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Hondur G, Bayraktar S, Sen E, Kiziltoprak H, Doguizi S, Elgin U. Macula vessel density and its relationship with the central visual field mean sensitivity across different stages of exfoliation glaucoma. Clin Exp Optom 2024; 107:184-191. [PMID: 37844422 DOI: 10.1080/08164622.2023.2259390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
CLINICAL RELEVANCE Alterations in ocular microvasculature may contribute to pathogenesis of exfoliation glaucoma (XFG) and may improve monitoring this aggressive type of open angle glaucoma. BACKGROUND This work aims to compare the macula vessel density and the relationship between macula vessel density and central visual field mean sensitivity between eyes with XFG and eyes with primary open-angle glaucoma (POAG) of different stages. METHODS In this cross-sectional observational study, the macula vessel density values were compared among 52 POAG cases (26 early stage, 26 moderate to advanced stage) and 53 XFG cases (27 early stage, 26 moderate to advanced stage). The vessel density values were evaluated with optical coherence tomography angiography. Vasculature-function and structure-function relationships were analysed by comparing macula vessel density, inner macula thickness and visual field mean sensitivity in early and moderate to advanced stages of XFG and POAG eyes separately. RESULTS The early stage XFG eyes had a significantly lower global macula vessel density compared with early stage POAG eyes (42.81 ± 3.85% and 46.56 ± 3.90%, respectively; p = 0.02). However, the tendency of XFG eyes for a lower vessel density compared with the POAG eyes did not exhibit any significance in moderate to advanced stages of glaucoma (37.39 ± 5.65% and 38.35 ± 4.67%, respectively; p = 0.9). The macula vessel density (%)-visual field mean sensitivity (1/Lambert) correlation was statistically significant in early stage XFG eyes (r = 0.464 p = 0.01), while no such correlation was notable for the early stage POAG eyes (r = -0.029 p = 0.89). CONCLUSION The macula vessel density appears to be more severely affected in early stage XFG than POAG of similar severity, suggesting a relatively greater value of vascular insufficiency in XFG. The significant vasculature-function association in early stage XFG, which was absent in early stage POAG, may infer the importance of macula vessel density in monitoring functional loss in early stages of XFG.
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Affiliation(s)
- Gozde Hondur
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Ankara, Turkey
| | - Serdar Bayraktar
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Ankara, Turkey
| | - Emine Sen
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Ankara, Turkey
| | - Hasan Kiziltoprak
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Ankara, Turkey
| | - Sibel Doguizi
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Ankara, Turkey
| | - Ufuk Elgin
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Ankara, Turkey
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Kiziltoprak H, Kocabas DO, Aydemir GA, Kalınlı EM, Aydemir E, Oren B. Choroidal Vascular Index in Patients With Attention-Deficit/Hyperactivity Disorder and Methylphenidate. J Pediatr Ophthalmol Strabismus 2023; 60:411-416. [PMID: 36546779 DOI: 10.3928/01913913-20221026-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate choroidal vascularity in children with attention-deficit/hyperactivity disorder (ADHD) who were not receiving therapy, children with ADHD who were regularly taking methylphenidate (MPH), and healthy controls. METHODS The study included three groups: patients with newly diagnosed ADHD without treatment, patients diagnosed as having ADHD who were already being treated with oral MPH, and controls. Both choroidal vascularity index (CVI) and choroidal thickness were measured using an enhanced-depth imaging mode of spectral-domain optical coherence tomography (EDIOCT) (Spectralis; Heidelberg Engineering GmbH). RESULTS There was a significant difference in CVI and stromal area between groups. Post-hoc univariate analysis showed that CVI was significantly lower in patients with ADHD treated with MPH compared with the other groups (P < .001, for each); however, there was no difference between the treatment-free ADHD group and controls (P = .305). In contrast, stromal area was significantly higher in patients with ADHD treated with MPH than the other groups (P < .001, for each group). The correlation of CVI with MPH treatment duration in patients with ADHD treated with MPH showed a significant, moderate negative correlation (P = .01, r = - 0.66). CONCLUSIONS CVI is reduced in patients with ADHD treated with MPH, and the decrease in CVI becomes significant with increasing duration of MPH treatment. This result reflects an indirect effect of MPH treatment on choroidal vascular structures. [J Pediatr Ophthalmol Strabismus. 2023;60(6):411-416.].
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Aydemir GA, Kocabaş DO, Bilen A, Aydemir E, Bayat AH, Oren B, Kiziltoprak H. Evaluation of Retinal Layer Thicknesses in Patients with Keratoconus Using Retinal Layer Segmentation Analysis. Klin Monbl Augenheilkd 2023; 240:1199-1206. [PMID: 35320863 DOI: 10.1055/a-1743-3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To conduct an evaluation of the effects of irregular astigmatism on the retinal nerve fiber layer (RNFL) and the retinal layers observed using spectral-domain optical coherence tomography (SD-OCT) in patients who had keratoconus (KC). MATERIALS AND METHODS A total of 255 eyes from 255 individuals, comprising 72 eyes of KC patients, 70 eyes of patients with astigmia, and 113 eyes of healthy controls were included in the analysis. RNFL scan maps (comprising global, temporal, superotemporal, inferotemporal, nasal, inferonasal, and superonasal maps) and macular thickness (MT) maps of a standard from the Early Treatment Diabetic Retinopathy Study (ETDRS) grid were assessed. The measurements were segmented automatically using Spectralis software, and included the RNFL, inner and outer plexiform layers (IPL, OPL), inner and outer nuclear layers (INL, ONL), ganglion cell layer, retinal pigment epithelium (RPE) in the central 6-mm ETDRS subfield. RESULTS The RNFL thickness in the KC group was lower when compared with the other two groups; however, statistically significant differences were noted in the global, temporal, superotemporal, and inferotemporal sectors (p < 0.05 for all). All of the central MT parameters showed significant variation among the groups, while a statistically significant decrease was noted in the KC group, except in the inferior outer sector (p = 0.741). In the segmentation analysis, the KC group had the significantly lowest IPL, ONL, RPE, and outer retinal layer (ORL) thickness among the groups (p < 0.05 for each). The astigmatic group was similar to the control group with regard to these parameters (p > 0.05 for each). CONCLUSION The eyes in the KC group appeared to have a thinner RNFL and MT when compared to those in the astigmatic and control groups. The ORLs, especially the ONL and RPE, were the most affected component of the macula in the KC group.
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Affiliation(s)
- Gozde Aksoy Aydemir
- Ophthalmology, Adiyaman Universitesi Egitim ve Arastirma Hastanesi, Adiyaman, Turkey
| | | | - Abdurrahman Bilen
- Ophthalmology, Adiyaman Universitesi Egitim ve Arastirma Hastanesi, Adiyaman, Turkey
| | - Emre Aydemir
- Ophthalmology, Adiyaman Universitesi Egitim ve Arastirma Hastanesi, Adiyaman, Turkey
| | - Alper Halil Bayat
- Ophyhalmology, Istanbul Medipol University, Birlik Mahallesi Bahçeler Caddesi No:5, Esenler/Istanbul, Turkey
| | - Burak Oren
- Ophthalmology, Adiyaman Universitesi Egitim ve Arastirma Hastanesi, Adiyaman, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology, Adiyaman Universitesi Egitim ve Arastirma Hastanesi, Adiyaman, Turkey
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Kiziltoprak H, Tekin K, Ibrahim Atesoglu H, Kocabas DO, Koc M, Toker MI. Could Corneal Densitometry be a Progression Criterion for Subclinical Keratoconus? Beyoglu Eye J 2023; 8:157-165. [PMID: 37766767 PMCID: PMC10521129 DOI: 10.14744/bej.2023.85688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/26/2023] [Accepted: 08/14/2023] [Indexed: 09/29/2023]
Abstract
Objectives The objective of this study is to investigate the changes in topometry, tomography, and corneal densitometry in subclinical keratoconus (SK) at the 6-month interval. Methods The clinical keratoconus and SK groups included 25 eyes; the control group included 22 eyes from 22 patients. Corneal topographic, tomographic, topometric, and densitometric values obtained using the Pentacam HR imaging system were analyzed. Results Posterior elevation (PE), Keratoconus index (KI), index of height asymmetry (IHA), index of height decentration (IHD), Dp, Da, Final D, maximum pachymetric progression index (PPImax), and maximum Ambrósio relational thickness parameters showed significant changes between the baseline and the 6th-month follow-up in SK group (p<0.05 for all values). There were significant changes in all zones except a central layer of 6-10 zone, anterior, and central layer of 10-12 zone between the baseline and the 6th-month follow-up in the SK group (p<0.05, for all values). The changes in mean±standard deviation of KI, IHA, IHD, PPImax parameters, and corneal densitometry values of the posterior layer of 0-2 mm and 2-6 mm zones were significant in the SK group compared to the controls (p<0.05, for all values). Conclusion PE, KI, IHA, IHD, and PPImax parameters as well as increasing corneal light backscatter of the posterior central layer might be useful for follow-up of progression of SK. New multimeric parameters created by combinations of topometric, tomographic, and corneal densitometry parameters could be the future of SK follow-up.
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Affiliation(s)
- Hasan Kiziltoprak
- Department of Ophthalmology, Faculty of Medicine, Adiyaman University, Adiyaman, Türkiye
| | - Kemal Tekin
- Department of Ophthalmology, Health Science University Ulucanlar Eye Training and Research Hospital, Ankara, Türkiye
| | | | | | - Mustafa Koc
- Department of Ophthalmology, Ideal Eye Center, Kayseri, Türkiye
| | - Mustafa Ilker Toker
- Department of Ophthalmology, Health Science University Ulucanlar Eye Training and Research Hospital, Ankara, Türkiye
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Recep ÖF, Kocabas DO, Kiziltoprak H, Ozulken K. Effects on Wavefront Aberration after Short-term Wear of Senofilcon A Photochromic Contact Lens. Klin Monbl Augenheilkd 2022. [PMID: 36347502 DOI: 10.1055/a-1973-8904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND To assess the variability in wavefront aberrations with short-term wear of photochromic senofilcon A contact lenses in both its activated and inactive states. METHODS AND MATERIAL In this cross-sectional study, 20 participants who had previously used soft contact lenses were enrolled. Corneal aberrometry measurements were performed on each subject, without contact lenses, using Sirius Scheimpflug-Placido topography. The photochromic lenses were illuminated using a blue-violet light (λ max = 420 nm) so as to provoke an activated state, and measurements were taken with the lenses inserted, in both states. The root mean square (RMS) of the aberrations was calculated, and the higher- and lower-order aberrations, astigmatism, coma, spherical aberration, and trefoil measurements were evaluated using a 5.0-mm pupil diameter. RESULTS The average contact lens sphere power was - 2.33 ± 1.07 D. The mean refractive errors with contact lens wear were 0.07 ± 0.18 D for the sphere and - 0.26 ± 0.15 D for the cylinder. The mean RMS values for all the corneal aberrations showed no statistically significant differences with and without contact lenses (p > 0.05). In a bivariate correlation analysis, there was a positive correlation between contact lens sphere power and coma (vertical and horizontal) in the activated state (r = 0.455, p = 0.44 and r = 0.495, p = 0.27, respectively). CONCLUSION The photochromic contact lenses did not influence ocular aberration during short-term wear, even when the photochromatic additive was activated. This property may help to provide more comfortable vision with lens wear. This finding needs to be verified by further studies.
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Affiliation(s)
| | | | - Hasan Kiziltoprak
- Ophthalmology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | - Kemal Ozulken
- Ophthalmology, TOBB Economics and Technology University Faculty of Medicine, Ankara, Turkey
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Nalcacioglu P, Sen E, Aydemir E, Kiziltoprak H, Yasar HH. Objective assessment of corneal backscattered light in myopic, hyperopic, and emmetropic children. Photodiagnosis Photodyn Ther 2022; 40:103031. [PMID: 35882289 DOI: 10.1016/j.pdpdt.2022.103031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND To determine the corneal densitometry(CD) values by using Scheimpflug imaging in myopic and hyperopic children and to compare the results with emmetropic children. METHODS The CD measurements of the subject were obtained with Scheimpflug tomography. The values were automatically measured in standardized grayscale units over an area 12mm in diameter, which was subdivided into 4 annular concentric zones(0-2mm, 2-6mm, 6-10mm, 10-12mm) and 3 corneal depths(anterior layer: anterior 120µm; central layer: from 120µm to the last 60µm; posterior layer: last 60µm). In addition, we evaluated the correlation between spherical equivalence and anterior corneal morphological parameters and the CD values. RESULTS A total of 211 participants were included in this prospective cross-sectional study. The eyes were divided into three groups related to their spherical equivalent(SE) refractive error values as follows: 88(41.7%) hyperopic eyes, 62(29.4%) myopic eyes, and 61(28.9%) emmetropic control eyes. The hyperopic eyes were found to have lower corneal densitometry values in 4 annular zones and the total 0-12 diameter of all layers except the central layer. However, only the 6-10mm annular zone of the central and posterior layers of the myopic eyes had lower corneal densitometry values than emmetropic eyes. There was also a significant correlation between spherical equivalent and corneal densitometry values in the anterior layer(0-2mm, 2-6mm zones), central layer(0-2mm, 10-12mm zones), posterior layer(6-10mm, 10-12mm zones, and the total 0-12mm diameter), and total corneal thickness(0-2mm zone) of the hyperopic eyes. CONCLUSIONS Backward scattering of light was lower in hyperopic eyes and this could indicate better visual quality.
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Affiliation(s)
- Pinar Nalcacioglu
- Department of Ophthalmology, Yildirim Beyazit University Medical School, Universiteler Avenue 1604 street no:9, Cankaya, Ankara, Turkey.
| | - Emine Sen
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - Emre Aydemir
- Adiyaman Education and Research Hospital, Department of Ophthalmology, Adiyaman, Turkey
| | - Hasan Kiziltoprak
- Adiyaman University Medical School, Department of Ophthalmology, Adiyaman, Turkey
| | - Hakan Halit Yasar
- University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
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Aksoy Aydemir G, Ilhan C, Pehlıvanoglu B, Aydemir E, Kiziltoprak H, Bolu S. Conjunctival Histopathological Changes in Children With Vitamin D Deficiency. Eye Contact Lens 2022; 48:289-294. [PMID: 35580362 DOI: 10.1097/icl.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to investigate tear function-associated clinical findings and conjunctival histopathological changes in children with vitamin D (Vit-D) deficiency. METHODS This study used a prospective case-control design. Group 1 (n=38) comprised pediatric patients with Vit-D deficiency, and group 2 (n=45) was the control group. Tear break-up times (TBUTs), Schirmer-1 test measurements, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (CIC) results of the groups were compared. RESULTS The participant demographic characteristics, including the mean age and the male-to-female ratio, were similar (P>0.05). The median TBUT and Schirmer-1 test measurement were 10 s (5-15) and 12 mm (6-19) in group 1 and 11 s (6-16) and 15 mm (8-21) in group 2 (P=0.004 and P=0.013, respectively). The median OSDI scores were 16 (10-20) in group 1 and 17 (10-21) in group 2 (P=0.092). According to the CIC, 25 samples in group 1 and 40 samples in group 2 were categorized as grade 0, 11 samples in group 1 and 5 samples in group 2 were categorized as grade 1, and 2 samples in group 1 and no sample in group 2 were categorized as grade 2 (P=0.027). CONCLUSION Significant conjunctival histopathological changes occur in children with Vit-D deficiency, and these changes have effects on some tear function-associated clinical findings including the Schirmer-1 test and TBUT measurements.
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Affiliation(s)
- Gozde Aksoy Aydemir
- Department of Ophthalmology (G.A.A., E.A., H.K.), Adıyaman University Research and Training Hospital, Adıyaman, Turkey ; Department of Ophthalmology (C.I.), Tayfur Ata Sokmen Medicine Faculty, Mustafa Kemal University, Hatay,Turkey; Department of Pathology (B.P.), Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey ; and Department of Pediatric Endocrinology (S.B.), Adıyaman University Research and Training Hospital,Adıyaman, Turkey
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Aydemir E, Kiziltoprak H, Aydemir GA. Comparison of Clinical Outcomes of Upper Eyelid Blepharoplasty Using Two Different Suture Techniques. Beyoglu Eye J 2022; 7:18-24. [PMID: 35265797 PMCID: PMC8874258 DOI: 10.14744/bej.2021.36349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 11/27/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To compare upper eyelid blepharoplasty patients' suture techniques with interrupted cutaneous in one eye and running cutaneous in the other in terms of edema, ecchymosis, and scar index. METHODS Among patients whose suture techniques with interrupted cutaneous in one eye and running cutaneous in the other, 34 patients in the vicryl group and 46 patients in the polypropylene group were included in the study. The patients' edema and ecchymosis levels on postoperative days 1, 7, and 30 days and 3 months were selected. The Manchester Scar Scale was used to evaluate the scar index at 30 days and 3 months after surgery. Suture material (either 6-0 polypropylene sutures or 6-0 vicryl sutures) were evaluated independently. RESULTS In vicryl group, there was significantly less ecchymosis and edema first week postoperatively in interrupted sutured eyelid than running sutured eyelid (p=0.001, p=0.011, respectively). In polypropylene group, there was significantly less ecchymosis at the first day and first week postoperatively in interrupted sutured eyelid than running sutured eyelid (p=0.025, p=0.001, respectively). The total scar index scores in both groups at first month and third month were significantly better at the interrupted sutured eyelid than running sutured eyelid (p<0.05, for all). CONCLUSION In upper eyelid blepharoplasty, an interrupted suture technique yielded the lowest rates of edema, ecchymosis, and scar formation compared with a running suture technique.
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Affiliation(s)
- Emre Aydemir
- Department of Ophthalmology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Hasan Kiziltoprak
- Department of Ophthalmology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
| | - Gozde Aksoy Aydemir
- Department of Ophthalmology, Adiyaman University Training and Research Hospital, Adiyaman, Turkey
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Aydemir E, Aksoy Aydemir G, Atesoglu Hİ, Goker YS, Kiziltoprak H, Ozcelik KC. Objective Assessment of Corneal and Lens Clarity in Patients with COVID-19. Optom Vis Sci 2021; 98:1348-1354. [PMID: 34905523 DOI: 10.1097/opx.0000000000001814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The severe acute respiratory syndrome coronavirus 2 virus, which causes the coronavirus disease 2019 (COVID-19) pandemic, can bind to epithelial cells in the human cornea and conjunctiva, which may result in changes of corneal and lenticular densitometry. PURPOSE We aimed to report the corneal and lenticular clarity of patients who had been diagnosed previously with confirmed infection of COVID-19. METHODS This was a prospective, cross-sectional study. Fifty-three patients who had recovered from COVID-19 and 51 healthy individuals who had not had COVID-19 (control) were included in this study. Measurement of the corneal (at a corneal diameter of 12 mm) and lens densitometry of participants was performed using a Pentacam HR Scheimpflug imaging system. Three different optimal depths as anterior, central, and posterior layers and four concentric zones, consisting of diameters of 0 to 2, 2 to 6, 6 to 10, and 10 to 12 mm, were chosen to perform the corneal densitometric measurements. The mean lenticular densitometric values were calculated in zone 1 at 2.0 mm, zone 2 at 4.0 mm, and zone 3 at 6.0 mm by taking the central part of the pupil as reference point. RESULTS When compared with the individuals in the control group, the corneal densitometry measurements in the patients in the COVID-19 group were considerably higher in anterior 0 to 2 mm, 2 to 6 mm, 6 to 10 mm zones and total diameter; center 0 to 2 and 2 to 6 mm zones and total diameter; posterior 0 to 2 mm zone; and total corneal 0 to 2 and 2 to 6 mm zones and total diameter (P < .05, for each). When compared with the individuals in the control group, all of the lens densitometry measurements, except for those located in zone 1, were determined to be significantly higher among the patients in the COVID-19 group (P < .05, for each). CONCLUSIONS Significant alterations were found in corneal and lenticular densitometric values in patients who had had COVID-19. The virus could adversely affect cornea and lens transparency.
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Affiliation(s)
- Emre Aydemir
- Ophthalmology Department, Adiyaman Training and Research Hospital, Adiyaman, Turkey
| | | | - Halil İbrahim Atesoglu
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Health Science University, Ankara, Turkey
| | | | - Hasan Kiziltoprak
- Ophthalmology Department, Adiyaman Training and Research Hospital, Adiyaman, Turkey
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Aydemir E, Aydemir GA, Atesoglu HI, Goker YS, Ozcelik KC, Kiziltoprak H. The Impact of Coronavirus Disease 2019 (COVID-19) on Retinal Microcirculation in Human Subjects. Klin Monbl Augenheilkd 2021; 238:1305-1311. [PMID: 34587629 DOI: 10.1055/a-1579-0805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of the study was to assess retinal microcirculation in patients with coronavirus disease 2019 (COVID-19) through the use of optical coherence tomography angiography (OCT-A) and compare the results with those obtained in healthy controls. METHODS The study enrolled 39 patients who had fully recovered from COVID-19 and 40 healthy controls. OCT-A image acquisitions were obtained using AngioVue software (version 2017.1.0.151) and the RTVue XR Avanti imaging system (Optovue Inc., Fremont, CA, USA). Nonflow area in the superficial capillary plexus (SCP), foveal avascular zone (FAZ) area in the whole retinal vasculature, FAZ perimeter, acircularity index of FAZ, and foveal density were automatically obtained with the FAZ assessment tool. Vessel density (VD) at the SCP and deep capillary plexus were also measured. RESULTS Compared to the control group, the nonflow area and the FAZ area in the whole retina was greater in the COVID-19 group; however no statistically significant difference was observed (p > 0.05 respectively). As for vessel densities, all superficial parafoveal VD parameters were considerably higher in the COVID-19 group compared to the control group (p < 0.05 respectively). Despite the fact that the vessel densities in the remaining zones were lower in the COVID-19 group, those differences were not statistically significant (p > 0.05 respectively). CONCLUSION VD at the parafoveal area of the SCP was significantly higher among patients in the late post-recovery period of COVID-19 disease compared to healthy controls. These findings show the impact of COVID-19 on the retinal microvasculature and its possible role as a risk factor for the development of ocular diseases.
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Affiliation(s)
- Emre Aydemir
- Ophthalmology Department, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | - Gozde Aksoy Aydemir
- Ophthalmology Department, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
| | | | - Yasin Sakir Goker
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | | | - Hasan Kiziltoprak
- Ophthalmology Department, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
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Kiziltoprak H, Tekin K, Dilli A, Teke MY. Retinal Vein Passing through a Congenital Optic Nerve Pit. J Ophthalmic Vis Res 2021; 16:308-311. [PMID: 34055271 PMCID: PMC8126749 DOI: 10.18502/jovr.v16i2.9101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/07/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | - Alper Dilli
- Diskapi Yildirim Bayazit Education and Research Hospital, Radiology Department, Ankara, Turkey
| | - Mehmet Yasin Teke
- Department of Retinal Diseases, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Kiziltoprak H, Tekin K, Cevik S, Kocer AM, Goker YS. Normative Data Assessment of Peripapillary and Macular Vessel Density and Foveal Avascular Zone Metrics Using Optical Coherence Tomography Angiography in Children. J Pediatr Ophthalmol Strabismus 2020; 57:388-398. [PMID: 33211897 DOI: 10.3928/01913913-20200903-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/12/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To quantify the vessel density of the macula and optic disc and foveal avascular zone (FAZ) in healthy children and to evaluate the effects of age, gender, axial length, body mass index (BMI), and refractive errors on vessel density and FAZ. METHODS This study enrolled 92 eyes of 92 participants (42 boys and 50 girls). Optical coherence tomography angiography (OCTA) was performed using AngioVue (Avanti; Optivue). FAZ area, nonflow area, superficial and deep vessel density, FAZ perimeter, acircularity index of FAZ, foveal density, and radial peripapillary capillary vessel density were analyzed by gender. Correlations between the investigated OCTA parameters and age, axial length, and BMI were evaluated. RESULTS Girls had significantly larger nonflow and FAZ area than boys (P = .01 and .02). Superficial and deep vessel density at the fovea was significantly higher in boys compared to girls (P = .01 and .03). Inferior temporal and superior temporal Radial peripapillary capillary vessel densities were significantly higher in girls than boys (P = .01 and .03). No significant difference was found in the macular and optic disc vessel density measurements within refractive groups (P > .05, for all). Regarding the correlation of age with FAZ and vessel density parameters, only nonflow area was positively correlated with age (r = 0.22, P = .03). CONCLUSIONS This study provides normative data for children. Although boys had greater foveal vessel density, girls had greater FAZ area and nonflow area. Refractive status of the eye and BMI did not influence the OCTA parameters. Although nonflow area was positively correlated with age, other parameters were steady within the ages of 7 to 18 years. [J Pediatr Ophthalmol Strabismus. 2020;57(6):388-398.].
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Ozulken K, Kiziltoprak H, Yuksel E, Mumcuoğlu T. A Comparative Evaluation of Diffractive Trifocal and New Refractive/Extended Depth of Focus Intraocular Lenses for Refractive Lens Exchange. Curr Eye Res 2020; 46:811-817. [PMID: 33047991 DOI: 10.1080/02713683.2020.1833347] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate and compare the visual performance and quality of life (QOL) associated with refractive/extended depth of focus (EDOF) intraocular lenses (IOLs) and diffractive trifocal IOLs in refractive lens exchange patients. MATERIALS AND METHODS This was a comparative interventional study of patients undergoing implantation of Lucidis (Swiss Advanced Vision, SAV‑IOL SA, Neuchâtel, Switzerland) or AT LISA tri 839MP (Carl Zeiss Meditec AG, Germany) IOLs. Near, intermediate, and distance best corrected and uncorrected visual acuities were collected at 1 and 3 months postoperatively. The vision-related QOL was evaluated 1 and 3 months after surgery, using the National Eye Institute Visual Function Questionnaire-14 (VF-14 QOL questionnaire). RESULTS A total of 74 patients underwent refractive lens exchange and IOL implantation, with 38 patients in the EDOF group and 36 in the trifocal group. Among all visual acuities, uncorrected near visual acuity was statistically significantly better with the Lucidis IOL at the first month (p = .02) and diminished at the third-month visit (p = .16). When we compared the VF-14 QOL questionnaire scores, reading small print, reading a newspaper or book, and driving at night were statistically significantly better in the Lucidis group at the first month (p = .00, for each). That difference persisted only in driving at night at the third-month visit (p = .04). Reading small print, driving at night, and doing fine handwork were the most difficult tasks in the AT LISA group at the first month, and only driving at night remained so at the third-month visit. CONCLUSIONS The refractive results and visual outcomes at all distances of EDOF and trifocal IOLs were highly satisfactory. However, the EDOF design in the Lucidis IOL achieves lower rates of glare in the early period after refractive lens exchange.
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Affiliation(s)
- Kemal Ozulken
- Ophthalmology Department, TOBB ETU Medical School, Ankara, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Bingol Women's Health and Children's Hospital, Bingol, Turkey
| | - Erdem Yuksel
- Ophthalmology Department, Kastamonu Medical School, Kastamonu, Turkey
| | - Tarkan Mumcuoğlu
- Ophthalmology Department, TOBB ETU Medical School, Ankara, Turkey
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Inanc M, Tekin K, Teke MY, Kiziltoprak H. Tomographic characteristics of focal choroidal excavation and its association with retinal disorders. Eur J Ophthalmol 2020; 31:1154-1160. [PMID: 32452223 DOI: 10.1177/1120672120927862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the morphological, clinical, and tomographic characteristics of focal choroidal excavation in the context of concomitant retinal pathologies. METHODS This case series included 13 eyes of 13 patients with focal choroidal excavation diagnosed by spectral-domain optical coherence tomography. Morphologic characteristics of excavation and quantitative thicknesses of retinal layers and choroid were analyzed in excavation area, area adjacent to excavation, and fellow eye without focal choroidal excavation by spectral-domain optical coherence tomography. RESULTS At the initial examinations, one eye had a history of blunt trauma, three eyes were diagnosed with choroidal neovascularization, one with choroidal osteoma, one with angioid streaks, one with retinal detachment, one with diabetic macular edema, one with optic pit, one with torpedo maculopathy, and the rest three with idiopathic focal choroidal excavation. The mean choroidal thickness in the area of focal choroidal excavation was statistically significantly thinner compared to in the area adjacent to focal choroidal excavation and fellow eye (p < 0.001) and total average outer nuclear layer thickness was statistically significantly thicker in the area of excavation compared with fellow eye (p = 0.007). CONCLUSION This study confirmed the presence of focal choroidal excavation in various ocular diseases and the evaluation of focal choroidal excavation using the spectral-domain optical coherence tomography demonstrated choroidal thinning and outer nuclear layer thickening in the area of the excavation.
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Affiliation(s)
- Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Mehmet Yasin Teke
- Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hasan Kiziltoprak
- Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Inanc M, Kiziltoprak H, Hekimoglu R, Tekin K, Ozalkak S, Koc M, Bayramoglu E, Zirh S, Yuruker S, Aycan Z. Alterations of Tear Film and Ocular Surface in Children with Type 1 Diabetes Mellitus. Ocul Immunol Inflamm 2020; 28:362-369. [PMID: 30806526 DOI: 10.1080/09273948.2019.1571212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To investigate whether diabetes mellitus (DM) affects ocular surface of children with well-controlled type 1 DM.Methods: Sixty-five diabetic patients and 55 age-matched controls enrolled to study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test, and conjunctival impression cytologic analysis were performed.Results: Schirmer test and TBUT results were significantly lower in DM group than controls (p = 0.001, for all). OSDI scores of all participants were within normal range. Impression cytology analysis showed grade 0 changes in all participants and there was no difference between groups for goblet cell density (p > 0.05). The TBUT results were significantly associated with duration of DM (r = -0.309, p = 0.036).Conclusion: Diabetic children without symptoms, signs, and definite diagnosis of dry eye still had lower TBUT and Schirmer test results than controls; however, impression cytology analysis was similar in both groups.
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Affiliation(s)
- Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Hasan Kiziltoprak
- Department is Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Rumeysa Hekimoglu
- Histology and Embryology Department, Kastamonu University, Kastamonu, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Servan Ozalkak
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Department is Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Elvan Bayramoglu
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Selim Zirh
- Histology and Embryology Department, Hacettepe University, Ankara, Turkey
| | - Sinan Yuruker
- Histology and Embryology Department, Usak University, Usak, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
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Koc M, Tekin K, Kiziltoprak H, Inanc M, Kosekahya P, Ozulken K, Durukan I. Topometric and Tomographic Evaluation of Subclinical Keratoconus. Ophthalmic Epidemiol 2020; 27:289-297. [PMID: 32172662 DOI: 10.1080/09286586.2020.1741010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the corneal topometric and tomographic findings that can be used in the diagnosis of subclinical keratoconus. METHODS A retrospective cohort study. The study group was selected from patients with clinically evident keratoconus in one eye and subclinical keratoconus without evident topographic findings in fellow eye. The age-matched control group was selected from patients who were candidates for laser in situ keratomileusis (LASIK) and did not develop ectasia after LASIK surgery at least 1-year follow-up. All subjects underwent topographic, topometric and tomographic (Belin-Ambrósio Enhanced Ectasia Display III) analyses via a Pentacam HR rotating Scheimpflug camera (Oculus, Germany, version 1.20r.98) before LASIK surgery. RESULTS The study group consisted of 151 patients (69 male and 82 female, mean age of 24.8 ± 7.2 years) and the control group also consisted of 150 patients (70 male and 80 female, mean age of 26.0 ± 6.3 years). There were statistically significant differences in all measured topometric (p˂.05) and tomographic (p˂.001) parameters between the eyes with subclinical keratoconus and those of the control group. In discriminating eyes with subclinical keratoconus from normal eyes, final D showed the highest area under curve value (0.858, sensitivity 85.2%, specificity 66.7%), followed by maximum pachymetric progression index (0.809, sensitivity 81.9%, specificity 69.4%) and average pachymetric progression index (0.796, sensitivity 81.9%, specificity 68.1%) in receiver operating characteristic analysis. CONCLUSION Topometric and tomographic parameters might be useful for early detection of keratoconus, but the sensitivity and specificity of any parameter are not high enough to be used alone.
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Affiliation(s)
- Mustafa Koc
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital , Ankara, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital , Van, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital , Ankara, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ercis State Hospital , Van, Turkey
| | - Pinar Kosekahya
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital , Ankara, Turkey
| | - Kemal Ozulken
- Ophthalmology Department, TOBB ETU Hospital , Ankara, Turkey
| | - Irfan Durukan
- Ophthalmology department, Era Eye Hospital , Ankara, Turkey
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Ilhan C, Citirik M, Uzel MM, Kiziltoprak H, Tekin K. The usefulness of systemic inflammatory markers as diagnostic indicators of the
pathogenesis of diabetic macular edema. Arq Bras Oftalmol 2020; 83:299-304. [DOI: 10.5935/0004-2749.20200051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022] Open
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Inanc M, Tekin K, Kiziltoprak H, Ozalkak S, Doguizi S, Aycan Z. Changes in Retinal Microcirculation Precede the Clinical Onset of Diabetic Retinopathy in Children With Type 1 Diabetes Mellitus. Am J Ophthalmol 2019; 207:37-44. [PMID: 31009594 DOI: 10.1016/j.ajo.2019.04.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/30/2019] [Accepted: 04/13/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate whether abnormal glucose metabolism in diabetes mellitus (DM) affects the retinal microcirculation of children with well-controlled type 1 DM and to compare these results with those obtained from healthy children. DESIGN Cross-sectional prospective study. METHODS This study enrolled 60 patients with DM without clinically detectable diabetic retinopathy (DR) and 57 age-matched control subjects. Optical coherence tomography angiography (OCT-A) was performed using AngioVue (Avanti, Optivue). Foveal avascular zone (FAZ) area, nonflow area, superficial and deep vessel densities, FAZ perimeter, acircularity index of FAZ (AI; the ratio of the perimeter of FAZ and the perimeter of a circle with equal area), and foveal density (FD-300; vessel density in 300 μm around FAZ) were analyzed. Correlations between the investigated OCT-A parameters with DM duration and glycated hemoglobin (HbA1c) levels were evaluated among patients with type 1 DM. RESULTS Differences in the mean values for FAZ perimeter, AI, and FD-300 were statistically significant between DM group and control group (P < .001, P = .001, and P = .009, respectively). There were also statistically significant differences between the groups for vessel densities of deep superior hemi-parafovea, deep temporal parafovea, and deep superior parafoveal zones (P = .008, P = .015, and P = .005, respectively). There were no significant correlations between DM duration and HbA1c levels with the investigated OCT-A parameters. CONCLUSION Diabetic eyes without clinically detectable DR exhibited alterations in FD-300, AI, perimeter, and vessel density of parafoveal capillaries in deep capillary plexus preceding the enlargement of FAZ; therefore, these new parameters might be sensitive imaging biomarkers to define early DR.
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Kiziltoprak H, Koc M, Tekin K, Hekimoglu R, Inanc M, Yılmaz AA, Elmaoğulları S, Aycan Z. Local Ocular Surface Alterations in Children with Hashimoto's Thyroiditis. Ocul Immunol Inflamm 2019; 28:791-797. [PMID: 31414613 DOI: 10.1080/09273948.2019.1642495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the ocular surface characteristics based on Schirmer's test, tear break-up time (TBUT), and conjunctival impression cytology (CIC) in children with Hashimoto's thyroiditis (HT). METHODS This study included 51 children with HT and 53 control subjects. The ocular surface characteristics of participants were assessed via Schirmer's test, TBUT, and CIC. Conjunctival samples were examined cytologically according to the Nelson grading system. RESULTS Schirmer's and TBUT results were significantly lower in HT group (p < .05). All samples in both the study and control groups were evaluated as grade 0 according to the Nelson classification (p = .841), however, goblet cell density (GCD) was significantly lower in HT group (p = .001). Schirmer test results were significantly associated with the duration of HT (p = .025, r = -0.311). CONCLUSION Hashimoto's thyroiditis without any ocular complaints may cause ocular surface changes with TBUT and Schirmer's. Although CIC analysis showed similar grading results, GCD was significantly decreased in HT group.
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Affiliation(s)
- Hasan Kiziltoprak
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital , Ankara, Turkey
| | - Mustafa Koc
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital , Ankara, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital , Van, Turkey
| | - Rumeysa Hekimoglu
- Histology and Embryology Department, Bezmialem University , Istanbul, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ercis State Hospital , Van, Turkey
| | - Aslıhan Araslı Yılmaz
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital , Ankara, Turkey
| | - Selin Elmaoğulları
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital , Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital , Ankara, Turkey
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Tekin K, Kiziltoprak H, Sekeroglu MA, Yetkin E, Bayraktar S, Yilmazbas P. Static and dynamic pupil characteristics in pseudoexfoliation syndrome and glaucoma. Clin Exp Optom 2019; 103:332-338. [PMID: 31364197 DOI: 10.1111/cxo.12945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/06/2019] [Accepted: 06/23/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To compare the static and dynamic pupillometry measurements in patients with pseudoexfoliation syndrome (PES), patients with pseudoexfoliation glaucoma (PEG) and age-matched healthy subjects using an automatic quantitative pupillometry system. METHODS This prospective, cross-sectional study consisted of 40 patients with PES, 30 patients with PEG and 43 control subjects. Static pupillometry measurements including scotopic pupil diameter, mesopic pupil diameter, low photopic pupil diameter, and high photopic pupil diameter were undertaken. Subsequently, dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were undertaken. These measurements were compared between the groups. RESULTS The scotopic, mesopic, and low photopic pupil diameter values were statistically significantly lower in patients with PES and PEG compared with controls (p < 0.001). However, these parameters were similar between the patients with PES and PEG (p > 0.05). The mean values of high photopic pupil diameter were similar within all groups (p = 0.54). The amplitude of pupil contraction values of the patients with PEG was statistically significantly lower than the patients with PES and the controls (p < 0.05). Patients with PES also had significantly lower amplitude of pupil contraction values compared with controls (p < 0.001). Additionally, the velocity of pupil contraction values was statistically significantly higher in control subjects when compared to the patients with PES and PEG (p < 0.05). CONCLUSION This study demonstrated that accumulation of pseudoexfoliative material can cause alterations in static and dynamic pupillary characteristics and the progression from PES to PEG may be associated with reduced amplitude of pupil contraction values.
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Affiliation(s)
- Kemal Tekin
- Opthalmology Department, Ercis State Hospital, Van, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Sekeroglu
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Esat Yetkin
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Serdar Bayraktar
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Pelin Yilmazbas
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Koc M, Aydemir E, Tekin K, Inanc M, Kosekahya P, Kiziltoprak H. Biomechanical Analysis of Subclinical Keratoconus With Normal Topographic, Topometric, and Tomographic Findings. J Refract Surg 2019; 35:247-252. [PMID: 30984982 DOI: 10.3928/1081597x-20190226-01] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 02/26/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the corneal biomechanical responses of subclinical keratoconus with normal topographic, topometric, and tomographic findings. METHODS In this prospective observational study, the study group was selected from patients with clinically evident keratoconus in one eye and subclinical keratoconus with normal topographic, topometric, and tomographic findings in the fellow eye. The control group was selected from candidates for contact lens use. The biomechanical analyses were performed using the Corvis ST (Oculus Optikgeräte, Wetzlar, Germany). The following parameters were analyzed: A1 velocity, A2 velocity, A1 length, A2 length, deformation amplitude ratio, stiffness parameter at the first applanation, Corvis Biomechanical Index, and Tomographic and Biomechanical Index (TBI). RESULTS The study group consisted of 21 patients (10 men and 11 women; mean age: 27.7 ± 6.9 years), and the control group consisted of 35 patients (17 men and 18 women; mean age: 26.1 ± 5.8 years). No significant differences were found between the eyes with subclinical keratoconus and normal eyes in corrected distance visual acuity and the topographic, topometric, and tomographic parameters (P > .05). Significant differences were found in the values of A2 length, A1 velocity, A2 velocity, and TBI between the subclinical keratoconus group and the control group (P < .05). In distinguishing eyes with subclinical keratoconus from normal eyes, the TBI showed the highest area under the curve (0.790; cut-off: 0.29; sensitivity: 67%; specificity: 86%) in the receiver operating characteristic analysis. CONCLUSIONS Biomechanical analysis with the Corvis ST may be used as a complementary diagnostic method in detecting subclinical keratoconus. [J Refract Surg. 2019;35(4):247-252.].
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Ozulken K, Yuksel E, Tekin K, Kiziltoprak H, Aydogan S. Comparison of Wavefront-Optimized Ablation and Topography-Guided Contoura Ablation With LYRA Protocol in LASIK. J Refract Surg 2019; 35:222-229. [PMID: 30984979 DOI: 10.3928/1081597x-20190304-02] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/04/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the refractive outcomes and aberration data analysis of wavefront-optimized (WFO) ablation and topography-guided Contoura ablation (TGCA) (Contoura on the WaveLight laser; WaveLight GmbH, Erlangen, Germany) in patients who had laser-assisted in situ keratomileusis (LASIK) for myopia or myopic astigmatism. METHODS In this comparative contralateral eye study, patients who underwent LASIK with TGCA in one eye and with WFO ablation in the fellow eye were analyzed. Aberration measurements and corneal topography were analyzed using the WaveLight Oculyzer II diagnostic device (Alcon Laboratories, Inc., Fort Worth, TX). Total corneal higher order aberrations (HOAs) including vertical and oblique astigmatism (Z2 2, Z2 -2), coma (Z3 1, Z3 -1), trefoil (Z3 3, Z3 -3), spherical aberration, and Q value were analyzed. These measurements were taken preoperatively and 3 months postoperatively. RESULTS This study comprised 32 patients. There were no significant differences between both procedures according to postoperative uncorrected and corrected distance visual acuity values, refractive errors, and manifest refraction spherical equivalents within ±0.50 diopters (D) of emmetropia (P > .05). The preoperative corneal HOAs and Q values were also similar between the groups (P > .05). At 3 months postoperatively, the vertical and horizontal coma values in the WFO ablation group were statistically significantly higher compared to the TGCA group (P = .013 and .020, respectively). Less stromal tissue was ablated in the TGCA group compared to the WFO ablation group (P < .001). CONCLUSIONS Although WFO ablation and TGCA protocols had statistically similar visual outcomes, the TGCA protocol was associated with a significantly lower induction in vertical and horizontal coma and smaller amount of tissue ablation compared to WFO ablation. [J Refract Surg. 2019;35(4):222-229.].
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Abstract
Diabetes mellitus (DM) is a chronic systemic disease that has increases in prevalence over time. DM can affect all ocular structures, with cataract being the most common ocular complication. Cataract is the leading cause of blindness worldwide. Due to several mechanisms, there is an increased incidence of cataract formation in the diabetic population. Advancements in technology have now made cataract surgery a common and safe procedure. However, the diabetic population is still at risk of vision-threatening complications, such as diabetic macular edema (ME), postoperative ME, diabetic retinopathy progression, and posterior capsular opacification.
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Affiliation(s)
- Hasan Kiziltoprak
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara 06240, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van 65400, Ercis, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van 65400, Ercis, Turkey
| | - Yasin Sakir Goker
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara 06240, Turkey
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Kosekahya P, Koc M, Caglayan M, Kiziltoprak H, Tekin K, Atilgan CU. Longitudinal corneal tomographical changes in eyes of patients with unilateral and bilateral non-progressive keratoconus. Cont Lens Anterior Eye 2018; 42:434-438. [PMID: 30413377 DOI: 10.1016/j.clae.2018.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/27/2018] [Accepted: 10/31/2018] [Indexed: 11/19/2022]
Abstract
AIM To evaluate the tomographic indices changes in keratoconic eyes which were classified as unilateral and bilateral non-progressive keratoconus according to the definition of Global Consensus on keratoconus and ectatic disease. METHODS Fifty non-progressive fellow eyes of 50 keratoconus patients who underwent corneal cross-linking treatment for the other progressive eyes (group 1), 50 eyes of 50 keratoconus patients who were followed up as bilateral non-progressive keratoconus (group 2), and 50 eyes of 50 control subjects (group 3) were included in this retrospective study. Topographic, topometric, and Belin-Ambrósio Enhanced Ectasia Display-III indices were recorded at baseline and after six months. RESULTS Groups were similar in terms of age and gender. The changes in topographic parameters and topometric indices were similar among the three groups (p > 0.05 for all values). The maximum pachymetric progression index (PPImax), maximum Ambrósio relational thickness (ARTmax), and final D significantly increased at sixth-months in group 1 (p < 0.001, p = 0.004, and p = 0.02 respectively) but did not change in groups 2 and 3 (p > 0.05 for all values). ARTmax, PPImax, and final D value changes indicated a statistically significant difference among the groups using the one-way ANOVA test (p = 0.03, p = 0.007, and p = 0.03 respectively). The Bonferroni posttest revealed that these values increased at a higher rate in group 1 than in group 2 (p = 0.03, p = 0.01, and p = 0.04 respectively) and group 3 (p = 0.04, p = 0.03, and p = 0.04, respectively). CONCLUSIONS Fellow eyes of keratoconus patients who have underwent CXL for their progressive eyes may be more prone to progress than the patients who have no progression in both eyes. Screening unilateral non-progressive patients more closely than those with bilateral non-progressive patients and evaluating the changes in final D, ARTmax, and PPImax values may be helpful in the follow up of non-progressive keratoconus.
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Affiliation(s)
- Pinar Kosekahya
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey.
| | - Mustafa Koc
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey
| | - Mehtap Caglayan
- Gazi Yasargil Training and Research Hospital, Department of Ophthalmology, Diyarbakir, Turkey
| | - Hasan Kiziltoprak
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey
| | - Kemal Tekin
- Ercis State Hospital, Department of Ophthalmology, Van, Turkey
| | - Cemile Ucgul Atilgan
- Ulucanlar Eye Training and Research Hospital, Department of Ophthalmology, Ankara, Turkey
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Yetkin E, Tekin K, Kiziltoprak H, Sekeroglu MA, Cankurtaran V, Yasar HH. Evaluation of static and dynamic pupil characteristics in hyperopic anisometropic amblyopia. Eur J Ophthalmol 2018; 29:486-493. [DOI: 10.1177/1120672118803514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose:The aim of this study is to perform a comparison of static and dynamic pupillometry measurements in patients with hyperopic anisometropic amblyopia and age-matched controls.Methods:This prospective cross-sectional study consisted of 38 patients with hyperopic anisometropic amblyopia and 80 control subjects. A quantitative pupillometry system was used to evaluate the pupil characteristics of higher hyperopic eyes (Group 1), the fellow eyes (Group 2), and healthy eyes (Group 3). Static pupillometry measurements were taken including scotopic pupil diameter, mesopic pupil diameter, low-photopic pupil diameter, and high-photopic pupil diameter. Subsequently, dynamic pupillometry measurements were taken including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation.Results:Groups 1 and 2 had statistically significantly lower scotopic and high-photopic pupil diameter values compared with Group 3 (p < 0.05). The amplitude of pupil contraction values were also statistically significantly lower in Groups 1 and 2 compared with Group 3 (p = 0.001 and p = 0.003). However, there were no significant differences between the study and the control eyes with respect to mesopic and high-photopic pupil diameter, resting diameter, latency of pupil contraction, duration of pupil contraction, velocity of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation values (p > 0.05, for all).Conclusion:Static and dynamic pupil characteristics of higher hyperopic eyes and their fellow eyes are similar. This may support that amblyopia is not a monocular disorder, but can affect both eyes.
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Affiliation(s)
- Esat Yetkin
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Sekeroglu
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Veysel Cankurtaran
- Ophthalmology Department, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Hakan Halit Yasar
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Tekin K, Sekeroglu MA, Kiziltoprak H, Doguizi S, Inanc M, Yilmazbas P. Static and dynamic pupillometry data of healthy individuals. Clin Exp Optom 2018; 101:659-665. [DOI: 10.1111/cxo.12659] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/17/2017] [Accepted: 12/18/2017] [Indexed: 08/30/2023] Open
Affiliation(s)
- Kemal Tekin
- Ophthalmology Department, Kars State Hospital, Kars, Turkey,
| | - Mehmet Ali Sekeroglu
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Sibel Doguizi
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Merve Inanc
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Pelin Yilmazbas
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
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Tekin K, Kiziltoprak H, Koc M, Goker YS, Kocer AM, Yilmazbas P. The effect of corneal infiltrates on densitometry and higher-order aberrations. Clin Exp Optom 2018; 102:140-146. [PMID: 30107640 DOI: 10.1111/cxo.12828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/05/2018] [Accepted: 07/12/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study aimed to measure the effects of persistent corneal subepithelial infiltrates associated with epidemic keratoconjunctivitis on corneal densitometry and total corneal higher order aberrations (HOAs), and to compare these measurements with the data obtained from their fellow unaffected healthy eyes. METHODS This prospective cross-sectional study included those who had persistent subepithelial infiltrates in only the affected eyes for at least three months and clinically normal fellow unaffected eyes. Corneal densitometry was measured with the densitometry software of the Pentacam HR-Scheimpflug corneal topographer over a 12 mm diameter of cornea. Further, total corneal HOAs including coma (Z[1,3], Z[3,-1]), trefoil (Z[3], Z[3,-3]), spherical aberration, higher order root mean square (HO-RMS), and total RMS in the Zernike analysis were analysed by the same Pentacam HR device. RESULTS Forty-six eyes of 23 participants were analysed in this study. The mean corneal densitometry values were statistically significantly higher in all annular concentric areas (0-2, 2-6, 6-10, and 10-12 mm) of the anterior and central corneal layers in the eyes with subepithelial infiltrates when compared to normal fellow eyes (p < 0.05, for each one). Additionally, there were statistically significant differences between the eyes with subepithelial infiltrates and normal fellow eyes with regard to coma, trefoil, HO-RMS, and total RMS in the Zernike analysis (p < 0.05, for each one). CONCLUSION This study quantitatively demonstrated that persistent corneal subepithelial infiltrates associated with epidemic keratoconjunctivitis decrease corneal transparency and corneal optical quality in affected eyes.
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Affiliation(s)
- Kemal Tekin
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Yasin Sakir Goker
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Ali Mert Kocer
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Pelin Yilmazbas
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Cankaya AB, Tekin K, Kiziltoprak H, Karahan S, Yilmazbas P. Assessment of corneal backward light scattering in the healthy cornea and factors affecting corneal transparency. Jpn J Ophthalmol 2018; 62:335-341. [DOI: 10.1007/s10384-018-0584-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 01/21/2018] [Indexed: 10/17/2022]
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Tekin K, Inanc M, Kurnaz E, Bayramoglu E, Aydemir E, Koc M, Kiziltoprak H, Aycan Z. Quantitative evaluation of early retinal changes in children with type 1 diabetes mellitus without retinopathy. Clin Exp Optom 2018; 101:680-685. [PMID: 29488254 DOI: 10.1111/cxo.12667] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/14/2017] [Accepted: 12/15/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To investigate whether abnormal glucose metabolism and duration of diabetes mellitus (DM) caused the thinning in retinal layers in children with type 1 DM without retinopathy by using spectral domain optical coherence tomography (SD-OCT) and to compare the results obtained with those in healthy children. METHODS This cross-sectional prospective study included 73 patients with type 1 DM (DM group) and 62 age-matched control subjects (control group). The duration of DM and the glycosylated haemoglobin (HbA1c) levels of the diabetic children were recorded. Macular and peripapillary retinal nerve fibre layer (RNFL) thickness measurements obtained by SD-OCT were compared. RESULTS There were significant differences in the mean values of the temporal inner, temporal outer and inferior outer macular thickness measurements between the groups (p = 0.031, p = 0.028 and p = 0.039, respectively). Moreover, the children with type 1 DM showed significantly thinner global, temporal superior and nasal inferior RNFL thickness measurements compared to the controls (p = 0.035, p = 0.022 and p = 0.034, respectively). Additionally, both the mean duration of DM and the mean HbA1c values were inversely and statistically significantly correlated with the mean temporal outer macular thickness and global RNFL thickness measurements in the DM group. CONCLUSIONS Retinal neural changes, which can be shown by SD-OCT, may be present in diabetic eyes even before clinically detectable retinal vasculopathy. Macular and RNFL thickness measurements might be useful indicators for early detection of diabetic retinopathy in the future.
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Affiliation(s)
- Kemal Tekin
- Ophthalmology Department, Kars State Hospital, Kars, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Erdal Kurnaz
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Elvan Bayramoglu
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Emre Aydemir
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
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Kosekahya P, Koc M, Caglayan M, Kiziltoprak H, Atilgan CU, Yilmazbas P. Repeatability and reliability of ectasia display and topometric indices with the Scheimpflug system in normal and keratoconic eyes. J Cataract Refract Surg 2018; 44:63-70. [DOI: 10.1016/j.jcrs.2017.10.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 11/16/2022]
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Can ME, Kaplan FE, Uzel MM, Kiziltoprak H, Ergun MC, Koc M, Simsek G. The association of Helicobacter pylori with choroidal and retinal nerve fiber layer thickness. Int Ophthalmol 2017; 38:1915-1922. [PMID: 28780617 DOI: 10.1007/s10792-017-0677-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the effect of Helicobacter pylori (H. pylori) infection on choroidal thickness (CT) and retinal nerve fiber layer thickness (RNFLT). METHODS The study included 25 patients with H. pylori infection and 25 healthy individuals as the control group. Helicobacter pylori patients were classified as the pre-treatment (Group 1; n: 25) and the post-treatment (Group 2; n: 25). RNFLT and CT were measured before and after treatment of H. pylori infection, using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The axial length and intraocular pressure were also measured. RESULTS The mean subfoveal CT was 320.96 ± 29.15 μm in Group 1 and 287.48 ± 49.17 in the control group (p = 0.007), while the mean subfoveal CT did not show any difference between Group 2 and the control group (p > 0.05). No statistically significant difference was determined between the H. pylori patients and the control group in respect of RNFLT values (p > 0.05). CONCLUSIONS CT increases during H. pylori infection and returns to the normal range within 6 weeks of treatment. RNFLT does not show any change during H. pylori infection. The data related to the subfoveal CT may be useful in understanding the pathogenesis of central serous chorioretinopathy developing in H. pylori patients.
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Affiliation(s)
- Mehmet Erol Can
- Department of Ophthalmology, Kecioren Training and Research Hospital, Yasamkent Mah. 3208 Sk. Gulbeng Sitesi No: 1-49, Cankaya, Ankara, Turkey.
| | - Fatma Efe Kaplan
- Department of Internal Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | | | - Hasan Kiziltoprak
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Cagri Ergun
- Department of Internal Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Gülcin Simsek
- Department of Pathology, Kecioren Training and Research Hospital, Ankara, Turkey
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