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Comparison of central corneal thickness with ultrasound pachymetry, noncontact specular microscopy and spectral domain optical coherence tomography
(Taylor & Francis Inc, 2018) Karaman Erdur, Sevil; Demirci, Göktuğ; Dikkaya, Funda; Kocabora, Mehmet Selim; Özsütçü, Mustafa
Background: To determine the agreement of central corneal thickness (CCT) measurements taken with ultrasonic pachymetry (USP), spectral domain optical coherence tomography (SD-OCT) and noncontact specular microscopy (NSM). Methods: A prospective, observational, cross-sectional study was performed in the outpatient ophthalmology clinic. CCT was measured in a total of 147 eyes of 147 consecutive healthy patients with USP, NSM, and SD-OCT. Same examiner performed all examinations. Bland-Altman plots were used to evaluate the agreement between instruments. Results: The average CCT values obtained by USP, NSM, and SD-OCT were 555 +/- 37 mu m, 554 +/- 34 mu m, and 546 +/- 34 mu m, respectively. There was a strong correlation between instruments: USP with SD-OCT (r = 0.937, p <0.01), USP with NSM (r = 0.943, p <0.01) SD-OCT with NSM (r = 0.975, p <0.01) for CCT. The mean differences (lower/upper limit of agreement) for CCT measurements were -10 +/- 12.9 pm (15.28/-35.28) between SD-OCT and USP-8.1 +/- 7.7 pm (7/-23.2) between SD-OCT and NSM, and 1.8 +/- 12.3 pm (25.9/-22.3) between USP and NSM. Conclusions: USP and NSM were found to have comparable CCT measurements and these two methods can be used correspondingly. However, CCT measurements by SD-OCT were lower when compared to other methods.
Comparison of corneal endothelial parameters measured by three different specular microscopy devices in healthy subject: A comparative clinical study
(Türkiye Klinikleri, 2022) Tükenmez Dikmen, Nejla; Yıldız, Elvin; Dikkaya, Funda; Turan Vural, Ece; Karaman Erdur, Sevil; Şimşek, Şaban
ABS TRACT Objective: The present study aimed to compare the Nidek CEM-530 (Nidek Co., Japan), Konan CellChek XL (Konan Medical, Hyogo, Japan), and Topcon SP-3000P (Topcon Corporation, Tokyo, Japan) noncontact specular microscopes (NCSM) in terms of endothelial cell density (ECD), morphological endothelial cell parameters, and central corneal thickness (CCT), in healthy subjects. Material and Methods: Right eyes of 49 patients were included in this study. ECD, CCT, average cell area, coefficient of variation, standard deviation of cell area, cell hexagonality ratio were evaluated with Nidek CEM-530, Topcon SP-3000P and The CellChek XL NCSMs. Results: The mean age was 36.2±9.6 years. The mean ECD was 2809±24.1, 2626±50.4, and 2588±32.1 in measurements with Konan CellCheck XL, Topcon SP-3000P, and Nidek CEM-530 NCSMs, respectively. The difference was statistically significant between Konan CellCheck XL with Nidek CEM-530 and Topcon SP-3000P (p<0.001 for both). The hexagonality ratio results between these 3 devices were statisti cally significant in all paired comparisons (p<0.001, for all). The mean CCT was 534.4±5.0, 553.9±5.6, 567.5±5.3 in measurements with Nidek CEM-530, Konan CellCheck XL, and Topcon SP-3000P, respectively. CCT values obtained with Topcon SP-3000P were found to be higher than with other devices (p<0.001, for both). Conclusion: Among the 3 devices, the highest ECD values were obtained with Konan CellCheck XL and the highest CCT values were obtained with Topcon SP-3000P. On account of the discrepancies in endothelial pa rameters tested in our study, we do not advise using these devices in terchangeably.
Comparison of optical coherence tomography measurements between high hyperopic and low hyperopic children
(SAGE Publications Ltd, 2020) Dikkaya, Funda; Karaman Erdur, Sevil
Purpose: To identify the peripapillary retinal nerve fiber layer, total macular, ganglion celllayer, and inner plexiform layer thicknesses in children with high hyperopia using spectraldomain optical coherence tomography.Methods: Twenty-one children with high hyperopia and 20 controls were enrolled in thisstudy. Subjects with spherical equivalent +5.0D or higher were evaluated in the study groupand subject with spherical equivalent between +0.25 and +2.0 D in the control group. Theretinal nerve fiber layer thickness, macular thickness, macular ganglion cell layer and innerplexiform layer thicknesses were measured using a spectral domain optical coherencetomography, and results were compared between groups.Results: The nasal and inferior quadrant and the global retinal nerve fiber layer thicknesswere significantly thicker in the study group. The mean thickness of inferior quadrant of theinner macula was significantly thicker in the study group than those in the control group.The mean thickness of the ganglion cell layer in nasal, temporal and inferior quadrant ofouter macula was significantly thinner in the study group than the control group. The meanthickness of the inner plexiform layer in the inferior quadrant of the inner macula and nasaland inferior quadrant of the outer macula were significantly higher in study group than thosein control group.Conclusion: High hyperopic children had thicker retinal nerve fiber layer when comparedto the controls. This difference should be taken into account when evaluating children withglaucoma or other optic disc disorders.
Comparison of the plusOptix S09 and spot vision photorefractor to cycloretinoscopy
(Springer Netherlands, 2019) Dikkaya, Funda; Karaman Erdur, Sevil
Purpose: The purpose of this study was to compare refraction measurements for children with the PlusOptix S09 and Spot Vision with cycloplegic retinoscopy. Methods: One hundred thirty-six eyes of 68 children (26 boys and 42 girls) were evaluated prospectively. The subjects were separated into two groups. Group 1 comprised the subjects age between 5 and 9 years. Group 2 comprised the subjects age between 10 and 18 years. Photorefraction with PlusOptix S09, photorefraction with Spot Vision and cycloplegic retinoscopy were performed in each patient. Spherical equivalents, spherical power, cylindrical power and axis values were compared between three methods. Results: The mean age of the patients was 7.12 ± 1.5 years in group 1 and 12.24 ± 1.8 years in group 2. Spherical equivalent and spherical power measured with PlusOptix S09 were statistically smaller than measured with cycloplegic retinoscopy for group 1 (p = 0.001, p = 0.001) and for group 2 (p = 0.000, p = 0.000). The mean cylindrical power measured with PlusOptix S09 was not statistically different compared to cycloplegic retinoscopy for both groups (p = 0.314, p = 0.05). Spherical equivalents measured with Spot Vision were statistically smaller than measured with cycloplegic retinoscopy for both groups (p = 0.000, p = 0.012). Spherical power measured with Spot Vision was statistically smaller than measured with cycloplegic retinoscopy for group 1 (p = 0.000), but the difference was not statistically significant for group 2 (p = 0.084). The mean cylindrical power measured with Spot Vision was statistically higher than cycloplegic retinoscopy for both groups (p = 0.000, p = 0.012). Conclusions: PlusOptix S09 and Spot Vision devices give acceptable results for screening, but prescription of spectacles should not be made according to PlusOptix S09 or Spot Vision devices alone.
Corneal biomechanical properties in obstructive sleep apnea syndrome
(Lippincott Williams & Wilkins, 2018) Dikkaya, Funda; Yıldırım, Rengin; Karaman Erdur, Sevil; Benbir, Gülçin; Aydın, Rukiye; Karadeniz, Derya
Objectives: To investigate the corneal biomechanical properties and anterior segment parameters in patients with obstructive sleep apnea syndrome (OSAS). Methods: Fifty-four eyes of 54 patients with OSAS and 20 eyes of 20 healthy subjects were included. Patients with mild and moderate OSAS (Respiratory Disturbance Index [RDI] <30) enrolled in group 1, those with severe OSAS (RDI>= 30) in group 2 and controls in group 3. Corneal biomechanical properties including corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured with ocular response analyzer. Maximum (Kmax), minimum (Kmin), and mean simulated (SimKm) keratometry values, corneal astigmatism (CA), and central corneal thickness (CCT) were evaluated with Pentacam Scheimpflug imaging. Results: The mean CH and CRF were significantly lower in group 2. The mean CH was 10.9 +/- 1.4 mm Hg in group 1,10.1 +/- 1.1 mm Hg in group 2, and 12.1 +/- 1.2 mm Hg in group 3 (P<0.001). The mean CRF was 11.1 +/- 1.8 mm Hg in group 1, 9.9 +/- 1.1 mm Hg in group 2, and 12.2 +/- 1.2 mm Hg in group 3 (P<0.001). The CH and CRF values were similar between the groups 1 and 3 (P = 0.867 and P = 0.743). Corneal-compensated intraocular pressure, IOPg, Kmax, Kmin, SimKm, CA, and CCT values were not statistically different among the three groups. Conclusions: Patients with severe OSAS had lower CH and CRF values. The lower CH and CRF values in the severe group were possibly related to changes of the structural properties in the cornea.
Effect of hemifacial spasm intraocular pressure measurement
(Hindawi Ltd, 2018) Cicik, Erdoğan; Yıldırım, Rengin; Arıcı, Ceyhun; Dikkaya, Funda; Arslan, Osman Şevki
Purpose. To evaluate the effect of hemifacial spasm (HFS) on intraocular pressure (IOP) measurement. Methods. Twenty-four consecutive patients with HFS and 25 age-and gender-matched randomly selected eyes of healthy volunteers underwent corneal pachymetry and IOP measurements using Goldmann applanation tonometer (GAT) and noncontact tonometer (NCT). IOP measurements were performed before (during HFS) and 2 weeks after Botox injections in HFS patients and in healthy volunteers without Botox injections. Results. There was no statistical difference between involved eye side and uninvolved eye side of HFS patients in measured central corneal thickness. Similarly, no difference was found between involved eye side of HFS patients and controls. There were no statistically significant differences comparing IOP values before treatment and levels measured at 2 weeks of Botox injections, either with GAT (p = 0 33, 0.11) or NCT (p = 0 80, 0.43) devices in the involved eyes and uninvolved eyes of patients with HFS, respectively. There were also no significant differences in these parameters (GAT (p = 0 63) and NCT (p = 0 54)) in controls. Conclusions. Contractions in facial muscles may not lead to significant increase in IOP in HFS patients. This result may help clinical decision making in the treatment of glaucoma patients with HFS. This trial is registered with NCT03390803.
Evaluation of high-risk features of primary enucleation of patients with retinoblastoma in a tertiary center of a developing country in the era of intra-arterial chemotherapy
(Springer, 2018) Dikkaya, Funda; Sarıcı, Ahmet Murat; Erbek, Firuze; Celkan, Tiraje; Mangan, Mehmet Serhat; Aydın, Övgü; Demirkesen, Cüyan; Pazarlı, Halit
Purpose To evaluate the frequency of high-risk histopathologic factors in Turkish children enucleated for retinoblastoma and to analyze the association between growth pattern, rosetta formation, tumor thickness, presence of necrosis, calcification, neovascularization, rate of mitosis, and high-risk histopathologic factors. Methods Pathology reports of 59 eyes who had received enucleation for retinoblastoma were reviewed retrospectively. The histopathologic data included presence of choroidal invasion, optic nerve invasion, scleral extension, tumor thickness, presence of necrosis, calcification, neovascularization, rosetta formation and lymphocyte infiltration, rate of mitosis, and growth pattern. Results This study included 59 eyes from 30 (50.8%) male and 29 (49.2%) female patients. The mean age was 22.87 +/- 18.99 months. There were 30 (50.8%) eyes with choroidal invasion, 30 (50.8%) eyes with optic nerve invasion, and 5 (8.5%) eyes with scleral invasion. Endophytic growth pattern was seen in 27 (45.8%) eyes, exophytic growth pattern was seen in 2 (3.4%) eyes, and combined growth pattern was seen in 30 (50.8%) eyes. Exophytic growth pattern was found statistically related to choroidal invasion (p = 0.00). Although tumor with greater thickness tended to have more choroidal invasion (p = 0.02), there was no relation between tumor thickness and optic nerve invasion (p = 0.09). Conclusions Incidences of choroidal and optic nerve invasion showed similarity with other developing countries. Because of higher incidence of high-risk factors, intra-arterial chemotherapy with its targeted effect should be preferred carefully.
Evaluation of stereopsis in children with corrected anisometropia according to type, severity, and presence of amblyopia
(Erciyes University, 2022) Dikkaya, Funda; Karaman Erdur, Sevil
Objective: This study was designed to determine the level of stereopsis in anisometropic children with and without amblyopia who used corrective glasses and to investigate the effect of the type and magnitude of anisometropia on the level of stereopsis. Materials and Methods: The medical records of 256 children with a diagnosis of non-amblyopic anisometropia or anisometropic amblyopia, and healthy controls were retrospectively reviewed for this study. Anisometropia was categorized into 3 groups: spherical equivalent-only anisometropia, astigmatic-only anisometropia, or combined anisometropia. The level of stereopsis was measured using the Titmus stereo test, compared between groups, and the correlation of the stereopsis with the magnitude of anisometropia was analyzed. Results: Patients in the non-amblyopic anisometropia group had a similar stereopsis level when compared with the control group (55.2 +/- 41.03 and 47.2 +/- 19.8 seconds of arc, respectively; p=0.223). The level of stereopsis was significantly less in the anisometropic amblyopia group (279.4 +/- 120 seconds of arc) compared with the non-amblyopic anisometropia (55.2 +/- 41.03 seconds of arc) and control groups (47.2 +/- 19.8 seconds of arc) (p=0.008, p=0.006, respectively). A greater spherical equivalent difference between the eyes resulted in poorer stereopsis in the anisometropic amblyopia group, and combined anisometropia was found to be associated with poorer stereopsis levels in the nonamblyopic anisometropia (NA) group. Conclusion: The NA patients had a similar level of stereopsis compared with controls while wearing corrective glasses. This result suggests that as long as patients have good visual acuity, stereopsis is preserved, and that refractive correction with glasses does not interfere with stereopsis in childhood anisometropia.
Experimental laboratory modeling of choroidal vasculature: A study of the dynamics of intraoperative choroidal hemorrhage during pars plana vitrectomy
(Turkish Ophthalmology Society, 2021) Doğramacı, Mahmut; Dikkaya, Funda; Şentürk, Fevzi; Aras, Cengiz
Objectives: Choroidal hemorrhages (CH) result from rupture of choroidal vessels leading to extravasation of blood into the suprachoroidal space. In this study, we aimed to understand the hemodynamics of CH by developing a purpose-built scale model of the choroidal vasculature and calculating stress levels in the model under different conditions. Materials and Methods: We modeled the choroidal vasculature using a rubber tube 10 cm in length and 1 cm in diameter that was wrapped with conductive thread to enable the measurement of stress at the walls of the tube. Stress levels across the tube were continuously measured under different systemic intravascular blood pressure levels (IVP), intraocular pressure (IOP) levels, and distortion. Results: Stress values across the choroidal vessel model correlated negatively with IOP and positively with IVP and distortion. All correlations were statistically significant (p<0.05) and were stronger when the model was filled with expansile tamponade compared to non-expansile tamponades. Distortion showed the strongest correlation in terms of increasing stress across the model, while IVP showed stronger correlation compared to IOP. Raising IOP to counteract the stress in the model was effective when the stress in the model was secondary to increased IVP, but this approach was not effective when the stress in the model was caused by distortion. Conclusion: Excessive distortion of the globe during surgical maneuvers could be the primary reason for the rarely observed intraoperative CH. Non-expansile ocular tamponade provides better support for the vascular bed against CH and should be the recommended choice of tamponade in patients with existing CH. Increasing IOP excessively is of limited effect in preventing CH in vessels that are under stress as a result of distorting surgical maneuvers.
Intraocular lens power calculation in traumatic aphakic patient following myopic lasik operation: Case report
(Gazi Eye Foundation, 2017) Arıcı, Ceyhun; Yıldırım, Rengin; Dikkaya, Funda; Yüksel Elgin, Cansu; Onur, Umut
A fi fty years old female patient with the history of Laser in situ keratomileusis (LASIK) presented at emergency room complaining of insertion of a hair clip piece into her left eye. On slit-lamp examination, there was a foreign body impacted in inferotemporal paracentral cornea extending into the lens via penetrating iris. Two and a half months after the corneal fi xation and traumatic cataract extraction, iridoplasty and secondary intraocular lens (IOL) implantation were applied. The stable refraction was – 0.50 – 0.75/160 degrees at the fi rst year of trauma. In traumatic aphakic eyes with the history of refractive surgery choosing appropriate IOL calculation formula may become more diffi cult because routinely used methods to calculate IOL power do not guarantee the same accuracy compared with naive eyes. Haigis-L formula might be a preferable method to calculate IOL power for these eyes.
Intravitreal dexamethasone implant results in the treatment of non-infectious uveitis
(Kare Publishing, 2022) Tükenmez Dikmen, Nejla; Turan Vural, Ece; Yenerel, Nursal Melda; Dikkaya, Funda; Savran Elibol, Emine; Koçkar, Alev
Objective: The objective of this study was to evaluate the efficacy of intravitreal dexamethasone implant in non-infectious uveitic macular edema. Methods: Between April 2013 and February 2017, 27 eyes of 21 patients were included in the study at Haydarpasa Numune Training and Research Hospital. The files of patients who underwent intravitreal dexamethasone implantation for non-infectious uveitic macular edema and followed up at least 6 months were retrospectively reviewed. The patients were evaluated in terms of best-corrected visual acuity (BCVA) and central macular thickness (CMT) before and at the 1st, 3rd, and 6th months after injection and the need for re-injection. Results: Twenty-seven eyes of 21 patients were included in the study. The mean age of the patients was 39.2±11.7 years. The mean monitoring time was 24.15±10.08 months. In patients who received single-dose intravitreal dexamethasone implant, the decrease in CMT measurements and improvement in BCVA measurements at 1, 3, and 6 months after injection compared to baseline was found to be statistically significant (p=0.001 for each). Recurrence was detected in 33.3% (n=9) of the cases during follow-up; in cases with recurrence, second implants were repeated after an average of 9.67±3.12 months. The third dexamethasone implantation was applied due to the second relapse of four cases from nine relapsing cases. Third implants were performed at an average of 12.50±4.79 months. During the follow-up period, the most common complications in our patients were cataract (37%) and increased intraocular pressure (40.7%). Conclusion: Intravitreal dexamethasone implantation is an effective and reliable treatment option in non-infectious uveitic macular edema. There was no difference between the first dose and re-implantations in terms of efficacy and safety.
Koroidin vasküler yapısının laboratuvar modellemesi: Pars plana vitrektomi esnasında intraoperatif koroidal hemoraji dinamiklerini değerlendiren bir çalışma
(2021) Doğramacı, Mahmut; Dikkaya, Funda; Şentürk, Fevzi; Aras, Cengiz
Amaç: Koroid kanamaları (KK), koroid damarlarının rüptürü ve kanın supra koroid boşluğuna ekstravazasyonu ile meydana gelir. Koroid damar sistemini daha iyi şekilde anlamak için, bu çalışmada amaca yönelik olarak ölçeklendirilmiş bir model kullanıldı. Bu model aracılığıyla, koroid damar sistemindeki stres düzeyleri farklı koşullar altında ölçüldü. Gereç ve Yöntem: Koroid damar yapısı modelinde, 1 cm genişliğinde ve 10 cm uzunluğunda lastik bir tüp kullanıldı. Modeldeki stres seviye ölçümü için ise özel iletken iplik kullanıldı. Modeldeki stres seviyeleri, farklı sistemik intravasküler kan basıncı seviyeleri (İVB), farklı göz içi basınç seviyeleri (GİB) ve farklı distorsiyon seviyeleri altında ölçüldü. Bulgular: Koroid damar modelindeki stres değerleri GİB ile negatif, İVB ve distorsiyon ile pozitif korelasyon gösterdi. Tüm korelasyonlar istatistiksel olarak anlamlı idi (p<0,05). Ancak, modelde ekspansil tamponad kullanıldığında bu korelasyon ekspansil olmayan tamponadlara göre daha kuvvetliydi. Distorsiyonun stres ile korelasyonu, İVB’nin korelasonuna göre daha güçlü idi. İVB’nin stres ile korelasyonu ise, GİB’nin korelasonuna göre daha güçlü idi. Distorsiyondan kaynaklanan damar yapısındaki stres, yüksek GİB etkisi ile karşılaştırıldığında gerileme gösterirken, yüksek İVB’den kaynaklanan damar yapısındaki stres tam tersine hafif bir artış sergiledi. Sonuç: Cerrahi işlemler sırasında göz küresinin aşırı distorsiyonu, nadiren görülen intraoperatif KK’lerin başlıca nedeni olabilir. Ekspansil olmayan oküler tamponat kullanımı, koroid kanamasına karşı vasküler yatak için daha iyi destek sağlar ve koroid kanaması saptanan hastalarda önerilen tampon çeşidi olmalıdır. GİB’nin aşırı artırılması, distorsiyondan kaynaklanan koroid damarlarındaki kanama riskinin önlenmesinde sınırlı etkiye sahiptir.
Obstrüktif uyku apne sendromunda retina sinir lifi analizi
(Dokuz Eylül Üniversitesi Tıp Fakültesi, 2018) Aydın, Rukiye; Dikkaya, Funda; Yıldırım, Rengin
Amaç: Obstrüktif uyku apne sendromu (OUAS) hastalarını retina sinir lifi tabakası (RSLT) kalınlıkları yönünden incelemek ve oküler değişikliklerin hastalığın şiddeti ile ilişkisini belirlemek. Gereç ve Yöntem: OUAS tanılı 54 hasta göz bulguları açısından değerlendirildi. Respiratory Disturbance Index-Anormal Solunum Olayı İndeksi (RDI) 5-29 olan 21’i grup 1, RDI>29 olan 33’ü ise grup 2 kapsamında sınıflandırıldı. Hastalara Optik Koherens Tomografi (OKT) ile RSLT ölçümleri yapıldı. Gruplar elde edilen veriler açısından karşılaştırılırken, verilerin RDI, ortalama ve minimum O2 satürasyonu ile olan ilişkileri de incelendi. Bulgular: Ortalama RSLT grup 1’de 117,33±7,57 ?m, grup 2’de ise 111,91 ±8,64 ?m olarak ölçüldü. RSLT’deki incelme istatistiksel olarak anlamlı bulundu (p=0,023). İnferior RSLT grup 1’de 147,95 ±12,97 ?m, grup 2’de 137,27±17,94 ?m olarak bulundu. Grup 2’deki incelme istatistiksel olarak anlamlı bulundu (p=0,032). Ortalama RSLT ile RDI arasında negatif korelasyon saptandı . Sonuç: OUAS hastalarında RSLT kalınlığında azalma meydana gelmekte ve bu değişimler OUAS’ın ağırlığı ile korelasyon göstermektedir. Bu iki durum arasındaki ilişkinin bilinmesi hastaların öncelikle göz hekimi tarafından görüldüklerinde olası OUAS semptomları yönünden sorgulanmalarına olanak sağlayacaktır.
Optical coherence tomography and fundus autofluorescence imaging in an infant with RD3-related leber congenital amaurosis
(Taylor and Francis Inc., 2020) Dikkaya, Funda; Seyhan, Serhat; Karaman Erdur, Sevil; Şentürk, Fevzi; Aras, Cengiz
Background: Leber congenital amaurosis (LCA) is both genetically and phenotypically heterogeneous group of retinal disorder. Mutations in retinal degeneration 3 (RD3) have been reported as an infrequent cause of LCA which account for less than 1% of all known LCA cases. This case report provides Optical Coherence Tomography (OCT) and Fundus Autofluorescence (FAF) findings of an infant with LCA related to a mutation in RD3. Materials and Methods: Single retrospective case report. Results: TruSight One Expanded Sequencing Panel was applied to the patient on the Illumina NextSeq. Homozygous pathogenic variant (c.112 C > T, p.Arg38Ter) was detected in the RD3 gene. Well-demarcated central foveal atrophy was noted in the infrared imaging. FAF imaging showed perifoveal hyperautofluorescent ring and irregular hyperautofluorescence outside the vascular arcade. An arrest in foveal development and loss of outer retinal structure including outer nuclear layer, external limiting membrane, ellipsoid zone and interdigitation zone at the fovea were detected in the OCT imaging. Conclusion: This study indicates that RD3-related LCA has a very severe phenotype with foveal development arrest and very early loss of all photoreceptor layer and external limiting membrane at the fovea.
Parkinson hastalığında retina sinir lifi tabakası ve makula kalınlığının değerlendirilmesi
(Dicle Üniversitesi Tıp Fakültesi, 2018) Dikkaya, Funda; Özkök, Ahmet; Delil, Şakir
Amaç: Parkinson hastalarını retina sinir lifi tabakası (RSLT) ve makula kalınlıkları yönünden incelemek ve sağlıklı kontrol grubu ile karşılaştırmak Yöntem: Parkinson tanısı alan yaş ortalaması 69,2±8,2 yıl olan 25 hasta ve sistemik hastalık öyküsü bulunmayan yaş ortalaması 67,2±7,1 yıl olan 19 hasta göz bulguları açısından değerlendirildi. Hastalara Optik Koherens Tomografi (OKT) ile RSLT ve makula kalınlık ölçümleri yapıldı. Gruplar elde edilen veriler açısından Student t testi ile karşılaştırıldı. Bulgular: İnferior kadran RSLT Parkinson grubunda 133,1±19,3 ?m, kontrol grubunda ise 145,1±19,6 ?m olarak ölçüldü. İnferior kadran RSLT’deki bu incelme istatistiksel olarak anlamlı bulundu (p=0,049). Diğer kadran RSLT ve makula kalınlıklarında gruplar arası fark tespit edilmedi. Sonuç: Çalışmamızda Parkinson hastalarında inferior kadran RSLT kalınlığında azalma tespit ettik. Parkinson hastalarında retinadaki dopamin miktarında meydana gelen azalma ganglion hücre kaybına yol açarak RSLT kalınlığında incelmeye neden olabilmektedir.
Posterior polar central choroidal dystrophy: A case report
(2017) Dikkaya, Funda; Özsütçü, Mustafa; Özbek, Merve; Karaman Erdur, Sevil; Şentürk, Fevzi
A 52-year-old male presented with a 25-year history of decreasing vision. Best corrected visual acuity was 0.3 in his right and 0.2 in his left eye. Fundoscopic examination showed bilateral symmetric atrophy of the retinal pigment epithelium and choriocapillaris in the posterior polar areas between vascular arcades and surrounding the optic disc. On fluorescein angiography, the large choroidal vessels beneath these affected regions were easily seen. Fundus autofluorescence imaging showed clearly defined hypoautofluorescent areas that corresponded to the aforementioned lesions. Atrophy of the choriocapillaris and outer retinal layer were detected in optical coherence tomography. Photopic and scotopic responses were subnormal in flash electroretinogram (ERG), and responses were also minimal in pattern ERG and multifocal ERG. The patient was diagnosed with posterior polar central choroidal dystrophy. We aimed to present the results of fluorescein angiography, fundus autofluorescence imaging, optical coherence tomography, and electrophysiological tests in this rare case of posterior polar central choroidal dystrophy.
Prevalence and severity of color vision deficiency among Turkish children
(Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş., 2020) Dikkaya, Funda; Özpınar, Ayşe
Objective: To determine the prevalence of color vision deficiency, ratio of deutan/protan and the distribution of the severity of color vision deficiency among Turkish children and to evaluate the usability the Color Assessment and Diagnosis (CAD) test in children. Material and Methods: A total of 1374 children (627 girls and 747 boys) of age 6-16 years were included in this study. The first 15 plates of the Ishihara test were used to evaluate to screen for color deficiency. Those who made three or more errors had their color vision examined using the CAD test to determine the type and severity of color vision deficiency. The prevalence of color vision deficiency in boys and girls, ratio of deutan and protan deficieny and the distribution of the severity of loss were calculated. The correlations of the CAD test result and number of mistakes on the Ishihara test with age were also evaluated. Results: Thirty seven boys (4.95%) and 3 girls (0.47%) made 3 or more errors and were categorized as having color vision deficiency. In total, 32 subjects completed the CAD test, 22 subjects (68.7%) were classified as deutan and 10 (31.2%) as protan with the ratio of 2.2:1. In terms of the CAD based color vision grading system for red-green deficiency 3 subjects (9.3%) were classed as color vision (CV) category 3, 5 subjects (15.6%) as CV category 4 and 24 subjects (75%) as CV category 5. There was no significant correlation between the CAD test result and number of mistakes on the Ishihara test with age (r=-0.075, p=0.684 and r=-0.191, p=0.295 respectively). Conclusion: The results reveal severe loss of red-green color vision in 75% of the children with color vision deficiency. The study also demonstrates that the CAD test can be used in children as young as six years.
Retina ven tıkanıklığına bağlı maküla ödemi tedavisinde pro re nata protokolünde intra-vitreal bevacizumab (Avastin®) tedavisinin etki ve yan etki profili
(2016) Sultan, Pınar; Arva Çökem, Sema; Sarıcı, Ahmet Murat; Uçar, Didar; Dikkaya, Funda
Amaç: Retina ven dal tıkanıklığı (RVDT) ve santral retina ven tıkanıklığına (SRVT) bağlı maküla ödemi tedavisinde Pro Re Nata (PRN) protokolünde intravitreal bevacizumab (İVB) enjeksiyonun görme keskinliği, maküla kalınlığına etkisini ve yan etkisini değerlendirmek.Gereç ve Yöntem: Bu retrospektif çalışmada RVDT ve SRVT'ye bağlı maküla ödemi tedavisi için İVB uygulanan hastaların enjeksiyon öncesi, enjeksiyon sonrası 1. ay, 4. ay, 6. ay, 12. ay, 24. ay ve son ay en iyi düzeltilmiş görme keskinliği (EİDGK), maküla kalınlığı, göz içi basınç (GİB) değişikleri, demografik verileri ve komplikasyonları değerlendirildi.Bulgular: Yaş ortalamaları 59.24±12.26 yıl (34-82 yıl) olan 45 hastanın (26 kişi RVDT; 19 kişi SRVT hastası) 45 gözü çalışmaya dahil edildi. Hastalar ortalama 24.36±29.09 ay (4-120 ay) takip edildi ve ortalama enjeksiyon sayısı 4.62±2.89 (3-16 enjeksiyon) olarak tespit edildi. Hipertansiyon (%59.9) en sık eşlik eden sistemik hastalık, glokom (%11.1) en sık göz hastalığıydı. RVDT hastalarında İVB sonrası tüm izlem aylarında EİDGK ölçümlerinde anlamlı artış ve maküla kalınlığında anlamlı azalma izlenirken (p<0.05); SRVT hastalarında ise İVB sonrası tüm izlem aylarında EİDGK ve maküla kalınlığı ölçümlerinde istatistiksel olarak anlamlı fark tespit edilmedi (p>0.05). Hem RVDT hem de SRVT hastalarında İVB sonrası tüm izlem aylarında GİB ölçümlerinde anlamlı fark izlenmedi (p>0.05). Sonuç: RVDT ve SRVT hastalarında sistemik ve oküler risk faktörlerinin tetkiki önemlidir. RVDT hastalarında tekrarlayan İVB enjeksiyonları ile EİDGK ve maküla kalınlığında anlamlı düzelme izlenirken; SRVT hastalarında değişiklik izlenmemesi SRVT'ye bağlı maküla ödeminde PRN protokolünde İVB etkisinin daha kısıtlı olduğunu düşündürebilir.
Retinal sensitivity and fixation analysis using microperimetry in children with anisometropic amblyopia
(Slack Inc, 2020) Dikkaya, Funda; Karaman Erdur, Sevil
Purpose: To determine retinal sensitivity and fixation in children with anisometropic amblyopia using macular analyzer integrity assessment (MAIA) microperimetry (CenterVue).Methods: Amblyopic and non-amblyopic eyes of 39 children with the diagnosis of anisometropic amblyopia were compared using MAIA microperimetry in terms of average threshold, fixation indexes (P1 and P2), and bivariate contour ellipse area (BCEA) for 95% and 63% of points. The correlations between visual acuity and microperimetry parameters were also analyzed.Results: The mean average threshold was 26.6 +/- 5.9 dB for amblyopic eyes and 28.6 +/- 1.9 dB for fellow eyes (P = .003). The mean P1 index was 80.2% +/- 20.3% for amblyopic eyes and 87.6% +/- 8.7% for fellow eyes (P = .032). The mean P2 index was 92.5% +/- 9.6% and 943% +/- 4.8% for amblyopic eyes and fellow eyes, respectively. The mean BCEA95 value was 12.9 degrees(2) +/- 17.2 degrees(2) and 9.4 degrees(2) +/- 82 degrees(2) and the mean BCEA63 value was 4.4 degrees(2) +/- 5.6 degrees(2) and 3.1 degrees(2) +/- 2.7 degrees(2) for amblyopic eyes and fellow eyes, respectively. No statistically significant difference was found for those parameters (P > .05).Conclusions: Retinal sensitivity and P1 fixation index were significantly lower in amblyopic eyes compared to non-amblyopic eyes. Because measuring visual acuity does not represent all functions of the visual system, microperimetric evaluation may give extra information about total visual function of amblyopic eyes.
Retrospective analysis of short term outcomes with ab interno gel implant in the treatment of open angle glaucoma
(2021) Dikkaya, Funda; Kocabora, Mehmet Selim; Yılmazlı, Cemil; Karaman Erdur, Sevil; Aşıcı, Arzu
Aim: To evaluate the intraocular pressure (IOP) lowering and safety profiles of the Xen45 Gel Stent implantation with preoperative Mitomycin C injection during a 6 months follow-up in patients with primary open-angle glaucoma (POAG). Material and Methods: Records of fourteen eyes of 13 POAG patients who underwent surgery with XEN45 Gel Stent combined with phacoemulsification were evaluated retrospectively. IOP changes, all complications and additional procedures during follow-up period were evaluated. Primary outcome measure was IOP, and the IOP target for complete success was defined as a postoperative IOP drop of more than 20% from preoperative baseline and IOP?6 and ?21 at 6 months without any glaucoma medications and qualified success was defined as a postoperative IOP reduction of more than 20% and IOP?6 and ?21 at 6 months with or without medications. Results: Mean preoperative medicated IOP was 28.4 ± 2.7 mmHg with a mean of 2.6 ± 0.6 topical anti- glaucoma molecules. After 6 month follow-up period, mean IOP decreased to 17.8 ± 1.5 mmHg (mean IOP reduction of 37%) on 0.4 ± 1.1 antiglaucoma molecules. The complete success rate after 6 months was achieved in 42.8% and qualified success in 85.7. Totally only 2 (14.2%) patients required additional procedure (1 needling and 1 trabeculectomy). Conclusion: The study showed that the XEN45 Gel Stent implantation combined with phaco-cataract surgery is an effective surgical method in POAG in case of uncontrolled IOP with a favorable safety profile and low complication rate.

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