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A case of cone dystrophy associated with choroidal neovascularization
(2018) Gülkılık, İbrahim Gökhan; Karaman Erdur, Sevil; Eliaçık, Mustafa; Odabaşı, Mahmut; Özsütçü, Mustafa; Demirci, Göktu?; Kocabora, Mehmet Selim
PURPOSE: To report a case of choroidal neovascularization (CNV) in a patient with cone dystrophy (CD). METHODS: Case report.RESULTS: A 20-year-old woman presented with diminished vision in her right eye. Fundus examination showed perifoveal retinal pigment epithelial changes and retinal hemorrhage consistent with subretinal CNV in the right eye, and mild retinal pigment epithelial changes with a dull foveal reflex in the left eye. Optical coherence tomography analysis and fundus fluorescein angiography also confirmed the subfoveal CNV in the right eye. Electroretinography showed decreased amplitudes in photopic and 30-Hz. flicker tests in both eyes, which confirmed cone dystrophy. A single intravitreal ranibizumab injection resolved the edema and stabilized the CNV during the follow-up of 6 months.CONCLUSION: Cone dystrophy is an inherited ocular disorder characterized by loss of cone photoreceptors. Association of CNV has been reported in patients with fundus flavimaculatus, best dystrophy, gyrate atrophy, choroideremia, retinitis pigmentosa, adult-onset foveomacular vitelliform dystrophy, Sorsby macular dystrophy, Bietti crystalline dystrophy, and myotonic dystrophy-related macular dystrophy. We report a case of a patient with CD in whom CNV developed in one eye and responded to a single ranibizumab injection.
A case of pigmented, free-floating vitreous cyst treated with micropulse diode laser
(Wiley-Blackwell, 2016) Gülkılık, Gökhan; Odabaşı, Mahmut; Erdur Karaman, Sevil; Özsütcü, Mustafa; Eliaçık, Mustafa; Demirci, Göktuğ; Kocabora, Mehmet Selim
Vitreous cysts, unattached to the retina, are rare findings that can be congenital or acquired.1 Although controversy exists, congenital vitreous cysts are usually nonpigmented and are believed to originate from the hyaloid vascular system.2 In contrast, acquired cysts usually have pigmented surfaces and are thought to arise from the iris or ciliary body pigment epithelium, which then dislodges into the vitreous either spontaneously or after blunt trauma.3 These cysts are usually asymptomatic and treatment is unnecessary. Argon laser or neodymium: yttrium aluminium garnet (Nd:YAG) laser photocystotomy and cyst removal with pars plana vitrectomy (PPV) have been described for the treatment of symptomatic cysts.4–6 We describe herein the first reported treatment of a pigmented, free-floating, vitreous cyst using a micropulse diode laser.
A new technique for encapsulated blebs filtration: Vitrector assisted cystectomy
(Masson Editeur, 2018) Gülkılık, İbrahim Gökhan; Karaman Erdur, Sevil; Kocabora, Mehmet Selim; Balcı, Özlem; Eliaçık, Mustafa; Odabaşı, Mahmut; Özsütçü, Mustafa
We introduce a new technique for the management of encapsulated non filtering blebs which are unresponsive to needling procedure. A 21 year-old man with a visual acuity of 20/30 presented with encapsulated bleb in the left eye 4 weeks after a successful trabeculectomy operation with adjunctive mitomycin C for medically uncontrolled glaucoma. The internal ostium was patent on gonioscopic examination. Intraocular pressure was 35 mmHg despite multiple therapies with bimatoprost, brimonidine, and dorzalomide-timolol fixed combination. He underwent two consecutive bleb needling procedures with adjunctive subconjunctival 5-fluorouracil (5-FU) injections which were successful initially but encapsulated bleb recurred. The 5-FU augmented bleb needling was performed at the slit lamp after cleaning the patient’s eyelid and periorbital skin with 10% providone iodine followed by instillation of a drop of 5% providone iodine. Needling of the bleb was performed using a 27-gauge needle. The aim was to remove episcleral scarring which was obstructing the intrascleral pathway. This was followed by an injection of 0.1 mL of 5-FU solution (50 mg/mL) along the far posterior margins of the bleb area.
Asimetrik retinitis pigmentosa
(2017) Yalçın Özbek, Merve; Aydın, Rukiye; Özsütçü, Mustafa; Kocabora, Mehmet Selim
Otuz iki yaşında kadın hasta kliniğimize sol gözde bulanık görme şikayeti ile başvurdu. Oftalmolojik muayenesinde, görme keskinlikleri sağgözde 1,0, sol gözde 0,8 idi. Fundus muayenesinde sağ gözde oldukça küçük sınırlı bir alanda birkaç adet kemik spikülü benzeri hiperpigmente alan görüldü. Sol gözde her kadranda, yaygın kemik spikülü tarzı pigmentasyon saptandı. Fundus otofloresans incelemesinde sol gözde maküla etrafında dikkat çeken hiperreflektif halo görünümü mevcuttu. Muayene ve fundus bulguları sonucunda tek taraflı retinitis pigmentosa olarak düşünülen olguya elektrofizyolojik testler yapıldı. Yapılan elektroretinografisinde sol gözde elektroretinografi yanıtları azalmıştı. Hastadamevcut bulgular ışığında asimetrik retinitis pigmentosa düşünüldü.
Az gören hastalarda Charles Bonnet sendromu sıklığı
(Galenos Yayıncılık, 2019) Tanrıverdi, Cafer; Karaduman Erdur, Sevil; Kocabora, Mehmet Selim; Yıldız, Sultan; Hanoğlu, Lütfü
Amaç: Çalışmamızın amacı görme azlığı olan olgular arasında Charles Bonnet sendromu (CBS) sıklığının araştırılmasıdır. Yöntemler: İstanbul Medipol Üniversitesi Göz Hastalıkları Kliniği’ne başvuran hastalar poliklinik kayıtlarından retrospektif olarak tarandı. Tarama sonucunda en iyi gören gözünün düzeltilmiş görme keskinliği 0,3 ve altında olan takipli hastalar not edilip sonraki kontrollerinde CBS açısından muayene edildi. Görme keskinliği ölçümleri Snellen eşeline göre yapıldı. Şizofreni, depresyon ve alkol kullanımı olanlar çalışmaya dahil edilmedi. Sadece kompleks görsel halüsinasyonu olan olgular CBS olarak değerlendirildi. Işık çakması ya da ışık hüzmesi gibi basit görsel halüsinasyonu olan olgular CBS kabul edilmediler. Bulgular: Tarama sonucunda kriterlere uygun görme azlığı bulunan 208 olgu olduğu görüldü. Bu olguların sonraki kontrollerinde yapılan muayene ile CBS bulguları olan 12 olgunun (%5,7) olduğu tespit edildi. Olguların yaş ortalaması 71±1,4 (minimum: 61 - maksimum: 77) yıl bulundu. Bunlardan 7’si (%58,3) kadın, 5’i (%41,7) erkek hasta idi. Sonuç: CBS az gören hastalar arasında hiç küçümsenmeyecek oranda sık görülen bir hastalıktır. Bu grup hastaların mevcut oküler hastalıklarının getirdiği olumsuz koşulların yanında halüsinasyonlar nedeniyle mediko-sosyal açıdan problem yaşamamaları için hastalığın teşhisinin son derece önemli olduğunu düşünmekteyiz.
Changes in anterior chamber depth after combined phacovitrectomy
(2016) Gülkılık, Gökhan; Karaman Erdur, Sevil; Özbek, Merve; Özsütçü, Mustafa; Odabaşı, Mahmut; Demirci, Göktuğ; Kocabora, Mehmet Selim; Eliaçık, Mustafa
Objectives: To evaluate changes in anterior chamber depth (ACD) and postoperative refractive outcomes after combined phacovitrectomy.Materials and Methods: This study included 10 eyes of 10 patients that underwent combined phacovitrectomy (study group) and 14 eyes of 14 patients that underwent phacoemulsification surgery (control group) at İstanbul Medipol University Ophthalmology Department. Preoperative and 3-month postoperative best corrected visual acuity (BCVA), ACD, change in ACD and refractive outcomes were compared between the two groups.Results: Preoperative ACD, postoperative ACD at 3 months and change in ACD were similar between two groups (p=0.403, p=0.886, p=0.841). Postoperative mean refractive outcomes were 0.22±0.51 diopter in the phacovitrectomy group and -0.39±0.53 diopter in the phacoemulsification group (p=0.019). BCVA was increased in both groups (p=0.001).Conclusion: Postoperative refractive outcomes in eyes that underwent combined phacovitrectomy are different from those in eyes that underwent only phacoemulsification surgery. This is important in determining preoperative intraocular lens power before combined phacovitrectomy.
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.
Dry eye assessment in patients with vitamin D deficiency
(Lippincott Williams and Wilkins, 2018) Demirci, Göktuğ; Erdur, Sevil Karaman; Özsütçü, Mustafa; Eliaçık, Mustafa; Ölmüşçelik, Oktay; Aydın, Rukiye; Kocabora, Mehmet Selim
Objectives: The aim of this study was to evaluate tear film function in patients with vitamin D deficiency. Methods: In a single center, 60 eyes of 30 patients with vitamin D deficiency (group 1), and 60 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear break-up time (TBUT), scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity. Results: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309 +/- 9 mOsm/L, 35.78 +/- 21.44 and 1.3 +/- 0.9, respectively) compared with group 2 (295610 mOsm/L, 18.69 +/- 17.21 and 0.4 +/- 0.8, respectively) (P<0.001 for all). Schirmer I test and TBUT results in group 1 (8.5 +/- 3.7 mm and 8.7 +/- 0.6 sec, respectively) were significantly lower compared with group 2 (16.6 +/- 2.4 and 18.1 +/- 0.5, respectively) (P<0.001 for all). Conclusions: This study demonstrates that vitamin D deficiency is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitamin D deficiency may be prone to dry eye.
Dry eye assessment in patients with vitiligo
(Lippincott Williams & Wilkins, 2018) Karaman Erdur, Sevil; Aydın, Rukiye; Balevi, Ali; Özsütçü, Mustafa; Kocabora, Mehmet Selim
Purpose:To evaluate tear osmolarity and tear film parameters in patients with vitiligo.Methods:A total of 25 eyes of 25 patients with vitiligo with periocular involvement (group 1), 30 eyes of 30 patients with vitiligo without periocular involvement (group 2), and 20 eyes of 20 controls (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film breakup time, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity.Results:Mean tear osmolarity was 332 16.3 mOsm/L in group 1, 308.8 +/- 19.5 mOsm/L in group 2, and 286.3 +/- 23.4 mOsm/L in group 3 (P < 0.001). There was no significant difference in Schirmer I test results among the 3 groups (16.5 +/- 3.2 mm in group 1, 16.3 +/- 4.7 mm in group 2, and 17.4 +/- 4.2 mm in group 3) (P = 0.175). Tear film breakup time measurements in groups 1 (9.8 +/- 3.5 seconds) and 2 (10.1 +/- 4.3 seconds) were significantly lower than those in group 3 (18.5 +/- 4.0 seconds) (P <0.001). There was no significant difference among the 3 groups on the Oxford scale (0.04 +/- 0.70 in group 1, 0.03 +/- 0.33 in group 2, and 0.03 +/- 0.20 in group 3) (P = 0.865). The mean Ocular Surface Disease Index score was significantly higher in groups 1 and 2 than in group 3 (42.1 +/- 16.5 in group 1, 39.9 +/- 17.3 in group 2, and 12.3 +/- 11.6 in group 3) (P <0.001). Conclusions:This study showed that vitiligo is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitiligo with periocular involvement may be more prone to dry eye than those without ocular involvement.
Efficacy and safety of pneumatic trabeculoplasty versus timolol added to latanoprost in primary open angle glaucoma
(Soc Editrice Univ, 2013) Kocabora, Mehmet Selim; Özsütçü, Mustafa; Kandemir, Nilay; Göçmez, Erhan; Fazıl, Korhan; Gülkılık, Gökhan
Background. To compare the safety and short-term additive hypotensive effect of pneumatic trabeculoplasty (PNT) versus timolol among patients receiving topical latanoprost for primary open angle glaucoma (POAG). Patients and Methods. This study prospectively evaluated 30 eyes of 30 patients with POAG receiving latanoprost monotherapy. We randomly assigned 15 eyes to PNT plus latanoprost (Group A), and 15 eyes to latanoprost/ timolol fixed combination therapy (Group B). PNT treatment was performed at days 0, 7, and 90. Follow-up visits occurred at day 1, week 1, and months 1 and 3. Results. Compared to baseline values, both treatments significantly lowered IOP (p <= 0.001). The mean IOP for Group A was 21.13 +/- 1.6 mmHg at baseline and 18.7 +/- 1.5 mmHg at three months (p <= 0.001). For Group B, mean IOP was 20.8 +/- 1.9 mmHg at baseline and 18.9 +/- 0.8 mmHg at three months (p <= 0.001). Transient conjunctival hyperaemia, the only adverse effect occurring after PNT, was observed in all patients in Group A. Conclusion. The additive IOP-lowering effect of PNT was similar to timolol in patients with POAG receiving latanoprost.
Evaluation of changes in retinal and choroidal thickness using spectral domain optical coherence tomography in unilateral non granulomatous acute anterior uveitis
(Elsevier Masson SAS, 2019) Balcı, Özlem; Tanrıverdi, Cafer; Aydın, Ali; Özsütçü, Mustafa; Gülkılık, Gökhan; Kocabora, Mehmet Selim
Purpose: To assess retinal and choroidal thickness changes in eyes with a first episode of unilateral non granulomatous acute anterior uveitis (AU). Methods: Thirty-one patients with acute unilateral non granulomatous AU who had undergone spectral domain optical coherence tomography (SD-OCT) of both eyes were included in this retrospective study. Retinal thickness (RT) as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) and subfoveal choroidal thickness (SFCT) obtained by SD-OCT were recorded. Healthy fellow eyes of the patients served as the control. Results: A significant thickening in 1 mm of ETDRS subfield and in subfoveal choroid was observed in eyes with acute AU when compared with the unaffected fellow eyes (P = 0.005 and P < 0.00001, respectively). RT and SFCT of affected eyes did not show a significant difference in terms of HLA-B27 antigen presence or absence (P > 0.05, for all). Conclusions: Significant posterior segment changes were detected in eyes with acute unilateral non granulomatous
Evaluation of outcomes of primary pseudophakic retinal detachment surgery
(Istanbul University, 2021) Yılmazabdurrahmanoğlu, Zeynep; Özbilen, Kemal Turgay; Kocabora, Mehmet Selim; Çekiç, Osman
Objective: To evaluate the results of pars plana vitrectomy (PPV) alone and combined with circumferential scleral buckling (CSB) surgeries for aphakic or pseudophakic rhegmatogenous retinal detachment (RRD). Materials and Methods: Thirty-seven eyes of 37 patients who underwent PPV (20 and 23 Gauge) alone or PPV combined with CSB due to pseudophakic or aphakic primary RRD were included in the study. Postoperative anatomical success (AS) and functional success (FS) were evaluated. The AS was defined as a completely flattened retina without any subretinal fluids after the removal of the silicone oil tamponade, if used. The FS was defined as two or more decimal improvements in the logMAR equivalent of Snellen visual acuity. Results: The mean age of the patients was 62.43 +/- 11.40 (32-80) years, 21 (56.8%) patients were male, and 16 (43.2%) were female. The mean follow-up time was 21.35 +/- 16.86 (6-84) months. PPV combined with CSB were performed in 23 patients. AS was found to be 86.5% (32/37), FS was 49.9% (17/37). No statistically significant difference was observed in both AS and FS between the groups according to preoperative PVR presence (AS-p=0.61, FS-p=0.14), preoperative macular involvement (AS-p=0.98, FS-p=0.36), whether PPV combined with CSB (AS-p=0.97, FS p=0.29), and the type of tamponade (p>0.05 in all). Conclusion: PPV with or without CSB is safe and effective in cases with primary pseudophakic retinal detachment and achieves good AS without being affected by the presence of PVR or macular involvement. However, functional success may not always follow.
Intraoperative and early postoperative flap-related complications of laser in situ keratomileusis using two types of Moria microkeratomes
(Springer, 2014) Karabela, Yunus; Müftüoğlu, Orkun; Gülkılık, İbrahim Gökhan; Kocabora, Mehmet Selim; Özsütçü, Mustafa
The purpose of this study is to describe the incidence, management, and visual outcomes of intraoperative and early postoperative flap-related complications of laser in situ keratomileusis (LASIK) surgery using two types of Moria M2 microkeratomes. This retrospective analysis was performed on 806 primary LASIK cases. The intraoperative and early postoperative flap-related complications were identified and categorized according to type of Moria microkeratome. There were 52 intraoperative and early postoperative complications-one case of partial flap (0.124 %), one case of free flap (0.124 %), one case of small flap (0.124 %), 13 cases of epithelial defect (1.61 %), 12 cases of flap striae (1.49 %), 10 cases of diffuse lamellar keratitis (1.24 %), 10 cases of interface debris (1.24 %), three cases of epithelial ingrowth (0.37 %), and one case of microbial infection (0.124 %). The overall incidence of flap complications was 6.45 %. There were 27 right eye (6.73 %) and 25 left eye (6.17 %) complications. The incidence of complications with the Moria automated metallic head 130 microkeratome was 4.22 % and with the Moria single-use head 90 microkeratome was 2.23 %. We observed one culture-negative interface abscess which was cured with surgical cleaning and intensive medical treatment. The most common complication encountered was epithelial defects, followed by flap striae. Our study showed that LASIK with a microkeratome has a relatively low incidence of intraoperative and early postoperative flap complications. The authors have no financial interest in any of the issues contained in this article and have no proprietary interest in the development of marketing of or materials used in this study.
Invivo generated autologous plasmin enzyme assisted vitrectomy, partial circumferential-oral retinotomy, silicone oil injection in patients with chronic retinal detachment without posterior vitreous detachment
(2024) Aras, Cengiz; Şentürk, Fevzi; Karaman Erdur, Sevil; Doğramacı, Mahmut; Kocabora, Mehmet Selim; Demircan, Ali; Budak, Yunus Emre
Purpose: To report the results of invivo generated autologous plasmin enzyme(IVAP) assisted vitrectomy, partial circumferential-oral retinotomy and silicone oil injection for surgical treatment of patients with chronic retinal detachment without posterior vitreous detachment(PVD). Methods: Study was performed in retrospective, comparative manner. A total of 16 consecutive eyes with chronic retinal detachment who had intravitreal injection of 50 µgr of t-PA and 0.1 ml of autologous whole blood, 3 days before surgery, underwent lens extraction with phacoemulsification, IVAP assisted vitrectomy, partial circumferential-oral retinotomy, and silicone oil injection(Study Group) were compared to a similar group of 15 eyes who had undergone vitrectomy, with or without lens extraction and silicone oil injection(Control Group) for the treatment of chronic retinal detachment. Primary outcome measures were initial retinal reattachment and number of operations at postoperative 6 months. Results: Mean age of 16 patients of whom 7 were female, was 39.31 ± 17.76 years in study group and 15 patients of whom 4 were female, was 35.40 ± 11.92 years (p = 0.607). Mean follow-up time was 10.68 ± 7.15 months in study group and 29.13 ± 18.83 months in control group (p = 0.001). Initial retinal reattachment was achieved in 87.50% (14 out of 16 patients) in the study group, whereas it was 46.66% (7 out of 15 patients) in the control group (p = 0.017). The mean number of operations for reattachment in the study group was 1.12 ± 0.34, whereas it was 1.46 ± 0.51 in the control group (p = 0.039) at postoperative 6 months While the preoperative LogMAR visual acuity was 1.25 ± 0.64, it was 0.53 ± 0.37 at postoperative 6 months in study group (p = 0.001). Conversely, in the control group, the preoperative LogMAR visual acuity was 1.22 ± 0.33, it was 1.20 ± 0.89 at postoperative 6 months (p = 0.780). At postoperative 6 months,, epiretinal membrane developed in 2 eyes of the study group, 1 eye in the control group, and phthisis bulbi occurred in 1 eye of control group. Conclusion: IVAP assisted vitrectomy, partial circumferential-oral retinotomy and silicone oil injection is effective and safe for the surgical treatment of chronic retinal detachment without PVD. (Figure presented.)
Lipemia retinalis following FLAG-Ida protocol in an 11-year-old patient with acute myeloid leukemia
(2025) Kaplan Koruk, Reyhan Hazal; Kocabora, Mehmet Selim; Karaman Erdur, Sevil; Yaman, Yöntem
Introduction: We report a case of early-onset lipemia retinalis secondary to the FLAG-Ida protocol in the treatment of acute myeloid leukemia (AML) in an 11-year-old girl. Case Report: An 11-year-old patient, diagnosed with AML at four months old, experienced a relapse and was treated with the FLAG-Ida protocol (fludarabine, idarubicin, granulocyte-colony stimulating factor, and high-dose cytarabine). Prior to allogeneic stem cell transplantation, she underwent a pre-transplantation eye examination. The patient exhibited normal visual acuity in both eyes. Fundus examination revealed cream-white retinal vessels and a salmon-pink retina, indicative of grade 3 lipemia retinalis. Laboratory tests, normal before treatment initiation, showed significantly elevated serum cholesterol (727.6 mg/dL) and triglyceride (6015.6 mg/dL) levels post-treatment. After receiving fenofibrate, these levels decreased markedly, and the retinal vessels normalized on follow-up fundus examination. Conclusion: Lipemia retinalis, characterized by creamy-white retinal vessels resulting from hypertriglyceridemia, can develop as a secondary condition to chemotherapy. Early detection and treatment of hyperlipidemia are crucial to prevent severe ocular and systemic complications. This case highlights the importance of monitoring lipid levels and conducting thorough ophthalmologic examinations in patients undergoing chemotherapy.
Measurement of intraocular pressure with applanation, dynamic contour, and air-puff tonometers: A comparative study in primary open-angle glaucoma and healthy cases
(2020) Özbilen, Kemal Turgay; Kocabora, Mehmet Selim
Objectives: This study aimed to investigate and compare the reliability of Goldmann applanation tonometer (GAT), dynamic contour (DCT), and noncontact (NCT) tonometers in intraocular pressure (IOP) measurement and the affecting parameters in healthy subjects and cases with primary open-angle glaucoma (POAG). Methods: Left eyes of 64 cases (32 males and 32 females) were selected for this prospective, controlled study. Of these cases, 33 had POAG, and 31 were selected as control. IOP measurement was performed using NCT, DCT, and GAT consecutively for each patient, and then central corneal thickness (CCT) was measured. Ocular pulse amplitude (OPA) and all values were recorded. Results: The mean age was 53.36±10 years (31–80 years), and CCT was 561±45 ?. IOP was found as 16.39±3.75 mmHg with GAT, 17.89±3.55 mmHg with DCT, and 15.76±3.49 mmHg with NCT. A significant difference was found between DCT with NCT and GAT. Whereas, a positive correlation was found between CCT with all the three methods used, with DCT as the weakest. While the correlation between all the three methods was excellent, the strongest was found to be between DCT and GAT. Thick corneas affected all the three methods, but DCT was the least affected. While DCT tends to measure higher than both GAT and NCT, this difference decreased as the corneal thickness increased. OPA was found to be 2.56±1.04 mmHg; no statistical difference was found between the groups. A correlation was found between OPA and IOP, and OPA was found to be significantly higher in women. Conclusion: DCT is minimally affected by corneal factors, especially in thin corneas, and shows excellent correlation with GAT. This new-generation digital tonometer can be used safely in glaucoma diagnosis and follow-up
Ocular surface and tear parameters in patients with chronic hepatitis c at initial stages of hepatic fibrosis
(Lippincott Williams and Wilkins, 2015) Karaman Erdur, Sevil; Kulaç Karadeniz, Derya; Kocabora, Mehmet Selim; Özsütçü, Mustafa; Gülkılık, İbrahim Gökhan; Demirci, Göktuğ; Eliaçık, Mustafa
Purpose: The aim of this study was to evaluate changes in ocular surface and tear function parameters in chronic hepatitis C at initial stages of hepatic fibrosis. Methods: Thirty-one patients with biopsy-proven chronic hepatitis C and 31 age-and sex-matched healthy control subjects without systemic hepatitis C infection were examined with the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I, tear film break-up time, and scoring of ocular surface fluorescein and Rose Bengal staining using modified Oxford and van Bijsterveld scoring systems, respectively. Results: All ocular surface parameters, except OSDI and corneal staining scores, were significantly worse in hepatitis C group. The control group had greater OSDI scores than the hepatitis C group, but there was no statistically important difference. In subgroup analysis, progression of hepatic fibrosis was found to be correlated strongly with decreased Schirmer test I, increased OSDI, lid parallel conjunctival folds, conjunctival, and corneal staining scores. Conclusion: Patients with chronic hepatitis C were more likely to exhibit severe ocular surface damage and signs of dry eye.
Power spectral density and coherence analysis of eye disease with and without visual hallucination
(Elsevier Ireland Ltd, 2021) Yıldız, Sultan; Yuluğ, Burak; Kocabora, Mehmet Selim; Hanoğlu, Lütfü
Objectives: Charles Bonnet Syndrome (CBS) is a rare clinical condition which has been defined as complex visual hallucinations (CVH) due to visual loss. This study investigated differences in the EEG power spectral density (PSD) and magnitude-squared coherences between patients with eye disease and hallucinations (VH+), and the control subjects with eye disease without hallucinations (VH-). Methods: 19 scalp channels EEG was recorded in four VH+ (CBS) and four VH- subjects during an eyes-closed resting condition. Artefact-free epochs were analyzed to obtain PSD values in the delta, theta, alpha1, alpha2, beta1, beta2 and gamma frequency bands. Coherence values were calculated through inter-hemispheric and intra-hemispheric electrodes pairs of interest. All subjects were performed with neuropsychological and behavioral assessments to evaluate cognitive functions. Results: The VH + group had increase PSD in theta, beta2 and gamma bands in central, parietal and occipital (O2) areas. The synchronicity was altered particularly in parietal and frontal-parietal regions especially at theta and alpha1 respectively. Conclusions: The aberrant activity in occipital and parietal regions suggest the mechanism of CBS. This is a major electrophysiological study of understanding CBS and visual hallucinations.
Predicting the refractive outcome and accuracy of IOL power calculation after phacoemulsification using the SRK/T formula with ultrasound biometry in medium axial lengths
(Dove Medical Press Ltd., 2017) Karabela, Yunus; Eliaçık, Mustafa; Kocabora, Mehmet Selim; Karaman Erdur, Sevil; Baybora, Hakan
Purpose: To evaluate the accuracy of the SRK/T formula using ultrasound (US) biometry in predicting a target postoperative refraction of +/- 1.00D in eyes with medium axial length (AL) that underwent phacoemulsification. Methods: The present study was a retrospective analysis, which included 538 eyes with an AL from 22.0 to 24.60 mm that underwent phacoemulsification and foldable intraocular lens (IOL) implantation (six different IOLs) in the bag. Preoperative AL was measured by US biometry and IOL power (IOLp) was calculated with the SRK/T formula. Patients had a complete ophthalmic examination, preoperatively and 1, 7, and 30 days after surgery. The achieved spherical equivalent (SE) and the prediction error (PE) were calculated. The prediction error was defined as the difference between attempted predicted target refraction and the achieved postoperative SE refraction. Statistical analysis was performed with SPSS V21. Results: The mean age of the patients was 66.96 +/- 9.67 years, the mean AL was 23.29 +/- 0.62 mm, the mean K1 was 43.62 +/- 1.49D, the mean K2 was 43.69 +/- 1.53D, the mean IOL power was 21.066 +/- 1.464D, the mean attempted (predicted) SE was -0.178 +/- 0.266D, and the mean achieved SE was -0.252 +/- 0.562D. The mean PE (difference between predicted and achieved SE) showed a relatively hyperopic shift (mean +/- standard deviation: 0.074 +/- 0.542D, ranging from -1.855 to 2.170D, P=0.001). A total of 93.87% of eyes were within +/- 1.00D of the PE and 92.75% of eyes within +/- 1.00D of achieved postoperative refraction. A total of 39 eyes (7.25%) had a refractive surprise. A total of 32 of 39 eyes were more myopic than -1.00D and 7 of them were more hypermetropic than +1.00D. There was no correlation between the mean PE and IOL type, AL, K1, K2, and IOLp. There were a positive statistically significant correlation between PE and age (r=0.095; P=0.028) and a negative statistically significant correlation between achieved SE and AL (Spearmans r=-0.125; P=0.04), and age (r=-0.141; P=0.01). Conclusion: The IOLp calculation using the SRK/T formula with US biometry may demonstrate very good postoperative refractive outcomes in medium eyes with a few refractive surprises.
Preoperative co-application of bevacizumab and tissue plasminogen activator in vitrectomy for proliferative diabetic retinopathy
(Consel Brasil Oftalmologia, 2024) Aras, Cengiz; Şentürk, Fevzi; Karaman Erdur, Sevil; Kocabora, Mehmet Selim; Doğramacı, Mahmut; Burke, Cahit; Aras, Efe
PURPOSE: To investigate the clinical benefits of the co-application of bevacizumab and tissue plasminogen activator as adjuncts in the surgical treatment of proliferative diabetic retinopathy. METHODS: Patients who underwent vitrectomy for proliferative diabetic retinopathy complications were preoperatively given intravitreal injection with either bevacizumab and tissue plasminogen activator (Group 1) or bevacizumab alone (Group 2). Primary outcomes were surgery time and number of intraoperative iatrogenic retinal breaks. Secondary outcomes included changes in the best-corrected visual acuity and postoperative complications at 3 months postoperatively. RESULTS: The mean surgery time in Group 1 (52.95 +/- 5.90 min) was significantly shorter than that in Group 2 (79.61 +/- 12.63 min) (p<0.001). The mean number of iatrogenic retinal breaks was 0.50 +/- 0.59 (0-2) in Group 1 and 2.00 +/- 0.83 (0-3) in Group 2 (p<0.001). The best-corrected visual acuity significantly improved in both groups (p<0.001). One eye in each group developed retinal detachment. CONCLUSION: Preoperative co-application of bevacizumab and tissue plasminogen activator as adjuncts in the surgical treatment of proliferative diabetic retinopathy shortens the surgery time and reduces the number of intraoperative iatrogenic retinal breaks.

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