Browsing by Author "Ozer, Muhammet Derda"

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Anti-Tumor Necrosis Factor-Alpha Treatment in Pediatric Patients With Pars Planitis: a Single-Center Experience From Turkey
(Springer, 2023) Ozer, Muhammet Derda; Batur, Muhammed
Aim To evaluate the effectiveness and safety of anti-tumor necrosis factor-alpha (anti-TNF-alpha) treatment (Adalimumab [ADA]) combined with immunomodulatory agents (IMAs) in the treatment of pars planitis (PP). Methods The patients with PP who were treated with anti-TNF-alpha agents for at least six months were qualified for the chart review. The outcome parameters were the steroid-free remission state, the best-corrected visual acuity (BCVA) and the central macular thickness (CMT) of the patients at the last visit. Results After a mean total follow-up time of 15.5 +/- 5.8 months (8-24 months), all the cases were in steroid-free remission at the last visit. The mean BCVA increased, and the mean CMT decreased significantly at the last visit (p < 0.001, p < 0.001, respectively). Conclusion ADA combined with IMAs offers effective and safe treatment modalities in the control of chronic intraocular inflammation in PP cases.
Authors' Reply To: Using Anterior Segment Optical Coherence Tomography To Compare the Smoothness of Anterior Iris Surface Between Two Eyes in Unilateral Fuchs' Uveitis Syndrome
(Springer, 2019) Ozer, Muhammet Derda; Kebapci, Fatih; Batur, Muhammed; Seven, Erbil; Tekin, Serek
Bakteriyel Keratit Tedavisinde Koenzim Q10 Göz Damlasının Korneal Yara İyileşmesi Üzerine Etkisi: Prospektif Klinik Çalışma
(2024) Batur, Muhammed; Seven, Erbil; Tekin, Serek; Ozer, Muhammet Derda
Amaç: Bu çalışmada, bakteriyel keratitte Koenzim Q10 (KoQ10) göz damlasının korneal yara iyileşmesi üzerindeki etkinliğini ve güve- nilirliğini değerlendirmeği amaçladık. Gereç ve Yöntemler: Bakteri- yel keratit tanısıyla yatırılarak tedavisi yapılan hastalar çalışmaya alındı. Hastaların yaşı, cinsiyeti ve hangi gözün tutulduğu kaydedildi. Hasta- lara tam bir göz muayenesi yapıldı ve hipopiyon olup olmadığı kayde- dildi. Korneal ülser büyüklüğü yatay ve dikey olarak ölçüldü. Hastalar rastgele 2 gruba ayr ıldı. Her iki gruba da topikal antibiyotik ve siklo- pentolat damla verildi. Birinci gruba ek olarak KoQ10 göz damlası 4×1 tedaviye eklendi. Tedavi öncesi ve tedaviye ba şlandıktan sonra ülser iyileşene kadar günlük olarak korneal ülser görüntüleri al ındı ve kay- dedildi. Bulgular: Çalışmaya alınan toplam 32 hastanın yaş ortalaması 51,16±25,31 (7-90) yıl olup, 20’si (%62,5) erkek, 12’si (%37,5) kadın idi. KoQ10 göz damlası verilen grup (n=16) ile kontrol grubunun (n=16) yaş, cinsiyet, sağ-sol göz tutulumu, hipopiyon varlığı ve korneal ülser boyutu açısından istatistiksel olarak anlamlı farkı yoktu (p>0,05). Or- talama iyileşme süresi KoQ 10 göz damlası verilen grupta 12,25±6,02 gün ve kontrol grubunda 19±12,9 gün idi (p=0,076). Sonuç: KoQ10 göz damlası, bakteriyel keratite bağlı gelişen korneal ülser tedavisindeki etkisi istatistiksel olarak anlaml ı bulunamadı. Ancak iyile şme süresi- nin kısalması açısından adjuvan ajan olarak düşünülebilir. Bu konuda daha geniş serilere sahip randomize, prospektif klinik çalışmalara ihti- yaç vardır.
Choroid Vascularity Index as a Parameter for Chronicity of Fuchs' Uveitis Syndrome
(Springer, 2020) Ozer, Muhammet Derda; Batur, Muhammed; Tekin, Serek; Seven, Erbil; Kebapci, Fatih
Purpose This study aimed to compare the choroidal vascularity index (CVI) of eyes having Fuchs' uveitis syndrome (FUS) with healthy fellow eyes (N). Methods This prospective, cross-sectional study included unilateral FUS cases and an age- and gender-matched healthy control group. Thirty-nine participants were included in the FUS group, and 24 age- and gender-matched individuals were randomly selected for the control group. Endothelial cell density (ECD) was measured using Tomey specular microscopy. Spectral-domain optical coherence tomography was used to acquire the choroidal images, and binarization was applied to the images. Two blinded investigators analyzed the CVI in both eyes of the FUS cases and the right eyes of the healthy control group. Results CVI was found to be significantly decreased in FUS (p < 0.001). Additionally, ECD had a strong positive correlation with CVI (r = 0.383, p = 0.008). Conclusion CVI may provide information about the chronicity of the disease.
Comparison of Both Eyes Anterior Segment Structures of Patients With Unilateral Blunt Trauma
(Elsevier, 2023) Mesen, Selma; Ozer, Muhammet Derda; Kebapc, Fatih; Batur, Muhammed
Background: To evaluate anterior segment optical coherence tomography (AS-OCT) data in patients with unilateral blunt ocular trauma (BOT), to determine the relationship of results with hyphema development.Methods: 21 patients who received unilateral BOT were included in the study. Healthy eyes of patients were included in the control group. Iris stromal thickness (IST), schlemm canal area (SCA) and pupil diameter were measured by AS-OCT of the participants. In addition, eyes with ocular trauma were divided into those with and without hyphema and compared in terms of these parameters. Results: The mean nasal and temporal (n-t) IST was measured as 373 & PLUSMN; 40 & mu;m and 369 & PLUSMN; 35 & mu;m in BOT in comparison with 344 & PLUSMN; 35 & mu;m and 335 & PLUSMN; 36 & mu;m in control eyes, respectively (p = 0.000 and p = 0.001, respectively). The mean nasal and temporal (n-t) SCA was measured as 12,571 & PLUSMN; 880 & mu;m2 and 12,162 & PLUSMN; 1181 & mu;m2 in developed hyphema in comparison with 10,455 & PLUSMN; 1506 & mu;m2 and 10,188 & PLUSMN; 939 & mu;m2 in did not develop hyphema, respectively (p = 0.016 and p = 0.002 respectively).Conclusion: The ISTs of the traumatized eyes in the nasal and temporal quadrants were statistically thicker than the other healthy eyes. SCA in both nasal and temporal quadrants of eyes with hyphema was statistically significantly larger than the group without hyphema.
Comparison of the Efficacy of Accelerated Corneal Cross-Linking Therapy in Different Pediatric Age Groups Having Progressive Keratoconus
(Springer, 2020) Ozer, Muhammet Derda; Batur, Muhammed; Mesen, Selma; Tekin, Serek; Seven, Erbil; Yasar, Tekin
Purpose To report a comparison analysis of accelerated corneal cross-linking (A-CXL) treatment for progressive keratoconus patients in different pediatric age groups. Study design Retrospective, cross-sectional. Methods Patients with progressive keratoconus aged <= 18 were retrospectively reviewed. Forty-one eyes of 41 patients were included in the study. Patients were divided into two groups according to their age (<= 14 years and 15-18 years). All patients underwent epithelium-off A-CXL protocol. Acquired data were compared between the two groups. Results The mean age was 14.3 +/- 1.8 (10-18) years. Twenty-five (61%) of the participants were male, and 16 (39%) were female. Twenty (49%) patients were separated into group 1 (<= 14 years of age), and 21 (51%) were in group 2 (15-18 years). Age at presentation was found to be the only factor in anticipating the progression of keratoconus at the second postoperative year visit (p < 0.001). Progression in keratometric values was detected in seven (35%) of the 20 eyes in group 1, and one (4%) of the 21 patients in group 2 (Z = - 2.44, p = 0.014). Conclusion Even if proper treatment is applied, the progression of keratoconus is likely in patients younger than 14 years of age. Instead of evaluating pediatric patients as a whole, closer follow-up and early treatment may be useful in younger age groups (<= 14 years).
Corneal and Lens Densitometry in Patients With Vernal Keratoconjunctivitis
(Springer, 2021) Yilmaz, Yusuf Cem; Ipek, Sefik Can; Ozer, Muhammet Derda
Aim To evaluate corneal and crystalline lens densitometry in patients with vernal keratoconjunctivitis (VKC). Methods This is a case-control study. Patients with VKC and age-gender-matched healthy controls underwent a complete ophthalmologic examination with corneal and crystalline lens densitometry measurements. Additionally, the anterior chamber parameters comprise anterior and posterior K-mean and astigmatism, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pachymeter, and corneal volume (CV). Patients who had clinically grade 0 or grade 1 VKC and with only tarsal conjunctiva involvement during the conductance of the study were included. The variables were compared statistically. Results One hundred and nine eyes were included in the study, in which fifty-one were in the VKC group. There were 25 males in the VKC group (26 female) and 22 males in the control group (36 female). A statistically significant difference was found between the groups in terms of posterior corneal astigmatism (p = 0.02). The mean corneal pachymeter, CV, ACD, ACA, and ACV were similar in both groups (p = 0.63, p = 0.26, p = 0.60, p = 0.41, and p = 0.32, respectively). The total mean corneal densitometry in the zones extending from 6 to 10 mm and 10 to 12 mm was increased in the VKC group compared to the control group (p = 0.04 and p = 0.012, respectively). The mean crystalline lens was found to be denser in the VKC group compared to the control group (8.96 +/- 1.6 vs. 8.5 +/- 0.57, respectively, p = 0.04). Conclusion Posterior corneal astigmatism is increased in VKC cases in comparison with age- and gender-matched controls. The peripheral anterior 6-12 mm annular corneal zone showed increased corneal densitometry in VKC cases compared to the healthy subjects. Additionally, the lens clarity is found to be decreased subclinically in VKC cases compared to control cases.
Corneal Parameters, Ocular Biometers, and Retinal and Choroidal Thickness in Acromegaly Patients
(Elsevier, 2023) Batur, Muhammed; Ozer, Muhammet Derda; Ucler, Rifki; Seven, Erbil; Tekin, Serek; Unal, Fikret
Background: To compare ocular findings of acromegaly patients with healthy individuals and investigate the relation of serum levels of insulin-like growth factor (IGF-1) along with growth hormone (GH) and pituitary tumor (adenoma) dimensions (TD) with specific ocular parameters. Methods: The ocular parameters of acromegaly patients (n = 38) were compared with those of healthy subjects (n = 36). These parameters were intraocular pressure, keratometric (K1-K2) values, central corneal thickness (CCT), total axial length along with anterior chamber-lens-vitreous length, retinal nerve fiber layer (RNFL) thickness, central foveal thickness (CFT), choroidal thickness (CT), ganglion cell layer thickness (GCLT), and inner plexiform layer thickness (IPLT). Also investigated was whether there was a correlation between disease duration, TD, GH, IGF-I, CCT, RNFL, CFT, GCLT, IPLT, and CT. Results: The lens length of the acromegaly group was increased (p = 0.014). GH and IGF-1 levels were positively correlated with CT and CCT, respectively (p = 0.041, r = 0.343) (p = 0.03, r = 0.347). Analysis of TD also found a highly negative correlation with the mean RNFL thickness of the acromegaly patients (p < 0.01, r = -0.603). The mean value of the inner parts of GCLT and IPLT was negatively correlated with TD (p = 0.041, r = -0.343 and p = 0.025, r = -0.379, respectively). Conclusion: Serum IGF-1 and GH levels might be determinant factors in CCT and CT, respectively. The pituitary adenoma size increasing may be prone to lead RNFL, ganglion cell layer, inner plexiform layer thinning. Increased lens thickness was found in the acromegaly group.
The Depigmentation Degree of Iris Pigment Epithelium in Pseudoexfoliation Syndrome
(Elsevier, 2021) Ozer, Muhammet Derda; Batur, Muhammed; Tekin, Serek; Seven, Erbil; Kebapci, Fatih; Bilmez, Rumeysa
Background: To compare the optical density of iris pigment epithelium (ODIPE) and iris stromal thickness (IST) measurements in patients having pseudoexfoliation syndrome (PXS) and age-gender matched participants. Methods: This is a cross-sectional study. Patients with PXS were enrolled in the study group. Age and gendermatched healthy subjects with no evidence of PXS were recruited as controls. After a comprehensive ophthalmological evaluation, the anterior segment images were acquired using anterior segment spectral-domain optical coherence tomography (AS SD-OCT). The acquired pictures were further analyzed using the ImageJ program. Two investigators measured the ODIPE and the IST of the subjects, and the repeatability and reproducibility were checked. SPSS program was used for statistical analysis. Results: The PXS group was comprised of twenty-two eyes (n = 22 patients), and the control group contained twenty-six eyes of 26 age and gender-matched healthy subjects. The mean temporal ODIPE of the study group was found to be decreased significantly in comparison to the mean temporal ODIPE of the control eye (p = 0.018). Both the mean nasal (N) and temporal (T) ISTs of the PEX eyes were thinner than the control eyes (p = 0.006 and p = 0.002, respectively). The mean baseline IOP was found to significantly negatively correlate with the ODIPE in the PEX group at both N and T sides (r = -0.531, p = 0.011 and r = -0.685, p < 0.001, respectively). Conclusion: The pupillary margin IPE was found more depigmented, and the mean N and T IST were significantly thinner in the PEX group by comparison with the age-gender matched healthy controls. The mean baseline IOP was negatively correlated with the pupillary margin's IPE pigmentation degree in patients with PXS.
Effect of Insulin Therapy on Ocular Biometric Parameters in Diabetic Patients
(Mary Ann Liebert, inc, 2020) Seven, Erbil; Yildiz, Saliha; Tekin, Serek; Altas, Ahmet Serkan; Ozer, Muhammet Derda; Batur, Muhammed; Yasar, Tekin
Purpose: To evaluate effects of insulin on ocular parameters in patients with type 2 diabetes mellitus who start insulin therapy. Methods: In this prospective study, ocular biometric parameters were obtained using optical biometer (Lenstar LS900; Haag-Streit AG) and refraction test (ARK-510A Auto refracto-keratometer; Nidek Co. Ltd, Aichi, Japan) before and at 3 months after initiating insulin therapy. In addition, patients' fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C), and blood lipid levels were measured at the same time points. Pretreatment and post-treatment results were compared. In addition, associations between ocular parameters with initial dose and type of insulin treatment regimen, HbA1C, and FBG levels were evaluated. Results: The patients' mean age was 51.2 +/- 12.9 (18-73) years. Post-treatment HbA1C and FBG levels (8.5% +/- 2.5% and 188.1 +/- 111.2 mg/dL, respectively) were significantly lower than pretreatment values (12% +/- 1.4% and 325.3 +/- 95.7 mg/dL, respectively; P < 0.001 for both). There was a significant positive correlation between the change in HbA1C and the change in lens thickness (P = 0.03), and a significant negative correlation between the change in FBG and the change in the spherical equivalent refraction (P = 0.045). Insulin dose and treatment regimen type were not significantly correlated with ocular parameters (P > 0.05). Conclusion: HbA1C-lowering glycemic effect of insulin was correlated with a small decrease in lens thickness. Long-term, randomized controlled trials including larger patient numbers are needed to shed light on the long-term effects of insulin use and glycemic control on ocular parameters.
Effectiveness of Pulmonary Surfactant in the Treatment of Corneal Edema
(Mary Ann Liebert, inc, 2021) Artuc, Tuncay; Batur, Muhammed; Seven, Erbil; Tekin, Serek; Ozer, Muhammet Derda
Purpose: To compare the effectiveness of topical surfactant and 3% sodium chloride (NaCl) in the treatment of corneal edema occurring after cataract surgery. Methods: Ninety eyes of 90 patients with no corneal disease who underwent cataract surgery were included in the study. Thirty eyes without corneal edema comprised group 1. Patients with corneal edema were divided into two groups: those treated with 3% NaCl (group 2, 30 eyes) and those treated with surfactant drop (group 3, 30 eyes). Results: The mean age was 70.8 +/- 6.6 years, with no significant age difference between the groups. Preoperatively, there was no significant difference in mean central corneal thickness (CCT) or mean endothelial cell count (ECC) among the groups (P = 0.999). On postoperative day 1, CCT was significantly lower in group 1 (P < 0.001) but did not differ between groups 2 and 3 (P = 0.999). There was no significant difference between groups in terms of ECC (P > 0.05). At postoperative day 7 and 14, CCT differed significantly between groups 1 and 2 (P < 0.001) and between groups 2 and 3 (P = 0.001), with no significant difference between groups 1 and 3 (P = 0.474). ECC was significantly higher in group 1 (P < 0.05), whereas there was no significant difference between groups 2 and 3 (P > 0.05). Conclusion: Topical pulmonary surfactant may be a more effective treatment option than 3% hypertonic NaCl for the treatment of corneal edema that develops after cataract surgery.
Evaluation of Successful and Failed Filtering Blebs After Trabeculectomy Using Anterior Segment Optical Coherence Tomography
(Wolters Kluwer Medknow Publications, 2021) Tekin, Serek; Seven, Erbil; Batur, Muhammed; Ozer, Muhammet Derda; Yasar, Tekin
Purpose: To evaluate filtering bleb characteristics using anterior segment optical coherence tomography (AS-OCT) and analyze correlations between these parameters and intraocular pressure (IOP). Methods: The study included 54 eyes of 43 patients who underwent trabeculectomy with mitomycin-C. The patients were divided into two groups based on mean postoperative IOP. The criterion for surgical success was mean unmedicated postoperative IOP <= 18 mmHg. Patients with IOP values >18 mmHg were prescribed anti-glaucoma drops and classified as a surgical failure. All patients underwent AS-OCT, and maximum bleb height, maximum bleb wall thickness, and maximum fluid-filled cavity height were measured. AS-OCT bleb parameters were compared between the successful and failed groups. Results: Of the 54 eyes, 37 (68.5%) were in the successful group, and 17 (31.5%) were in the failed group. Mean preoperative IOP values in the successful and failed groups were 26.9 +/- 6.5 mmHg and 22.9 +/- 4.9 mmHg, preoperatively, versus postoperative values of 13.3 +/- 2.1 mmHg and 22.8 +/- 2.8 mmHg, respectively. Mean postoperative follow-up time was 17.4 +/- 9.5 months in the successful group and 19.1 +/- 10.1 months in the failed group (P = 0.22). In the successful and failed groups, mean bleb height was 1473.7 +/- 150.6 mu m and 1165.4 +/- 217 mu m (P < 0.001), bleb wall thickness was 670.5 +/- 119.9 mu m and 538.8 +/- 144.3 mu m (P = 0.001), and fluid-filled cavity height was 736.5 +/- 196.8 mu m versus 532.5 +/- 226.2 mu m (P = 0.001), respectively. Conclusions: The results of this study showed that higher AS-OCT values for bleb height, wall thickness, and fluid-filled cavity height were associated with greater functional success. These parameters may be helpful in determining bleb functionality.
Evaluation of the Initial Optical Coherence Tomography Parameters in Anticipating the Final Visual Outcome of Central Retinal Vein Occlusion
(Wolters Kluwer Medknow Publications, 2020) Ozer, Muhammet Derda; Batur, Muhammed; Mesen, Selma; Tekin, Serek; Seven, Erbil
Purpose: To evaluate the predictive and associated factors in determining the visual outcome in patients having central retinal vein occlusion (CRVO)-related macular edema (ME). Methods: The charts of the patients who were treated due to CRVO-related visual disturbance were reviewed. The optical coherence tomography (OCT) images of eyes were analyzed, and disorganization of retinal inner layers (DRILs), ellipsoid zone (EZ) and external limiting membrane (ELM) disruption length, hyper-reflectivity of retinal inner layer (HRIL) existence, baseline and final visual acuity (VA), subfoveal thickness (SFT), subretinal fluid (SRF), and injection numbers were noted. The regression and correlation analyses were applied. Results: Thirty eyes of thirty patients were included in the study. The mean follow-up time was 17.5 +/- 11 (8-47) months. The mean baseline VA was 1.4 +/- 0.7 (0.2-3.1) logMAR. A total of 87 intravitreal injections were applied for the treatment of ME during the follow-up. The initial mean central subfield thickness was 795 +/- 264 (1470-398) mu m. HRIL and SRF were observed in 16 and 23 eyes at the initial visit, respectively. The final mean VA was 1.2 +/- 0.9 (0.1-3.1) logMAR. At the final visit, additional OCT parameters were evaluated. The mean DRIL length was 463 +/- 324 mu m. The mean disruption length of EZ and ELM was 367 +/- 247 mu m and 414 +/- 327 mu m, respectively. The final mean SFT was 290 +/- 91 mu m. SRF presence at the initial visit was found to be associated with elongated EZ and ELM disruption length at the final visit (P = 0.03 and P = 0.04, respectively). On linear regression analyses, none of the baseline features (SRF, SFT, and HRIL) except baseline poor best corrected visual acuity were found to be predictive in anticipating the final visual outcome (P = 0.04). On linear bivariate analysis, the final poor visual outcome was found to be affected by EZ disruption length of >= 500 mu m at the last visit (P = 0.02). Conclusion: Baseline VA was the only predictive factor in anticipating the final visual outcome. At the final visit, extensive disruption length of EZ in the subfoveal area was associated with a poor visual outcome.
Hemicentral Retinal Artery Occlusion: a Rare Complication of Orbital Cellulitis
(Slack inc, 2020) Seven, Erbil; Artuc, Tuncay; Tekin, Serek; Batur, Muhammed; Ozer, Muhammet Derda
A 14-year- old boy presented with acute vision loss and swelling of the right eye. An anterior segment examination revealed a relative afferent pupillary defect, severe proptosis, and ophthalmoplegia in his right eye. The fundus examination revealed inferior hemicentral retinal artery occlusion. Although the authors proceeded with systemic medical treatment, the findings did not improve. An endoscopic orbital decompression was performed. With both medical and surgical treatment, the orbital cellulitis resolved and the patient's visual acuity improved.
In Vivo Analysis and Comparison of Anterior Segment Structures of Both Eyes in Unilateral Fuchs' Uveitis Syndrome
(Springer, 2019) Ozer, Muhammet Derda; Kebapci, Fatih; Batur, Muhammed; Seven, Erbil; Tekin, Serek
PurposeTo compare corneal endothelial cell density (ECD), iris stromal thickness (IST), iris pigment epithelium optical density (IPE OD), and Schlemm's canal (SC) measurements in patients having unilateral Fuchs' uveitis syndrome (FUS).MethodsThis is a randomized, prospective study. Currently, diagnosed unilateral FUS and phakic cases were defined to be the inclusion criteria to the study. The specular microscope was used to measure ECD. Anterior segment images were acquired by using SD-OCT. The images were extracted and uploaded to the ImageJ program for further analysis. Two blinded investigators analyzed the IST, IPE OD, and SC area in both healthy (N) and affected eyes (FUS) and the comparative analysis was made by using SPSS program.ResultsOf twenty-one participants, 13 were female (62%). The mean age of the participants was 309 (18-47) years. ECD was 2228 +/- 365 and 2513 +/- 209cells/mm(2) in the FUS and N, respectively (p<0,001). In FUS, the mean nasal and temporal (n-t) IST was measured as 380 +/- 44 and 347 +/- 41m, compared to 393 +/- 61 and 355 +/- 62m in N, respectively (p=0.3 and p=0.4 respectively). The mean n-t IPE OD was measured as 1110 +/- 499 and 937 +/- 370 in FUS, compared to 1147 +/- 528 and 1267 +/- 428 in N, respectively (p=0.008 temporal). The mean n-t SC area was measured as 5479 +/- 1951 and 5624 +/- 2722m(2) in FUS, compared to 5736 +/- 2574 and 5633 +/- 1835m(2) in N, respectively (p=0.9 and p=0.7 respectively).Conclusion Decreased ECD in FUS may lead to serious complications after cataract surgery. Temporal IPE depigmentation occurs prior to the nasal side in FUS.
In Vivo Analysis and Comparison of Anterior Segment Structures of Both Eyes in Unilateral Herpetic Anterior Uveitis
(Taylor & Francis inc, 2021) Ozer, Muhammet Derda; Batur, Muhammed; Seven, Erbil; Tekin, Serek; Kebapci, Fatih
Purpose: To compare the Schlemm's canal area (SCA) and to define iris features in patients with unilateral herpetic anterior uveitis (HAU) by using anterior segment spectral-domain optical coherence tomography (AS SD-OCT). Methods: Unilateral HAU cases that had been in complete remission for >= 3 months were included. Two investigators analyzed the iris features of HAU. SCA in both healthy (N), and affected eyes (HAU) were compared. Results: The mean age of the participants (n = 22) was 36.3 +/- 15 (17-70) years. The mean nasal and temporal (n-t) SCA was measured as 10,844 +/- 4806 mu m(2)and 8,772 +/- 3138 mu m(2)in HAU in comparison with 10,200 +/- 4,824 mu m(2)and 10,045 +/- 3,889 mu m(2)in N, respectively (p= .47 andp= .12, respectively). The most common iris features were the sectoral iridoplegia (100%) on biomicroscopy and the disorganization of the iris layers (DIL) (77%) on AS SD-OCT images. Conclusion: SCA found similar on both sides. DIL is the most common iris feature of affected eyes.
İntermediyer Üveitler: Klinik Bulgular, Tanı ve Tedavi
(2021) Tugal-tutkun, Ilknur; Oray, Merih; Ozer, Muhammet Derda
İntermediyer üveit (İMU) enflamasyonun ana tutulum bölgesinin vitreus ve periferik retina olduğu üveittir. Hastalık genellikle sinsi başlangıçlıdır. Hastalar uçuşma veya bulanık görmeden şikayet ederler. Klinik bulgular; hafif-orta ön segment inflamasyonu, vitreus hücreleri, vitreusta yoğunluk ve bulanıklık, kar topu opasiteleri, pars plana eksudası ve periferik periflebittir. Kistoid maküla ödemi, epiretinal membran, katarakt, glokom, vazoproliferatif tümör, vitre içi hemoraji, retinoskizis ve retina dekolmanı olası komplikasyonlar arasındadır. İMU idiyopatik olabileceği gibi etyopatogenezinde farklı enfeksiyöz ve non-enfeksiyöz hastalıklar da bulunabilmektedir. Hastalığın tanısı kliniktir. Ayırıcı tanıda multiple skleroz, sarkoidoz, tüberküloz, Lyme hastalığı, enflamatuar barsak hastalıkları ve primer vitreoretinal lenfoma düşünülebilir. Tedavinin ilk adımı altta yatan enfeksiyöz hastalık veya malignite olasılığını dışlamaktır. İMU tedavisinde lokal ve/veya sistemik uygulanan kortikosteroidler tedavinin ilk basamağını oluşturur. Kortikosteroid dışı uzun süreli tedavi seçenekleri arasında antimetabolitler ve klasik tedaviye dirençli olgularda biyolojik ajanlar bulunmaktadır.
Long-Term Results of Accelerated Corneal Cross-Linking in Adolescent Patients With Keratoconus
(Lippincott Williams & Wilkins, 2019) Ozer, Muhammet Derda; Batur, Muhammed; Mesen, Selma; Tekin, Serek; Seven, Erbil
Purpose: To report long-term results of accelerated corneal collagen cross-linking treatment in patients with progressive keratoconus in the pubertal period. Methods: Patients with progressive keratoconus aged 14 and younger were retrospectively reviewed. Thirty-five eyes of 23 patients, who were followed for at least 4 years postoperatively, were included in the study. Demographic characteristics, uncorrected visual acuity, best-corrected visual acuity, and corneal topography data were recorded. All patients underwent an epi-off accelerated corneal collagen cross-linking protocol. Results: The mean age of the participants was 13 +/- 0.5 (11-14) years. Male to female ratio was 3/2. The mean pupillary center to cone apex distance was 1.6 +/- 0.5 mm. At presentation, 11 eyes (31%) were classified as stage 1 keratoconus; 14 eyes (40%) were classified as stage 2 keratoconus, 8 eyes (23%) were classified as stage 3 keratoconus, and 2 eyes (6%) were classified as stage 4 keratoconus. The mean follow-up period was 56 +/- 8 months. At the first year of the follow-up, central corneal thickness (CCT) and thickness of thinnest point of the cornea (TTPC) were found to be decreased significantly in comparison to preoperative values (P = 0.02 and P = 0.003, respectively). At the second year of follow-up, only TTPC was found to be decreased in comparison to preoperative value (P = 0.01). At the last follow-up visit, CCT was found to be increased significantly in comparison to preoperative CCT (P = 0.04). Conclusions: After an average follow-up of 56 months, progression was determined in 20% of the eyes despite appropriate treatment. In the last visit, progression was found to be associated with K1, K2, CCT, TTPC, and age.
The Long-Term Surgical Outcomes of Conjunctival-Limbal Autograft Procedure With or Without Penetrating Keratoplasty in Eyes With Unilateral Limbal Stem Cell Deficiency
(Wolters Kluwer Medknow Publications, 2020) Ozer, Muhammet Derda; Altinkurt, Emre; Alparslan, Nilufer
AIM: The aim of the study is to report the results of conjunctival-limbal autograft (CLAU) transplantation and penetrating keratoplasty (PK) in eyes with limbal stem cell deficiency (LSCD) due to chemical or thermal injury. METHODS: Thirty-one eyes of the 31 patients, who had unilateral LSCD due to chemical or thermal injury, were included in the study. Bilaterally affected cases and LSCD due to Steven-Johnson syndrome and mucous membrane pemphigoid were excluded from the study. All patients underwent a complete ophthalmologic examination. The surgical procedures, postoperative complications, ocular surface status, and visual outcomes were noted. RESULTS: In the CLAU group, regular corneal epithelium and ambulatory vision (<= 1.0 logarithm of the minimum angle of resolution [20/200]) were achieved in 81% of eyes, including 22 eyes (71%) that were assessed after a mean follow-up period of 58 months, respectively. The 5-year survival rate of corneal allograft was 33%, 4 +/- 13.9 in the CLAU applied eyes. In addition, the corneal graft clarity maintenance rate was found to be higher in patients having >= 12 months duration between CLAU and PK, which is statistically significant (62% vs. 23%,P = 0.046). CONCLUSION: Waiting at least 1 year after CLAU transplantation to perform PK increases corneal clarity. Eyelid problems, even if the eyelids were reconstructed properly, remain a major risk factor for the development of the epithelial disorder in the early and late postoperative period in CLAU applied eyes.
Morning Glory Sendromuna Eşlik Eden Keratokonus Olgusu
(2021) Batur, Muhammed; Tekin, Serek; Ozer, Muhammet Derda; Öcal, Halit; Seven, Erbil
Morning Glory Sendromu, çevresine göre daha kabarık korioretinal pigment epitel halkasıyla çevrelenmiş, huni şeklindeki bir optik disk anomalisidir. Bu çalışmada MorningGlory Sendromu olan bir olgunun klinik özellikleri sunulmuştur.