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Ayhan MS, Neubauer J, Uzel MM, Gelisken F, Berens P. Interpretable detection of epiretinal membrane from optical coherence tomography with deep neural networks. Sci Rep 2024; 14:8484. [PMID: 38605115 PMCID: PMC11009346 DOI: 10.1038/s41598-024-57798-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
This study aimed to automatically detect epiretinal membranes (ERM) in various OCT-scans of the central and paracentral macula region and classify them by size using deep-neural-networks (DNNs). To this end, 11,061 OCT-images were included and graded according to the presence of an ERM and its size (small 100-1000 µm, large > 1000 µm). The data set was divided into training, validation and test sets (75%, 10%, 15% of the data, respectively). An ensemble of DNNs was trained and saliency maps were generated using Guided-Backprob. OCT-scans were also transformed into a one-dimensional-value using t-SNE analysis. The DNNs' receiver-operating-characteristics on the test set showed a high performance for no-ERM, small-ERM and large-ERM cases (AUC: 0.99, 0.92, 0.99, respectively; 3-way accuracy: 89%), with small-ERMs being the most difficult ones to detect. t-SNE analysis sorted cases by size and, in particular, revealed increased classification uncertainty at the transitions between groups. Saliency maps reliably highlighted ERM, regardless of the presence of other OCT features (i.e. retinal-thickening, intraretinal pseudo-cysts, epiretinal-proliferation) and entities such as ERM-retinoschisis, macular-pseudohole and lamellar-macular-hole. This study showed therefore that DNNs can reliably detect and grade ERMs according to their size not only in the fovea but also in the paracentral region. This is also achieved in cases of hard-to-detect, small-ERMs. In addition, the generated saliency maps can be used to highlight small-ERMs that might otherwise be missed. The proposed model could be used for screening-programs or decision-support-systems in the future.
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Affiliation(s)
- Murat Seçkin Ayhan
- Institute for Ophthalmic Research, University of Tübingen, Elfriede Aulhorn Str. 7, 72076, Tübingen, Germany
| | - Jonas Neubauer
- University Eye Clinic, University of Tübingen, Tübingen, Germany
| | - Mehmet Murat Uzel
- University Eye Clinic, University of Tübingen, Tübingen, Germany
- Department of Ophthalmology, Balıkesir University School of Medicine, Balıkesir, Turkey
| | - Faik Gelisken
- University Eye Clinic, University of Tübingen, Tübingen, Germany.
| | - Philipp Berens
- Institute for Ophthalmic Research, University of Tübingen, Elfriede Aulhorn Str. 7, 72076, Tübingen, Germany.
- Tübingen AI Center, Tübingen, Germany.
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Özcanlı Çay Ö, Karahan E, Uzel MM. Evaluating the effectiveness of inflammatory markers in pediatric open globe injury using a modified pediatric ocular trauma score. ULUS TRAVMA ACIL CER 2024; 30:129-134. [PMID: 38305654 DOI: 10.14744/tjtes.2024.22905] [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: 02/03/2024]
Abstract
BACKGROUND This study aims to assess pediatric patients with Open Globe Injury (OGI) using the Modified Pediatric Ocular Trauma Score (MPOTS) and to investigate the correlation between Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lympho-cyte ratio (PLR) parameters with the prognosis determined by MPOTS. METHODS In this retrospective study, we included pediatric patients with OGI. Recorded data encompassed demographic details, injury type, duration from injury to surgery, complete ophthalmological examinations, initial and final visual acuities, anterior segment and fundus findings, and NLR and PLR values. Patients were categorized into three groups based on their MPOTS scores: Grade I (≤30 points), indicating high risk; Grade II (35-65 points), moderate risk; and Grade III (≥70 points), low risk. Differences between categories were statistically evaluated. RESULTS The study comprised 22 patients. In Category I, the duration from injury to surgery was longer (p=0.018). The most common injury type in this category was globe rupture, occurring in four (50%) patients, with a significant difference noted between the groups (p=0.041). Category I exhibited lower final visual acuity and higher NLR and PLR values compared to the other categories (p<0.050 for all values). Both NLR and PLR demonstrated significant negative correlations with MPOTS (respectively, r=-0.869, p<0.001; r=-0.809, p<0.001). CONCLUSION The Modified Pediatric Ocular Trauma Score is an effective and practical method for assessing the prognosis of pediatric patients with Open Globe Injury (OGI). Furthermore, there is evidence indicating a negative correlation between MPOTS and the increase in NLR and PLR values that often follows OGI in this patient population.
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Affiliation(s)
- Özlem Özcanlı Çay
- Department of Pediatrics, Balıkesir City Hospital, Balıkesir-Türkiye
| | - Eyyup Karahan
- Department of Ophthalmology, Balıkesir University, Faculty of Medicine, Balıkesir-Türkiye
| | - Mehmet Murat Uzel
- Department of Ophthalmology, Balıkesir University, Faculty of Medicine, Balıkesir-Türkiye
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Kaya P, Uzel MM. Development and progression of myopia in children during the COVID-19 pandemic in urban area in Turkey. Int Ophthalmol 2023; 43:3823-3829. [PMID: 37498447 DOI: 10.1007/s10792-023-02824-w] [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: 06/27/2021] [Accepted: 07/10/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE To investigate the relationship between digital screen time and the development and progression of myopia during the 2019 coronavirus disease (COVID-19) pandemic. METHODS Children aged 7-18 years who had regular refractive measurement follow-ups before and after the COVID-19 pandemic were included in the study. They were divided into two groups according to their initial refractive status, emmetropic and myopic. The relationship between spherical equivalent refraction (SER) changes and digital screen time before and after the pandemic was analyzed. RESULTS A total of 255 children were included in the study. During the pandemic in the emmetropic group, digital screen time increased by 5.98 ± 2.13 h/day, and the mean SER decreased from - 0.02 to - 0.55 D (p < 0.001). During the pandemic in the myopic group, the digital screen time increased by 6.25 ± 2.36 h, and the mean SER decreased from - 1.82 to - 2.72 D (p < 0.001). A significant correlation was found between the increase in digital screen time and the change in SER in the emmetropic and myopic groups (r = - 0.261, p = 0.015, r = - 0.269, p = 0.001, respectively). CONCLUSION Increased digital screen time during the COVID-19 pandemic is associated with a myopic shift in emmetropic children and myopic progression in myopic children. As a result of COVID-19, increasing cases of myopia should be addressed as a public health concern.
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Affiliation(s)
- Pınar Kaya
- Department of Ophthalmology, Zonguldak Devrek State Hospital, Zonguldak, Turkey.
| | - Mehmet Murat Uzel
- Department of Ophthalmology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey
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Uzel MM, Karahan E, Koroglu Canli M, Guler C. The prognostic role of optical coherence tomography in diabetic macular edema patients undergoing early dexamethasone implant shift. Eur J Ophthalmol 2021; 32:1562-1569. [PMID: 34020568 DOI: 10.1177/11206721211019569] [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: 11/17/2022]
Abstract
PURPOSE To determine the prognostic characteristics of optical coherence tomography (OCT) parameters by evaluating diabetic macular edema (DME) patients with early dexamethasone (DEX) shift after three doses of intravitreal ranibizumab (RNB) injection. METHODS Fifty-four eyes of 34 patients who had DEX implant after three doses of RNB were included in this retrospective study. Early DEX shift includes patients who received direct DEX implant replacement after three doses of RNB load. Baseline OCT values and factors affecting best corrected visual acuity (BCVA) and central macular thickness (CMT) response were analyzed with logistic regression analyses. RESULTS The presence of subretinal fluid and hyperreflective spot (HRS) >20 were found to be a negative predictive factor for anatomical response. (p = 0.009, p = 0.001, respectively) Low initial BCVA creates a positive effect on visual gain.( p = 0.041) Giant outer nuclear layer cysts, completely disrupted inner segment-outer segment and HRS > 20 have a negative effect on visual gain. (p = 0.025, p = 0.043, p = 0.023, respectively) According to the receiver operating characteristic analysis, the subretinal fluid volume threshold at which >20% reduction in CMT occurs was determined to be 0.85 mm3. (sensitivity 70%, specificity 84% area under the curve 0.817, p = 0.021). CONCLUSION The presence of high number of HRS and high subretinal fluid volume at the baseline negatively affect prognosis even in patient groups with early DEX shift.
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Affiliation(s)
- Mehmet Murat Uzel
- Department of Ophthalmoloy, Balıkesir University School of Medicine, Balıkesir, Turkey
| | - Eyyup Karahan
- Department of Ophthalmoloy, Balıkesir University School of Medicine, Balıkesir, Turkey
| | - Melek Koroglu Canli
- Department of Ophthalmoloy, Balıkesir University School of Medicine, Balıkesir, Turkey
| | - Cenap Guler
- Department of Ophthalmoloy, Balıkesir University School of Medicine, Balıkesir, 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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Ozulken K, Yuksel E, Uzel MM. Effect of topical pilocarpine on refractive surgery outcomes. Int Ophthalmol 2019; 40:733-740. [PMID: 31758508 DOI: 10.1007/s10792-019-01235-0] [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: 08/16/2019] [Accepted: 11/16/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the effect of topical pilocarpine on topical cycloplegia and on the results of refractive surgery. METHODS The study included 100 eyes of 100 patients who underwent laser-assisted in situ keratomileusis. Group 1 comprised patients who wanted to undergo surgery on the same day after cycloplegic examination and were applied with 2% pilocarpine hydrochloride; group 2 comprised patients whose pupils spontaneously went into the natural position. Corneal thickness, mean refractive spherical equivalent (MRSE), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), pupil diameter, pupil center shift and high-order aberrations (HOAs) were compared between the two groups. RESULTS There were no statistically significant differences between the groups in respect of preoperative age, gender, corneal thickness, MRSE, UDVA and CDVA. The pupil diameter was not statistically significant between the groups. Pupil diameter after pilocarpine was not statistically significant when compared with the natural pupil diameter. There were no statistically significant differences in postoperative HOA between the two groups. CONCLUSIONS The pupillary dilatation and the associated pupillary shift were reduced with pilocarpine. Postoperative refractive values and aberrations showed no difference between the groups.
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Affiliation(s)
- Kemal Ozulken
- Ophthalmology Department, TOBB ETU Medical School Hospital, Yasam Cad. No:5 Sogutozu, Ankara, Turkey.
| | - Erdem Yuksel
- Ophthalmology Department, Kastamonu University, Kastamonu, Turkey
| | - Mehmet Murat Uzel
- Ophthalmology Department, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
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Yuksel E, Ozulken K, Uzel MM, Taslipinar Uzel AG, Aydoğan S. Comparison of Samfilcon A and Lotrafilcon B silicone hydrogel bandage contact lenses in reducing postoperative pain and accelerating re-epithelialization after photorefractive keratectomy. Int Ophthalmol 2019; 39:2569-2574. [DOI: 10.1007/s10792-019-01105-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/29/2019] [Indexed: 11/30/2022]
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Abstract
Optic disk pit, one of the optic disk cavitary anomalies, is generally congenital and unilateral and occurs equally in males and females. Optic disk pit maculopathy is characterized by intraretinal and subretinal fluid at the macula, causing visual deterioration. The origin of the macular fluid and the mechanism of transition to the subretinal space in optic disk pit maculopathy pathophysiology are not yet fully understood. With the evolution of imaging modalities, especially optic coherence tomography, our knowledge of this disorder continues to increase. Although many different treatments have been tried, there is no consensus on the most effective.
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Uzel MM, Citirik M, İlhan Ç, Tekin K. The impact of duration on the recurrence of rhegmatogenous retinal detachment: optimal cutoff value. Int Ophthalmol 2018; 39:2089-2095. [DOI: 10.1007/s10792-018-1045-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022]
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Uzel MM, Koc M, Can C, Polat S, Yılmazbaş P, Ileri D. Effect of accelerated corneal crosslinking on ocular response analyzer waveform-derived parameters in progressive keratoconus. Arq Bras Oftalmol 2018; 82:18-24. [PMID: 30403263 DOI: 10.5935/0004-2749.20190003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 05/19/2018] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the effect of accelerated corneal crosslinking on corneal biomechanics with an ocular response analyzer in patients with progressive keratoconus. METHODS In this retrospective study, 50 eyes of 45 patients with progressive keratoconus who underwent accelerated corneal crosslinking were evaluated with ocular response analyzer waveform parameters before and one year after corneal crosslinking. Paired two-tailed Student's t-test was performed to compare the parameters before vs. after corneal crosslinking. RESULTS Mean patient age was 17.6 ± 3.6 (range 9-25) years. A significant increase was observed in p1 area, p2 area, h2, and dive2 values. No significant difference in corneal hysteresis, corneal resistance factor, or other waveform-derived parameters was observed at one year postoperatively. CONCLUSION For estimating the effect of accelerated corneal crosslinking on corneal biomechanics, parameters such as p1 area, p2 area, h2, and dive2 are more sensitive than corneal hysteresis and corneal resistance factor. These results may help us to find out which corneal crosslinking method is most effective for stiffening the cornea.
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Affiliation(s)
- Mehmet Murat Uzel
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Cigdem Can
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Sibel Polat
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Pelin Yılmazbaş
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Dilek Ileri
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Affiliation(s)
| | - Serdar Ozates
- Ulucanlar Eye Research and Training Hospital, Ophthalmology Department, Ankara, Turkey
| | - Mustafa Koc
- Ulucanlar Eye Research and Training Hospital, Ophthalmology Department, Ankara, Turkey
| | - Ayse Guzin Taslipinar Uzel
- Yıldırım Beyazıt University, Ataturk Research and Training Hospital, Ophthalmology Department, Ankara, Turkey
| | - Pelin Yılmazbaş
- Ulucanlar Eye Research and Training Hospital, Ophthalmology Department, Ankara, Turkey
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Uzel MM, Elgin U, Boral B, Çiçek M, Şen E, Şener B, Yılmazbaş P. The effect of trabeculectomy on serum brain-derived neurotrophic factor levels in primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2018; 256:1173-1178. [PMID: 29417213 DOI: 10.1007/s00417-018-3923-y] [Citation(s) in RCA: 6] [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] [Received: 09/28/2017] [Revised: 01/08/2018] [Accepted: 01/24/2018] [Indexed: 01/28/2023] Open
Abstract
PURPOSE We aimed to investigate the effect of trabeculectomy on serum brain-derived neurotrophic factor (BDNF) levels. Our secondary goal was to compare serum and aqueous humor (AH) BDNF levels in primary open-angle glaucoma (POAG) and control subjects. METHODS This prospective, cross-sectional study consists of 20 eyes of with advanced-stage POAG who had trabeculectomy and 19 eyes of age- and sex-matched control healthy subjects who had cataract surgery. Serum and AH samples were obtained preoperatively in trabeculectomy group and control subjects. Serum samples were obtained at the third postoperative month in both groups. RESULTS The aqueous humor and serum levels of BDNF at the surgery day were found to be strongly positive correlated (r = 0.868; p < 0.001). Serum and AH BDNF levels of POAG cases were significantly lower than control subjects at the surgery day (respectively p = 0.038, p = 0.011). In POAG cases, serum BDNF levels significantly increased at the third month after trabeculectomy while there was not a significant difference in control subjects with cataract surgery (p < 0.001; p = 0.717 respectively). CONCLUSION Trabeculectomy was found to have a positive effect on serum BDNF levels in POAG cases.
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Affiliation(s)
| | - Ufuk Elgin
- University of Health Sciences, Ulucanlar Eye Research and Training Hospital, Ankara, Turkey
| | - Barış Boral
- Faculty of Medicine, Immunology Department, Cukurova University, Adana, Turkey
| | - Muharrem Çiçek
- Faculty of Medicine, Microbiology Department, Hacettepe University, Ankara, Turkey
| | - Emine Şen
- University of Health Sciences, Ulucanlar Eye Research and Training Hospital, Ankara, Turkey
| | - Burçin Şener
- Faculty of Medicine, Microbiology Department, Hacettepe University, Ankara, Turkey
| | - Pelin Yılmazbaş
- University of Health Sciences, Ulucanlar Eye Research and Training Hospital, Ankara, Turkey
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Koç M, Yaşar HH, Uzel MM, Çolak S, Durukan I, Yılmazbaş P. Anterior Segment Changes during Accommodation in Accommodative Esotropia. Korean J Ophthalmol 2018; 32:45-51. [PMID: 29376230 PMCID: PMC5801089 DOI: 10.3341/kjo.2017.0012] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/07/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the anterior segment biometric parameters of non-accommodative and accommodative refractive accommodative esotropia (RAE). Methods Eighty-one eyes of 81 patients were included in this prospective, case-control study. The patients were divided into three groups as follows: the RAE group (n = 31), the hypermetropia group (n = 25), and the emmetropia group (n = 25). Measurements were obtained in the non-accommodative (0.0 diopters) and accommodative status (-5.0 diopters) using a Pentacam HR. The anterior chamber depth (ACD), anterior chamber volume (ACV), pupil diameter (PD), and anterior chamber angle (ACA) were evaluated at all four quadrants. Results The ACD, ACV and PD values in the RAE group were lower than those of the other groups in both states (p < 0.05). The ACD values were lower in the hypermetropia group than in the emmetropia group for the non-accommodative status (p = 0.024) but were similar for the accommodative status (p = 0.225). PD and ACV values were lower in the hypermetropia group than in the emmetropia group in both states (non-accommodative status, p = 0.011 and p = 0.022; accommodative status, p = 0.026 and p = 0.034, respectively). Changes in ACD, ACV and PD during accommodation (Δ) were not significant in the RAE group but were significant for the other groups (hypermetropia: ΔACD, p = 0.001; ΔACV, p = 0.001; ΔPD, p = 0.002; emmetropia: ΔACD, p < 0.001; ΔACV, p = 0.001; ΔPD, p < 0.001). These changes were significantly lower in the hypermetropia group than in the emmetropia group (ΔACD, p = 0.012; ΔACV, p = 0.031; ΔPD, p = 0.034). Conclusions The anterior chamber in RAE patients was shallower and the increase in convexity of the anterior surface or forward movement of the crystalline lens was more limited during accommodation in RAE.
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Affiliation(s)
- Mustafa Koç
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Hakan Halit Yaşar
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mehmet Murat Uzel
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
| | - Salih Çolak
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Irfan Durukan
- Department of Ophthalmology, Kayserigöz Hospital, Kayseri, Turkey
| | - Pelin Yılmazbaş
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Ilhan C, Uzel MM, Citirik M. Intraocular Hemorrhage due to use of Sildenafil in a Patient with Diabetes. Med Hypothesis Discov Innov Ophthalmol 2018; 7:122-125. [PMID: 30386801 PMCID: PMC6205676] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Sildenafil is one of the most commonly used drugs for sexual dysfunction or to increase libido, and it regulates endothelial nitric oxide synthase enzyme via selective phosphodiesterase-V inhibition. Sildenafil can be easily obtained without a medical indication or prescription yet it is not considered as a completely safe medication. Hemoptysis and hemorrhagic stroke are some important adverse effects of sildenafil. The case of the current report was a 67-year-old diabetic patient with simultaneous anterior and posterior segment hemorrhage after the use of 100 mg sildenafil citrate. Anterior chamber clearance and pars plana vitrectomy were performed for the patient because the hyphema and vitreous hemorrhage did not resolve during the follow-up period. There are very limited data available in the literature suggesting an increase in the risk of hyphema or vitreous hemorrhage due to the use of sildenafil. This is the first report that reveals the bleeding effect of sildenafil use in a patient with type 2 diabetes.
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Affiliation(s)
- Cagri Ilhan
- Department of Ophthalmology, Hatay State Hospital, Hatay, Turkey,Correspondence to: Cagri Ilhan MD, Department of Ophthalmology, Hatay State Hospital, Hatay, Turkey. E-mail:
| | - Mehmet Murat Uzel
- Department of Ophthalmology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Mehmet Citirik
- Department of Ophthalmology, University of Health Sciences, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
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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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Abstract
PURPOSE To assess the decentration and tilt of one-piece foldable acrylic intraocular lens following two different intraocular lens implantation techniques. METHODS This prospective, randomized clinical study conducted on 102 eyes of 91 patients who underwent cataract surgery between September 2015 and May 2016 at Ulucanlar Eye Training and Research Hospital, Ankara, Turkey. Intraocular lens implantations were performed with the help of an ophthalmic viscosurgical device or a hydroimplantation technique during surgery. The main outcomes, which were evaluated one day and one month after surgery, were corrected distant visual acuity, intraocular lens tilt, and decentration at the vertical and horizontal meridians. All outcomes were compared between and within implantation technique groups. RESULTS Angle of tilt and decentration of intraocular lens at the vertical and horizontal meridians showed no significant change within the ophthalmic viscosurgical device and hydroimplantation groups during follow-up (p > 0.05 for all). However, intraocular lens at both meridians were significantly lower in the hydroimplantation group (Vertical: p = 0.004, Horizontal: p = 0.015), and intraocular lens decentration tilt at both meridians were significantly lower in the hydroimplantation group than in the ophthalmic viscosurgical device group (Vertical: p = 0.004, Horizontal: p = 0.039). Postoperative corrected distant visual acuity outcomes showed no difference between and within the groups during follow-up (p > 0.05 for all). CONCLUSIONS The intraocular lens implantation technique had an important effect on intraocular lens position. The hydroimplantation technique induces central placement of one-piece foldable acrylic intraocular lenses postoperatively by reducing decentration and the angle of tilt.
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Affiliation(s)
- Serdar Ozates
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Mustafa Koc
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Mehmet Murat Uzel
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
| | - Pelin Yilmazbas
- a Department of Opthalmology, Ulucanlar Eye Training and Research Hospital , Ankara , Turkey
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Uzel MM, Citirik M, Kekilli M, Cicek P. Local ocular surface parameters in patients with systemic celiac disease. Eye (Lond) 2017; 31:1093-1098. [PMID: 28304385 DOI: 10.1038/eye.2017.31] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 01/10/2017] [Indexed: 12/20/2022] Open
Abstract
PurposeThis was a collaborative study from the Ophthalmology and Gastroenterology departments of a tertiary care hospital, designed to investigate the local ocular surface parameters in patients with celiac disease (CD).MethodsFifty-six eyes of 28 patients with CD and 58 eyes of 29 healthy adult subjects serving as controls were evaluated. The Schirmer test, tear-film break-up time, and conjunctival impression cytology were performed in addition to a complete ophthalmological examination. Impression cytology specimens of each group were graded and scored in the range 0-3.ResultsThe 28 patients with CD consisted of 24 females (86%) and 4 males (14%). The mean age was 34.4±11.3 years (22-55 years). Tear-film break-up time and Schirmer test results were significantly lower in the study group than in the controls (P<0.05). Also, there was a significant difference between the groups for impression cytology grading scores (P=0.001).ConclusionsThe CD group showed a marked preponderance of females with an F/M ratio of six females per male, as reported in the literature. Tear-film functions and conjunctival surface epithelial morphology were significantly altered in patients with CD.
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Affiliation(s)
- M M Uzel
- SB Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - M Citirik
- SB Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
| | - M Kekilli
- Department of Gastroenterology, SB Ankara Teaching and Research Hospital, Ankara, Turkey
| | - P Cicek
- SB Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey
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18
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Affiliation(s)
- Mustafa Koç
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Fuat Yavrum
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mehmet Murat Uzel
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Emre Aydemir
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Kemal Özülken
- Ophthalmology Department, Dünyagöz Hospital, Ankara, Turkey
| | - Pelin Yılmazbaş
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Koc M, Uzel MM, Aydemir E, Yavrum F, Kosekahya P, Yılmazbaş P. Pterygium size and effect on intraocular lens power calculation. J Cataract Refract Surg 2016; 42:1620-1625. [DOI: 10.1016/j.jcrs.2016.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 11/26/2022]
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Uzel MM, Citirik M, Ilhan C, Inanc M. The Effect of Bevacizumab Pretreatment on the Choice of Endotamponade in Diabetic Tractional Retinal Detachment. Ophthalmic Surg Lasers Imaging Retina 2016; 47:924-929. [DOI: 10.3928/23258160-20161004-05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/30/2016] [Indexed: 11/20/2022]
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Koc M, Uzel MM, Tekin K, Kosekahya P, Ozulken K, Yilmazbas P. Effect of preoperative factors on visual acuity, corneal flattening, and corneal haze after accelerated corneal crosslinking. J Cataract Refract Surg 2016; 42:1483-1489. [DOI: 10.1016/j.jcrs.2016.08.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/26/2016] [Accepted: 08/12/2016] [Indexed: 11/26/2022]
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