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Öğe Assessment of macular capillary perfusion in patients with inactive Vogt-Koyanagi-Harada disease: an optical coherence tomography angiography study(Springer, 2020) Karaca, Irmak; Yilmaz, Suzan Guven; Afrashi, Filiz; Nalcaci, SerhadPurpose To assess macular capillary perfusion in patients with inactive Vogt-Koyanagi-Harada (VKH) disease by using optical coherence tomography angiography (OCTA). Methods A total of 51 eyes of 51 patients with inactive VKH (group 1, n = 23) and healthy volunteers (group 2, n = 28) underwent detailed eye examination including OCTA (RTVue-XR Avanti) scanning. OCTA images (6 x 6 mm) were assessed for central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), vessel densities (VD) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), choriocapillaris (CC) flow area and vessel flow density (VFD), foveal avascular zone (FAZ) area and acircularity index (AI). Results the mean ages of group 1 (13 female, 10 male) and group 2 (15 female, 13 male) were 39.9 +/- 11.8 (range, 24-58) and 38.9 +/- 8.5 (range, 29-51) years, respectively (p = 0.773). CRT and SFCT were 218.2 +/- 39.4 mu m and 195.6 +/- 28.6 mu m in group 1, while 243.5 +/- 9.7 mu m and 316.7 +/- 20.1 mu m in group 2, respectively (p < 0.05). VD in SCP and DCP were significantly lower in group 1 (50.6 +/- 4.7% vs. 54.3 +/- 3.4% and 53.9 +/- 3.6% vs. 61.1 +/- 2.7% respectively; p < 0.05). FAZ areas were 0.32 +/- 0.11 mm(2) in group 1 and 0.25 +/- 0.06 mm(2) in group 2 (p = 0.046). There was no statistically significant difference between groups regarding AI, CC flow area, and VFD (p > 0.05). There was weak negative correlation between BCVA (logMAR) and parafoveal and perifoveal VD in SCP and DCP of group 1 (p < 0.05). Conclusion Macular capillary perfusion was significantly reduced both in SCP and DCP in patients with inactive VKH disease.Öğe Chronically retained feathery chestnut-burr spine-related corneal injury: clinical features and outcome(Springer, 2020) Karaca, Irmak; Selver, Ozlem Barut; Palamar, Melis; Egrilmez, SaitPurpose To establish the clinical features and outcomes of patients with chronically retained, feathery chestnut-burr spine-related corneal injury. Methods the data of the patients who presented with chestnut-burr-related corneal injury between 2010 and 2018 were retrospectively evaluated. Nineteen eyes of 19 patients, with chronically retained corneal intrastromal feathery chestnut-burr spines, were included. Results the mean age of the patients (11 male and 8 female) was 29.8 +/- 19.9 years. Best-corrected visual acuity was 0.13 +/- 0.23 logMAR at initial examination and increased to 0.0 +/- 0.0 logMAR at last visit. Chestnut-burr spines were located in the peripheral cornea in 14 eyes (73.7%) and in the central cornea in 5 eyes (26.3%). Localized corneal edema surrounding the chestnut-burr spines were detected in all eyes. No eyes were Seidel positive. Three eyes (15.8%) had low-grade anterior chamber reaction. None of the patients had epithelial ulceration or any sign of infection at initial presentation. in order to control acute localized inflammation, all patients were put on topical steroid (loteprednol etabonate). the mean duration of topical steroid treatment was 3.8 +/- 1.8 (range 2-7) months. During the follow-up period, inflammation was controlled and no sign of reinflammation occurred. Conclusion Acute inflammation in intrastromal chestnut-burr spines can be well controlled with easy tapering of topical steroids. However, as the reinflammation possibility cannot be excluded, long-term follow-up of these patients is mandatory.Öğe Çiğ Et Tüketimi İlişkili Toxocara Nöroretiniti(2018) Karaca, Irmak; Menteş, Jale; Nalçacı, SerhadTek gözde ani ve ağrısız görme kaybı ile başvuran, öyküsünde çiğ et tüketimi anamnezi olan bir hastada optik disk ödemi ve maküla yıldızı şeklinde eksudasyonlar ile karakterize nöroretinit tablosu saptanmıştır. Toxocara serolojisi pozitif olan hastaya uygulanan steroid ve albendazol kombine tedavisi ile görme keskinliğinde artış ve klinik tabloda tamamen gerileme saptanmıştır.Öğe Comparison of central corneal thickness and endothelial cell measurements by Scheimpflug camera system and two noncontact specular microscopes(Springer, 2018) Karaca, Irmak; Yilmaz, Suzan Guven; Palamar, Melis; Ates, HalilTo investigate the correlation of Scheimpflug camera system and two noncontact specular microscopes in terms of central corneal thickness (CCT) and corneal endothelial cell morphology measurements. One hundred eyes of 50 healthy subjects were examined by Pentacam Scheimpflug Analyzer, CEM-530 (Nidek Co, Ltd, Gamagori, Japan) and CellChek XL (Konan Medical, California, USA) via fully automated image analysis with no corrections made. Measurement differences and agreement between instruments were determined by intraclass correlation analysis. The mean age of the subjects was 36.74 +/- 8.59 (range 22-57). CCTs were well correlated among all devices, with having CEM-530 the thinnest and CellChek XL the thickest measurements (intraclass correlation coefficient (ICC) = 0.83; p < 0.001 and ICC = 0.78; p < 0.001, respectively). Mean endothelial cell density (ECD) given by CEM-530 was lower than CellChek XL (2613.17 +/- 228.62 and 2862.72 +/- 170.42 cells/mm(2), respectively; ICC = 0.43; p < 0.001). Mean value for coefficient of variation (CV) was 28.57 +/- 3.61 in CEM-530 and 30.30 +/- 3.53 in CellChek XL. Cell hexagonality (HEX) with CEM-530 was higher than with CellChek XL (68.70 +/- 4.16% and 45.19 +/- 6.58%, respectively). ECDs with CellChek XL and CEM-530 have good correlation, but the values obtained by CellChek XL are higher than CEM-530. Measurements for HEX and CV differ significantly and show weak correlation. Thus, we do not recommend interchangeable use of CellChek XL and CEM-530. In terms of CCTs, Pentacam, CEM-530 and CellChek XL specular microscopy instruments are reliable devices.Öğe Contact Lens-Associated Microbial Keratitis in a Tertiary Eye Care Center in Turkey(Lippincott Williams & Wilkins, 2020) Karaca, Irmak; Selver, Ozlem Barut; Palamar, Melis; Egrilmez, Sait; Aydemir, Sohret; Yagci, AyseObjectives: To evaluate the risk factors, causative microorganisms, and presenting features of infection in patients with contact lens-associated microbial keratitis (CLAMK) admitted to a tertiary referral center in Turkey. Methods: A retrospective review of the medical records of 62 patients who were diagnosed as CLAMK in our clinic between 2012 and 2018 was conducted. Results: the mean age of the patients (22 men and 40 women) at the time of diagnosis was 24.5 +/- 8.3 years (range, 16-48). the mean best-corrected visual acuity (BCVA) was 0.7 +/- 0.9 log of minimal angle of resolution (logMAR) (0-3) before treatment and increased to 0.1 +/- 0.1 logMAR (0-0.4) at the end of the follow-up. All patients, except one using rigid gas-permeable CL, were frequent replacement soft CL users. Thirty-one (50%) patients declared overnight wear, and 37 (58.9%) patients declared showering or swimming in CLs regularly. Cultures of either corneal scrapings or CL materials were positive in 40 (64.5%) eyes, 12 (19.4%) of which had mixed infections. Thirteen strains of microorganisms were demonstrated, among which there were seven (53.8%) gram-negative bacteria, one (7.7%) gram-positive bacteria, four (30.7%) fungi, and Acanthamoeba (7.7%). the most common pathogen was Pseudomonas aeruginosa, followed by Serratia marcescens and Stenotrophomonas maltophilia. According to culture results, P. aeruginosa infections were associated with significantly worse BCVA. Keratitis foci were either centrally or paracentrally located in 39 (62.9%) eyes, and 16 eyes (25.8%) presented with hypopyon. Conclusion: Along with growing number of CL users, CLAMK constitutes an important problem with possibly worse visual outcomes. Thus, in addition to meticulous treatment, management of risk factors and behavioral modifications is crucial.Öğe Dikkat Eksikliği ve Hiperaktivite Bozukluğu Tanısı Alan Çocuklarda Tedavi Öncesi Stereopsis, Füzyonel Verjans Amplitüdleri ve Refraksiyon Kusurlarının İncelenmesi(2020) Karaca, Irmak; Biler, Elif Demirkılınç; Onay, Melis Palamar; Özbaran, Burcu; Üretmen, ÖnderAmaç: Dikkat eksikliği ve hiperaktivite bozukluğu (DEHAB) tanısı alan çocuklarda tedavi öncesi stereopsis ve füzyonel verjans amplitüdlerinin kontrol grubuyla karşılaştırmalı olarak incelenmesi. Gereç ve Yöntem: Ege Üniversitesi Çocuk Ruh Sağlığı ve Hastalıkları Kliniği’nde yeni DEHAB tanısı alan ve daha önce tedavi almamış 23 hasta ve 48 DEHAB saptanmayan kontrol olgusu çalışmaya dahil edildi. Hastaların detaylı oftalmolojik muayenelerine ek olarak stereopsis ve füzyonel verjans amplitüdleri retrospektif olarak değerlendirildi. Bulgular: Ortalama yaş DEHAB tanısı alanlarda (14 erkek, 9 kız) 10,68±2,34 (7-16) iken, kontrol grubunda (25 erkek, 23 kız)12,23±2,16 (7-15) idi (p=0,605; ki-kare testi). Tüm hastalarda ön segment ve fundus muayeneleri doğaldı. Tüm çocuklarda en iyi düzeltilmiş görme keskinliği 20/20 düzeyindeydi. TNO testi ile değerlendirme yapılabilenlerde ortalama stereopsis DEHAB olanlarda 142,14±152,65 (15-480) sec/arc, kontrol grubunda 46,3±44,11 (15-240) sec/arc idi (p<0,001; t-testi). Uzak bakışta ortalama konverjans amplitüdü (UKA) ve diverjans amplitüdü (UDA) sırasıyla 19,87±8,40 (6 ila 38) prizma diyoptri ve -9,09±-4,34 (-4 ila -25) PD; yakın bakışta ortalama konverjans amplitüdü (YKA) 37,30±12,81 (14 ila 70) PD, UDA (YDA) -13,13±-3,45 (-4 ila -20) PD olarak ölçüldü. Siklopleji sonrası ortalama sferik eşdeğer 1,06±1,13 (-1 ila 4,63) diyoptri iken, 6 hastada belirgin refraksiyon kusuru (4 hastada hipermetropi, 2 hastada astigmatizma) saptandı. Gruplar arasında UKA, UDA, YKA, YDA ile sferik eşdeğerler açısından istatistiksel olarak anlamlı fark görülmedi (sırasıyla p=0,123, p=0,176, p=0,464, p=0,489, p=0,086; t-testi). Sonuç: DEHAB tanısı alan çocuklarda tedavi öncesi ortalama stereopsis kontrol grubundan anlamlı olarak düşük saptanırken, füzyonel verjans amplitüdleri açısından belirgin fark izlenmemiştiÖğe Dikkat Eksikliği ve Hiperaktivite Bozukluğu Tanısı Alan Çocuklarda Tedavi Öncesi Stereopsis, Füzyonel Verjans Amplitüdleri ve Refraksiyon Kusurlarının İncelenmesi(2020) Karaca, Irmak; Biler, Elif Demirkılınç; Onay, Melis Palamar; Özbaran, Burcu; Üretmen, ÖnderAmaç: Dikkat eksikliği ve hiperaktivite bozukluğu (DEHAB) tanısı alan çocuklarda tedavi öncesi stereopsis ve füzyonel verjans amplitüdlerinin kontrol grubuyla karşılaştırmalı olarak incelenmesi. Gereç ve Yöntem: Ege Üniversitesi Çocuk Ruh Sağlığı ve Hastalıkları Kliniği’nde yeni DEHAB tanısı alan ve daha önce tedavi almamış 23 hasta ve 48 DEHAB saptanmayan kontrol olgusu çalışmaya dahil edildi. Hastaların detaylı oftalmolojik muayenelerine ek olarak stereopsis ve füzyonel verjans amplitüdleri retrospektif olarak değerlendirildi. Bulgular: Ortalama yaş DEHAB tanısı alanlarda (14 erkek, 9 kız) 10,68±2,34 (7-16) iken, kontrol grubunda (25 erkek, 23 kız)12,23±2,16 (7-15) idi (p=0,605; ki-kare testi). Tüm hastalarda ön segment ve fundus muayeneleri doğaldı. Tüm çocuklarda en iyi düzeltilmiş görme keskinliği 20/20 düzeyindeydi. TNO testi ile değerlendirme yapılabilenlerde ortalama stereopsis DEHAB olanlarda 142,14±152,65 (15-480) sec/arc, kontrol grubunda 46,3±44,11 (15-240) sec/arc idi (p<0,001; t-testi). Uzak bakışta ortalama konverjans amplitüdü (UKA) ve diverjans amplitüdü (UDA) sırasıyla 19,87±8,40 (6 ila 38) prizma diyoptri ve -9,09±-4,34 (-4 ila -25) PD; yakın bakışta ortalama konverjans amplitüdü (YKA) 37,30±12,81 (14 ila 70) PD, UDA (YDA) -13,13±-3,45 (-4 ila -20) PD olarak ölçüldü. Siklopleji sonrası ortalama sferik eşdeğer 1,06±1,13 (-1 ila 4,63) diyoptri iken, 6 hastada belirgin refraksiyon kusuru (4 hastada hipermetropi, 2 hastada astigmatizma) saptandı. Gruplar arasında UKA, UDA, YKA, YDA ile sferik eşdeğerler açısından istatistiksel olarak anlamlı fark görülmedi (sırasıyla p=0,123, p=0,176, p=0,464, p=0,489, p=0,086; t-testi). Sonuç: DEHAB tanısı alan çocuklarda tedavi öncesi ortalama stereopsis kontrol grubundan anlamlı olarak düşük saptanırken, füzyonel verjans amplitüdleri açısından belirgin fark izlenmemiştiÖğe Dry eye and Meibomian gland dysfunction with meibography in patients with lamellar ichthyosis(Elsevier Science Bv, 2018) Palamar, Melis; Karaca, Irmak; Onay, Huseyin; Ertam, Ilgen; Yagci, AysePurpose: To evaluate the dry eye findings and Meibomian gland dysfunction as demonstrated with meibography in patients with lamellar ichthyosis. Methods: Twenty-four eyes of 12 patients with lamellar ichthyosis (Group 1) and twenty-four eyes of 12 healthy individuals (Group 2) were enrolled. Comprehensive eye examination along with corneal and conjunctival fluorescein staining with Oxford scoring, tear film break-up time, Schirmer 1 test, ocular surface disease index (OSDI) score assessment, and evaluation of upper and lower eyelid Meibomian glands using infrared filter of slit-lamp biomicroscope (SL-D701, TOPCON, Tokyo, Japan) were performed. The Meibomian glands were graded from grade 0 (no loss of Meibomian glands) to grade 3 (gland dropout > 2/3 of the total Meibomian glands). Results: The mean ages of Group 1 and Group 2 were 25.3 +/- 15.6 years (range, 9-61 years) and 25.3 +/- 13.3 years (range, 9-52 years), respectively (p = 0.997). No significant difference in terms of best-corrected visual acuity, Schirmer 1 test and Oxford scores were detected in between groups. Mean tear film break-up time was lower (p = 0.013), and OSDI score, lower, upper and total (upper + lower) meiboscores were significantly higher in Group 1 as compared with Group 2 (p < 0.001, p = 0.001, p = 0.001, p = 0.001, respectively). Conclusion: Lamellar ichthyosis is associated with evaporative type dry eye disease with decreased tear film break-up time, normal Schirmer 1 values and Meibomian gland dysfunction that can objectively be demonstrated with meibography. For this reason, in order to prevent undesired complications, these patients should be examined and treated for dry eye disease especially targeting Meibomian gland dysfunction.Öğe Effect of Tropicamide on Laser Flare Meter Measurements in Patients with Pseudoexfoliation(Taylor & Francis Inc, 2020) Karaca, Irmak; Yilmaz, Suzan Guven; Palamar, Melis; Ates, HalilPurpose: To investigate the effect of 1% tropicamide on anterior chamber aqueous flare (ACAF) measurements acquired with laser flare meter in patients with pseudoexfoliation. Methods: Thirty-three eyes of 33 patients with pseudoexfoliation were enrolled. Patients with the history of other ocular diseases, intraocular surgeries, and the presence of severe posterior synechia were excluded. Besides routine ophthalmological examination, ACAF levels were measured by laser flare meter device (Kowa FM 600) before and after instillation of 1% tropicamide. Results: The mean age of 33 patients was 67.3 +/- 7.1 (53-85) years. Patients had a mean best corrected visual acuity of 0.25 +/- 0.41 (1.80-0.00) logMAR, cup-to-disc ratio of 0.45 +/- 0.22 (0.2-1), and IOP of 15.33 +/- 2.82 (9-20) mmHg. Although the mean ACAF value increased from 14.68 +/- 8.40 (3.4-40.4) photon/ms predilation to 15.41 +/- 10.74 (3.8-46.8) photon/ms post-dilation, the difference was not statistically significant (p=0.835). Conclusions: ACAF values in patients with pseudoexfoliation did not significantly differ after instillation of 1% tropicamide.Öğe Effect of tropicamide on laser flare meter measurements in patients with pseudoexfoliation(2019) Yılmaz, Suzan Güven; Karaca, Irmak; Onay, Melis Palamar; Ateş, Halil…Öğe Effect of Tropicamide on Laser Flare Meter Measurements in Patients with Pseudoexfoliation(Taylor & Francis Inc, 2019) Karaca, Irmak; Yilmaz, Suzan Guven; Palamar, Melis; Ates, HalilPurpose: To investigate the effect of 1% tropicamide on anterior chamber aqueous flare (ACAF) measurements acquired with laser flare meter in patients with pseudoexfoliation. Methods: Thirty-three eyes of 33 patients with pseudoexfoliation were enrolled. Patients with the history of other ocular diseases, intraocular surgeries, and the presence of severe posterior synechia were excluded. Besides routine ophthalmological examination, ACAF levels were measured by laser flare meter device (Kowa FM 600) before and after instillation of 1% tropicamide. Results: The mean age of 33 patients was 67.3 +/- 7.1 (53-85) years. Patients had a mean best corrected visual acuity of 0.25 +/- 0.41 (1.80-0.00) logMAR, cup-to-disc ratio of 0.45 +/- 0.22 (0.2-1), and IOP of 15.33 +/- 2.82 (9-20) mmHg. Although the mean ACAF value increased from 14.68 +/- 8.40 (3.4-40.4) photon/ms predilation to 15.41 +/- 10.74 (3.8-46.8) photon/ms post-dilation, the difference was not statistically significant (p=0.835). Conclusions: ACAF values in patients with pseudoexfoliation did not significantly differ after instillation of 1% tropicamide.Öğe Effects of subthreshold yellow pattern laser treatment in diabetic macular edema: Optical coherence tomography angiography study(2022) Karaca, Irmak; Afrashi, Filiz; Nalçacı, Serhad; Menteş, Jale; Akkın, CezmiPurpose: The purpose of the study was to assess the effects of subthreshold yellow pattern laser (SYPL) treatment in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods: Thirty eyes of 30 diabetic patients diagnosed as naïve DME (central subfield thickness [CST] <400 µm) between October 2018 and January 2020 at Ege University Faculty of Medicine, Department of Ophthalmology were prospectively included in the study. Fovea sparing SYPL were performed to the macula. Comprehensive eye examination along with OCTA was performed at baseline, 1st month, and 3rd month of follow-up. Data during the follow-up were compared with the baseline. Results: The mean age of the patients (15 male and 15 female) was 63.7±6.7 (48–74) years. The mean diabetes duration was 17.9±5.4 (13–27) years and mean HbA1c was 6.6±0.5 (5.7–7.7) g/dL. Best-corrected visual acuity (BCVA) did not show significant change during the follow-up (p=0.698). CST measurements were 323.7±40.1 (262–393) µm, 316.8±40.9 (268–377) µm and 318.1±39.9 (226–396) µm at baseline, 1st, and 3rd month, respectively (p=0.591). On OCTA, mean vessel density (VD) in superficial capillary plexus were 44.7±4.6 (37.4–52.3), 45.6±4.7 (38.6–54.9), and 44.6±3.9 (37.5–49.8); while mean VD in deep capillary plexus (DCP) was 43.1±4.8 (36.3–52.7), 45.3±4.8 (38.9–54.2), and 42.7±3.3 (37.4–49.3) at baseline, 1st, and 3rd month, respectively (p=0.383 and p=0.291). Foveal avascular zone area did not change significantly during the follow-up (p=0.998). Conclusion: SYPL treatment in DME appears to be safe with no statistically significant difference in macular capillary perfusion, as well as no change in BCVA and CST during the 3 months of follow-up.Öğe Evaluation of CNTNAP2 gene rs2107856 polymorphism in Turkish population with pseudoexfoliation syndrome(Springer, 2019) Karaca, Irmak; Yilmaz, Suzan Guven; Palamar, Melis; Onay, Huseyin; Akgun, Bilcag; Aytacoglu, Burcu; Aykut, Ayca; Özkınay, Feristah FerdaPurposeTo investigate rs2107856 single-nucleotide polymorphism (SNP) of CNTNAP2 gene in Turkish population with pseudoexfoliation and to correlate clinical characteristics with the genotypic profile.Materials and methodsForty-three patients with pseudoexfoliation syndrome (PXS), 46 patients with pseudoexfoliation glaucoma (PXG) and 99 healthy controls were enrolled. Comprehensive ophthalmological examination, central corneal thickness measurement and retinal nerve fiber layer thickness analysis of the peripapillary area were performed. Blood samples of 2mL with EDTA were obtained and sent for genetic analysis. The role of the detected polymorphism on disease tendency along with the genotype and allele frequencies in each group was evaluated.ResultsThe mean age of the groups was 70.08.0 (range 51-86) in PXS, 71.2 +/- 8.8 (range 51-93) in PXG and 64.6 +/- 8.3 (range 51-91) in controls. The percentages of homozygote individuals were 11.6, 10.9, 21.2%, and heterozygote individuals were 41.9, 45.7, 42.4% in patients with PXS, PXG and controls, respectively. There was no statistically significant difference between groups in terms of both genotype and allele frequencies of rs2107856 (p=0.429 and p=0.178, respectively). Retinal nerve fiber layer thickness did not differ between SNP-positive and SNP-negative individuals in PXG, and there was no significant difference between genotype and age, sex, best corrected visual acuity, intraocular pressure, central corneal thickness, cup/disk ratio and retinal nerve fiber layer thickness in any of the groups (p>0.05).Conclusion rs2107856 SNP of CNTNAP2 gene has no association with PXS and PXG in the evaluated Turkish population.Öğe Evaluation of Ocular Surface and Meibomian Glands Alterations with Meibography in Patients with Inactive Behcet's Uveitis(Taylor & Francis Inc, 2019) Karaca, Irmak; Palamar, Melis; Yilmaz, Suzan Guven; Ates, HalilPurpose: To evaluate the ocular surface and meibography of patients with inactive Behcet's uveitis.Methods: Twenty-five right eyes of 25 patients with inactive Behcet's uveitis (Group 1) and 25 right eyes of 25 healthy individuals (Group 2) were enrolled. Detailed eye examination along with Schirmer 1 test, tear film break-up time (t-BUT), ocular surface staining with fluorescein and Oxford scoring, and ocular surface disease index (OSDI) score assessment were performed. Lower and upper eyelid Meibomian glands were examined with infrared filter of slit-lamp biomicroscope (SL-D701 with DC-4 digital camera and BG-5 background illuminator, TOPCON, Tokyo, Japan (from grade 0 (no dropout of Meibomian glands) to grade 3 (gland dropout >2/3 of the total Meibomian glands)).Results: The mean ages were 36.847.39 (range, 23-59) and 33.88 +/- 8.25 (range, 18-55) in Group 1 and Group 2, respectively (p =0.547). When compared with Group 2, in Group 1, best-corrected visual acuity (0.28 vs. 0.00 logMAR, p <0.001), Schirmer 1 test (18.68 vs. 23.69, p =0.017) and mean tear film break-up time (10.76 vs. 13.36, p =0.026) were significantly lower; Oxford scale and OSDI scores were higher (p =0.039 and p <0.001, respectively). No significant difference in lower, upper and total (upper + lower) meiboscores were detected in between groups (p =0.062, p =0.228 and p =0.152, respectively).Conclusion: Despite the tendency toward dry eye syndrome, Behcet's uveitis does not seem to be associated with quantitative Meibomian gland changes, which is demonstrated by gland drop-out with meibography.Öğe Evaluation of Periorbital Tissues in Obstructive Sleep Apnea Syndrome(Turkish Ophthalmological Soc, 2020) Karaca, Irmak; Yagci, Ayse; Palamar, Melis; Tasbakan, Mehmet Sezai; Basoglu, Ozen K.Objectives: To evaluate periorbital tissue alterations including eyelid laxity and eyelash ptosis in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: Based on polysomnography, 96 eyes of 48 patients with moderate/severe OSAS (Group 1) and 44 eyes of 22 patients with simple snoring (Group 2) were enrolled. Comprehensive eye examination along with eyelid laxity measurements including vertical and anterior distraction, presence of dermatochalasis, interpalpebral distance, and levator function were assessed. The presence and severity of eyelash ptosis were also noted. Results: The mean ages of Group 1 and Group 2 were 49.9 +/- 11.4 (range: 26-67) and 50.6 +/- 8.9 (range: 27-69) years, respectively (p-0.557). The mean vertical and anterior distraction distances in Group 1 (13.3 +/- 4.1 [range, 6-271 mm and 7.4 +/- 2.1 [range, 3-13.5] mm, respectively) were significantly higher than in Group 2 (p<0.05). Dermatochalasis and eyelash ptosis were found to be significantly more frequent in Group 1 (52.1% and 81.3%, respectively). The severity of eyelash ptosis was also higher in OSAS (p<0.05). No significant difference in interpalpebral distance or levator muscle function was detected. Conclusion: in patients with severe OSAS, eyelid laxity was more prominent and eyelash ptosis was more frequent and severe.Öğe Graft Failure and Repeat Penetrating Keratoplasty(Baskent Univ, 2021) Selver, Ozlem Barut; Karaca, Irmak; Palamar, Melts; Egrilmez, Sait; Yagci, AyseObjectives: in this study, we report the indications and outcomes of repeat penetrating keratoplasty and the reasons for graft failure. Materials and Methods: We performed a retrospective data analysis of patients who had undergone 2 or more penetrating keratoplasties for the same eye between 1991 and 2016. Results: Among 1613 penetrating keratoplasties, 149 regrafts of 105 eyes were reviewed. The mean follow-up time after repeat penetrating keratoplasty was 3.2 +/- 3.9 (range, 3 months to 17 years) years. The mean number of penetrating keratoplasties was 2.25 +/- 0.69 per eye (range, 2-6). The most common primary indication for repeat penetrating keratoplasty was bullous keratopathy (31.4%), which was followed by corneal dystrophy (20.0%). The mean follow-up time was 8.05 +/- 5.03 years (range, 8 mo to 24.75 y). At the last follow-up, 62 eyes (59%) had clear grafts and the mean best-corrected visual acuity was 1.26 +/- 0.99 (range, 0-3) logMAR. Endothelial failure, especially late endothelial failure (36.9%), and glaucoma-related endothelial failure (18.8%) were the most common reasons for failed grafts. Allograft rejection (17.4%) and graft infection (14.1%) constituted the next most frequent causes. Conclusions: Graft failure is a common indication among penetrating keratoplasties. Primary indications and reasons for failed grafts affect long-term outcomes. Therefore, a better understanding of the indications for risk, leading causes of failed grafts, and complications could help to determine effective preventive measures.Öğe Miyopi ve Glokom(2018) Karaca, Irmak; Yılmaz, Suzan GüvenGünümüzde prevalansında hızlı bir artış görülen miyopi, beraberinde eşlik eden komplikasyonlar nedeniyle düşük görmenin ve yasal körlüğün ana nedenlerinden biri olarak kabul edilmektedir. Miyopi ile birlikte görülen hastalıklardan biri de glokomdur. Miyopi ve glokom arasındaki ilişki halen kesin olarak açıklanamamış olsa da, yüksek miyop ve açık açılı glokom hastalarının, benzer skleral kollajen özelliklerini paylaştığı ve glukokortikoidlere benzer hipersensitif yanıtlar gösterdikleri düşünülmektedir. Bu derlemede, miyopi ve glokom arasındaki ilişki epidemiyoloji, patogenetik mekanizmalar, klinik özellikler ve ayırıcı tanı açısından irdelenmiştir.Öğe Multimodal Imaging Characteristics of Circumscribed Choroidal Hemangioma Accompanying with Central Serous Chorioretinopathy: A Case Report(2022) Karaca, Irmak; Yılmaz, Suzan Güven; Menteş, Jale; Markov, Gueorgui; Tuncer, SamurayA 42-year-old man presented with a temporal visual field defect in his right eye. His history revealed systemic steroid use before onset of his complaints. Multimodal imaging techniques including ultrasonography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography angiography (OCTA) suggested the presence of circumscribed choroidal hemangioma (CCH) accompanying with central serous chorioretinopathy (CSCR) in the right eye, which might have worsened with systemic steroid treatment. CCH may rarely present with accompanying CSCR. Besides, OCTA is a non-invasive reliable method for the diagnosis of CCH in terms of visualizing vascular features of tumor.Öğe Obstrüktif uyku apne sendrom (OUAS)'lu olgularda kornea biyomekaniği ve gözyaşı disfonksiyonu ile etkileşimi(Ege Üniversitesi, 2017) Karaca, Irmak; Yağcı, AyşeAMAÇ: Obstrüktif Uyku Apne Sendromu (OUAS) prevalansı, son yıllarda obezitenin artmasıyla daha da artmaktadır. İntermitan hipoksi, siklik desaturasyonlar ve katekolaminlerdeki artış gibi OUAS'daki patofizyolojik mekanizmaların okülovasküler sağlığı da etkilediği belirtilmektedir. Bu çalışmada, OUAS'lu hastalarda göz yaşı ve oküler yüzey değişiklikleri, meibom gland disfonksiyonu (MGD) varlığı ile birlikte, kornea biyomekaniği ve kornea endotel değişikliklerinin, ayrıca retina sinir lifı tabakası (RSLT) ve subfoveal koroid kalınlık (SFKK) ölçümlerinin hastalık şiddetine göre ve kontrol grubuyla karşılaştırmalı olarak araştınlması amaçlanmıştır. GEREÇ ve YÖNTEM: Ege Üniversitesi Tıp Fakültesi Hastanesi (EÜTFH) Göğüs Hastalıkları AD Uyku Polikliniğine Mart 2016 ile Mayıs 2017 tarihleri arasında başvuran ve Polisomnografık ve/veya Poligrafik değerlendirme sonucunda 15 Basit Horlama ve 57 OUAS (hafif, orta ve ağır OUAS; sırasıyla 9, 12 ve 36 hasta) tanısı alan olgu çalışmaya dahil edildi. Tüm hastalarda tam bir oftalmolojik muayeneyi takiben gözyaşı testleri (Schirmer ve t-BUT) araştınldı. Kornea topografisi, kornea biyomekaniği, endotel hücre morfolojisi, RSLT ve SFKK ölçümleri belirlendi. Meibografi ile MGD değerlendirildi. istatistiksel analizlerde, hafif OUAS & Basit Horlama (Grup 1), orta OUAS (Grup 2) ve ağır OUAS (Grup 3) gruplanna ait veriler karşılaştınldı. BULGULAR: Çalışmaya dahil edilen hastaların ortalama yaşı Grup 1 (13 erkek, 11 kadın), Grup 2 (11 erkek, 1 kadın) ve Grup 3 (28 erkek, 8 kadın)'de sırasıyla 47.9±10.5 (27-69), 51.5±12.9 (26-69) ve 50.8+8.3 (35-68) idi. Anterior ve vertikal distraksiyon mesafeleri, ağır OUAS'lularda anlamlı olarak daha yüksek izlendi (p<0.05, Kruskal Wallis test). OUAS şiddeti arttıkça, üst (Grup 1, 2 ve 3'te sırasıyla; 0.8±0.9 (0-3), 1.1±1.6 (0-4) ve 1.8±1.9 (0-8)) ve total (Grup 1, 2 ve 3'te sırasıyla; 1.1±2.2 (0-6), 1.8± 2.2(0-6) ve 2.8±2.3 (0-11)) meiboskorun anlamlı olarak arttığı, t-BUT (11.5+5.1 (4-24), 10.1±5.8 (4-18) ve 7.1±6.5 (2-17)) azaldığı saptandı (p<0.05, Kruskal Wallis test). t-BUT ile üst ve total meboskor değerleri arasında orta düzeyde negatif korelasyon mevcuttu (Spearman korelasyon katsayısı (r)=-0.425, p<0.001 and r=-0.352, p=0.002). Kornea topografik ve biyomekanik özellikleri, endotel hücre morfolojisi ölçümleri ve SFKK açısından gruplar arasında fark görülmedi (p>0.05, Kruskal Wallis test). RSLT'yla ilgili olarak, inferonazal RSLT kalınlığımn ağır OUAS'lularda anlamlı olarak daha ince olduğu izlenirken (Grup 1, 2 ve 3'te sırasıyla; 129.23.6 (80.0-168.5), 116.4±25.3 (71.5-167.5) ve 102.9±18.9 (63.5-144.0)), diğer kadranlarda anlamlı fark saptanmadı. SONUÇ: OUAS'lu hastalarda MGD görülmekte olup MGD hastalık şiddetiyle korelasyon göstermektedir. Kornea topografisi, kornea biyomekaniği, endotel hücre morfolojisi, SFKK açısından gruplar arasında anlamlı fark izlenmezken, inferonazal RSLT kalınlığının OUAS şiddeti arttıkça anlamlı bir şekilde azaldığı belirlenmiştir.;Obstructive sleep apnea syndrome, OSAS, non-contact meibography, meibom gland dysfunction, dry eye.;Obstrüktif uyku apne sendromu, OUAS, non-kontakt meibografi, meibom gland disfonksiyonu, kuru göz.Öğe Obstrüktif uyku apne sendromlu hastalarda oküler değişikliklerin ve meibografi eşliğinde meibom gland disfonksiyonunun araştırılması(Ege Üniversitesi, Tıp Fakültesi, 2018) Karaca, Irmak; Yağcı, AyşeAMAÇ: Obstrüktif Uyku Apne Sendromu (OUAS) prevalansı, son yıllarda obezitenin artmasıyla daha da artmaktadır. İntermitan hipoksi, siklik desaturasyonlar ve katekolaminlerdeki artış gibi OUAS'daki patofizyolojik mekanizmaların okülovasküler sağlığı da etkilediği belirtilmektedir. Bu çalışmada, OUAS'lu hastalarda göz yaşı ve oküler yüzey değişiklikleri, meibom gland disfonksiyonu (MGD) varlığı ile birlikte, kornea biyomekaniği ve kornea endotel değişikliklerinin, ayrıca retina sinir lifi tabakası (RSLT) ve subfoveal koroid kalınlık (SFKK) ölçümlerinin hastalık şiddetine göre ve kontrol grubuyla karşılaştırmalı olarak araştırılması amaçlanmıştır. GEREÇ ve YÖNTEM: Ege Üniversitesi Tıp Fakültesi Hastanesi (EÜTFH) Göğüs Hastalıkları AD Uyku Polikliniğine Mart 2016 ile Mayıs 2017 tarihleri arasında başvuran ve Polisomnografik ve/veya Poligrafik değerlendirme sonucunda 15 Basit Horlama ve 57 OUAS (hafif, orta ve ağır OUAS; sırasıyla 9, 12 ve 36 hasta) tanısı alan olgu çalışmaya dahil edildi. Tüm hastalarda tam bir oftalmolojik muayeneyi takiben gözyaşı testleri (Schirmer ve t-BUT) araştırıldı. Kornea topografisi, kornea biyomekaniği, endotel hücre morfolojisi, RSLT ve SFKK ölçümleri belirlendi. Meibografi ile MGD değerlendirildi. İstatistiksel analizlerde, hafif OUAS & Basit Horlama (Grup 1), orta OUAS (Grup 2) ve ağır OUAS (Grup 3) gruplarına ait veriler karşılaştırıldı. BULGULAR: Çalışmaya dahil edilen hastaların ortalama yaşı Grup 1 (13 erkek, 11 kadın), Grup 2 (11 erkek, 1 kadın) ve Grup 3 (28 erkek, 8 kadın)'de sırasıyla 47.9±10.5 (27-69), 51.5±12.9 (26-69) ve 50.8±8.3 (35-68) idi. Anterior ve vertikal distraksiyon mesafeleri, ağır OUAS'lularda anlamlı olarak daha yüksek izlendi (p<0.05, Kruskal Wallis test). OUAS şiddeti arttıkça, üst (Grup 1, 2 ve 3'te sırasıyla; 0.8±0.9 (0-3), 1.1±1.6 (0-4) ve 1.8±1.9 (0-8)) ve total (Grup 1, 2 ve 3'te sırasıyla; 1.1±2.2 (0-6), 1.8± 2.2(0-6) ve 2.8±2.3 (0-11)) meiboskorun anlamlı olarak arttığı, t-BUT (11.5±5.1 (4-24), 10.1±5.8 (4-18) ve 7.1±6.5 (2-17)) azaldığı saptandı (p<0.05, Kruskal Wallis test). t-BUT ile üst ve total meboskor değerleri arasında orta düzeyde negatif korelasyon mevcuttu (Spearman korelasyon katsayısı (r)=-0.425, p<0.001 and r=-0.352, p=0.002). Kornea topografik ve biyomekanik özellikleri, endotel hücre morfolojisi ölçümleri ve SFKK açısından gruplar arasında fark görülmedi (p>0.05, Kruskal Wallis test). RSLT'yla ilgili olarak, inferonazal RSLT kalınlığının ağır OUAS'lularda anlamlı olarak daha ince olduğu izlenirken(Grup 1, 2 ve 3'te sırasıyla; 129.23.6 (80.0-168.5), 116.4±25.3 (71.5-167.5) ve 102.9±18.9 (63.5-144.0)), diğer kadranlarda anlamlı fark saptanmadı. SONUÇ: OUAS'lu hastalarda MGD görülmekte olup MGD hastalık şiddetiyle korelasyon göstermektedir. Kornea topografisi, kornea biyomekaniği, endotel hücre morfolojisi, SFKK açısından gruplar arasında anlamlı fark izlenmezken, inferonazal RSLT kalınlığının OUAS şiddeti arttıkça anlamlı bir şekilde azaldığı belirlenmiştir.
