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Öğe Abnormal retrobulbar blood flow variables in central serous chorioretinopathy(Wiley, 2020) Kılıç, Deniz; Karahan, Mine; Vural, Esra; Dursun, Mehmet E.; Demirtaş, Atılım A.; 0000-0002-3591-721XPurpose To evaluate if the retrobulbar blood flow variables were deteriorated in central serous chorioretinopathy (CSC) patients. Methods We included 25 CSC patients and 25 healthy subjects. We used color Doppler ultrasonography to assess the ophthalmic artery (OA), the central retinal artery (CRA), and the posterior ciliary arteries (PCA) for peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI). Results Mean ages of the patients and controls were 42.3 +/- 8.5 and 41.3 +/- 9.4 years, respectively (P = .853). There were no significant differences between the two groups with regard to the values of PSV, EDV, and RI of CRA (P = .406, P = .627, P = .227) and PCA (P = .785, P = .403, P = .935, respectively). The PSV and EDV of OA were lower in the CSC patients (P = .005, P = .024, respectively). Whereas the RI of OA was not significantly different (P = .729). Submacular choroidal thickness (SCT) was greater in CSC patients (P < .001). There was a negative correlation between SCT and PSV of PCA (P = .022, r = -0.457) and between SCT and EDV of PCA (P = .004, r = -0.560) in CSC patients. Conclusion Hemodynamic changes in OA and a negative correlation between PCA values and SCT suggest ocular circulatory dysfunction in patients with CSC.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 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 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 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 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 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 Macular vessel density in patients recovered from COVID 19(Elsevier, 2021) Hazar, Leyla; Karahan, Mine; Vural, Esra; Ava, Sedat; Erdem, Seyfettin; Dursun, Mehmet Emin; Keklikci, UgurPurpose: The purpose is to evaluate macular vascular densities (VDs) using optical coherence tomography angiography (OCTA) in patients effected by coronavirus disease-2019 (COVID-19). Methods: The superficial (SF) and deep macular VD of 50 patients with SARS CoV2 pneumonia who had positive polymerase chain reaction (PCR) tests and who recovered after receiving treatment and 55 healthy age- and gender-matched controls were compared using OCTA. Blood inflammation parameters were also recorded. Results: There was no statistically significant difference between the two groups in terms of age and gender (p = 0.147 and p = 0.504, respectively). Nor was there a difference with respect to smokers between the two groups (p = 0.231). In COVID-19 patients, the VDs in superior hemi quadrant, superior quadrant and inferior quadrant, were significantly lower (p = 0.033, p = 0.029 and p = 0.042, respectively) in superficial plexus. It was also significantly lower in parafovea, superior hemi and superior quadrants (p = 0.026, p < 0.001 and p = 0.004, respectively) in deep plexus. In addition, white blood cell and neutrophil counts were significantly negatively correlated with the VD of the deep parafovea, deep superior quadrant and deep superior hemi quadrant (p < 0.05). There was no difference between the patient and control groups in both superficial and deep foveal avascular zone (FAZ) (p = 0.101 and p = 0.691 respectively). Conclusion: In COVID-19 disease, VD is low in some sectors in both SF and deep layers, but no change in FAZ. The effect of COVID 19 disease on the retina and whether it makes the retina sensitive to damage can only be understood with long-term follow-up.Öğe Relationship of obesity and related disorders with ocular parameters in children and adolescent(Taylor & Francis, 2021) Hazar, Leyla; Oyur, Gülistan; Yılmaz, Gülay Can; Vural, EsraPURPOSE To evaluate the effect of obesity and obesity-related high blood pressure (BP) on the retinal nerve fiber layer (RNFL) and macula in children and adolescents. MATERIALS AND METHODS Thirty-two obese patients followed up in the pediatrics endocrinology clinic between 2018 and 2019 were evaluated in the ophthalmology clinic. The results were compared with 25 healthy subjects, matched for age and sex. Anthropometric measurements, and systolic and diastolic BP were measured. The study consisted of three groups: Group 1, patients with obesity; Group 2, those with obesity and associated hypertension (obesity-related HT); and Group 3, healthy controls. A complete ophthalmologic examination was performed. Macular and RNFL thicknesses were determined using spectral domain optical coherence tomography (SD-OCT). RESULTS There were no statistically significant differences between the groups in terms of gender, age, and intraocular pressure (p > .05). The inferior RNFL thickness and central foveal thickness were statistically thinner in the obesity-related HT group (p < .001 and p = .040). The systolic and diastolic BP and fasting glucose values were significantly higher in the obesity-related HT group than the other groups (p < .001; p < .001; p = .026, respectively). In linear regression modeling in obese and obesity-related HT groups, a significant assocation was found between diastolic BP and temporal RNFL thickness (p = .027) as well as between the systolic BP and triglyceride values and the nasal RNFL thickness values (p = .016 and p = .025, respectively). CONCLUSIONS Inferior RNFL thickness and central foveal thickness were significantly thinner in patients with obesity-related HT. The effects of obesity-related HT on the retina should be evaluated using SD OCT, since no signs were found in a routine ocular examination.
