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    Accelerated corneal collagen cross-linking for progressive keratoconus
    (Taylor & Francis Ltd, 2014) Cinar, Yasin; Cingu, Abdullah Kursat; Turkcu, Fatih Mehmet; Yuksel, Harun; Sahin, Alparslan; Yildirim, Adnan; Caca, Ihsan
    Purpose: To evaluate the efficacy of accelerated corneal cross-linking (CXL) procedure for progressive keratoconus. Materials and methods: Twenty-three eyes of 23 patients undergone accelerated CXL procedure were evaluated preoperatively and postoperatively at 1st, 3rd and 6th month for uncorrected distant visual acuity (UDVA), best corrected distant visual acuity (CDVA), spherical error, cylindrical error, spherical equivalent (SE), keratometric values and thinnest corneal thickness (TCT) values with corneal topography by Scheimpflug camera and endothelial cell density (ECD). Results: The mean UDVA was improved from 0.97 +/- 0.41 logarithm of minimal angle of resolution (logMAR) to 0.76 +/- 0.45 logMAR at the 6th month after CXL (p = 0.332). The mean CDVA was improved from 0.49 +/- 0.30 logMAR to 0.34 +/- 0.22 logMAR at the 6th month after CXL (p = 0.026). The mean sphere was decreased from -4.47 +/- 4.1 diopter (D) to -3.79 +/- 3.86 D and the mean cylinder was decreased from -5.60 +/- 2.2D to -4.55 +/- 1.98 D and the mean SE was decreased from -7.22 +/- 4.48 D to -6.36 +/- 4.34 D at the 6th month after CXL (p = 0.128, p = 0.002 and p = 0.045, respectively). Flat keratometry, steep keratometry, mean keratometry and maximum keratometry were significantly reduced at the 6th month after CXL (p = 0.025, p < 0.001, p = 0.004 and p = 0.03, respectively). TCT and ECD were not changed significantly the 6th month after CXL (p = 0.135 and p = 0.082, respectively). Conclusion: Accelerated CXL procedure was effective to stabilize progression of keratoconus with significant reduction in topographic keratometric values and significant increase in CDVA in 6 months.
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    Activation of toxoplasma retinochoroiditis during pregnancy and evaluation of ocular findings in newborns
    (Springer, 2017) Turkcu, Fatih Mehmet; Sahin, Alparslan; Yuksel, Harun; Cinar, Yasin; Cingu, Kursat; Altindag, Suat; Deveci, Ozcan
    The purpose of this study was to evaluate patients with activation of toxoplasma retinochoroiditis during pregnancy and ocular findings in newborns. A total of 17 pregnant patients who were clinically and serologically diagnosed with ocular toxoplasmosis were retrospectively reviewed. After birth, ocular findings for all infants were recorded. The mean age of the patients was 29.08 +/- 5.71 years. In all cases, activation was present in only one eye. In 13 cases, anterior uveitis was associated with posterior uveitis. Visual acuity in all cases prior to treatment was 0.3 +/- 0.21 and increased to 0.55 +/- 0.29 after treatment. The mean gestational age of the patients was 19.76 +/- 8.71 weeks at the time of hospital admission. No case of toxoplasmic ocular involvement was identified in the infants on postnatal examination. In the case of toxoplasma retinochoroiditis during pregnancy, appropriate treatment and follow-up is very important to protect the newborns and to prevent impaired vision in mothers.
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    Amblyopia and Refractive Errors Among School-Aged Children With Low Socioeconomic Status in Southeastern Turkey
    (Slack Inc, 2013) Caca, Ihsan; Cingu, Abdullah Kursat; Sahin, Alparslan; Ari, Seyhmus; Dursun, Mehmet Emin; Dag, Umut; Balsak, Selahattin
    Purpose: To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. Methods: A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. Results: There were 11,118 females and 9,944 males. The average age was 10.56 +/- 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). Conclusion: Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors. [J Pediatr Ophthalmol Strabismus 2013;50:37-43.]
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    Anterior segment parameters of rabbits with rotating Scheimpflug camera
    (Wiley-Blackwell, 2015) Yuksel, Harun; Turkcu, Fatih M.; Ari, Seyhmus; Cinar, Yasin; Cingu, Abdullah K.; Sahin, Muhammed; Sahin, Alparslan
    BackgroundRabbit is one of the most commonly used experimental animals for corneal studies due to similarity of size to human cornea and ease of manipulation. In this study, we assessed anterior segment parameters of the healthy rabbit eyes with Pentacam HR (Oculus, Wetzlar, Germany). MethodsSix-month-old, approximately 2.5-3kg weighted, 30 female New Zealand rabbits were used in the study. Right eye of the each rabbit was imaged with Pentacam HR under intramuscular ketamine hydrochloride (Ketalar; Eczacibasi, Turkey) anesthesia (50mg/kg). After the imaging, the rabbits with blinking errors, which results in low-quality images, were excluded from the study. Keratometric readings, central corneal thickness (CCT), anterior chamber depth (ACD), and anterior and posterior elevation values, and lens density were noted. ResultsIn this study, the flattest and the steepest keratometric values were found as 43.341.86, 42.7 +/- 2.0, and 43.9 +/- 1.9diopters, respectively. The mean CCT and ACD of rabbits were found as 388 +/- 39m and 2.08 +/- 0.16mm, respectively. Mean of the anterior and posterior elevation at thinnest point was found as 1.29 +/- 4.28 and 3.91 +/- 6.17m, respectively. ConclusionsKeratometric readings and anterior and posterior elevation values of rabbits were similar to human; however, corneal thickness and anterior chamber depth (ACD) values were lower than humans.
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    Approach of Turkish ophthalmologists to micronutrition in age-related macular degeneration
    (Consel Brasil Oftalmologia, 2015) Sahin, Muhammed; Yuksel, Harun; Sahin, Alparslan; Cingu, Abdullah Kursat; Turkcu, Fatih Mehmet; Ozkurt, Zeynep Gursel; Caca, Ihsan
    Purpose: To evaluate the knowledge and behaviors of ophthalmologists in Turkey concerning micronutrition support in patients with age related macular degeneration (ARMD). Methods: This study involved 1,845 ophthalmologists. A scientific poll was sent to all participants by email. The survey covered the following: demographic features, subspecialty knowledge about micronutrition preference for prescribing micronutrition to age related macular degeneration patients, and the reason for this preference. If a participant indicated that he or she prescribed micronutrition, the participant was also asked to indicate the source of the treatment and supplemental treatments. Results: Of 1,845 ophthalmologists, 249 responded to the survey. Of the respondents, 9% (22) never, 43% (107) sometimes, 37% (92) frequently, and 11% (27) always used micronutrition. The most frequent prescribing subgroup was general ophthalmology (22%), followed by the retina-uvea subspecialty (13.9%). The micronutrition prescribing ratio was 54.8% in retina-uvea specialists when the frequent and always responses were combined. There was no statistically significant difference between subgroups with respect to prescribing micronutrition. Among the ophthalmologists prescribing micronutrition, 57.1% of them did not use the Age-Related Eye Disease Study-1 (AREDS) criteria, and only 31.3% prescribe micronutrition according to AREDS criteria. The results for the general ophthalmologist and retina-uvea specialist subgroups were similar, 56.3% vs 20.2%, and 54.1% vs 36.1%, respectively. Micronutrition was not recommended for the following reasons: expensive (55.4%), low patient expectancy (40%), no effect (30%), and low patient drug compliance (25.4%). Moreover, 55.2% of the clinicians recommended physical activities, dietary changes, and smoking cessation; 7.3% did not recommend these behavioral changes. Conclusion: This survey demonstrated that micronutrition preference in age related macular degeneration was low in ophthalmologists in Turkey. Additionally, retina specialists have a lower rate of prescribing micronutrition. Micronutrition support and behavior such as smoking cessation, dietary changes, etc. should be recommended more often to patients with age related macular degeneration.
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    AUTHOR REPLY TO: Mean platelet volume in pseudoexfoliation syndrome and glaucoma
    (Wichtig Editore, 2014) Turkcu, Fatih Mehmet; Yuksel, Harun; Sahin, Alparslan; Cinar, Yasin; Yuksel, Hatice; Cingu, Kursat; sahin, Muhammed
    [Abstract Not Available]
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    Author reply: approach to micronutrition in age-related macular degeneration
    (Consel Brasil Oftalmologia, 2015) Sahin, Muhammed; Sahin, Alparslan; Turkcu, Fatih Mehmet
    [Abstract Not Available]
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    Automated quantification of foveal avascular zone and vascular density in Behcet's disease
    (Springer London Ltd, 2020) Turkcu, Fatih Mehmet; Sahin, Alparslan; Karaalp, Umit; Cinar, Yasin; Sahin, Muhammed; Ozkurt, Zeynep Gursel; Keklikci, Ugur
    PurposeTo measure the vascular density (VD) and foveal avascular zone (FAZ) area in patients with Behcet's disease (BD) obtained by optical coherence tomography angiography (OCTA).MethodsVD and FAZ area in the deep and superficial retinal vascular networks were measured in all eyes.ResultsThirty BD and 31 control subjects were included in the study. The mean overall VD measured in the entire scan was lower in BD compared with control group in both the superficial (49.526.54 vs 53.57 +/- 2.87%, respectively; p=0.003) and deep (53.44 +/- 7.44 vs 58.41 +/- 3.01%, respectively; p=0.002) areas. The FAZ in the BD group was significantly increased at the level of the superficial (0.52 +/- 0.67 vs 0.28 +/- 0.1 mm(2), respectively; p=0.05) and deep (0.91 +/- 1.25 vs 0.39 +/- 0.14 mm(2), respectively; p=0.024) areas compared with those of the control group. The deep and the superficial FAZ areas were positively correlated with disease duration and negatively with VA.Conclusionp id=ParIn the patients with BD, OCTA showed decreased VD in both the superficial and deep retinal vascular networks. Besides, the VA was correlated with the VD and FAZ.
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    Bilateral Optic Disc Drusen Mimicking Papilledema
    (Korean Neurological Assoc, 2012) Sahin, Alparslan; Cingu, Abdullah Kursat; Ari, Seyhmus; Cinar, Yasin; Caca, Ihsan
    Background Optic disc drusen, which are calcified deposits that form anterior to the lamina cribrosa in the optic nerve, may mimic papilledema. Case Report We report herein three cases referred to us with suspicion of disc swelling and papilledema. Following ophthalmologic evaluation with B-scan ultrasound, red-free fundus photography, and computed tomography, the diagnosis of papilledema was excluded in all cases and optic disc drusen was diagnosed. Conclusions Clinical suspicion of optic disc drusen in cases presenting with swelling of the optic nerve head is important in order to avoid unnecessary interventions and anxiety. The reported cases highlight the commonly encountered clinical presentations and the practical aspects of diagnosis and management of optic disc drusen. J Clin Neurol 2012;8:151-154
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    Bilateral Optic Pit Maculopathy: Case Report
    (Ortadogu Ad Pres & Publ Co, 2011) Oltulu, Refik; Sahin, Alparslan; Kerimoglu, Hurkan
    In this paper, we present an unusual case of bilateral optic pit maculopathy. Optic disc pits occur in less than 1 in 10000 and are bilateral in 10% to 15% of cases. Approximately 50% of cases with congenital optic disc pits are associated with serous macular detachment. Long-standing serous detachments are usually associated with cystic degeneration of macula and pigment loss from the underlying retinal pigment epithelium. Hence, most eyes with serous macular detachment associated with an optic disc pit have a relatively poor visual prognosis. Here, we emphasized the clinical importance of assessment of bilateral optic disc pit.
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    Central serous chorioretinopathy due to tadalafil use
    (Springer, 2013) Turkcu, Fatih Mehmet; Yuksel, Harun; Sahin, Alparslan; Murat, Mehmet; Bozkurt, Yasar; Caca, Ihsan
    Phosphodiesterase-5 (PDE5) inhibitors are commonly used in the treatment of erectile dysfunction. There are a small number of case reports that associate this agent with central serous chorioretinopathy (CSCR). Our report presents the treatment approach to a 42-year-old patient who described blurred vision and metamorphopsia and was diagnosed with CSCR following the use of tadalafil, a PDE5 inhibitor.
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    Comment on the article entitled Intravitreal bevacizumab as single drug therapy for retinopathy of prematurity in 12 patients
    (Soc Argentina Pediatria, 2014) Sahin, Alparslan; Murat, Mehmet
    [Abstract Not Available]
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    Comparison of Central Corneal Thickness Measurements with a Rotating Scheimpflug Camera, a Specular Microscope, Optical Low-Coherence Reflectometry, and Ultrasound Pachymetry in Keratoconic Eyes
    (Taylor & Francis Inc, 2015) Cinar, Yasin; Cingu, Abdullah Kursat; Turkcu, Fatih Mehmet; Cinar, Tuba; Sahin, Alparslan; Yuksel, Harun; Ari, Seyhmus
    Objective: To compare central corneal thickness (CCT) measurements with a rotating Scheimpflug camera (RSC), noncontact specular microscopy (SM), optical low-coherence reflectometry (OLCR), and ultrasonic pachymetry (UP) in keratoconus (KC) patients. Method: In this prospective study, four CCT measurements taken with an RSC, SM, OLCR, and UP were compared in 81 eyes of 44 consecutive KC patients. The KC patients were divided into four subgroups according to Amsler-Krumeich's KC classification. Results: The RSC and UP measurements of the CCT were not statistically significant in all the groups. Comparison of the SM vs. the OLCR measurements yielded statistically significant differences in all the KC patients and in all KC stages. In all the KC patients, RSC and OLCR showed a high correlation coefficient factor (r = 0.87, p = 0.000). Conclusion: CCT measurements with RSC are comparable to those achieved with UP. Compared with the other devices, according to SM measurements, the central cornea is thicker in all keratoconic eyes and in all KC grades, and it is thinner according to OLCR. RSC, UP, SM, and OLCR should not be used interchangeably in keratoconic eyes.
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    Comparison of Optical versus Ultrasonic Biometry in Keratoconic Eyes
    (Hindawi Ltd, 2013) Cinar, Yasin; Cingu, Abdullah Kursat; Sahin, Muhammed; Sahin, Alparslan; Yuksel, Harun; Turkcu, Fatih Mehmet; Cinar, Tuba
    Purpose. To compare the measurements of optical versus ultrasonic biometry devices in keratoconic eyes. Materials and Methods. Forty-two eyes of 42 keratoconus (KC) patients enrolled in the study were examined. Clinical and demographic characteristics of the patients were noted, and detailed ophthalmological examination was performed. Following Pentacam measurements, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were obtained using the Lenstar and US biometer to determine the reproducibility of the measurements between the two devices in keratoconic eyes. The Bland-Altman method was used to describe the agreement between the two devices. Results. The Lenstar could not measure at least one of the biometric properties in one eye and did not automatically give the corrected ACD in 2/3 of our study population. The Lenstar measured CCT (average difference 5.4 +/- 19.6 mu m; ICC = 0.90; P < 0.001), LT (average difference 0.13 +/- 0.17 mm; ICC = 0.67; P < 0.001), and AL (average difference 0.10 +/- 0.76 mm; ICC = 0.75; P < 0.001) thinner than US biometer, whereas it measured ACD (average difference 0.18 +/- 0.17 mm; ICC = 0.85; P < 0.001) deeper than US biometer in keratoconic eyes. Conclusion. Although the difference between the measurements obtained using the two devices might be clinically acceptable, US biometry and Lenstar should not be used interchangeably for biometric measurements in KC patients.
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    Congenital Bilateral Upper Eyelid Eversion: Report of a Case
    (Informa Healthcare, 2014) Cingu, Abdullah Kursat; Sahin, Alparslan; Yuksel, Harun; Ozkok, Ahmet; Ari, Seyhmus; Caca, Ihsan
    Congenital bilateral upper eyelid eversion is a rare condition and the definite cause is not known. It is often seen in Black babies or babies with Down's syndrome. With early diagnosis and appropriate treatment, the condition can be managed without surgery. We report a case of congenital upper eyelid eversion in an otherwise healthy Caucasian neonate, born by normal vaginal delivery. The case responded well to conservative treatment, including eyelid repositioning, lubricants, antibiotic ointment, and eyelid patching.
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    Continuous amnioinfusion via an epidural catheter following spontaneous membrane rupture: A case report
    (Galenos Yayincilik, 2013) Turgut, Abdulkadir; Katar, Selahattin; Sak, Muhammet Erdal; Turgut, Fethiye Gulden; Sahin, Alparslan; Basaranoglu, Serdar; Yalinkaya, Ahmet
    Preterm premature rupture of membranes (PPROM) is seen in 3% of all pregnancies, and is a frequent cause of preterm birth, neonatal mortality and morbidity. The most important complications are maternal and foetal infection, prematurity, umbilical cord compression, hypoxia or asphyxia due to cord prolapse, pulmonary hypoplasia and extremity deformities. The basic approach to PPROM therapy aims to prevent premature birth and the development of foetal distress, and decrease the risk of maternal and foetal infection, and amniotic fluid loss. In compliance with these objectives, alternatives of PPROM therapy demonstrate a wide spectrum, including watchful waiting, amniopatch application, recurrent amnioinfusions and emergency birth. However, repeated amnioinfusions in cases of fluid loss, especially within 6 hours of therapy, provides only minimal benefit. In this case presentation, we attempted to describe a different and cost-effective continuous amnioinfusion technique performed to confer survival benefit for an immature anhydramniotic foetus affected by PPROM at the border of viability.
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    Cutaneous Anthrax of the Eyelid
    (Iranian Soc Ophthalmology, 2010) Sahin, Alparslan; Caca, Ihsan; Ece, Aydin; Ari, Seyhmus; Sen, Velat
    Purpose: Cutaneous anthrax of the eyelid is a rare condition in clinical practice, but should be considered in the differential diagnosis of preseptal and orbital cellulitis. Here we report a case of palpebral anthrax. Case report: A 5-year-old girl with anthrax infection of the right upper eyelid is presented. Her eyelid showed an edematous, necrotic, and partially bullous lesion. Following complete healing of the eyelid lesion, mild cicatricial ectropion resulted. Conclusion: Anthrax is a rare disease that is not well known by ophthalmologists. Clinicians should be aware of the complications and the management of palpebral anthrax.
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    Cutaneous Palpebral Anthrax: Case Report
    (Ortadogu Ad Pres & Publ Co, 2012) Ari, Seyhmus; Sakin, Feyyat; Sahin, Alparslan; Caca, Ihsan
    Anthrax is an infectious disease caused by Bacillus anthracis. Cutaneous, respiratory and gastrointestinal involvements can be seen. The face and eyelids are the most commonly involved areas in cutaneous anthrax. If eyelid anthrax is not promptly treated, it may cause severe deformities of eyelids including cicatrization and ectropion. In this study, a 38-year-old male presenting with right eye palpebral cutaneous anthrax was reported. There was periorbital edema and a black eschar on right eyelid leading to closed eye. Gram-positive rods were seen in the microscopic examination of scrapings taken from the lesion. The patient received high dose intravenous penicillin G (16 million units/day) for 10 days. The lesion healed within 10 days, leaving no clinical evidence of any eyelid deformity. No eyelid deformity was observed during one-year follow-up period. Observing this case suggested that early diagnosis and treatment can prevent development of potential antrhax eyelid complications.
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    Demographic and etiologic characteristics of children with traumatic serious hyphema
    (Turkish Assoc Trauma Emergency Surgery, 2013) Turkcu, Fatih Mehmet; Yuksel, Harnn; Sahin, Alparslan; Cingu, Kursat; Ari, Seyhmus; Cinar, Yasin; Sahin, Muhammed
    BACKGROUND We aimed to evaluate the etiologic factors, complications, follow-up, and treatment outcomes in serious hyphema following blunt ocular trauma in childhood. METHODS The medical records of 136 patients diagnosed as grade 3 or 4 hyphema due to blunt ocular trauma between January 2006 and December 2011 were evaluated. Visual acuity (VA), complications, and medical and surgical treatments were analyzed. Factors affecting visual prognosis were compared in grade 3 and 4 hyphema cases. RESULTS The mean age of patients was 9.7+/-4 years. Etiologic factors for trauma were stone in 53 (39%), bead bullet in 25 (18.4%) and others in 58 (42.6%) patients. The most common complication of grade 3 and 4 hyphema was traumatic mydriasis (19.1%), followed by cataract (9.6%) and glaucoma (5.1%). Medical treatment was successful in 114 (83.8%) patients, and 22 (16.2%) patients underwent surgery. Mean initial and final VA of grade 4 patients were found to be significantly lower than those of grade 3 patients. CONCLUSION In grade 3 and 4 hyphema due to blunt trauma, visual prognosis worsened in the presence of additional ocular pathologies. Considering the bad visual prognosis of severe hyphema patients, prompt treatment and close follow-up may prevent complications resulting in poor VA.
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    Diagnosis of Malignant Hypertension with Ocular Examination: A Child Case
    (Informa Healthcare, 2014) Yildirim, Adnan; Turkcu, Fatih Mehmet; Yuksel, Harun; Sahin, Alparslan; Cinar, Yasin; Caca, Ihsan
    A 12-year-old female patient was admitted to our clinic complaining about low vision. Bilateral optic disc edema, macular star, and preretinal hemorrhages were found in fundoscopic examination. In fundus fluorescein angiography, massive leakage in the late phase was seen in the optic nerve head and macular area. These findings were compatible with high-grade hypertensive retinopathy. The patient consulted with pediatrics and a diagnosis of vesicourethral reflux and malignant hypertension was made.