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4. WHY DO PATIENTS WAIT FOR PTERYGIUM SURGERY?

Author

Doğan, Mustafa, Sabaner, Mehmet Cem, Norman Özdamar, Esma, Yavaş, Güliz Fatma, Duman, Reşat, and Doğan, Mustafa

Subjects
Pterjium, Ameliyat gecikmesi, Delay of surgery, Bilgilendirme, Informing, Surgery, Pterygium, Cerrahi
Abstract

AMAÇ: Pterjium cerrahisi yapılan hastalarda ameliyat zamanını etkileyen faktörleri bulmak ve alınabilecek önlemleri tespit etmek amaçlanmıştır. GEREÇ VE YÖNTEM: Ocak 2014-Şubat 2017 arası kliniğimizde pterjium nedeniyle cerrahi yapılan 53 hastanın 53 gözü çalışmaya alındı. Hastaların bilgileri, ameliyatı bekleme sebepleri ve cerrahi öyküsü sorgulandı. Hastaların cevaplarına göre gruplandırma yapıldı: Hastalığını bildiği halde çok fazla rahatsızlık duymamak (grup 1), hastalığının farkında olmamak (grup 2), ameliyat olmak için pterjiumun biraz daha ilerlemesini beklemek (grup 3), pterjium cerrahisi daha önce geçirip yine tekrarlamasından endişe etmek (grup 4) ve ameliyattan korkmak (grup 5). BULGULAR: En çok karşılaşılan pterjium ameliyatı geciktirme nedeni; hastalığını bildiği halde çok fazla rahatsızlık duymamak idi. İkinci sırada ise, ameliyat olmaktan korkmak olduğu tespit edildi. Cerrahiyi geciktirme nedenleri dağılımı şu şekilde idi: 1.Grup 23 (%43.4), 2.grup 8 (%15.09), 3.grup 8 (%15.09), 4.grup 4 (%7.55), 5.grup 10 (%18.87) hasta. SONUÇ: Pterjiumda hasta kaynaklı ameliyat zamanı gecikmesinin ameliyat başarısını ve sonuçlarını etkileyebileceği, yapılacak ameliyatla ilgili hastaların bilgilendirilmesi, hastaların endişelerinin giderilmesinde psikolojik-sosyal destek verilmesi ameliyat olma zamanında gecikmeleri önleyebilir. OBJECTIVE: It was aimed to find out the factors affecting the operation time in patients undergoing pterygium surgery and to determine the precautions that can be taken. MATERIAL AND METHODS: The study included 53 patients who were operated for pterygium in our clinic between January 2014 and February 2017. The reasons for delaying the surgery were asked to the patients. Five groups were formed between 1-5 according to the answers. The groups were as follows: 1. Patients who don’t feel uncomfortable even though knowing the pterygium disease, 2. Patients who are unaware of pterygium disease, 3. Patients who want to wait for the pterygium tissue to grow a little more, 4. Patients who are concerned about recurrence because they had undergone pterygium surgery previously from the same eye, 5. Patients who are afraid of any surgery. RESULTS: The most common reason for delaying pterygium surgery was that the patient was not feeling uncomfortable even though they knew that they had the pterygium disease. The second reason was to be afraid of any surgery. The distribution of reasons for delaying surgery was as follows: Group 1: 23 (43.4%), Group 2: 8 (15.09%), Group 3: 8 (15.09%), Group 4: 7.55% Group 5: 10 patients (18.87%). CONCLUSIONS: Patient-related delay in pterygium surgery may affect surgical success and results. Informing patients about the operation and providing psychological-social support to alleviate patients' worries may prevent delays of surgery.

Published
2020

7. The long-term outcomes of transcanalicular diode laserassisted endoscopic dacryocystorhinostomy in isolated nasolacrimal duct obstruction.

Author

Sabaner, Mehmet Cem, Kahveci, Orhan Kemal, Duman, Reşat, Erol, Mehmet Akif, Çetinkaya, Ersan, Yiğit, Kenan, Yavaş, Güliz Fatma, and Duman, Rahmi

Subjects
DACRYOCYSTORHINOSTOMY, OSTEOTOMY, LASER therapy
Abstract

Aims: To evaluate the long-term surgical success of transcanalicular dacryocystorhinostomy (TCDCR) with diode-laser in the treatment of epiphora due to isolated naive nasolacrimal duct obstruction (NLDO) in adults. Methods: This retrospective study included patients with isolated naive NLDO, who underwent diode laser-assisted TCDCR. No patients had pathology in the nasal region detected by an otorhinolaryngologist. The included patients had documented information about epiphora evaluation with lacrimal system irrigation with fluorescein dye, and annual direct imaging of osteotomy patency with nasal endoscopy. Success was defined as no postoperative epiphora, conjunctivitis or dacryocystitis, an open passage in the lacrimal system lavage, and patient satisfaction. Results: The study included 116 patients [mean age: 49.6±11.4 years, female: 67 (57.8%)]. The success rate was 84.5% in the first year, 80.2% in the second year, and 76.7% in the third year. Following the operation, 9 (7.8%) patients had epiphora, 8 (6.9%) patients were not satisfied, and 1 (0.8%) patient developed conjunctivitis/dacryocystitis in the first year. Three (2.6%) patients had dissatisfaction and 2 (1.7%) patients had the complaints of epiphora correlated with nasolacrimal lavage obstruction in the second year. Two (1.7%) patients were dissatisfied and 2 (1.7%) patients had epiphora complaints confirmed with nasolacrimal lavage in the third year. Conclusions: The present study showed that the treatment of epiphora due to isolated NLDO with diode laser-assisted TCDCR can provide long-term success in major outcomes in adult patients. [ABSTRACT FROM AUTHOR]

Published
2021
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9. İris rengi ve retina pigment epitel melanininin alerjik rinite olan etkisi

Author

DEREKÖY, Sefa, KENAR, Fethullah, YAVAŞ, Güliz Fatma, KÜSBECİ, Tuncay, ÖZTÜRK, Faruk, and AYÇİÇEK, Abdullah

Subjects
genetic structures, Health Care Sciences and Services, Allergic rhinitis, iris color, retina pigment epithelium, Arden ratio, sense organs, Allergic rhinitis,iris color,retina pigment epithelium,Arden ratio,melanin, Sağlık Bilimleri ve Hizmetleri, melanin
Abstract

Objective: The purpose of this case control study is to establish the influence of iris color and retina pigment epithelium melanin on allergic rhinitis.Methods: Ninety-nine subjects diagnosed prospectively as allergic rhinitis and 85 control subjects were included in the study. Color of iris was recorded after ophthalmic examination. Electro-oculographic measurement was done after pupil dilatation and Arden ratios were recorded.Results: Mean age was 29.44±9.8 years in subject with allergic rhinitis and 32.67±12.9 years in control subjects (p>0.05). Measured mean Arden ratio was 158.22±29.4 in subjects with allergic rhinitis and 179.34±29.3 in normal subjects (p

Published
2016

12. Pupilla çapının optik koherans tomografi ölçümü üzerine etkisinin değerlendirilmesi

Author

YAVAŞ, Güliz Fatma, SARAÇ, Esin, ACAR, Nergiz, ALGÜL, Ufuk, KAZAR, Ahmet, Yavaş, Güliz Fatma, Saraç, Esin, Acar, Nergiz, Algül, Ufuk, and Kazar, Ahmet

Subjects
Üroloji ve Nefroloji, Pediatri, makula,optik koherans tomografi,pupilla, Tıbbi Araştırmalar Deneysel
Abstract

Amaç: Bu çalışmanın amacı, pupilla dilatasyonunun Optik Koherans Tomografisi (OKT) ile yapılan ölçümlerin kalitesine ve sonuçlarına etkisini değerlendirmektir. Gereç ve Yöntem: Çalışmaya hastanemiz Göz polikliniğine başvuran, OKT ölçümünü engelleyebilecek yüksek refraksiyon kusuru, korneal lökom veya katarakt gibi ortam patolojisi olmayan 20-80 yaşları arasındaki 60 olgu rastgele olarak dahil edildi. Tüm olguların Stratus OKT ile makula görüntüleri alındı. Takiben olguların pupillaları dilate edil- dikten sonra OKT ölçümleri tekrar edildi. Sonuçlar istatistik- sel olarak eşleştirilmiş örnekler t-testi ile değerlendirildi. Bulgular: Olguların dilatasyon öncesi pupilla çapı 4.07 ± 1.0 mm olup dilatasyon sonrası 7.57 ± 1.1 mm idi (p ‹0.001). Ölçümler için sinyal kuvveti dilatasyon öncesinde 5.72 ± 1.4 olup dilatasyon sonrasında 5.57 ± 1.6 idi ( p=0.28). Ölçülen makula kalınlığı dilatasyon öncesinde 265.50 ± 81.2 ?m olup dilatasyon sonrasında 277,927 ± 77.8 ?m idi ( p =0.050 ). Makula küp volümü dilatasyon öncesinde 10.05 ± 1.9 mm3 olup dilatasyon sonrasında 10.31 ± 1.7 mm3 idi ( p=0.173). Ortalama makula küp hacmi kalınlığı dilatasyon öncesinde 279.07 ± 51.2 ?m olup dilatasyon sonrasında 286.26 ± 46.3 ?m idi ( p=0.173). Sonuç: Pupilla dilatasyonu OKT çekimlerinde sinyal kuvveti- ni etkilememektedir. Makulanın değerlendiril-mesinde OKT ölçümlerine pupilla dilatasyonunun etkisi yoktur ve OKT ölçümleri, hastalara dilatasyon öncesinde ya da sonrasında güvenle uygulanabilir. Aim: In this study, we aimed to assess the effect of pupil dilatation on optical coherence tomography (OCT) measurement quality and results. Material and Method: Sixty subjects aged between 20 – 80 years without any media pathologies that could effect OCT measurements like high refractive error, corneal leukoma or cataract who came to our Ophthalmology Department were included in the study randomly. Macular scans were taken from all subjects using Stratus OCT. After pupil dilatation, OCT measurements were repeated. Results were evaluated using paired samples t-test. Results: Mean pupil diameter was 4.07 ± 1.0 mm before dilatation and 7.57 ± 1.1 mm after dilatation (p‹0.001). Signal strength for measurements was 5.72 ± 1.4 before dilatation and 5.57 ± 1.6 after dilatation ( p=0.28). Central macular thickness was measured to be 265.50 ± 81.2 μm before dilatation and 277,927 ± 77.8 μm after dilatation ( p =0.050 ). Macular cube volume was measured to be 10.05 ± 1.9 mm3 before dilatation and 10.31 ± 1.7 mm3 after dilatation ( p=0.173). Cube average thickness was measured to be 279.07 ± 51.2 μm before dilatation and 286.26 ± 46.3 μm after dilatation ( p=0.173). Conclusion: Pupil dilatation does not affect signal strength of OCT measurements. Pupil does not influence macular evaluation by OCT and OCT can be performed before and after mydriasis reliably.

Published
2012

15. The analyses of C677T and A1298C polymorphisms on the MTHFR gene and factor V Leiden mutation in pseudotumor cerebri patients

Author

Coşar, Murat, Eser, Betül, Erdoğan, Müjgan Özdemir, Eser, Olcay, Aslan, Adem, Yıldız, Handan, Korkmaz, Serhat, Yavaş, Güliz Fatma, and Tıp Fakültesi

Subjects
Pseudotumor Cerebri, Factor V Leiden, MTHFR, C677T Polymorphism, A1298C Polymorphism
Abstract

Eser, Betül (Balikesir Author), Background: In this study, we aimed to investigate the genetic factors which may cause to thrombosis such as C677T and A1298C methylen-thetrahydropholate reductase (MTHFR) gene polymorphisms and Factor V Leiden mutation. Methods: A case-control study was performed to detect C677T and A1298C MTHFR and Factor V Leiden gene polymorphisms in 30 patients which have headache and prediagnosed as pseudotumor cerebri (PC) after neurological examination and cranial magnetic resonance imaging. The intracranial pressures of the patients were measured via lumbar punction and 16 of 30 patients were diagnosed as PC and the rest 14 patients diagnosed as normal patients (control group). The C677T and A1298C polymorphisms of the MTHFR gene and Factor V Leiden polymorphisms in PC and normal patients were analyzed. Results: The 677 CC/CT and 677 CC/TT MTHFR genotypes between the PC patients and controls were significant. However, 677 CT/TT MTHFR genotypes between the PC patients were not significant. We were not found 677 TT genotype in control groups. We compared 1298 AA/AC/CC genotype frequencies between the PC patients and controls groups, and the difference was not significant. There were no participants with AA genotype of Factor V Leiden. A significant association was not found between GA/GG of Factor V Leiden genotypes between PC patients and controls groups. (chi(2)=0.01, P=0.72). Conclusion: We think that C677T polymorphisms of the MTHFR can be regarded as a risk factor for PC patients. However, A1298C polymorphisms of the MTHFR and factor V Leiden polymorphisms cannot be regarded as major risk factors for PC in the Turkish population.

Published
2013

16. Effect of pupil diameter an optic coherence tomography measurements

Author

Yavaş, Güliz Fatma, Saraç, Esin, Acar, Nergiz, Algül, Ufuk, Kazar, Ahmet, Afyon Kocatepe Üniversitesi, Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, and Afyon Kocatepe Üniversitesi, Tıp Fakültesi

Subjects
Optik Koherans Tomografi, Makula, Pupilla
Abstract

Amaç: Bu çalışmanın amacı, pupilla dilatasyonunun Optik Koherans Tomografisi (OKT) ile yapılan ölçümlerin kalitesine ve sonuçlarına etkisini değerlendirmektir. Gereç ve Yöntem: Çalışmaya hastanemiz Göz polikliniğine başvuran, OKT ölçümünü engelleyebilecek yüksek refraksiyon kusuru, korneal lökom veya katarakt gibi ortam patolojisi olmayan 20-80 yaşları arasındaki 60 olgu rastgele olarak dahil edildi. Tüm olguların Stratus OKT ile makula görüntüleri alındı. Takiben olguların pupillaları dilate edildikten sonra OKT ölçümleri tekrar edildi. Sonuçlar istatistiksel olarak eşleştirilmiş örnekler t-testi ile değerlendirildi. Bulgular: Olguların dilatasyon öncesi pupilla çapı 4.07 ± 1.0 mm olup dilatasyon sonrası 7.57 ± 1.1 mm idi (p ‹0.001). Ölçümler için sinyal kuvveti dilatasyon öncesinde 5.72 ± 1.4 olup dilatasyon sonrasında 5.57 ± 1.6 idi ( p=0.28). Ölçülen makula kalınlığı dilatasyon öncesinde 265.50 ± 81.2 µm olup dilatasyon sonrasında 277,927 ± 77.8 µm idi ( p =0.050 ). Makula küp volümü dilatasyon öncesinde 10.05 ± 1.9 mm³ olup dilatasyon sonrasında 10.31 ± 1.7 mm³ idi ( p=0.173). Ortalama makula küp hacmi kalınlığı dilatasyon öncesinde 279.07 ± 51.2 µm olup dilatasyon sonrasında 286.26 ± 46.3 µm idi ( p=0.173). Sonuç: Pupilla dilatasyonu OKT çekimlerinde sinyal kuvvetini etkilememektedir. Makulanın değerlendiril-mesinde OKT ölçümlerine pupilla dilatasyonunun etkisi yoktur ve OKT ölçümleri, hastalara dilatasyon öncesinde ya da sonrasında güvenle uygulanabilir. Aim: In this study, we aimed to assess the effect of pupil dilatation on optical coherence tomography (OCT) measurement quality and results. Material and Method: Sixty subjects aged between 20 – 80 years without any media pathologies that could effect OCT measurements like high refractive error, corneal leukoma or cataract who came to our Ophthalmology Department were included in the study randomly. Macular scans were taken from all subjects using Stratus OCT. After pupil dilatation, OCT measurements were repeated. Results were evaluated using paired samples t-test. Results: Mean pupil diameter was 4.07 ± 1.0 mm before dilatation and 7.57 ± 1.1 mm after dilatation (p‹0.001). Signal strength for measurements was 5.72 ± 1.4 before dilatation and 5.57 ± 1.6 after dilatation ( p=0.28). Central macular thickness was measured to be 265.50 ± 81.2 µm before dilatation and 277,927 ± 77.8 µm after dilatation ( p =0.050 ). Macular cube volume was measured to be 10.05 ± 1.9 mm³ before dilatation and 10.31 ± 1.7 mm³ after dilatation ( p=0.173). Cube average thickness was measured to be 279.07 ± 51.2 µm before dilatation and 286.26 ± 46.3 µm after dilatation ( p=0.173). Conclusion: Pupil dilatation does not affect signal strength of OCT measurements. Pupil does not influence macular evaluation by OCT and OCT can be performed before and after mydriasis reliably.

Published
2012

23. Periocular mexametric melanin and erythema indexes in adult glaucoma patients treated with topical prostaglandin analogs.

Author

Duman, Nilay, Duman, Reşat, Yavaş, Güliz Fatma, Doğruk Kaçar, Seval, Özuğuz, Pınar, and Çetinkaya, Ersan

Subjects
GLAUCOMA, PROSTAGLANDINS, MELANINS, ERYTHEMA, HYPERPIGMENTATION, PATIENTS
Abstract

Context: Although topical prostaglandin analogs (PGAs) have been previously associated with periocular skin hyperpigmentation, studies using objective clinical methods are lacking. Furthermore changes in periocular skin erythema indexes associated with topical PGAs have not been reported previously. Objective: The purpose of the present study was to evaluate periocular melanin and erythema indexes in patients treated with topical PGA using an objective clinical method – Mexameter. Methods: About 45 glaucoma patients treated with topical PGA therapy, and 30 age-, and sex-matched controls were enrolled in the study. Demographic data, medical history including duration of therapy, PGA type, involved eye (unilateral, bilateral) were noted, and skin phototypes were evaluated. Melanin and erythema indexes on medial and lateral upper and lower eyelids, and normal skin from the upper cheeks were measured using Mexameter MX-18. The index of difference for lower/upper eyelid was calculated. Reading results of patients and controls were compared. Results: Melanin and erythema indexes of upper/lower eyelids, and the index of differences for upper/lower eyelids were significantly higher in patients despite similar clinical findings (p < 0.05). Duration of therapy and type of PGA were not associated with skin changes (p > 0.05). Conclusions: Both periocular melanin and erythema indexes increased in both upper and lower eyelids due to PGA therapy compared to controls, despite similar clinical findings. Mexametric evaluation is more sensitive than clinical evaluation, and may be used as an objective, sensitive clinical method to evaluate periocular skin changes, even smallest changes, in such patients. [ABSTRACT FROM AUTHOR]

Published
2017
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24. Düğümsüz Skleral Fiksasyonlu Göz İçi Lensi İmplantasyonu Sonuçları.

Author

YAVAŞ, Güliz Fatma, KÜSBECİ, Tuncay, YİĞİT, Safiye, ERMİŞ, Sıtkı Samet, and İNAN, Ümit Übeyt

Subjects
*GLAUCOMA treatment, *INTRAOCULAR lenses, *VISUAL acuity, *INTRAOCULAR pressure, *OPERATIVE surgery, *SURGICAL complications, GLAUCOMA surgery
Abstract

Purpose: To evaluate the results of knotless Z-suture scleral fixation intraocular lens (IOL) implantation technique to ciliary sulcus. Materials and Methods: Twenty subjects whom Z- suture scleral fixation IOL implantation was performed, were included in the study. Visual acuity, intraocular pressure, operative and postoperative complications were recorded. Results: Best corrected visual acuity at postoperative 2. month was significantly higher compared to the best corrected visual acuity at preoperative period (p=0.037). Best corrected visual acuity remained the same at 6 subjects and increased at 14 subjects and except 1 case all subjects achieved a visual acuity of logMAR 0.3 or better. Only in 1 subject, hyphema was seen during operation. At the postoperative period, suture exposure was seen at 1 subject at 1. month and 2 subjects developed secondary open angle glaucoma which was controlled by medical treatment. No intraocular lens dislocation or tilt was seen. Conclusion: Complications of Z-suture scleral fixation IOL implantation technique are minimal and it can be performed in short duration, easily and safely. [ABSTRACT FROM AUTHOR]

Published
2012

25. Zafer Bölgesinde (Afyon-Kütahya-Uşak) İlerlemiş Katarakt Olgularında Ameliyat Zamanını Etkileyen Sebepler ve Demografik Faktörler.

Author

DOĞAN, Mustafa, SABANER, Mehmet Cem, NORMAN ÖZDAMAR, Esma, DUMAN, Reşat, and YAVAŞ, Güliz Fatma

Abstract

Purpose: We aimed to demonstrate the reasons of demographic factors for the delay of operation time in mature cataract patients and to determine the measures to be taken to prevent delay. Materials and Method: The study involved 98 patients operated by phacoemulsification in Afyon Kocatepe University Hospital from January 2014 to December 2016. The patients had stage 4 mature cataracts in whom visual activity was from perception positive to two meter finger count. The reasons for the delay of surgery were asked. According to the answers, nine groups were formed numbered from one to nine. The proportion of the number of patients in each group to the total number of patients was obtained. Results: The groups of patients were as follows: 1. Those who he/she had unaware of low visual acuity/unaware of cataract, 2. Those who had hesitated of surgery because a person that she/he knew completely lost sight after surgery, 3. Those who lacked access to health services, 4. Those who worried about getting worse after the surgery, 5. Those who had a variety of health problems preventing the operation, 6.Those who had waited because the other eye is well seen, 7. Those who had delayed to go hospital because of family problems, 8. Those who had not knew that their vision will improve with cataract surgery, 9. Those who had afraid a pain of surgery. The distribution of formed groups was as follows: 19 (19,4%) patients in group 1, 3 (3,1%) patients in group 2, 11 (11.2%) patients in group 3, 28 (28,6%) patients in group 4, 12 (12,2%) patients in group 5, 8 (8,2%) patients in group 6, 9 (9,2%) patients in group 7, 1 (1,0%) patients in group 8 and 7 (7,2%) patients in group 9. The most common reasons for delayed surgery time are "worried about getting worse after the surgery" and "unaware of low visual acuity/unaware of cataract". Conclusion: The delayed surgery time can be prevented by explaining the negative results of operation delay to the patients and giving them psychological and social support to help them overcome their fears. [ABSTRACT FROM AUTHOR]

Published
2018

26. İris Kıskaçlı Göz İçi Lens İmplantasyonu Sonuçlarımız.

Author

DUMAN, Reşat, VALİYEV, İlkin, BAYSAL, Zeki, YAVAŞ, Güliz Fatma, and İNAN, Ümit Übeyt

Abstract

Purpose: To evaluate the outcomes of the iris-claw intraocular lens implantation in aphakic cases. Materials and Methods: The study included 20 eyes of 19 cases who had undergone posterior or anterior chamber iris-claw intraocular lens implantation at Afyon Kocatepe University Department of Ophthalmology between 2010 and 2015. Medical records of cases were retrospectively evaluated, and best-corrected visual acuities, intraocular pressures, operative and post-operative complications were recorded. Results: Anterior chamber implantation was performed in 2 cases, while posterior chamber implantation in 18 cases. Minimal haemorrhage was observed in the anterior chamber from the angular region in one case during the operation. Transient intraocular pressure elevation was detected in two of our patients postoperatively. And in one patient iris deformity was observed after the operation. Post-operative best-corrected visual acuities were significantly higher than pre-operative values (p < 0.001). Conclusion: In aphakic cases iris-claw lens implantation is a safe surgical technique that has some advantages of preserving iridocorneal angle, not required pupil dilation, and easier implantation into the anterior or posterior to the pupil. [ABSTRACT FROM AUTHOR]

Published
2017

27. Makülayı Tutan Rasemöz (Salkımsı) Hemanjiom.

Author

DOĞAN, Mustafa, ÇETİNKAYA, Ersan, DUMAN, Reşat, and YAVAŞ, Güliz Fatma

Abstract

Retinal racemose hemangioma; is one of the rare congenital arteriovenous malformations. It's mostly unilateral and is characterized by dilated and tortuous retinal vessels. It may involve large areas in the retina. Macular involvement is rare. In this study, we report macular racemose hemangioma without any systemic disorders in a fifteen year-old female's right eye. [ABSTRACT FROM AUTHOR]

Published
2015

28. Miyopik olgularda maküla fonksiyonun anatomik ve elektrofizyolojik olarak değerlendirilmesi

Author

Deniz, Yağmur, Yavaş, Güliz Fatma, and Göz Hastalıkları Anabilim Dalı

Subjects
Electrophysiology, Tomography-optical coherence, Göz Hastalıkları, Eye Diseases, Myopia, Electroretinography, Anatomy, Eye diseases, Macula lutea
Abstract

Bu çalışmanın amacı; miyopik olgularda arka segment parametrelerini değerlendirerek makülanın anatomik yapısını spektral domain optik koherens tomografi (SDOKT) ile ve fonksiyonel açıdan pattern elektroretinografi (PERG) ile incelenmek ve aralarındaki korelasyonu saptamaktır. Çalışma grubu 78'i kadın, 40'ı erkek toplam 118 olgudan oluşturuldu. Kırma kusuru derecesine göre olgular 4 gruba ayrıldı. Birinci grup 0.00/-0.75 D arası (kontrol grubu), ikinci grup -1.00/-2.75 D arası, üçüncü grup -3.00/-5.75 D arası, dördüncü grup -6.00 D ve üstü olarak belirlendi. Tüm olgularda peripapiller RSLT kalınlığı, maküla kalınlığı, retina katlarının kalınlığı ve koroid kalınlığı SDOKT kullanılarak ölçüldü ve ardından PERG testi uygulandı. Miyopi derecesi artışı ile T kadran hariç RSLT kalınlığında azalma olduğu gözlendi. Maküler kalınlık ve retina katlarının (dış pleksiform tabaka hariç) kalınlıkları ile miyopi derecesi arasında bir ilişki bulunamadı. Yüksek miyopi grubunda maküler kalınlık ile N95 amplitüdü arasında negatif korelasyon saptandı. Miyopi derecesi ve AU artışı ile subfoveal koroid kalınlığı azalmaktaydı. AU ile subfoveal koroidal kalınlık arasında negatif korelasyon olduğu görüldü. P50 ve N95 dalgalarının amplitüdlerinde yüksek miyopi grubu ile kontrol grubuarasında istatiksel olarak anlamlı fark olduğu bulundu. Miyopi derecesinin artması ile ilişkili olarak P50 ve N95 amplitüdündeki azalma belirginleşiyordu. N95 amplitüdündeki azalma aksiyel uzunluk artışı ile korelasyon göstermekteydi. Maküler retina katlarında anatomik bir değişiklik olmadan ve EİDGK etkilenmemiş iken P50 amplitüdünde azalma olması, fonksiyonel açıdan makülanın yüksek miyop olgularda etkilenebileceğini düşündürmektedir. N95 amplitüdündeki azalmanın ise AU'daki artış ve global peripapiller RSLT kalınlığındaki azalma ile ilişkili olabileceği düşünüldü.Anahtar Kelimeler: Spektral Domain Optik Koherens Tomografi, patternelektrografi, miyopi. The aim of this study is to evaluate the posterior segment parameters, the anatomical structure of macula with Spectral Domain Optic Coherence Tomography (SD-OCT) and electrophysiological function of the macula with pattern electroretinography (PERG) in myopic cases and to determine the correlation between them. The study group included 118 subjects (78 female, 40 male). Cases were divided into four groups according to the degree of refractive errors. The first group was between 0.00 / -0.75 D (control group), the second group between -1.00/ -2.75 D, the third group between -3.00 / -5.75 D and the fourth group as -6.00 D and higher. Peripapillary RNFL thickness, macular thickness, thickness of the retinal layers and choroidal thickness were measured using SD-OCT in all cases and then PERG test was applied. It was found that there was a decrease in RNFL thickness except T quadrant with the increase in degree of myopia. There was no correlation between macular thickness and the thickness of retinal layers (except the outer plexiform layer) and the degree of myopia. Negative correlation was found between macular thickness and N95 amplitude in high myopia group. It was found that subfoveal choroidal thickness decreased with increased degree of myopia and increase in AL. There was a negative correlation between AL and subfoveal choroidal thickness. There was a statistically significant difference between the high myopia group and the control group in the amplitudes of P50 and N95 waves. The decrease in P50 and N95 amplitude was observed to be associated with the increase in the degree of myopia. The decrease in N95 amplitude correlated with the increase in axial length. The decrease in P50 amplitude without an anatomical change in macular retinal layers and without reduction of BCVA is suggestive that macula can be affected in high myopia cases in terms of function. The decrease in N95 amplitude wasthought to be related with increase in AL and decrease in global peripapillary RNFL thickness.Keywords: Spectral Domain Optical Coherence Tomography, patternelectrography, myopia. 87

Published
2019

29. Transkanaliküler multi-diod lazer dakriosistorinostominin etkinliği ve güvenirliği

Author

Bakan, Osman, Yavaş, Güliz Fatma, and Göz Hastalıkları Ana Bilim Dalı

Subjects
Dacryocystitis, Göz Hastalıkları, Eye Diseases, Lacrimal duct obstruction, Laser therapy, Lacrimal apparatus diseases, Lacrimal apparatus, Dacryocystorhinostomy
Abstract

Amaç: Kronik dakriosistit hastalarında lakrimal drenajın sağlanması için transkanaliküler multidiod lazer dakriosistorinostominin etkinliğini ve güvenirliğini değerlendirmeyi amaçladık.Gereç ve Yöntem: Çalışmaya eylül 2008 ile mart 2012 tarihleri arasında kliniğimizde kronik dakriosistit tanısıyla opere olan 65 hastanın 70 gözü retrospektif olarak dahil edildi. Olguların 51'i kadın (% 72,86), 19'u erkek (% 27,14) idi (p=0.009). Olguların ortalama yaşları 50,6 ± 17,3 yıl (18 ? 84 yıl) idi. Ameliyat esnasında ameliyatı engelleyecek septum deviasyonu veya konka hipertrofisi gibi nazal patolojisi olan olgulara septoplasti veya konka rezeksiyonu uygulandı. Tüm hastalara 0° nazal video endoskop eşliğinde transkanaliküler multidiod lazer DSR ve silikon tüp entübasyonu yapıldı.Bulgular: Transkanaliküler lazer DSR işleminin süresi ortalama 26,50±4,9 dk (16-39 dk) olarak saptandı. İşlem esnasında kemik pencere açılması için kullanılan enerji ortalama 287,3±27,9 J (239 J ? 367 J) idi. Hastalarda ortalama 8,01 aylık takip sonrasında başarı oranı % 90 idi. 3. ay kontrolünde nazolakrimal tıkanıklık gelişen 7 hastaya revizyon için tekrar transkanaliküler multidiod lazer DSR önerildi. 5 hastanın onayıyla revizyon cerrahisi uygulandı ve 3 hastada başarılı olunurken 2 hastanın 1. hafta kontrollerinde nazolakrimal tıkankılık izlendi. Ameliyat esnasında herhangi bir komplikasyon izlenmedi. Ameliyat sonrasında komplikasyon olarak 3 olguda (% 4.29) ilk gün hafif şiddette epistaksis, 5 olguda (% 7.14) yaklaşık 5 gün devam eden kapak ödemi ve ekimoz, 4 olguda (% 5.71) ise punktumlardan silikon tüpün prolabe olduğu izlendi.Sonuç: Endoskopik transkanaliküler multidiod lazer DSR sonuçları başarılı olup ameliyat süresinin ve ameliyat sonrası iyileşme süresinin kısa olması, hemorajinin az olması, cilt insizyonunun olmaması, çevre dokuların daha az hasar görmesi sebebi ile diğer cerrahi yöntemlere alternatif olarak kabul edilebilir. Purpose: To evaluate the efficacy and reliability of transcanalicular multidiode laser dacryocystorhinostomy in creating a patent lacrimal system in patients with chronic dacriocystitis.Materials and Methods: Seventy eyes of 65 patients operated with the diagnosis of chronic dacryocystitis in our clinic between september 2008 and march 2012 were included in the study retrospectively. 51 (72,86%) of the subjects were female and 19 (27,14%) of the subjects were male (p=0.009). Mean age was 50.6 ± 17,3 years (18 ? 84 years). If there were nasal pathologies like septal deviation or chonchal hypertrophy on examination that could block surgery, septoplasty or choncha resection was performed. Transcanalicular multidiode laser DCR and silicone tube intubation was performed using 0° nasal video endoscope to all subjects.Results: Mean time for transcanalicular laser DCR surgery was found to be 26,50±4,9 minutes (16-39 minutes). Mean energy used for creating bone defect was 287,3±27,9 J (239 J ? 367 J). Success rate after a mean follow up time of 8.01 months was 90.0%. All 7 subjects that were closed at the 3. month control were adviced transcanalicular laser DCR as revision surgery. Five of the subjects accepted it, 3 were successfull but 2 were not successfull on the first week control. No complication was seen during operation. After the operation, 3 subjects (4.29%) developed minimal epistaxis, 5 subjects (7.14%) developed eyelid edema and ecimosis that lasted 5 days, and 4 subjects (5.71%) developed silicone tube prolapsus from the punctum.Conclusion: Endoscopic transcanalicular multidiode laser DCR are found to be successfull. As both the surgery time and the recovery time after surgery are short, hemorrhage is very little, skin incision is not performed, neighbourhood structures are damaged very little, it can be an alternative to other surgery techniques. 72

Published
2012

30. Primer açık açılı glokom olguları ile nonarteritik anterior iskemik optik nöropati olgularında optik sinir başının morfolojik ve fonksiyonel olarak değerlendirilmesi

Author

Eğicioğlu, Mutlu, Yavaş, Güliz Fatma, and Göz Hastalıkları Ana Bilim Dalı

Subjects
Göz Hastalıkları, Eye Diseases
Abstract

Bu çalışmada primer açık açılı glokom (PAAG) ve non arteritik iskemik optik nöropati (NAİON) olgularında optik sinir başı fonksiyonel ve morfolojik değişikliklerini değerlendirmeyi ve benzer yaş grubundan oluşan normal olgular ile karşılaştırmayı amaçladık.Çalışmaya Afyon Kocatepe Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı Glokom biriminde takip edilen 24 PAAG'lu hastanın 24 gözü ve Nörooftalmoloji, biriminde takip edilen 17 NAİON'li hastanın 17 gözü dahil edildi. Kontrol grubundaki 23 hasta ise, polikliniğimize göz muayenesi için başvuran presbiyopi haricinde herhangi bir sistemik veye oküler hastalığı olmayan olgulardan oluşturuldu. Optik sinir başı morfolojik değerlendirilmesi Heildelberg retina tomografisi (HRT) ile yapılarak disk alanı, rim alanı, rim hacmi, C/D oranı, RSLT ve RSLT kesitsel alanı kaydedildi. Gangliyon hücre tabakasının fonksiyonel olarak değerlendirilmesinde patern ERG kullanıldı.Çalışmada PAAG, NAİON ve kontrol grupları arasında istatistiksel olarak anlamlı yaş farkı bulunmadı. Topografik değerlendirmede PAAG olgularında disk alanı ve C/D oranı kontrol grubundan fazla iken, rim alanı ve rim hacmi bakımından fark saptanmadı. Non arteritik iskemik optik nöropati olgularının disk alanı yönünden kontrol grubu ile arasında fark saptanmadı ancak C/D oranı kontrol grubundan anlamlı olarak düşük saptandı. Rim alanı ve rim hacmi NAİON olgularında kontrol grubundan fazla saptandı. Primer açık açılı glokom ve NAİON olguları arasında topografik değerlendirmede gruplar arasında RSLT ve RSLT kesitsel alanı bakımından fark saptanmadı. Optik sinir başının fonksiyonel değerlendirilmesi ise PERG ile yapıldı. Patern ERG incelemesinde gruplar arasında P50 latansı ve N95 latansı bakımından anlamlı fark izlenmedi. Glokom olgularında P50 amplitüdü kontrol grubuna göre farklılık göstermemekte idi ancak N95 amplitüdü düşük saptandı. P50 ve N95 amplitüdleri NAİON grubunda kontrol grubu ve glokom grubundan anlamlı olarak düşük idi. N95/P50 amplitüd oranı, hem NAİON grubunda, hemde glokom grubunda kontrol grubundan düşük olup ancak NAİON grubu ile glokom grubu arasında fark saptanmadı.Geniş optik diskler glokomatöz hasara daha yatkındırlar ancak geniş optik disklerde de çukurluk alanının yapısal olarak geniş olabileceği, dolayısı ile erken glokom teşhisinde belirgin glokomatöz hasar gelişimi olana kadar optik diskte topografik değişiklik olmayabileceği unutulmamalıdır. NAİON gelişiminde ise küçük optik disk, geniş rim alanı ve küçük optik disk alanı bir risk faktörüdür. Patern elektroretinografi parametreleri glokomda ve NAİON'de optik disk RSLT'den daha önce değişim göstermektedir. Glokomatöz hasara özellikle N95 amplitüdü duyarlıdır. Non arteritik iskemik optik nöropatide ise hem P50 amplitüdü hem de N95 amplitüdü belirgin olarak etkilenmektedir.Retina sinir lifi tabakasında değişiklik olmadan PERG değişiklikleri olabilmesi sebebi ile glokomatöz hasarın erken dönemde saptanabilmesinde optik sinirin fonksiyonel olarak değerlendirilmesi önem taşımaktadır. Hem PAAG olgularında, hem de NAİON'de optik sinir başında RSLT değişiklikleri olmadan gangliyon hücrelerinin fonksiyonları etkilenebileceğinden bu olgularda topografik değerlendirme ile beraber elektroretinografik değerlendirme önem taşımaktadır The aim of this study was to determine the morphologic and functional changes in optic nerve head in subjects with primary open angle glaucoma (POAG) and non arteritic ischemic optic neuropathy (NAION) and to compare the results with age matched normal subjects.Twenty-four patients with POAG being controlled in glaucoma department, 17 NAION patients being controlled in neuroophthalmology department at Afyon Kocatepe University Ophthalmology Clinic were enrolled in the study. Twenty-three normal subjects referred to the same clinic for presbiopia having no other ophthalmologic or systemic disease served as control group. The morphologic evaluation of optic nerve head was performed by Heidelberg retina tomography (HRT) and disc area, rim area, rim volume, C/D ratio, retinal nerve fiber layer (RNFL) and RNFL cross sectional area were recorded. The functional analysis of ganglion cell layer was performed by pattern ERG.We could not find any statistically significant in age among subjects with POAG, NAİON and control group. In POAG, disc area and C/D ratio was greater compared to control group whereas no difference could be detected for rim area and rim volume. No significant difference could be found in disc area between subjects with NAION and control group but C/D ratio was significantly lower in NAION group. Rim area and rim volume was greater in NAION subjects compared to control group. We could not find any difference between groups in terms of RNFL and RNFLCS. Latancies of P50 and N95 in PERG were not different among groups. In subjects with glaucoma, amplitude of P50 was not different compared to control group but amplitude of N95 was significantly lower. In subjects with NAION, both amplitude of P50 and amplitude of N95 were lower compared to control group and subjects with glaucoma. The N95/P50 ratio was significantly lower in both POAG and NAION compared to control group whereas there was no significant difference between study groups.Larger optic discs are more prone to glaucomatous changes but the cupping area may be altered in larger optic discs and so, it should not be forgotton that no topographic change in optic nerve head may be seen before significant glaucomatous damage. Small optic disc and large rim area are risc factors for NAION. In both POAG and NAION, PERG parameters are affected before optic nerve head RNFL. Especially N95 amplitude is affected in POAG whereas both P50 amplitude and N95 amplitude are affected in NAION.As changes in PERG can be seen before changes in RNFL in glaucoma, the functional evaluation of optic nerve head is important in the early diagnosis of glaucoma. As both in POAG and in NAION, ganglion cell functions can be altered without changes in RNFL, electroretinographic evaluation is important in these subjects besides topographic evaluation. 66

Published
2009

31. Laser-assisted dacryocystorhinostomy in nasolacrimal duct obstruction: 5-year follow-up.

Author

Doğan M, Alizada A, Yavaş GF, Kahveci OK, and Bakan O

Abstract

Aim: To evaluate the long-term sucess rate of laser-assisted dacryocystorhinostomy (L-DCR) in patients with nasolacrimal duct obstruction (NDO)., Methods: Forty-one eyes of forty patients aged between 21-85y (mean 56.7y) who underwent L-DCR for the treatment of NDO were included in this retrospective, non-randomized study. The follow-up time was 72mo. Functional sucess was defined as the disappearance of epiphora under normal conditions and the presence of a patent ostium on lacrimal irrigation. Anatomical success was defined as a patent lacrimal passage on syringing besides continuing epiphora. Surgical failure was defined as persistent epiphora and closed ostium., Results: Twenty-seven of 40 patients (67.5%) were female and 13 of 40 patients (32.5%) were male. The NDO was right-sided in 17 (42.5%) patients and left-sided in 22 (55%) patients whereas 1 (2.5%) patient had undergone bilateral surgery. In 11 (27.5%) patients there were additional nasal abnormalities requiring simultaneous surgical approach. The average time for L-DCR was 26.50±4.9min (16-39min) and the average total amount of laser energy used was 287±27.9 J (239-367 J). At the 5y follow-up, anatomical sucess rate was 75.0% (30 patients) and functional success rate was 65.0% (26 patients), whereas surgical failure was seen in 25% (10 patients). Revision of surgery was performed in 10 cases (25.0%); failure of revision surgery was seen in 2 cases (5.0%)., Conclusion: Transcanalicular L-DCR is a reliable and fast procedure in the treatment of NDO. It can be alternative to external DCR which is accepted as the gold standard currently. The functional and anatomical success rate is higher in the first months and years, but still satisfactory at fifth year.

Published
2018
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32. Factors Affecting Compliance to Intravitreal Anti-Vascular Endothelial Growth Factor Therapy in Patients with Age-Related Macular Degeneration.

Author

Polat O, İnan S, Özcan S, Doğan M, Küsbeci T, Yavaş GF, and İnan ÜÜ

Abstract

Objectives: To determine factors influencing compliance in patients with neovascular age-related macular degeneration (n-AMD) undergoing intravitreal anti-vascular endothelial growth factor (VEGF) therapy., Materials and Methods: The files of n-AMD patients recommended treatment with ranibizumab were reviewed retrospectively. The treatment regimen was 3 consecutive monthly injections followed by monthly follow-up with intravitreal injections as needed (pro re nata, PRN). Demographic and ocular characteristics were recorded. The patients were categorized into 2 groups: full compliance to treatment, or incomplete loading schedule and/or irregular maintenance treatment. All patients were interviewed by phone about factors affecting continuation of treatment., Results: Mean age of the 314 patients (160 female, 154 male) included in the study was 71.6±9.1 years. A total of 246 patients (78.3%) could complete 3 consecutive injections at 1-month intervals after the start of treatment; 57 patients (18.2%) did not attend monthly follow-up during the 1-year follow-up period following the 3 consecutive monthly injections. Overall, 39.8% of the patients were not able to fully comply with the ranibizumab treatment by PRN regimen for 1 year. Better visual acuity at baseline, smaller lesion size, living closer to the hospital, higher education and sociocultural level, and better financial status were determined as factors affecting patient compliance. The most frequent reasons to discontinue treatment were fear of injection, disbelief in the benefit of the treatment, financial limitations, continuation of treatment at another center, and comorbid systemic diseases., Conclusion: Patient compliance and success rates of anti-VEGF therapy may be increased by determining the factors affecting patient compliance and raising awareness about n-AMD among patients and their relatives., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Published
2017
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33. Neutrophil-to-Lymphocyte Ratio as a Marker in Patients with Non-arteritic Anterior Ischemic Optic Neuropathy.

Author

Polat O, Yavaş GF, İnan S, and İnan ÜÜ

Abstract

Background: Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over the age of 50 and is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. Although the precise cause of NAION remains elusive, the etiology of NAION is believed to be multifactorial., Aims: To evaluate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available prognostic factor for clinical disease activity in patients with NAION., Study Design: Case-control study., Methods: Forty-five patients with the diagnosis of NAION and 50 age- and sex-matched controls with/without any systemic or ocular diseases except cataract were retrospectively enrolled in the study. Demographic characteristics and laboratory findings including complete blood count of all patients and control subjects were obtained from the electronic medical record. The neutrophil and lymphocyte counts were recorded and the NLR was calculated., Results: White blood cell, neutrophil, NLR and platelet values of the NAION patients were significantly higher than those of the controls (p<0.001, p<0.001, p=0.004, p=0.037, respectively). Initial NLR values were negatively correlated with initial and the third month best corrected visual acuity levels in the study group. The optimum NLR cut-off point for NAION was 1.94., Conclusion: NLR could be considered as a new inflammatory marker for assessment of the severity of inflammation in NAION patients with its quick, cheap, easily measurable property with routine complete blood count analysis.

Published
2015
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