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    Characteristics of the cornea in patients with pseudoexfoliation syndrome
    (Consel Brasil Oftalmologia, 2015) Oltulu, Refik; Satirtav, Gunhal; Kayitmazbatir, Emine Tinkir; Bitirgen, Gulfidan; Ozkagnici, Ahmet; Karaibrahimoglu, Adnan
    Purpose: To quantify the morphological alterations in corneal nerve fibers and cells in patients with pseudoexfoliation syndrome (PEX) and their relationship with the presence of hyperreflective endothelial deposits observed using in vivo confocal microscopy. Methods: One eye each of 37 patients with PEX and 20 age-matched healthy control subjects was evaluated by in vivo corneal confocal microscopy. Patients with PEX were further classified into two groups: those with and without hyperreflective endothelial deposits. We evaluated the densities of basal epithelial cells, anterior and posterior stromal keratocytes, and endothelial cells and structure of sub-basal nerve fibers. Results: The mean anterior and posterior stromal keratocyte and endothelial cell densities and corneal sub-basal nerve plexus variables were significantly lower in patients with PEX compared with those in healthy control subjects. The mean basal epithelial cell density did not significantly differ. Conclusion: Eyes with PEX presented decreased corneal sub-basal nerve plexus variables and cell densities in all corneas, except for the mean basal epithelial cell density. Further, a trend of lower corneal sub-basal nerve plexus measurements in patients with hyperreflective endothelial deposits compared with those without endothelial deposits was observed.
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    In Vivo confocal Microscopic evaluation of corneal nerve Fibers and Dendritic cells in Patients With Behcet's Disease
    (Frontiers Media Sa, 2018) Bitirgen, Gulfidan; Kayitmazbatir, Emine Tinkir; Satirtav, Gunhal; Malik, Rayaz A.; Ozkagnici, Ahmet
    Central and peripheral nervous system involvement may occur during the course of Behcet's disease (BD). In vivo corneal confocal microscopy (CCM) can detect corneal small fiber damage and immune cell density. The aim of this study was to assess central corneal sensitivity, corneal subepithelial nerve plexus morphology and dendritic cell (DC) density in patients with BD. Forty-nine consecutive patients with BD and 30 healthy control subjects were included in this cross-sectional study conducted at a tertiary referral university hospital. Central corneal sensitivity was measured using the contact corneal esthesiometer (Cochet-Bonnet; Luneau, France). The laser scanning CCM (Heidelberg, Germany) was used to quantify corneal nerve fiber density (NFD), nerve branch density (NBD), nerve fiber length (NFL), and DC density. There was a significant reduction in NFD (P = 0.001) and NFL (P = 0.031) and an increase in DC density (P = 0.038) in patients with BD compared to healthy controls, whereas corneal sensitivity (P = 0.066) and NBD (P = 0.067) did not differ significantly. There was no difference in corneal sensitivity, corneal nerve parameters, or DC density between BD patients with [n = 18 (36.7%)] and without a previous history of uveitis (P > 0.05 for all). Disease duration [median (IQR), 6.5 (4.0-14.5) years] correlated with corneal sensitivity (rho = -0.463; P = 0.001) and NFD (rho = -0.304; P = 0.034) and corneal sensitivity correlated with NFD (rho = 0.411; P = 0.003) and NFL (rho = 0.295; P = 0.039) in patients with BD. CCM demonstrates corneal sub-basal nerve fiber loss and increased DC density, providing a non-invasive ophthalmic means to identify peripheral neuropathy and inflammation in patients with BD.
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    Spectral Domain Optical Coherence Tomography Findings in Posterior Microphthalmia
    (Turkish Ophthalmological Soc, 2014) Kayitmazbatir, Emine Tinkir; Ozturk, Banu Turgut; Kerimoglu, Hurkan; Ozkagnici, Ahmet; Okudan, Suleyman
    The retinal spectral domain optical coherence tomography (SD-OCT) findings of two posterior microphthalmia cases are presented in this case report. For this purpose, the findings of two siblings aged five and seven years who presented to our clinic with the complain of far-sightedness and high hypermetropia were evaluated. Both cases diagnosed to have posterior microphthalmia demonstrated normal biomicroscopic anterior segment examination and gonioscopy findings and the axial lengths were measured to be shorter than 17mm. The SD-OCT analysis of papillomacular folds detected in fundus examination revealed contribution of only neurosensorial retina. Beneath the retinal fold, we observed bilateral cysts in the intraretinal area in one of the cases and a triangle-shaped hyporeflective space with an apex corresponding to that of the retinal fold in the subretinal area in both cases. SD-OCT is an adjunctive imaging tool for diagnosis and follow-up of degenerative changes in posterior microphthalmia. These changes may be also important for visual prognosis.