densitiy of whole image, superior hemi and nasal regions were found to be significantly lower in group 2 and group 3 compared with the control group. Parafoveal region in group 3 had significantly lower vascular densities than the controls. A significantly larger FAZ was also found in group 1 and group 3 in the deep capillary plexus, compared with the controls. Conclusion: We detected smaller vascular densities in both the superficial capillary plexus and deep capillary plexus and a larger deep capillary plexus FAZ in OSAS patients. Therefore, OCTA may be useful as a non-invasive method to understand the systemic effects of OSAS.Öğe Examination of the effects of COVID 19 on corneal endothelium(Springer, 2021) Erdem, Seyfettin; Karahan, Mine; Ava, Sedat; Dursun, Mehmet Emin; Hazar, Leyla; Keklikçi, UğurPurpose To demonstrate the efects of the disease on the corneal endothelium in individuals recovering from COVID-19 through specular microscopy. Methods Eighty individuals recovering from COVID-19 (group 1) and 72 healthy controls (group 2) were included in this prospective study. After examining visual acuity, refractive defect detection, anterior and posterior segment examinations, and specular microscopy measurements were calculated from images with at least 100 cells. The mean cell density (CD), mean coefcient of variation (CV), mean hexagonal cell percentage, mean cell area (AVG), and central corneal thickness (CCT) were evaluated. Results The mean time from diagnosis of the disease in group 1 was 54.25±6.36 days. The mean time elapsed since the PCR test became negative was 38.45±6.87 days. Only four were treated in the hospital. Specular microscopy data showed that the CD was 2713.56±246.25 and 2845.80±299.27 in groups 1 and 2, respectively (p=0.003). The CV values were 42.92±6.79 and 40.16±5.97, respectively (p=0.009). The hexagonality were 46.51±7.35 and 49.12±6.87, respectively (p=0.024). The AVG was 371.60±34.64 and 353.16±35.29, respectively (p=0.007). The CCT values were 553.00±73.2, and 526.84±33.57, respectively (p=0.005). Conclusion A decrease in the number of endothelial cells and hexagonal cells (polymorphism) as well as an increase in the cell area change coefcient (polymegatism) and the average cell area were observed from corneal specular microscopic examination of individuals recovering from COVID-19 in the early period of the disease. These results may be important in understanding the systemic efects of the diseaseÖğe İntravitreal Bevacizumab ile Tedavi Edilen Prematüre RetinopatiliBebeklerde Risk Faktörlerinin Değerlendirilmesi(2021) Keklikçi, Uğur; Ava, Sedat; Hazar, Leyla; Karahan, Mine; Erdem, Seyfettin; Vural, Esra; Dursun, Mehmet EminAmaç: Prematüre retinopatisi (PR) olgularında retinopatinin şiddeti ile anne ve bebekteki risk faktörlerinin ilişkisini analiz etmekYöntemler: Haziran 2017- Ekim 2020 yılları arasında Dicle Üniversitesi Tıp Fakültesinde prematüre retinopatisi nedeniyle takip edilen bebeklerin verileri retrospektif olarak değerlendirildi. Prematüre bebeklerin, doğum yaşı, doğum ağırlığı, takip süresince eşlik eden komorbid hastalıklar, annenin gebelik problemleri kaydedildi. Tedavisiz takip edilenler (grup 1) ve intravitreal bevacizumab tedavisi uygulananlar (grup 2) karşılaştırıldı.Sonuçlar: Çalışmaya 167 prematüre bebek alındı. Prematüre bebeklerin 99’unda (%60) tedavi gerektirmeyen PR vardı (grup 1), 68’ine (%40) intravitreal bevacizumab (grup 2) uygulandı. Grup 2’nin gestasyonel yaşı ve doğum ağırlığı grup 1’den anlamlı olarak düşük iken (p<0.001 ve p<0.001) cinsiyet dağılımları açısından fark yoktu (p=0.387). İkizden ikize transfüzyon, Rh uyumsuzluğu, korioamnionit, erken membran rüptürü oranları iki grupta benzer bulundu (p>0.05). Grup 2’de Respiratuar Distress Sendromu (RDS) anlamlı olarak daha yaygın görüldü (p=0.010). Lojistik regresyon analizinde doğum ağırlığı anlamlı bağımsız risk faktörü olarak bulundu (p=0.048; %95 GA, 0.993-1.00). Tartışma: Tedavi gerektiren PR’ li bebeklerde düşük doğum ağırlığı bağımsız bir risk faktörüdür. Eşlik eden komorbid durumların etkisini daha iyi ortaya koymak için büyük ölçekli, çok merkezli çalışmalara ihtiyaç vardır.Öğe Is there a relationship between hematological inflammatory parameters and age-related macular degeneration?(SAGE Publications Ltd, 2021) Karahan, Mine; Hazar, Leyla; Erdem, Seyfettin; Ava, Sedat; Dursun, Mehmet Emin; Demirtaş, Atılım Armaǧan; Keklikçi, UğurPurpose: We aimed to analyze blood inflammation parameters in patients with age-related macular degeneration (AMD). Methods: In this retrospective study, patients were divided into three groups: wet-type AMD (n = 60), dry-type AMD (n = 60), and healthy controls (n = 71). The laboratory and demographic data of the patients were analyzed. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated manually. Results: The mean NLR was 2.26 ± 1.42 in the dry-type AMD group, 3.90 ± 1.65 in the wet-type AMD group, and 1.84 ± 0.61 in the control group (p < 0.001). The mean MLR was 0.30 ± 0.20 in the dry-type AMD group, 0.47 ± 0.31 in the wet-type AMD group, and 0.28 ± 0.14 in the control group (p < 0.001). The mean PLR was 129.31 ± 79.82 in the dry-type AMD group, 156.67 ± 83.99 in the wet-type AMD group, and 135.59 ± 58.68 in the control group (p = 0.101). Receiver operating characteristic (ROC) curve analyses revealed that the area under the curve (AUC) for NLR and MLR was 0.920 and 0.717, respectively, for wet-type AMD. The sensitivity and specificity of NLR for wet-type AMD were 64% and 93%, respectively, whereas MLR was 63% and 75%, respectively. Conclusion: Simple blood tests revealed that NLR and MLR were significantly higher in patients with wet-type AMD than in patients with dry-type AMD and healthy controls, which implies low-grade inflammation.
