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7. Evaluating the quality and reliability of YouTube videos on myopia: a video content analysis.

Author

Kayabaşı, Mustafa, Köksaldı, Seher, and Durmaz Engin, Ceren

Abstract

Purpose: To evaluate the quality and reliability of YouTube videos as an educational resource about myopia. Methods: The videos were identified by searching YouTube with the keywords 'myopia' and 'nearsightedness', using the website's default search settings. The number of views, likes, dislikes, view ratio, source of the upload, country of origin, video type, and described treatment techniques were assessed. Each video was evaluated using the DISCERN, Journal of the American Medical Association (JAMA), Ensuring Quality Information for Patients (EQIP), Health On the Net Code of Conduct Certification (HONcode), and the Global Quality Score (GQS) scales. Results: A total of 112 videos were included. The classification of videos by source indicated that the top three contributors were health channels (30 videos [26.8%]), physicians (24 videos [21.4%]), and academic centers (19 videos [16.9%]). Most of these videos originated from the United States (74 videos [66.1%]) and focused on the pathophysiology (n = 89, 79.4%) and the treatment (n = 77, 68.7%) of myopia. Statistical comparisons among the groups of video sources showed no significant difference in the mean DISCERN score (p = 0.102). However, significant differences were noted in the JAMA (p = 0.011), GQS (p = 0.009), HONcode (p = 0.011), and EQIP (p = 0.002) scores. Conclusions: This study underscored the variability in the quality and reliability of YouTube videos related to myopia, with most content ranging from 'weak to moderate' quality based on the DISCERN and GQS scales, yet appearing to be 'excellent' according to the HONcode and EQIP scales. Videos uploaded by physicians generally exhibited higher standards, highlighting the importance of expert involvement in online health information dissemination. Given the potential risks of accessing incorrect medical data that can affect the decision-making processes of patients, caution should be exercised when using online content as a source of information. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Multimodal Imaging Characteristics and Diagnostic Value of Choroidal Nodules in Patients with Neurofibromatosis Type 1.

Author

Ahmadova, Nargiz, Kayabaşı, Mustafa, Koksaldı, Seher, Hümaz, Eda, and Saatci, Ali Osman

Subjects
*UVEA, *HAMARTOMA, *DIAGNOSTIC imaging, *OPTICAL coherence tomography, *NEUROFIBROMATOSIS 1, *RETROSPECTIVE studies, *ANGIOGRAPHY, *MAGNETIC resonance imaging, *UVEAL diseases, *MEDICAL records, *SLIT lamp microscopy
Abstract

Objectives: Yasunari nodules are choroidal lesions observed in patients diagnosed with neurofibromatosis type 1 (NF-1) and characterized by relatively irregular dome-shaped, plaque-like, or patchy boundaries. The present study examines the multimodal imaging characteristics of Yasunari nodules and their value in the diagnosis of NF-1. Materials and Methods: Medical records including optical coherence tomography (OCT), enhanced depth imaging OCT, infrared reflectance (IR) imaging, OCT angiography, and color fundus images of NF-1 patients who were examined at the Department of Ophthalmology in Dokuz Eylül University Faculty of Medicine between January 2022 and December 2023 were retrospectively reviewed for the presence of Yasunari nodules. Results: A total of 54 eyes of 27 patients were included in the study. At least one choroidal nodule was detected on IR imaging in 52 eyes (96.3%). In 31 (72.1%) of the 43 eyes (79.6%) with available high-quality OCT angiography images, choroidal nodules were observed as areas showing a flow deficit in the choriocapillaris layer. Of the total 54 eyes included, Lisch nodules without choroidal nodules were observed in 2 eyes (3.7%). In 16 eyes (29.6%), Lisch nodules were not detected despite the presence of choroidal nodules. Both Lisch nodules and choroidal nodules were detected in the other 36 eyes (66.7%). Conclusion: Yasunari nodules are frequently observed in NF-1 cases and can be easily detected with multimodal imaging techniques, especially IR imaging. The ability to visualize choroidal nodules before the appearance of Lisch nodules demonstrates the importance of Yasunari nodules in the diagnosis of NF-1. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Active toxoplasma chorioretinitis in immunocompromised patients: a case series.

Author

Kayabaşı, Mustafa, Mammadov, Turhan, Köksaldı, Seher, Arıkan, Gül, Kaynak, Süleyman, and Saatci, Ali Osman

Subjects
*IMMUNOCOMPROMISED patients, *TOXOPLASMA, *IMMUNOGLOBULIN M, *IRIDOCYCLITIS, *ANKYLOSING spondylitis, *HEMATOLOGIC malignancies
Abstract

Toxoplasma chorioretinitis (TC) can exhibit atypical features in immunocompromised patients including bilaterality, extensive spread, multifocal presentation, large areas of retinal necrosis without adjacent retinal scarring, and diffuse necrotizing retinitis resembling the viral retinitis that may cause confusion in the differential diagnosis. The aim of this study was to present the clinical features of four eyes of three immunocompromised patients with active toxoplasma chorioretinitis. Two of the patients were female and one, male. Two patients had hematological malignancies and the remaining patient was under adalimumab treatment for ankylosing spondylitis. Visual complaints began 10 days to four months prior to TC diagnosis. All four eyes had mild-to-moderate anterior chamber cells together with severe vitritis on slit-lamp examination while there were solitary chorioretinitis lesions on fundoscopy. Despite all patients were negative for anti-toxoplasma immunoglobulin M, all were positive for immunoglobulin G. All three patients were successfully treated with a combined treatment of systemic and intravitreal anti-toxoplasmic drugs. Clinicians should be cautious for the possible toxoplasma chorioretinitis besides the other infectious entities when a new uveitis episode is detected in an immunosuppressed patient in order to avoid misdiagnosis and thereby wrong treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Büyük Taklitçi - Oküler Sifiliz

Author

Köksaldı Kayabaşı, Seher, Kayabaşı, Mustafa, and Saatci, Ali Osman

Abstract

We examined a 44-year-old woman without any known systemic disease with a decreased vision of a month duration in her left eye. She had undergone left uneventful cataract surgery with intraocular lens implantation elsewhere 14 years ago. On examination, her Snellen visual acuity was 1.0 (with the correction of –0.50–0.25 × 120) in the right eye and 0.4 (with the correction of +0.75–2.25 × 115) in the left. There was left hypochromic heterochromia. While the right anterior segment was unremarkable, there were small to medium-sized keratic precipitates, 3+ anterior chamber cells, a posterior chamber intraocular lens with an intact posterior capsule, and a few vitreous cells in the left eye. Fundus autofluorescence imaging revealed peripapillary hyperautofluorescence in the left eye, and fluorescein angiography revealed a marked optic nerve head and perivascular leakage at the posterior pole. The findings were not compatible with Fuchs uveitis, so the full infectious panel was worked out. Serologic investigations yielded the presence of syphilis, and the patient was treated successfully with systemic antibiotics. Our case demonstrates the mimicking nature of ocular syphilis and the importance of high clinical suspicion when reaching the correct diagnosis.

Published
2023

13. Unilateral macular neovascularization formation during the follow-up of a 15-year-old boy with Bietti crystalline dystrophy and the successful treatment outcome with a single intravitreal ranibizumab injection

Author

Saatci, Ali Osman, Kayabaşı, Mustafa, and Ataş, Ferdane

Subjects
Bietti crystalline dystrophy, macular neovascularization, optical coherence tomography, ddc: 610, macula, optical coherence tomography angiography
Abstract

Objective: To report the successful outcome with a single intravitreal ranibizumab injection in a 15-year-old boy with Bietti crystalline dystrophy (BCD) who developed a unilateral macular neovascularization (MNV)Methods: A retrospective case reportResults: A 15-year-old Caucasian boy with Bietti crystalline dystrophy was diagnosed to have a unilateral MNV a year after the initial examination with the help of multimodal imaging and he was treated with a single intravitreal ranibizumab injection. Five months later, visual acuity improved and anatomically a dry-looking macula was noted.Conclusion: MNV is among the rare macular complications of BCD. The present case is the third reported pediatric case with MNV in association with BCD and the first pediatric BCD patient who received a vascular endothelial growth factor inhibitor (anti-VEGF) agent.

Published
2023

15. Presentation of Ocular Syphilis with Bilateral Optic Neuropathy.

Author

Kayabaşı, Mustafa, Köksaldı, Seher, Saatci, Ali Osman, and Bajin, Meltem Söylev

Subjects
*OPTICAL coherence tomography, *NEUROPATHY, *RHODOPSIN, *MAGNETIC resonance imaging, *CHOROID diseases, *SYPHILIS, *OPTIC disc
Abstract

A 60-year-old otherwise healthy male presented with a 1 year history of bilateral progressive visual loss. His best-corrected visual acuity was counting fingers at 2 m with his right eye and counting fingers at 0.5 m with his left eye. Visual field testing revealed bilateral near-total loss of visual fields. Slit-lamp examination was unremarkable, apart from bilateral grade two nuclear sclerotic cataracts. Both optic discs were pale-looking with some retinal pigment epithelial alterations at the left papillomacular region. Enhanced depth imaging optical coherence tomography depicted punctate hyperreflective dots at the inner choroidal level corresponding to the retinal pigment epithelial changes in the left eye. Fundus autofluorescence imaging revealed patchy hyper-autofluorescent and hypo-autofluorescent areas, and there was mild staining in the early and late phases of the fluorescein angiogram at the papillomacular region in the left eye. A diagnosis of bilateral optic neuropathy was made. A full systemic work-up was carried out, and serological tests pointed out the presence of syphilis with normal cranial magnetic resonance imaging. He was treated accordingly. Our case clearly demonstrates the importance of a high clinical suspicion for syphilis in cases of optic neuropathy. [ABSTRACT FROM AUTHOR]

Published
2023
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16. The place of dexamethasone implant in patients with Vogt–Koyanagi–Harada disease who experienced systemic treatment-related hepatic dysfunction: A case series.

Author

Ataş, Ferdane, Kayabaşı, Mustafa, and Saatci, Ali

Abstract

We presented our observation with dexamethasone (DEX) implant in six eyes of three patients with Vogt–Koyanagi–Harada (VKH) disease who experienced hepatic dysfunction due to the systemic immunosuppressive therapy during their follow-up. Three cases who could not continue with the azathioprine (AZA) or adalimumab (ADA) treatment due to elevated liver enzymes were given consecutive bilateral DEX implant injections during the follow-up. In the first case, oral AZA was discontinued due to an elevation of the liver enzymes at the 2nd month of AZA treatment, and then she received five bilateral DEX implant administrations during the follow-up of 61 months without any intraocular pressure rise or disease recurrence. The remaining two patients had an elevation of the liver enzymes when ADA treatment was added to the prophylactic isoniazid therapy and they each received three bilateral DEX implant administrations within a year again without any complications and disease recurrence. DEX implant can be a safe and effective alternative for individuals with VKH disease whose systemic treatment is ceased due to adverse effects of the systemic treatment and intravitreal therapy with DEX implant can be beneficial to achieve a recurrence-free follow-up. [ABSTRACT FROM AUTHOR]

Published
2023
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17. Diyabetik Retinopati Şiddetine Göre Optik Koherens Tomografi ve Optik Koherens Tomografi Anjiyografi Bulgularının Değerlendirilmesi

Author

Kayabaşı, Mustafa, Öztürk, Arif Taylan, and Saatci, Ali Osman

Abstract

Amaç:Farklı şiddetteki diyabetik retinopati (DR) olgularının optik koherens tomografi (OKT) ve OKT anjiyografi bulgularının karşılaştırılmasıMetot:Çalışmaya Ekim 2018 ile Haziran 2022 tarihleri arasında muayene edilen ve aynı vizitte floresein anjiyografi (FA), OKT ve 6x6 OKT anjiyografi tetkikleri mevcut olan tedavi naif 57 olgunun 101 gözü dahil edildi. Hafif veya orta nonproliferatif DR’li 41 göz grup 1; ağır veya çok ağır nonproliferatif DR ile proliferatif DR’li 60 göz grup 2 olarak sınıflandı. Tüm gözler için FA’da makuler ve periferik iskemi varlığı; OKT’de santral makula kalınlığı (SMK) ile hiperreflektif nokta (HN), iç retinal katlarda disorganizasyon, interdigitasyon zonu düzensizliği, ellipsoid zondüzensizliği, myoid zon (MZ) düzensizliği, eksternal limitan membran (ELM) düzensizliği, epiretinal membran (ERM), subretinal sıvı (SRS) ve intraretinal sıvı (İRS) varlığı; OKT anjiyografide foveal avasküler zon (FAZ) genişliği ile yüzeyel vasküler pleksus, derin vasküler pleksus ve koryokapillaris katlarındaki vasküler dansite (VD) verileri kaydedildi. Veriler ki-kare, student t ve Mann-Whitney U testleriyle istatistiksel olarak karşılaştırıldı.Bulgular:Elli yedi olgunun (35 erkek, 22 kadın) ortalama yaşı 57.5±10.1 yıldı. Derin kapiller pleksus ile koryokapillaris katlarındaki ortalama foveal VD ve ortalama SMK gruplar arasında istatistiksel anlamlı düzeyde farklı bulundu. Bu değerler sırasıyla grup 1’de 20.9±5.2, 51.7±4.3 ve 257.1±62 µm iken grup 2’de 23.5±7.1, 49.4±6.7 ve 320.8±144.6 µm idi (sırasıyla p=0.047, p=0.038 ve p=0.003). Grup 2’de grup 1’e göre makuler iskemi (pSonuç:Progresif görme kaybı ve körlüğe yol açabilen DR’nin tanı ve takibinde noninvaziv OKT ve OKT anjiyografi verilerinden yola çıkılarak retinopati şiddeti ile ilgili fikir sahibi olunabilir, hastaların takip sıklığı bireysel olarak düzenlenebilir. Objective: Comparison of optical coherence tomography (OCT) and OCT angiography findings in diabetic retinopathy (DR) cases of different severity.Methods: 101 eyes of 57 treatment-naive patients who were examined between October 2018 and June 2022 and who had fluorescein angiography (FA), OCT and 6x6 OCT angiography examinations at the same visit were included in the study. Group 1 of 41 eyes with mild or moderate nonproliferative DR; 60 eyes with severe or very severe nonproliferative DR and proliferative DR were classified as group 2. Presence of macular and peripheral ischemia in FA for all eyes; Central macular thickness (CMT) and hyperreflective dots (HS), inner retinal folds disorganization, interdigitation zone irregularity, ellipsoid zone irregularity, myoid zone (MZ) irregularity, external limiting membrane (ELM) irregularity, epiretinal membrane (ERM) in OCT presence of subretinal fluid (SRF) and intraretinal fluid (IRF); In OCT angiography, the width of the foveal avascular zone (FAZ) and vascular density (VD) data in the superficial vascular plexus, deep vascular plexus and choriocapillaris layers were recorded. Data were compared statistically with chi-square, student t and Mann-Whitney U tests.Results: The mean age of 57 cases (35 males, 22 females) was 57.5±10.1 years. The mean foveal VD and mean CMT in the deep capillary plexus and choriocapillaris layers were statistically significantly different between the groups. These values were 20.9±5.2, 51.7±4.3, and 257.1±62 µm in group 1, respectively, and 23.5±7.1, 49.4±6.7, and 320.8±144.6 µm in group 2 (p=0.047, p=0.038, and p=0.003, respectively). ). Macular ischemia (pConclusion: In the diagnosis and follow-up of DR, which can lead to progressive vision loss and blindness, an idea about the severity of retinopathy can be obtained from the data of noninvasive OCT and OCT angiography, and the frequency of follow-up of the patients can be adjusted individually.

Published
2022

18. Sifilitik Optik Nöropati Olgusu

Author

Men, Süleyman, Saatci, Ali Osman, Kayabaşı, Mustafa, and Söylev Bajin, Meltem Fatma

Abstract

GİRİŞ VE AMAÇ:Sifilize sekonder optik nöropati gelişen olgu sunumuYÖNTEM:Olgu sunumuOLGU:60 yaş erkek hasta, 2 yıl önce başlayan, sol gözde daha belirgin olan her iki gözde az görme şikayeti ile başvurdu. Özgeçmiş sorgulamasında özellik yoktu. Muayenesinde görme keskinlikleri sağ gözde 2 metreden, sol gözde ½ metreden parmak sayma düzeyindeydi. Bilateral pupil ışık reaksiyonları alınamayan hastanın renkli görmesi her iki gözde Ishiara eşeli ile 0/21 idi. Humphrey 30-2 görme alanı testinde ortalama deviasyon değerleri sağ gözde-23,81 dB, sol gözde -28,84 dB idi. Ön segment muayenesi nükleer skleroz dışında olağandı. Göz içi basınçları bilateral 15 mmHg olarak ölçülen hastanın fundoskopik bakısında bilateral optik disklerde temporal solukluk ve sol gözde papillomakuler bölgede hafif pigment değişiklikleri mevcuttu. Optik koherens tomografide sağ göz normal olup solda papillomakuler bölgede koroidde punktat hiperreflektif noktalar mevcuttu. Peripapiller retina sinir lifi tabakası kalınlığı incelemesinde sağ gözde totale yakın atrofi, sol gözde temporal atrofi olduğu görüldü. Fundus otofloresan incelemede sağ göz normal olup sol gözde papillomakuler bölgede parçalı hiperotofloresan ve hipootofloresan alanlar izenirken floresein anjiyografide sağ göz bulguları normal olup solda papillomakuler bölgede erken ve geç dönemde hafif boyanma izlenmekteydi . Tam enfeksiyöz panel ve romatolojik panel araştırması yapıldı. Anti-treponema pallidum IgM ve IgG testlerinin pozitif sonuçlanması üzerine olgu nörosifiliz olarak değerlendirilerek kranioorbital manyetik rezonans görüntüleme (MRG) istendi. MRG sonucu normal olarak raporlanan olgu sifilize sekonder optik nöropati olarak değerlendirildi ve intravenöz kristalize penisilin tedavisi başlandı.SONUÇ:Sifiliz, çeşitli prezentasyonlarla karşımıza çıkabilen ve birçok oküler hastalığı taklit edebilen “büyük taklitçi” olarak bilinmektedir. Optik nöropati olgularında sifiliz olasılığı mutlaka akılda tutulmalı ve buna yönelik tetkikler planlanmalıdır. AIM: A case report of optic neuropathy secondary to syphilis.METHOD: Case reportCASE: A 60-year-old male patient presented with the complaint of low vision in both eyes, which started 2 years ago, which was more prominent in the left eye. There was no feature in the medical history. On examination, visual acuities were counting fingers from 2 meters in the right eye and from ½ meters in the left eye. The color vision of the patient, whose bilateral pupillary light reactions could not be detected, was 0/21 on the Ishiara chart in both eyes. In the Humphrey 30-2 visual field test, mean deviation values were -23.81 dB in the right eye and -28.84 dB in the left eye. Anterior segment examination was normal except for nuclear sclerosis. The patient, whose intraocular pressure was measured as 15 mmHg bilaterally, showed temporal pallor in the bilateral optic discs and slight pigment changes in the papillomacular region of the left eye. Optical coherence tomography showed normal right eye and punctate hyperreflective spots in the left papillomacular region in the choroid. Peripapillary retinal nerve fiber layer thickness examination revealed near-total atrophy in the right eye and temporal atrophy in the left eye. Fundus autofluorescence examination showed normal right eye, and fragmented hyperautofluorescent and hypoautofluorescent areas in the papillomacular region of the left eye, while the right eye findings were normal in fluorescein angiography, and mild staining was observed in the papillomacular region in the early and late periods on the left. A full infectious panel and rheumatological panel investigation were performed. After positive results of anti-treponema pallidum IgM and IgG tests, the case was evaluated as neurosyphilis and cranioorbital magnetic resonance imaging (MRI) was requested. The patient, whose MRI result was reported as normal, was evaluated as syphilis secondary optic neuropathy and intravenous crystallized penicillin treatment was started.CONCLUSION: Syphilis is known as a "great imitator" that can present with various presentations and mimic many ocular diseases. The possibility of syphilis should be kept in mind in cases of optic neuropathy and investigations should be planned accordingly.

Published
2022

20. Embedded Episcleral Foreign Body Mimicking Nodular Anterior Scleritis.

Author

Özbek, Zeynep, Lebe, Banu, Kayabaşı, Mustafa, and Saatci, Ali Osman

Subjects
SLIT lamp microscopy, SCLERA, HYPEREMIA, FOREIGN bodies in eyes, EYE diseases
Abstract

A 56-year-old man was referred to our clinic for unilateral nodular scleritis unresponsive to systemic corticosteroids. A localized, nodular hyperemia on the nasal bulbar conjunctiva surrounding a central cystlike lesion together with vascular engorgement was observed on slit-lamp examination of the left eye. No abnormal fundoscopic findings were noted. Surgical exploration revealed an embedded episcleral brown colored, soft to touch, splinter-like organic foreign body (FB) which was confirmed by the histopathological examination. Nodular hyperemia resolved during the postoperative follow-up period, and mild scar tissue accompanied by scleral thinning developed in the left nasal bulbar conjunctiva. Ocular injury associated with FBs may cause significant ocular morbidity depending on the nature and location of the FB. Severe visual disability may occur if left untreated. Subconjunctival FBs are rare and may present with a clinical picture mimicking episcleritis or scleritis. History of trauma involving a FB should always be assessed for an accurate differential diagnosis and appropriate management of patients with anterior scleritis. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Kronik Santral Seröz Koryoretinopatide Eşik Altı Lazer Fotokoagülasyonun Etkinliği

Author

Kaya, Mahmut, Kaynak, Süleyman, Koçak, Nilüfer, Öztürk, Arif Taylan, and Kayabaşı, Mustafa

Abstract

AMAÇ:Kroniksantral seröz koryoretinopati (SSKR) olgularında eşik altı lazer fotokoagülasyon (EALF) tedavisinin etkinliğinin değerlendirilmesiGEREÇ VE YÖNTEM:Mart 2018 - Haziran 2021 tarihleri arasında kliniğimizde SSKR tanısı alan ve takipleri yapılan 35 hastanın 35 gözü çalışmaya alındı. EALF tedavisi 6 aydan fazla subretinal sıvı (SRS) varlığında uygulandı. EALF öncesi ve sonrası SRS yüksekliği, SRS taban genişliği, subfoveal koroid kalınlığı (SKK) değerlendirildi.SRS’nin tamamen rezorbe olması tedaviye tam yanıt; SRS’nin azalması tedaviye kısmi yanıt; SRS’nin değişmemesi veya artması EALF tedavisine yanıtsızlık olarak değerlendirildi.BULGULAR:Olguların ortalama yaşı 48.3±10.7, takip süresi 15.47±22.89 aydı. Tüm olguların %77.1’i erkek idi. Olguların %72.4’ünde fundus floresein anjiyografide tek, %27.6’sında birden fazla odak mevcuttu. EALF tedavi öncesi ve sonrası SRS yüksekliği 210.3±80.6 µm ve 63.4±75.5 µm (pTARTIŞMA VE SONUÇ:Kronik SSKR’de eşik altı lazer fotokoagülasyon etkili bir tedavi yöntemidir. Konvansiyonel lazer fotokoagülasyon, fotodinamik tedavi, intravitreal anti-vasküler endotelyal büyüme faktörü enjeksiyonlarının yanı sıra eşik altı lazer fotokoagülasyon da tedavide düşünülebilecek ucuz ve kolay uygulanabilen bir tedavi seçeneğidir. OBJECTIVE: Evaluation of the efficacy of sub-threshold laser photocoagulation (STLP) treatment in patients with chronic central serous chorioretinopathy (CSC).MATERIALS AND METHODS: Thirty-five eyes of 35 patients who were diagnosed and followed up in our clinic between March 2018 and June 2021 were included in the study. STLP treatment was applied in the presence of subretinal fluid (SRF) for more than 6 months. SRF height, SRF floor width, and subfoveal choroidal thickness (SCT) were evaluated before and after STLP. Complete resorption of SRF is a complete response to treatment; Decreased SRF partial response to treatment; Change or increase in SRF was considered as unresponsive to STLP treatment.RESULTS: The mean age of the cases was 48.3±10.7, and the follow-up period was 15.47±22.89 months. 77.1% of all cases were male. Fundus fluorescein angiography had a single focus in 72.4% of the cases and more than one focus in 27.6%. SRF height before and after STLP treatment was 210.3±80.6 µm and 63.4±75.5 µm (pDISCUSSION AND CONCLUSION: Subthreshold laser photocoagulation is an effective treatment method in chronic CSC. In addition to conventional laser photocoagulation, photodynamic therapy, intravitreal anti-vascular endothelial growth factor injections, sub-threshold laser photocoagulation is an inexpensive and easily applicable treatment option that can be considered in the treatment.

Published
2021

24. Ahmed Glokom Valf İmplantasyonu Sonrası Ciddi Koroid Efüzyon Gelişimi ve Yönetimi: Olgu Sunumu

Author

Güney, Furkan, Kayabaşı, Mustafa, Özçelik, Oğuzhan, Arıkan, Gül, and Günenç, Üzeyir

Abstract

AMAÇ: Ahmed glokom valf (AGV) implantasyonu sonrası ciddi koroid efüzyonu gelişen bir olgunun klinik bulgularını, takip ve tedavi sonuçlarını sunmak.YÖNTEM: 39 yaşında bayan olgu kliniğimize seton cerrahisi sonrası ciddi koroid efüzyonu gelişmesi nedeniyle refere edilmiş idi. Bilateral afak olan olgunun sağ gözüne vitreoretinal cerrahi sonrası gelişen glokom nedeniyle dış merkezde 9 gün önce AGV implantasyonu yapılmıştı. Cerrahi sonrası ciddi koroid efüzyonu gelişen olguya dış merkezde sistemik steroid başlanmasına rağmen koroid efüzyonunda düzelme olmaması nedeniyle olgu kliniğimize yönlendirilmiş idi.BULGULAR: Oftalmolojik bakıda sağ gözde görme persepsiyon (+), projeksiyon (+) düzeyinde idi. Sağ gözde hipotoni (göz içi basıncı 2 mmHg) mevcuttu. Biyomikroskopik bakıda ön kamara sığdı. Ön kamarada üst kadranda AGV tüp ucu seçiliyordu. Fundus bakısında optik disk ve maküla seçilmiyordu. Oküler ultrasonografide ciddi koroid efüzyonu (öpüşen koroid) saptandı. Hastaya acil olarak genel anestezi altında koroid efüzyonu drenajı ve AGV implanta da revizyon işlemi uygulandı. AGV implant revizyonunda ön kamaradaki tüp ucu çıkarılarak geçici olarak konjonktiva altına yerleştirildi. Postoperatif 1. gün koroid efüzyonunun oldukça azalmış olduğu ve görme keskinliğinin 3 MPS düzeyinde olduğu görüldü ve göz içi basıncı (GİB) 10 mmHg saptandı. Takiplerde GİB yükselen olguya postoperatif 2. hafta transskleral diod lazer siklofotokoagulasyon uygulandı. Lazer sonrası GİB geçici düşen ve sonra tekrar yükselen olguda postoperatif 3. ayda AGV çıkarıldı ve çıkarılan implant alt nazal kadranda tüp ucu silier sulkusta olacak şekilde yerleştirildi. Göz içi basıncı bu cerrahiden sonra normal seviyede seyreden olgu halen kliniğimizde takip edilmektedir.SONUÇ: AGV implantasyonu sonrası ciddi koroid efüzyonu ile karşılaşılabilmektedir. Görmeyi tehdit eden ciddi koroid efüzyonu varlığında gecikmeden yapılacak drenaj ile yüz güldürücü sonuçlar alınabilir. Bu olgularda tekrar koroid efüzyonunu önlemek için gerekirse Ahmed glokom valfine revizyon da uygulanabilmektedir.

Published
2021

25. Akut Retinal Nekrozlu Olgularımızın Fonksiyonel ve Anatomik Sonuçları

Author

Saatci, Ali Osman, Ayhan, Ziya, Ataş, Ferdane, Kaya, Mahmut, and Kayabaşı, Mustafa

Abstract

AMAÇ:Akut retinal nekroz (ARN) gelişen olgularda tedavi sonrası fonksiyonel ve anatomik sonuçların değerlendirilmesi.GEREÇ VE YÖNTEM:Kliniğimizde Aralık 2011 – Nisan 2021 yılları arasında ARN tanısıyla en az 6 ay takip edilen, 9 hastanın 11 gözü retrospektif olarak değerlendirildi. Tüm hastalara intravitreal ve sistemik antiviral tedavi uygulandı. Hastaların final fonksiyonel ve anatomik sonuçları incelendi.BULGULAR:Hastaların ortalama yaşı 44.5±18.1 yıl ve takip süresi 24.05±29.67 aydı. Olgularımızın 5’i (%55.6) erkek idi. Vitreus örneğinden çalışılan polimeraz zincir reaksiyonu sonucunda 7 gözde (%63.6) varisella zoster virüsü tespit edildi. Başvuruda tüm olgulara parenteral asiklovir başlandı. 10-14. günden sonra 1 olguda oral asiklovire; 8 olguda oral valasiklovire geçildi. 1 göze sadece foskarnet sodyum, 2 göze hem gansiklovir hem de foskarnet sodyum olmak üzere; 10 göze ortalama 6.18±7.12 kez intravitreal gansiklovir ve 3 göze ortalama 0.63±1.50 kez intravitreal foskarnet sodyum uygulandı. En iyi düzeltilmiş görme keskinliği tanı sırasında persepsiyon projeksiyon (+) ile 0.3 arasında değişmekte iken takip süresinin sonunda el hareketi ile 0.7 arasında değişmekteydi. 7 gözde (%63.6) takip sırasında yırtıklı retina dekolmanı gelişti. 2 gözde (%18.1) 20 G, 2 gözde (%18.1) 23 G ve 2 gözde (%18.1) 25 G pars plana vitrektomi, çevreleyeci skleral çökertme ve silikon yağ endotamponadı ile cerrahi tamir gerçekleştirildi. Retina dekolmanı gelişen 1 olgu (%11.1), önerilen cerrahi tedaviyi kabul etmedi. 1 olgunun (%11.1) takibinde katarakt cerrahisi sonrası dirençli psödofakik kistoid makula ödemi gelişmesi nedeniyle; intravitreal gansiklovir şemsiyesi altında deksametazon implant uygulandı. 1 olguda (%11.1) başvuru sırasında bilateral ARN mevcuttu. Takip süresince, unilateral başlangıçlı olgulardan 1’inde (%11.1) diğer gözde ARN gelişti.TARTIŞMA VE SONUÇ:Akut retinal nekroz, günümüzde halen ciddi görme kaybına yol açabilen bir hastalıktır. Erken tanı ve etkili bir tedavi ile görme kaybı önlenebilir. Sistemik ve intravitreal antiviral ilaçlar tedavinin temelini oluşturmaktadır. Gerekli durumlarda vitreoretinal cerrahi fonksiyonel ve anatomik başarıyı artırabilmektedir. OBJECTIVE: To evaluate the functional and anatomical results after treatment in patients with acute retinal necrosis (ARN).MATERIALS AND METHODS: Eleven eyes of 9 patients who were followed up in our clinic for at least 6 months with the diagnosis of ARN between December 2011 and April 2021 were evaluated retrospectively. All patients received intravitreal and systemic antiviral therapy. Final functional and anatomical results of the patients were reviewed.RESULTS: The mean age of the patients was 44.5±18.1 years and the follow-up period was 24.05±29.67 months. Five of our cases (55.6%) were male. As a result of the polymerase chain reaction studied from the vitreous sample, varicella zoster virus was detected in 7 eyes (63.6%). Parenteral acyclovir was started in all cases at admission. 10-14. oral acyclovir in 1 case after the day; Oral valacyclovir was used in 8 cases. Foscarnet sodium only in 1 eye, and both ganciclovir and foscarnet sodium in 2 eyes; An average of 6.18±7.12 times intravitreal ganciclovir was administered to 10 eyes and an average of 0.63±1.50 times intravitreal foscarnet sodium was administered to 3 eyes. The best corrected visual acuity ranged from perception projection (+) to 0.3 at diagnosis, and ranged from hand movement to 0.7 at the end of the follow-up period. Ruptured retinal detachment developed in 7 eyes (63.6%) during follow-up. Surgical repair was performed with pars plana vitrectomy, circumferential scleral buckling, and silicone oil endotamponade in 2 eyes (18.1%) 20 G, 2 eyes (18.1%) 23 G, and 2 eyes (18.1%) 25 G. One patient (11.1%) who developed retinal detachment did not accept the recommended surgical treatment. In the follow-up of 1 case (11.1%), due to the development of resistant pseudophakic cystoid macular edema after cataract surgery; Dexamethasone implant was applied under the umbrella of intravitreal ganciclovir. Bilateral ARN was present in 1 case (11.1%) at presentation. During the follow-up, 1 (11.1%) of the unilateral onset cases developed ARN in the other eye.DISCUSSION AND CONCLUSION: Acute retinal necrosis is a disease that can still cause severe vision loss today. Vision loss can be prevented with early diagnosis and effective treatment. Systemic and intravitreal antiviral drugs form the basis of treatment. When necessary, vitreoretinal surgery can increase functional and anatomical success.

Published
2021

26. Great imitator -- ocular syphilis.

Author

Köksaldı, Seher, Kayabaşı, Mustafa, and Saatci, Ali Osman

Subjects
SYPHILIS complications, UVEITIS, VISION disorders, DIFFERENTIAL diagnosis, OPHTHALMIC drugs, INTRAMUSCULAR injections, CYTOMEGALOVIRUSES, IMMUNOGLOBULINS, ANGIOGRAPHY, PREDNISOLONE, CEFTRIAXONE
Abstract

We examined a 44-year-old woman without any known systemic disease with a decreased vision of a month duration in her left eye. She had undergone left uneventful cataract surgery with intraocular lens implantation elsewhere 14 years ago. On examination, her Snellen visual acuity was 1.0 (with the correction of -0.50-0.25 × 120) in the right eye and 0.4 (with the correction of +0.75-2.25 × 115) in the left. There was left hypochromic heterochromia. While the right anterior segment was unremarkable, there were small to medium-sized keratic precipitates, 3+ anterior chamber cells, a posterior chamber intraocular lens with an intact posterior capsule, and a few vitreous cells in the left eye. Fundus autofluorescence imaging revealed peripapillary hyperautofluorescence in the left eye, and fluorescein angiography revealed a marked optic nerve head and perivascular leakage at the posterior pole. The findings were not compatible with Fuchs uveitis, so the full infectious panel was worked out. Serologic investigations yielded the presence of syphilis, and the patient was treated successfully with systemic antibiotics. Our case demonstrates the mimicking nature of ocular syphilis and the importance of high clinical suspicion when reaching the correct diagnosis. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Unilateral macular neovascularization formation during the follow-up of a 15-year-old boy with Bietti crystalline dystrophy and the successful treatment outcome with a single intravitreal ranibizumab injection

Author

Kayabaşi, Mustafa, Ataş, Ferdane, and Saatci, Ali Osman

Subjects
bietti crystalline dystrophy, macula, macular neovascularization, optical coherence tomography, optical coherence tomography angiography, Ophthalmology, RE1-994
Abstract

Objective: To report the successful outcome with a single intravitreal ranibizumab injection in a 15-year-old boy with Bietti crystalline dystrophy (BCD) who developed a unilateral macular neovascularization (MNV)Methods: A retrospective case reportResults: A 15-year-old Caucasian boy with Bietti crystalline dystrophy was diagnosed to have a unilateral MNV a year after the initial examition with the help of multimodal imaging and he was treated with a single intravitreal ranibizumab injection. Five months later, visual acuity improved and anatomically a dry-looking macula was noted.Conclusion: MNV is among the rare macular complications of BCD. The present case is the third reported pediatric case with MNV in association with BCD and the first pediatric BCD patient who received a vascular endothelial growth factor inhibitor (anti-VEGF) agent.

Published
2023
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30. Evaluating the reliability of the responses of large language models to keratoconus-related questions.

Author

Kayabaşı M, Köksaldı S, and Durmaz Engin C

Abstract

Clinical Relevance: Artificial intelligence has undergone a rapid evolution and large language models (LLMs) have become promising tools for healthcare, with the ability of providing human-like responses to questions. The capabilities of these tools in addressing questions related to keratoconus (KCN) have not been previously explored., Background: In this study, the responses were evaluated from three LLMs - ChatGPT-4, Copilot, and Gemini - to common patient questions regarding KCN., Methods: Fifty real-life patient inquiries regarding general information, aetiology, symptoms and diagnosis, progression, and treatment of KCN were presented to the LLMs. Evaluations of the answers were conducted by three ophthalmologists with a 5-point Likert scale ranging from 'strongly disagreed' to 'strongly agreed'. The reliability of the responses provided by LLMs was evaluated using the DISCERN and the Ensuring Quality Information for Patients (EQIP) scales. Readability metrics (Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Coleman-Liau Index) were calculated to evaluate the complexity of responses., Results: ChatGPT-4 consistently scored 3 points or higher for all (100%) its responses, while Copilot had five (10%) and Gemini had two (4%) responses scoring 2 points or below. ChatGPT-4 achieved a 'strongly agree' rate of 74% across all questions, markedly superior to Copilot at 34% and Gemini at 42% ( p  < 0.001); and recorded the highest 'strongly agree' rates in general information and symptoms & diagnosis categories (90% for both). The median Likert scores differed among LLMs ( p  < 0.001), with ChatGPT-4 scoring highest and Copilot scoring lowest. Although ChatGPT-4 exhibited more reliability based on the DISCERN scale, it was characterised by lower readability and higher complexity. While all LLMs provided responses categorised as 'extremely difficult to read', the responses provided by Copilot showed higher readability., Conclusions: Despite the responses provided by ChatGPT-4 exhibiting lower readability and greater complexity, it emerged as the most proficient in answering KCN-related questions.

Published
2024
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31. Erdafitinib-Induced Bilateral Multifocal Serous Retinal Detachments and Severe Dry Eye Related Unilateral Peripheral Ulcerative Keratitis in a Patient with Metastatic Urothelial Carcinoma.

Author

Kayabaşı M, Bilkay Görken İ, Durak İ, Karaoğlu A, and Saatci AO

Abstract

Background: A case of bilateral multifocal serous retinal detachments and dry eye complicated with unilateral peripheral ulcerative keratitis (PUK) during erdafitinib therapy is described., Case Description: A 76-year-old male underwent a baseline examination two months after initiating 8 mg erdafitinib therapy (April 2023) due to metastatic urothelial carcinoma. Left subfoveal serous retinal detachment was observed initially but the treatment was resumed as he was asymptomatic. In May 2023, bilateral multifocal subretinal fluid pockets were identified, and the patient was still asymptomatic. However, in June 2023 he complained of bilateral redness and a stinging sensation in his right eye. Bilateral severe dry eye and right PUK were diagnosed. He was prescribed dexamethasone eye drops and sodium hyaluronate artificial tears for both eyes. One week later corneal staining decreased, and progression of PUK ceased. Erdafitinib therapy was discontinued in June 2023 due to the planned transurethral prostatectomy. By July 2023, after discontinuation of the drug and administration of the topical treatment, the dry eye improved and the PUK became inactive. There was also resolution of subretinal fluid pockets in the right eye and a reduction of subretinal fluid pockets in the left eye. After the reinitiation of erdafitinib therapy, serous retinal detachments recurred in both eyes in September 2023, but both corneas remained stable with topical low-dose dexamethasone, cyclosporine-A and artificial tear usage., Conclusion: Erdafitinib therapy may lead to concurrent anterior and posterior segment complications. Multidisciplinary monitoring is crucial for patients undergoing erdafitinib therapy to prevent possible visual disturbances., Learning Points: Erdafitinib, a tyrosine kinase inhibitor of fibroblast growth factor receptors 1 to 4, is administered for the treatment of locally advanced, unresectable or metastatic urothelial carcinoma but however is fraught with several systemic and ocular side effects.Concurrent anterior and posterior segment ocular involvement could be encountered in patients undergoing erdafitinib therapy.Maintaining a high level of suspicion and closely monitoring for potential ocular complications through collaborative efforts is essential for all patients undergoing erdafitinib therapy., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2024.)

Published
2024
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32. Bartonella Henselae Related Unilateral Anterior Uveitis and Subsequent Multifocal Retinitis in a Case Under Certolizumab Treatment.

Author

Kayabaşı M, Kefeli I, Çakar Özdal P, and Saatci AO

Abstract

Introduction: A case of ocular bartonellosis under anti-tumour necrosis factor treatment is described., Case Description: A 29-year-old woman with psoriasis who had been on certolizumab treatment was examined with a left visual deterioration following a fever bout, malaise, and placoid erythematous rashes on her neck. As there was acute anterior uveitis in her left eye, it was recommended to stop certolizumab treatment for a possible infectious aetiology. However, her physician elected to continue the certolizumab treatment. Ten days later, the patient noticed further visual decline despite the topical steroid treatment. This time, there were scattered yellow-white small retinitis foci at the left posterior pole. Infectious agents were searched and while Bartonella henselae antibodies were negative for immunoglobulin M, the immunoglobulin G titre was 1/80. Clinical findings were improved with the systemic treatment of oral trimethoprim-sulfamethoxazole (160/800 mg twice daily for six weeks) and azithromycin (500 mg once daily for two weeks)., Discussion: Though extremely rare, ocular bartonellosis should be kept in mind in patients on anti-tumour necrosis factor treatment as rapid and accurate diagnosis may end up with an excellent visual outcome and full recovery., Learning Points: Anti-tumour necrosis factor treatment is fraught with several ocular side effects including myositis, corneal infiltrates, scleritis, uveitis, optic neuritis, retinal vasculitis and ophthalmoplegia.When a new uveitis episode occurs in cases undergoing anti-tumour necrosis factor therapy, its cause poses a diagnostic challenge as it can have either an infectious or a non-infectious nature.Though very rare, ocular bartonellosis may also occur in immunocompromised individuals and a prompt diagnosis and appropriate treatment can lead to an excellent visual recovery., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2024.)

Published
2024
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33. The place of dexamethasone implant in patients with Vogt-Koyanagi-Harada disease who experienced systemic treatment-related hepatic dysfunction: A case series.

Author

Ataş F, Kayabaşı M, and Saatci AO

Abstract

We presented our observation with dexamethasone (DEX) implant in six eyes of three patients with Vogt-Koyanagi-Harada (VKH) disease who experienced hepatic dysfunction due to the systemic immunosuppressive therapy during their follow-up. Three cases who could not continue with the azathioprine (AZA) or adalimumab (ADA) treatment due to elevated liver enzymes were given consecutive bilateral DEX implant injections during the follow-up. In the first case , oral AZA was discontinued due to an elevation of the liver enzymes at the 2 nd month of AZA treatment, and then she received five bilateral DEX implant administrations during the follow-up of 61 months without any intraocular pressure rise or disease recurrence. The remaining two patients had an elevation of the liver enzymes when ADA treatment was added to the prophylactic isoniazid therapy and they each received three bilateral DEX implant administrations within a year again without any complications and disease recurrence. DEX implant can be a safe and effective alternative for individuals with VKH disease whose systemic treatment is ceased due to adverse effects of the systemic treatment and intravitreal therapy with DEX implant can be beneficial to achieve a recurrence-free follow-up., Competing Interests: The authors declare that there are no conflicts of interests of this article., (Copyright: © 2022 Taiwan J Ophthalmol.)

Published
2022
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