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    Açık göz yaralanmalarında aile faktörünün önemi
    (2007) Dağ, Umut; Şakalar, Yıldırım B.; Ünlü, Kaan; Keklikçi, Uğur; Bozarslan, Berivan Şenol
    AMAÇ: Açık göz yaralanması nedeniyle kliniğimize başvuran çocuk hastaların epidemiyolojik özelliklerini, ebeveynlerinin eğitim düzeyini ve ailenin sosyoekonomik durumunu incelemek. YÖNTEM: Mart 2005 - Mart 2007 tarihleri arasında açık göz yaralanması şikayetiyle başvuran 0-15 yaş grubundaki 172 hasta çalışmaya dahil edildi. Olgular yaş, cins, yaralanmanın ne ile oluştuğu, yaralanmanın nedeni ve meydana geldiği sosyal çevre, ebeveynlerin eğitim düzeyi ve meslekleri, ailedeki çocuk sayısı, ailenin sosyoekonomik ve çevresel şartları yönünden prospektif olarak değerlendirildi. BULGULAR: Olguların 117'si (%68) erkek, 55'i (%32) kadındı. Ortalama yaş 7.8 ± 5.6 yıl (1-15 yaş) idi. Olguların118'inde (%68.6) anne, 52'sinde (%30.2) baba okur-yazar değildi. Göz yaralanmalarının en sık sokakta ve oyun esnasında (%53.5) meydana geldiği tespit edildi. Olguların %79.6'sında ailede kişi başı aylık gelir 150 Yeni Türk Lirası'dan (YTL.) daha azdı ve %65'inde aile beş veya daha fazla çocuğa sahipti. Olguların 102'si (%59.3) kırsal alanda yaşamaktaydı. TARTIŞMA: Anne-baba eğitim düzeyi ve ailenin sosyoekonomik durumu ile açık göz yaralanmaları arasında ciddi bir ilişki mevcuttur. Toplumun eğitim düzeyinin yükseltilmesi, bilinçli ebeveynlerin artması ve sosyoekonomik şartların düzeltilmesi ile bu tip yaralanmaların önemli ölçüde azalacağı kanaatine varıldı.
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    Akut Posterior Multifokal Plakoid Pigment Epitelyopatili Bir Olguda Optik Koherens Tomografi Bulguları
    (2010) Alakuş, Mehmet Fuat; Keklikçi, Uğur; Şakalar, Yıldırım Bayezit; Ünlü, Kaan
    Elli iki yaşında erkek hasta sağ gözde görme azlığı şikayeti ile başvurdu. Görme keskinliği sağ gözde 2 metreden parmak sayma ve sol gözde 20/20 idi. Fundus muayenesinde makülayı tutan sarı-beyaz renkli subretinal lezyonlar görüldü. Sol gözde akut posterior multifokal plakoid pigment epitelyopati ile uyumlu retina pigment epitel atrofi alanları mevcuttu. Sağ gözde floresein anjiografi ile erken dönemde hipofloresan lezyonlar ve geç dönemde boyanma belirlendi. Akut fazda optik koherens tomografi ile etkilenmiş alanlarda retina pigment epiteli düzeyinde düzensizlikler görüldü. Steroid tedavisi sonrası 1. ayda görme keskinliği sağ gözde 20/20 düzeyine ulaştı. Fundus muayenesinde lezyonların gerilediği görüldü ve optik koherens tomografide retina pigment epitelinde hafif bozulmalar ve dış reflektif bantta artmış reflektans görüldü
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    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, Uğur
    Purpose 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.
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    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, Uğur
    The 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.
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    Can dynamic and static pupillary responses be used as an indicator of autonomic dysfunction in patients with obstructive sleep apnea syndrome?
    (Springer, 2021) Erdem, Seyfettin; Yılmaz, Süreyya; Karahan, Mine; Dursun, Mehmet Emin; Ava, Sedat; Alakuş, Mehmet Fuat; Keklikçi, Uğur
    Purpose We aimed to reveal whether static and dynamic pupillary responses can be used for the detection of autonomic nervous system (ANS) dysfunction in patients with obstructive sleep apnea syndrome (OSAS). Methods We included in this study patients with OSAS, who were divided into three groups according to the apnea-hypopnea index (AHI) (group 1, mild [n = 20]; group 2, moderate [n = 20]; and group 3, severe [n = 20]), and healthy controls (group 4, n = 20). Pupillary responses were measured using a pupillometry system. Results Static (mesopic PD, P = 0.0019; low photopic PD, P = 0.001) and dynamic pupil responses (resting diameter, P = 0.004; amplitude of pupil contraction, P < 0.001; duration of pupil contraction, P = 0.022; velocity of pupil contraction, P = 0.001; and velocity of pupil dilation, P = 0.012) were affected in patients with different OSAS severities. Also, AHI was negatively correlated with mesopic PD (P = 0.008), low photopic PD (P = 0.003), resting diameter (P = 0.001), amplitude of pupil contraction (P < 0.001), duration of pupil contraction (P = 0.011), velocity of pupil contraction (P < 0.001), and velocity of pupil dilation (P = 0.001). Conclusion We detected pupil responses innervated by the ANS were affected in the OSAS patients. This effect was more significant in the severe OSAS patients. Therefore, the pupillometry system can be an easily applicable, noninvasive method to detect ANS dysfunction in the OSA patients.
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    A case report: Acute myopia and angle-closure glaucoma attack after topiramate use
    (Dicle Üniversitesi Tıp Fakültesi, 2019) Aslan, Adar; Keklikçi, Uğur; Bilgen, Kadir
    Topiramate acetate is a commonly used drug prescribed by neurologists and psychiatrists for the treatment of various diseases including migraine. Topiramate therapy can cause a forward displacement of the iris-lens diaphragm which can result in acute bilateral angle-closure glaucoma and myopia. Common complaints include visual disturbances and eye pain. In this case report, we offered a patient who had a sudden loss of vision and severe eye pain due to acute myopia and angle-closure glaucoma after the use of topiramate for migraine. This case report aimed to increase awareness among neurologists, psychiatrists and ophthalmologists about the side effects that may occur with the use of topiramate
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    Çocuk Korneal Travma Hastasında Rotasyonel Otokeratoplasti
    (2018) Han, Çağla Çilem; Keklikçi, Uğur; Çınar, Yasin
    Sağ gözüne tahta çarpması nedeniyle kliniğimize başvuran dokuz yaşında erkek hastada sağ gözde kornea saat 4’ten saat 9 yönündeki lim-busa uzanan yay şeklinde kornea merkezinden geçen delinme alanı izlendi. Görme keskinliği ışık hissi düzeyinde idi. Primer dikişle kornea ke-si alanı kapatıldı. Daha sonra travmatik katarakt gelişmesi üzerine fakoemülsifikasyon ve göz içi lensi yerleştirimi yapıldı. Kontrol muayene-lerinde kornea merkezini kapatan lökom alanı ve göz içi lensi yakalanması gelişmesi üzerine rotasyonel otokeratoplasti ameliyatı, ön vitrekto-mi ve göz içi lensi yerleştirimi ameliyatı yapıldı. Ameliyattan sonraki kontrollerinde görme ekseninin açık olduğu ve düzeltmeli görme keskin-liğinin Snellen eşeline göre 0.2 olduğu saptandı.Bu olgu sunumunda, çocuklar ambliyopi çağında olduğu için, merkez görmeyi bozarak kalıcı görme azlığına neden olabilecek kornea le-kelerinin rotasyonel otokeratoplasti ile çevreye taşınabileceği, bu sayede optik eksenin açılabileceği, aynı zamanda cerrahi sırasında otogreftkullanılmadığı için red ihtimalinin dışlanacağının belirtilmesi amaçlanmıştır.
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    Çocukluk çağı akut lenfoblastik lösemilerde oftalmolojik bulgular
    (Sağlık Elemanları Vakfı, 1996) Sak, Arif; Söker, Murat; Keklikçi, Uğur; Haspolat, Yusuf Kenan
    Dicle Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalına başvuran ve ALL tanısı olan 30 hastanın oftalmolojik bulguları incelendi. Vakalar yaş, cins, klinik ve hematolojik bulgularına göre prognoz açısından gruplandırıldı. İyi prognozlu gruptaki 14 (%46.6) hastanın 7 (%23.3) sinde ve kötü prognozlu 16 (%53.3) hastanın tümünde oftalmolojik bulgular saptandı.
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    Çok düşük frekanslı manyetik alanın ratlarda lens üzerine etkileri
    (Dicle Üniversitesi Tıp Fakültesi, 2008) Keklikçi, Uğur; Akpolat, Veysi; Özekinci, Selver; Ünlü, Kaan; Çelik, M. Salih; Tunik, Selçuk
    Bu çalışmanın amacı çok düşük frekanslı manyetik alanın (ELF MF) lens fibrilleri ve lens epitel hücreleri üzerine etkisini değerlendirmektir. Yirmi adet erişkin, dişi Spraque Dawley rat, her birisi 10 rattan oluşan 2 grupa ayrıldı. Deney grubu, günde 2 saat olmak üzere 7 gün ELF MF aldı. İkinci grup standart laboratuar şartlarına alınarak, kontrol grubu olarak kullanıldı. Materyaller lenste kataraktöz değişiklik ve lens epitel hücrelerinde histolojik değişiklikler yönünden değerlendirildi. Biomikroskopik muayenede lenste patoloji saptanmadı. Materyallerin mikroskopik incelemesinde, kontrol grubunda lens fibrilleri ve lens epitel hücrelerinde değişiklik saptanmadı. Deney grubunda ise yüzeyel epitel hücre konturlarında hafif pleomorfizm dışında patoloji saptanmadı. Çalışmada, ELF MF’nin lens fibrillerinde ve epitelinde belirgin bir histopatolojik değişikliğe yol açmayabileceği sonucuna varıldı.
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    Crystalline gene mutations in Turkish children with congenital cataracts
    (Springer, 2021) Karahan, Mine; Demirtaş, Atılım Armağan; Erdem, Seyfettin; Ava, Sedat; Tekeş, Selahattin; Keklikçi, Uğur
    Purpose To detect crystallin gene mutations in Turkish children with congenital cataracts. Methods The present study included 56 children (38 males and 18 females) who were diagnosed with congenital cataract in our ophthalmology clinic. The patients' blood samples were collected and sent to the medical genetics laboratory. The samples were assessed using the sequence analysis method, which covered all exons of CRYAA, CRYAB, CRYBB1, CRYBB2, CRYBB3, CRYGC and CRYGD. Results In total, 56 patients with congenital cataracts were included in the present study. Of these, 68% were male and 32% were female. The age range of the patients was 2 months to 5 years. The mean age of onset was 21.08 +/- 15.15 months. All the patients had bilateral congenital cataracts. The female-to-male ratio was 1:2.1. Mutation analysis was performed to detect possible mutations in CRYAA, CRYAB, CRYBB1, CRYBB2, CRYBB3, CRYGC and CRYGD. Of the four mutations detected, one was novel (c.383A > T in CRYGD) and three were known (c.592C > T in CRYBB2, c.164A > G in CRYGC and c.592C > T in CRYBB2). Two of these three mutations were detected in the same gene (CRYBB2). Crystallin gene mutations were detected in 7% of patients with congenital cataracts (four out of 56 patients) in the present study. Conclusions We think that mutations in crystallin genes are responsible for 7% of congenital cataract cases in our country. The detection of these mutations may help in the molecular diagnosis of congenital cataracts.
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    Effect of fasting on diurnal fluctuation of parafoveal and peripapillary vessel density and related oculodynamic and haemodynamic parameters
    (Elsevier, 2021) Demirtaş, Atılım Armağan; Karahan, Mine; Erdem, Seyfettin; Han, Çağla Çilem; Keklikçi, Uğur
    Purpose: To investigate the effects of Ramadan fasting on diurnal superficial-deep parafoveal vessel density (pfVD) and nerve head (NH)-radial peripapillary capillary (RPC) peripapillary vessel density (ppVD) using optical coherence tomography angiography (OCTA), as well as other related oculodynamic and haemodynamic parameters, and to compare these findings with those in the nonfasting period in healthy individuals. Methods: A total of 105 healthy individuals, 42 women and 63 men, were included in this prospective study. OCTA was used to examine the superficial-deep pfVD and NH-RPC ppVD. In the third week of Ramadan, OCTA readings were obtained twice daily at 08:00 and 16:00 hour (h) under fasting conditions and compared with nonfasting values 2 weeks after Ramadan. Both intraocular pressure (IOP) and blood pressure values were assessed accordingly. Results: The mean age (23-51) of individuals was 34.37 +/- 7.04 years. In comparison with the 08:00-h values, the 16:00-h IOPs, superficial-deep pfVDs and RPC ppVDs were substantially reduced both during the fasting and nonfasting periods (P = 0.001, P = 0.009, P = 0.006, P = 0.006, P = 0.004, P = 0.004, P = 0.41, P = 0.032 and P = 0.021). No differences were found in the diurnal change of superficial-deep pfVDs, NH-RPC ppVDs, IOPs and mean ocular perfusion pressures (MOPPs) between the fasting and nonfasting periods, whereas the same was not true for mean arterial blood pressures (MABPs) (P = 0.049). Conclusions: The parafoveal and peripapillary VDs (except for NHpp-VD) and IOPs were found to have decreased significantly throughout the day both in fasting and nonfasting periods. Our study confirms the diurnal changes in the IOPs, MOPPs, superficial-deep pfVDs and NH-RPC ppVDs under dehydration and normal terms.
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    Ektodermal displazili olgularda konjonktiva bası sitolojisi
    (2012) Meşe, Ayşe; Söker, Sevda; Nergiz, Yusuf; Akkuş, Murat; Keklikçi, Uğur
    Ektodermal displazi ektodermal kökenli doku ve organları etkileyen bir belirtiler grubudur. Bu çalışmada ektodermal displazili olgularda konjonktiva etkilenmesini araştırmak amacıyla girişimsel olmayan bir yöntem olan bası sitolojisi tekniği kullanılmıştır. Dicle Üniversitesi Tıp Fakültesi Göz Hastalıkları ve Protetik Diş Sağlığı ve Hastalıkları Bilim Dallarında takipte olan ektodermal displazili üç hastanın altı gözü çalışma kapsamına alındı. Üst bulber konjonktivaya uygulanan bası sitoloji yöntemi ile selüloz asetat kağıdı yüzeyine alınan hücre grupları (%70’lik etil alkol, %37’lik formaldehit ve glisiyal asetik asitin 20:1:1 oranındaki) sıvısında sabitlendikten sonra “periodik acid schiff” ve hematoksilen-eozin ile boyandı. Ektodermal displazili olgularda bası sitolojisi ile hücre bütünlüğünde azalma, çekirdekte yer yer piknotik değişimler, epitelyal hücre şeklinde değişimler ve goblet hücre kaybı gözlendi. Ektodermal displazili olgularda göz kuruluğu bulguları bası sitolojisi tekniği ile desteklendi. Bası sitolojisinin, ektodermal displazinin göz izleminde, girişimsel olmayan bir yöntem olarak kullanılabileceği sonucuna varıldı.
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    Elektrik çarpmasına bağlı olabileceği düşünülen retina dekolmanı olgusu
    (2010) Ünlü, Kaan; Keklikçi, Uğur; Alakuş, Mehmet Fuat; Bayezıt, Yıldırım
    Elli yedi yaşında bayan hasta elektrik çarpmasından bir gün sonra sol gözde görme kaybı şikayeti ile başvurdu. Sistemik muayenede herhangi bir patoloji yoktu. Göz muayenesinde, görme keskinliği sağ gözde 20/20 ve sol gözde el hareketleri idi. Sağ gözde periferik retinada, üst temporal bölgede iki retina deliği ve sığ retina dekolmanı saptandı. Sol gözde makülayı da içine alan subtotal retina dekolmanı ve üst temporal retinada iki adet retina deliği gözlendi. Sol göze skleral çökertme cerrahisi sonrası 1. ayda görme keskinliği 20/200’e yükseldi ve takipler boyunca değişmedi. Elektrik çarpması vitreoretinal yapışıklık bölgelerinde traksiyon sonucu retina deliklerine ve retina dekolmanına yol açabilir. Bu nedenle elektrik çarpması sonrasında göz komplikasyonları riski açısından dikkatli olunmalıdır.
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    Evaluation of anterior segment parameters with Pentacam in children with poorly-controlled type 1 Diabetes Mellitus without diabetic retinopathy
    (Elsevier, 2021) Karahan, Mine; Demirtaş, Atılım Armağan; Erdem, Seyfettin; Ava, Sedat; Dursun, Mehmet Emin; Beştaş, Aslı; Haspolat, Yusuf Kenan; Keklikçi, Uğur
    urpose: To determine the effect of abnormal glucose metabolism on the cornea, lens, anterior chamber volume (ACV), and anterior chamber depth (ACD) in children with poorly-controlled type 1 diabetes mellitus (DM) without diabetic retinopathy (DR). Methods: After the complete ophthalmologic examination of children with poorly-controlled (glycosylated hemoglobin [HbA1c] >7.0 %) type 1 DM without DR and age-matched healthy subjects (control group), the central corneal thickness (CCT), keratometry (K) values (Kmean front and back, and Kmax), radius (R) values (Rmin front and back), corneal volume (CV), ACD, ACV, pupil diameter, mean lens density (MLD), lens density standard deviation (LD SD), and maximum lens density (LD max) were measured using Pentacam High Resolution. Endothelial cell density was measured using a specular microscope. The results were assessed and compared between the two groups. Results: There were 60 patients (38 boys and 22 girls) in the DM group and 30 (14 boys, 16 girls) in the control group. There were considerable differences between the groups in terms of CCT, CV, ACD, MLD, LD SD and LD max, and Kmean back. Further, there was a positive correlation between HbA1c and MLD, LD SD, CV, and CCT in patients with DM. Conclusion: The results of our study demonstrate that poorly-controlled type 1 DM without DR affects the cornea, ACD, and LD based on anterior segment measurements taken with a Scheimpflug camera. CCT, CV, LD SD, and MLD values may be parameters that can be used to follow-up patients with type 1 DM.
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    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, Uğur
    Purpose: 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.
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    Evaluation of ocular hypoperfusion in patients with acromegaly by using optical coherence tomography angiography
    (Taylor & Francis, 2021) Karahan, Mine; Demirtaş, Atılım Armağan; Erdem, Seyfettin; Ava, Sedat; Pekkolay, Zafer; Keklikçi, Uğur
    Purpose: This study aimed to evaluate the retinal blood vessel parameters and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) in patients with acromegaly in comparison with healthy controls. Methods: A total of 45 patients with acromegaly and 45 healthy controls were included in this study. In all patients, the vessel density (VD) of the deep and superficial macular vascular networks and the foveal avascular zone (FAZ) were measured using OCTA. The correlation of insulin-like growth factor 1 (IGF-1) level and disease duration with deep macular VD and FAZ values was analyzed. All parameters were registered. Results were assessed and compared between the two groups. Results: Deep macular plexus VD values were lower in patients with acromegaly compared to the control group. No significant differences in VD values in the superficial segment, except for that in the inferior parafovea (P = .01) were found between the two groups. Furthermore, patients with acromegaly showed enlargement in the superficial (P = .30) and deep FAZ areas (P < .001). IGF-1 level and disease duration showed a significant negative correlation with the deep whole image (R = -0.216, P = .041, R = -0.339, P = .001, respectively), deep parafovea (R = -0.271, P = .01; R = -0.372, P < .001, respectively), deep parafovea superior hemi (R = -0.342, P = .001; R = -0.350, P = .001, respectively), deep parafovea temporal (R = -0.224, P = .034; R = -0.234, P = .026, respectively), deep parafovea nasal (R = -0.320, P = .002; R = -0.361, P < .001, respectively), and deep parafovea superior VD values (R = -0.293, P = .005; R = -0.307, P = .003, respectively) and a significant positive correlation with the deep FAZ area values (R = 0.244, P = .02; R = 0.329, P = .002, respectively). Conclusion: VD values in the deep macular capillary plexus were lower in patients with acromegaly, and the superficial and deep FAZ area enlarged. Patients with acromegaly may have an increased risk of developing ocular vascular complications. OCTA can be used to evaluate retinal blood VD in patients with acromegaly.
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    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, Uğur
    Background: 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.
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    Evaluation of peripapillary microcirculation in patients with acromegaly
    (KARE yayıncılık, 2021) Karahan, Mine; Demirtaş, Atılım Armağan; Hazar, Leyla; Ava, Sedat; Pekkolay, Zafer; Keklikçi, Uğur
    Objectives: 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.
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    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, Esra
    Purpose: 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.
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    Evaluation of retrobulbar blood flow by color doppler ultrasonography after intravitreal ranibizumab injection in patients with neovascular age-related macular degeneration
    (Wiley-Blackwell, 2013) Sakalar, Yıldırım Bayezit; Şentürk, Senem; Yıldırım, Mine; Keklikçi, Uğur; Alakuş, Mehmet Fuat; Ünlü, Kaan
    Purpose. This study aimed to evaluate the changes in retrobulbar blood flow by using color Doppler sonography in patients who had undergone intravitreal ranibizumab injection for neovascular age-related macular degeneration (AMD). Methods. The study comprised 37 AMD patients who had undergone intravitreal 0.5 mg ranibizumab injection. The ophthalmic artery, central retinal artery, and short lateral posterior ciliary artery of both eyes of patients were evaluated by color Doppler sonography. Peak systolic velocity, end-diastolic velocity, and resistance index were calculated before injection, and after injection on day 7 and day 30. The pre- and postinjection values were compared using Wilcoxon signed rank test. Results. In a comparison with the preinjection values of peak systolic velocity, end-diastolic velocity, and resistance index, the postinjection values at both day 7 and day 30 showed no statistically significant difference in ophthalmic artery, lateral posterior ciliary artery, and central retinal artery (p > 0.05). Similarly, for the same parameters, pre- and postinjection values in the uninjected fellow eye showed no statistically significant difference (P > 0.05). Conclusions. Intravitreal ranibizumab injection for neovascular AMD does not cause a significant change in the retrobulbar blood flow in either the injected eye or the fellow eye.