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Öğe Analysis of Peripapillary Choroidal Thickness in Unilateral Amblyopia(Lippincott Williams & Wilkins, 2019) Bitirgen, Gulfidan; Mirza, Enver; Ozkagnici, Ahmet; Iyisoy, Mehmet SinanPurpose: To evaluate the peripapillary choroidal thickness (CT) in children with unilateral amblyopia using spectral-domain optical coherence tomography (SD-OCT). Methods: One hundred and six eyes of 53 children with unilateral amblyopia and 20 eyes of 20 children with normal vision were involved in this study. Of the 53 children with unilateral amblyopia, 29 (54.7%) had hyperopic anisometropic amblyopia and 24 (45.3%) had strabismic amblyopia. Peripapillary CT was measured from 6 mm length radial B-scans at the optic nerve head using the enhanced depth imaging program of an SD-OCT (Heidelberg Engineering, Germany). Age, sex, refractive error, and best-corrected visual acuity were also recorded. Results: The average peripapillary CT was greater in amblyopic eyes than in the fellow eyes of the children with amblyopia (P = 0.002), and control eyes (P < 0.001). There was no significant difference between the fellow eyes of children with amblyopia and the control eyes (P = 0.158). The average peripapillary CT was negatively correlated with axial length (AL) in amblyopic eyes (r = -0.381; P = 0.005) and fellow eyes (r = -0.392; P = 0.004) but not in control eyes (r = -0.232; P = 0.325). After adjustment for the possible effects of AL, the average peripapillary CT in amblyopic eyes was still greater than in fellow eyes (P = 0.014) and control eyes (P = 0.022). Conclusion: The peripapillary choroid of eyes with amblyopia was thicker than that of the fellow eyes and control eyes. No significant difference was observed between fellow eyes and control eyes.Öğe Assessment of Monocyte/HDL Ratio in Branch Retinal Vein Occlusion(Taylor & Francis Inc, 2020) Satirtav, Gunhal; Mirza, Enver; Oltulu, Refik; Mirza, Gunsu Deniz; Kerimoglu, HurkanPurpose: The purpose of this article was to evaluate monocyte count and high-density lipoprotein (HDL) cholesterol levels and their ratio (monocyte/HDL ratio [MHR]) in patients with branch retinal vein occlusion (BRVO). Materials and Methods: A total of 50 participants were included in the study. Participants were divided into two groups: Twenty-five patients diagnosed with BRVO and 25 participants as the control group. Ocular examination findings and hematologic parameters were accessed from the file records and database, retrospectively. Results: The mean MHR was significantly higher in BRVO group compared to the control group (13.4 +/- 5.2 vs. 8.1 +/- 2.2, p < 0.001). In receiver operating characteristics analysis, the area under the curve for MHR was 0.862, and an MHR of >9.5 predicted BRVO with a sensitivity of 76% and specificity of 70.8%. Conclusion: The present study showed that elevated MHR is significantly associated with BRVO. Therefore, MHR may be a useful marker for the emergence of BRVO.Öğe The Causes and Frequency of Monocular and Binocular Blindness in Adults Applying to the Health Committee of a University Hospital in Central Anatolia(Galenos Publ House, 2021) Mirza, Gunsu Deniz; Okka, Mehmet; Mirza, Enver; Belviranli, SelmanObjectives: The aim of this study was to investigate the frequency of blindness and the pathologies that cause blindness in the Konya province of Turkey. Materials and Methods: The records of individuals over 18 years of age who applied to the health committee of Meram School of Medicine Hospital between January 2015 and December 2018 were evaluated retrospectively. Results: After reviewing the records of 4,268 applicants, a total of 222 applicants were included in the study (159 patients with monocular blindness, 63 patients with binocular blindness). The most common causes of monocular blindness were optic atrophy (13%), amblyopia (11%), and phthisis bulbi (10%). The most common causes of binocular blindness were retinitis pigmentosa (28%), proliferative diabetic retinopathy (13%), and unoperated cataract (11%). The frequency of monocular blindness was 3.7% (95% confidence interval [CI]: 3.2-4.3%) and binocular blindness was 1.5% (95% CI: 1.1-1.9%) in the sample. The frequency of blindness increased with age, with a positive correlation between mean age and blindness (p=0.002). Monocular blind applicants had a significantly lower mean age than binocular blind applicants (48.8 +/- 13.3 vs. 55.0 +/- 13.1 years, p=0.002) and binocular blind women had a significantly higher mean age than binocular blind men (62.7 +/- 16.0 vs. 53.2 +/- 11.7 years, p=0.023). The prevalence of monocular and binocular blindness was significantly higher in men than women (p=0.032). Conclusion: The results of this study show that many of the pathologies that cause blindness are preventable or treatable, and that blindness is associated with age.Öğe Conjunctival Impression Cytology and Dry Eye in Patients With Ulcerative Colitis: A Pilot Study(Lippincott Williams & Wilkins, 2018) Oltulu, Pembe; Oltulu, Refik; Asil, Mehmet; Satirtav, Gunhal; Mirza, EnverPurpose: The aim of this study was to compare signs of dry eye between ulcerative colitis (UC) patients and healthy subjects. Methods: Fifteen patients with UC (group 1) and 15 healthy subjects (group 2) were enrolled in this study. Tear volume measurement, Schirmer-I test with no anesthetic, tear break-up time, and conjunctival impression cytology (CIC) were evaluated in both groups. Results: Patients with UC showed lower tear volumes when compared with healthy subjects (P<0.05). There was a statistically significant difference in distribution of CIC grades between groups 1 and 2 (P<0.05). Tear break-up time and Schirmer-I measurements were significantly lower in group 1 compared with group 2 (P<0.05). Conclusions: The results of this study indicate that UC is associated with demonstrable disturbances in tear function and conjunctival cytology.Öğe Conjunctival impression cytology and tear film parameters in patients with multiple sclerosis(Springer, 2022) Belviranli, Selman; Oltulu, Pembe; Uca, Ali Ulvi; Gundogan, Ali Osman; Mirza, Enver; Altas, Mustafa; Turk, NazliPurpose To evaluate conjunctival impression cytology (CIC) findings and tear film parameters in patients with multiple sclerosis (MS) compared with controls. Methods Thirty-three patients with MS (MS group) and 33 age- and sex-matched healthy subjects (control group) were included in this cross-sectional comparative study. CIC grades, tear break-up time (TBUT), Schirmer 1 test results, and Ocular Surface Disease Index (OSDI) scores were compared between the two groups, and correlations between CIC grade, TBUT, Schirmer 1 test result, OSDI score, Expanded Disability Status Scale score, and disease duration were analyzed. Results Mean CIC grade was higher in the MS group than in the control group (1.48 +/- 0.71 and 0.39 +/- 0.56, respectively; p < 0.001). In the MS group, CIC of the 14 participants (42.4%) was grade 2-3. In the control group, CIC of the only one participant (3.3%) was grade 2, and none of them was grade 3. TBUT (8.12 +/- 3.16, 13.06 +/- 4.23 s in MS and control groups, respectively; p < 0.001) and Schirmer 1 test results (8.45 +/- 5.75, 17.36 +/- 10.89 mm in MS and control groups, respectively; p < 0.001) were lower, and OSDI score (36.36 +/- 19.19, 13.70 +/- 15.36 in MS and control groups, respectively; p < 0.001) was higher in the MS group compared to the control group. Conclusion In patients with MS, objective findings of dry eye, subjective symptoms related to dry eye, and CIC abnormalities, including high grades of conjunctival squamous metaplasia and goblet cell loss, are more common. Patients with MS should be monitored for ocular surface alterations and dry eye disease.Öğe Dry eye disease and ocular surface characteristics in patients with keratoconus(Wolters Kluwer Medknow Publications, 2022) Mirza, Enver; Oltulu, Refik; Oltulu, Pembe; Mirza, Gunsu D.; Okka, MehmetPURPOSE: The purpose of this study is to investigate the ocular surface alterations in patients with mild or severe keratoconus (KC). METHODS: A total of 80 participants were included in the study. The corneal topography was performed on each participant using Pentacam and the grouping was done accordingly. The patients with Kmax >= 52.0 D (severe KC) were considered Group 1 (n = 28), the patients with Kmax >= 47.2 and <52.0 D (mild KC) were considered Group 2 (n = 30). Healthy control participants with Kmax <47.2 D were considered Group 3 (n = 22). Tear breakup time (TBUT), Schirmer-I test, ocular surface disease index (OSDI) questionnaire, and conjunctival impression cytology (CIC) were evaluated among the groups. RESULTS: The mean values of TBUT and Schirmer-I test were significantly lower (P = 0.012, P = 0.012) and the mean scores of OSDI and CIC were significantly higher (P = 0.006, P < 0.001) in Group 1 and Group 2 than in Group 3. The mean values of TBUT and Schirmer-I test were lower and the mean scores of OSDI and CIC were higher in Group 1 than in Group 2 but the differences were insignificant (P > 0.05 for all). CONCLUSION: These results indicated that the tests associated with dry eye disease are correlated with KC. Tear film alterations and goblet cell loss are higher in severe KC.Öğe Evaluation of inflammatory biomarkers in patients with keratoconus(Sage Publications Ltd, 2022) Oltulu, Refik; Katipoglu, Zeynep; Gundogan, Ali Osman; Mirza, Enver; Belviranli, SelmanObjective: To investigate the monocyte-to-HDL-cholesterol ratio (MHR), neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), eosinophil-to-lymphocytes ratio (ELR), platelet distribution width (PDW), red blood cell distribution width (RDW), mean platelet volume (MPV), MPV to platelet count ratio (MPV/PC), and RDW to platelet ratio (RPR) that are accepted as inflammatory markers in patients with keratoconus. Methods: In this study, 43 patients with keratoconus and 43 healthy individuals as the control group were retrospectively evaluated. High density lipoprotein cholesterol (HDL-c), lymphocyte, neutrophil, eosinophil, monocyte, platelet, MPV, PDW, and RDW values were obtained with complete blood count performed on the peripheral blood samples. Results: Absolute monocyte (593 +/- 182 vs 492 +/- 177; p < 0.05) and neutrophil (4860 +/- 1553 vs 3954 +/- 1297; p < 0.01) counts were statistically significantly higher in the keratoconus groups compared to the control group. MHR (13.18 +/- 5.02 vs 9.88 +/- 4.45; p < 0.01) and NLR (2.30 +/- 0.87 vs 1.77 +/- 0.61; p < 0.01) were statistically significantly higher and LMR (4.07 +/- 1.67 vs 5.18 +/- 2.06; p < 0.01) was significantly lower in the keratoconus group. As a result of univariate logistic regression analysis, it was observed that MHR and NLR were statistically significant relationship with keratoconus (p = 0.02 and p = 0.021) (Odds ratio = 5.41 (95% CI: 1.169-6.669) and Odds ratio:5.28 (95% CI: 1.024-6.321); respectively). No statistically significant difference was found between the groups in terms of PLR, ELR, RDW, MPV, PDW, MPV/PC, and RPR. Adjusting for age and gender, multivariate regression analysis revealed that MHR was the most significant parameter to demonstrate relationship with keratoconus (p = 0.025) (Odds ratio = 4.99 (95% CI: 1.019-6.332)). Conclusion: MHR and NLR values considered as inflammatory markers were statistically significantly higher and LMR value was significantly lower in the keratoconus group. Among these values, MHR was the most reliable parameter.Öğe Evaluation of The Effect of Intraocular Silicone Oil on Retinal Nerve Fiber Layer Thickness in Patients Treated with Pars Plana Vitrectomy and Endolaser for Rhegmatogenous Retinal Detachment(2018) Mirza, Enver; Gündüz, Mehmet Kemal; Şatırtav, Günhal; Kerimoğlu, Hürkan; Mirza, Günsu DenizPurpose: To evaluate the effect of silicone oil (SiO) on retinal nerve fi ber layer thickness (RNFLT) by using optical coherence tomog-raphy in patients who underwent pars plana vitrectomy and SiO injection for retinal detachment.Material and Methods: A total of 50 eyes of 50 patients were retrospectively enrolled in this study. 34 patients (68%) were male,16patients (32%) were female. SiO was injected in 50 eyes and the healty fellow eyes (50 eyes) were evaluated as controls. RNFLT mea-surements were compared with the control eyes,one and three months after PPV and one month after SiO removal.Results: In siliconized eyes the temporal, inferotemporal,nasal,inferonasal quadrants and global measurements were signifi cantly thi-cker at fi rst month after PPV compared to controls (p0.001,p0.001,p0.044,p0.002,p0.001 respectively). Temporal quadrantand global measurements were signifi cantly thicker at third month after PPV (p0.001,p0.034). At fi rst month after SiO removal, thetemporal, nasal quadrants, global measurements were signifi cantly thicker (p0.004,p0.01,p0.018). Also siliconized eyes RNFLTmeasurements were evaluated between fi rst, second and third visit separately. Almost there was no signifi cant difference in quadrantsfor the measurements of the subsequent visits.Conclusions: A transient increase in RNFLT in some of the quadrants compared to the control eyes was found in the study due to thepresence of SiO in the globe.Öğe Evaluation of the Systemic Inflammation in Patients with Pterygium: Monocyte-to- High-Density Lipoprotein Cholesterol Ratio and Hematologic Indexes of Inflammation(Wolters Kluwer Medknow Publications, 2021) Belviranli, Selman; Oltulu, Refik; Gundogan, Ali O.; Mirza, Enver; Okka, MehmetPURPOSE: The purpose of this study is to evaluate systemic inflammation in patients with pterygium using the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and hematologic indexes of inflammation. METHODS: Thirty-one patients with primary pterygium and 31 age-and sex-matched healthy participants were enrolled in this retrospective study. The MHR, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, monocyte-to-eosinophil ratio, mean platelet volume-to-platelet count ratio, platelet distribution width, and red cell distribution width were compared between the two groups. RESULTS: There was not a statistically significant difference in terms of the MHR between the pterygium group and the control group (P = 0.693). The NLR was higher in the pterygium group than in the control group (P = 0.028). In the other hematologic indexes, there were no statistically significant differences between the two groups (P > 0.05 for all). CONCLUSION: The MHR is not associated with the presence of pterygium. An increased NLR in patients with pterygium may be an indicator of systemic inflammation.Öğe The Frequency and Causes of Blindness in a Rural Region of Central Anatolia of Turkey(Aves, 2019) Mirza, Enver; Mirza, Gunsu Deniz; Oltulu, Refik; Okka, Mehmet; Ozkagnici, AhmetObjective: This study aimed to evaluate the frequency and primary causes of blindness in adults aged 18 years and more in Sarikaya rural region of Yozgat, Turkey, to contribute to the epidemiologic information about blindness in our country. Materials and Methods: Patients who were examined between October 2016 and March 2017 in Sarikaya State Hospital, Clinic of Ophthalmology, were prospectively investigated. Demographic and ophthalmic examination data, presented visual acuities (VA), primary causes of blindness, and monocular blindness were recorded. Blindness was defined as presented visual acuities (VA) definition of World Health Organization criteria. Results: A total of 3423 participants, aged 18-96 years, were examined. Among them, 1887 participants (55%) were female and 1536 (45%) were male. The frequency of blindness was 15% (95% CI: 1.1%-2.0(%); and cataract was the primary cause of blindness (42%). Age-related macular degeneration (21%) and uncorrected refractive error (13%) were the next main causes of blindness. The frequency of monocular blindness was 4% (95% CI: 3.8%-5.2%), and cataract (27%) followed by phthisis bulbi/evisceration (13%) and glaucoma (12%) were the leading causes of monocular blindness. Conclusion: In this rural region of Central Anatolia, the primary cause of blindness and monocular blindness was an unoperated cataract. The patterns of age-specific causes of blindness are variable, but most of them are avoidable or treatable. Thus, awareness should be increased in societies, and people should be prevented from blindness with health-care programs in rural regions of developing countries.Öğe Ganglion cell complex thickness changes in patients with different states of bipolar disorder(Springernature, 2022) Cokunlu, Yusuf; Mirza, Enver; Caliskan, Ali Metehan; Inanli, Ikbal; Cicek, Ismet Esra; Ozcimen, Muammer; Eren, IbrahimObjectives Neuroimaging studies in patients with bipolar disorder have suggested that a neuropathological process may be effective in this disease. Neurodegenerative changes in the retina can be followed by optical coherence tomography, a non-invasive imaging method that allows in vivo visualization of the retinal layers. The aim of this study was to investigate the possible differences in optical coherence tomography parameters during euthymic, manic, and depressive episodes in patients diagnosed with bipolar disorder. Methods A total of 150 patients with bipolar disorder were included in the study, divided into three groups (50 patients in a euthymic state, 50 patients in a manic state, and 50 patients in a depressive state) and compared with 50 healthy controls. Ganglion cell complex thickness was measured with automated macular segmentation software of spectral-domain optical coherence tomography. Results Ganglion cell complex thicknesses were thicker in all quadrants in patient groups than the control group but the differences were significant in perifoveal superior and perifoveal inferior quadrants (p < 0.001, p < 0.001). There were no differences in ganglion cell complex thickness among the patient groups (p > 0.05). Conclusion The evaluation of ganglion cell complex thickness by spectral-domain optical coherence tomography may give a clue for monitoring neurodegenerative changes in patients with bipolar disorder.Öğe Impact of unilateral trigeminal neuralgia on bilateral ocular surface alterations(Wiley, 2022) Altas, Mustafa; Oltulu, Pembe; Uca, Ali Ulvi; Belviranli, Selman; Gundogan, Ali Osman; Mirza, Enver; Oltulu, RefikObjective To evaluate ocular surface alterations in both eyes of patients with unilateral trigeminal neuralgia (TN) compared with controls. Background Corneal nerves mainly originate from the trigeminal nerve, and neurosensory abnormalities are important factors in ocular surface alterations and dry eye etiopathogenesis. Methods Twenty-four patients with idiopathic unilateral TN and 24 healthy controls with similar sex and age distributions were included in this cross-sectional study conducted from February 15 to September 15, 2021. The eyes on the affected sides of the patients with TN were treated as Group 1, their contralateral eyes as Group 2, and the right eyes of the controls as Group 3. All participants were evaluated for tear film and ocular surface using the Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and conjunctival impression cytology grading. Results The mean (SD) ages of the patients with TN (17 of 24 females, 70.8%) and controls (15 of 24 females, 62.5%) were 49.7 (11.7) and 48.5 (9. 6) years, respectively. The median [25th, 75th percentile] Schirmer 1 test results in Groups 1, 2, and 3 were 5.0 [4.0, 14.0], 7.0 [3.2, 11.7], and 10.0 [6.0, 15.7] mm, respectively, with no statistically significant differences between Groups 1 and 2 (p = 0.697), Groups 1 and 3 (p = 0.133), or Groups 2 and 3 (p = 0.129). The median TBUT scores in Groups 1, 2, and 3 were 7.0 [5.0, 10.0], 8.0 [5.2, 10.0], and 12.5 [8.0, 13.0] s, respectively, showing reduced times for both Groups 1 and 2 versus Group 3 (median difference = -3.0 [95% CI: -5.0, -1.0], p = 0.001, and median difference = -3.0 [95% CI: -5.0, -2.0], p = 0.001, respectively). Conjunctival impression cytology grades were significantly higher in Groups 1 and 2 versus Group 3 (median difference = 2.0 [95% CI: 1.0, 2.0], p < 0.001, and median difference = 1.0 [95% CI: 1.0, 2.0], p < 0.001, respectively). The median OSDI score in TN patients (30.2 [25.0, 34.9]) was significantly higher than in the controls (8.3 [0.0, 18.7]), with a median difference of 20.8 (95% CI: 14.7, 27.1), p < 0.001. Conclusion Even if pain is unilateral in patients with TN, there are significant abnormalities in conjunctival cytology and tear functions in both eyes. There seem to be various pathophysiological mechanisms of TN that affect the bilateral ocular surface and lead to significant alterations.Öğe İntraoküler silikon yağının retina sinir lifi kalınlığına etkisinin optik koherens tomografi ile değerlendirilmesi(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2016) Mirza, Enver; Gündüz, Mehmet Kemalİntraoküler silikon yağı (SiY) verilerek başarılı pars plana vitrektomi (PPV) ile regmatojen retina dekolmanı (RD) onarımı yapılan hastalarda peripapiller retina sinir lifi tabakası (RSLT) kalınlığının optik koherens tomografi (OKT) ile değerlendirilmesi. Gereç ve Yöntem: Toplam 50 hastanın 50 gözü çalışmaya dahil edildi. Hastaların % 68'i (n=34) erkek, % 32'si (n=16) kadındı. 1000 centistokes (cst) SiY (n=37) ve ağır SiY (n=13) olmak üzere iki tip SiY uygulandı ve hastaların diğer sağlam gözü kontrol olarak değerlendirildi. Tüm olgularda Spectralis® OKT cihazı kullanılarak peripapiller RSLT kalınlığı PPV sonrası 2. haftadaki, PPV sonrası 3. aydaki ve SiY alındıktan sonra 1. aydaki alınmış ölçümleri değerlendirildi. Peripapiller RSLT kalınlıkları kadranlar halinde 3 ölçüm arasında, kontrol gözleri ile ve iki tip SiY arasında karşılaştırıldı. Bulgular: Silikonize gözlerin RSLT ölçümleri incelendiğinde PPV sonrası 3. aydaki ölçümlerde genel olarak PPV sonrası 2. haftadaki ilk ölçümlere kıyasla kalınlık artışı söz konusudur. Fakat bu kalınlık artışı global olarak (p=0,011) ve yalnızca nazal kadranda (p=0,004) istatistiksel olarak anlamlıdır. SiY alımı sonrası 1. aydaki ölçümde ise bu fark istatistiksel olarak anlamını kaybetmiştir. PPV sonrası 3. aydaki ve SiY alımı sonrası 1. aydaki ölçümler kıyaslandığında, ayrıca PPV sonrası 2. haftadaki ölçümler ile SiY alımı sonrası 1. aydaki ölçümler kıyaslandığında RSLT kalınlıklarında istatistiksel olarak anlamlı fark bulunmamıştır. Silikonize gözler ile kontrol gözlerin RSLT kalınlık ölçümleri karşılaştırıldığında ise PPV sonrası 2. haftada global (p<0,001), temporal superior (p<0,001), temporal inferior (p=0,001), nazal superior (p=0,044) ve nazal inferior (p=0,002) kadranların RSLT ölçümleri silikonize gözlerde anlamlı düzeyde daha kalındı. PPV sonrası 3. ayda silikonize gözlerin aynı şekilde global (p=0,034) ve temporal superior (p=0,001) kadrana ait ölçümleri kontrol gözlere göre anlamlı derecede kalındı. SiY alımından 1. ay sonraki ölçümlerde ise global (p=0,018) ve temporal superior (p=0,004) kadranın yanı sıra nazal superior (p=0,010) kadranda da silikonize ve kontrol gözler arasında anlamlı farklılık görülmüştür. Normal ve ağır SiY uygulanan gözlerin RSLT ölçümleri kıyaslandığında PPV sonrası 2. haftadaki ölçümde normal SiY uygulanan gözlerde inferonazal kadranda istatistiksel olarak anlamlı kalınlaşma (p=0,027) görülse de bu farklılık diğer iki ölçümde azalmış ve istatistiksel değerini kaybetmiştir (p=0,882, p=0,576). Diğer ölçümlerde ise SiY tipleri arasında RSLT kalınlığında anlamlı fark görülmemiştir. Sonuç: Bu çalışmada ortalama 3 aylık takipte RD onarımı yapılan vitrektomize gözlere uygulanan silikon yağının peripapiller RSLT kalınlığı üzerinde belirgin bir etkisinin olmadığı tespit edilmiştir. Kontrol gözler ile silikonize gözlerin RSLT kalınlıkları kıyaslandığında ise global olarak özellikle de temporal kadranlarda silikonize gözlerin RSLT'da kalınlık artışı söz konusudur. Uygulanan iki SiY tipi arasında değerlendirilen diğer parametrelerde belirgin fark olmadığı görülmüştür.Öğe Kubbe şekilli makülalı bir olguda eşlik eden foveal seröz retina dekolmanı - Klinik seyir ve literatür özeti(2017) Oltulu, Refik; Şatırtav, Günhal; Okka, Mehmet; Kerimoğlu, Hürkan; Mirza, EnverYüksek miyop hastalarda, optik koherens tomografi (OKT) ile görülen posterior stafi lom içerisindeki makülanın konveks protrüzyonu Gaucher ve arkadaşları tarafından Kubbe şekilli maküla (Dome Shaped Makula - KŞM) olarak tanımlanmıştır. KŞM'ya seröz retina dekolmanı (SRD), retina pigment epitel (RPE) düzensizlikleri veya koroidal neovaskülarizasyon (KNV) gibi görme keskinliğinin azalmasından sorumlu olan bazı komplikasyonlar eşlik edebilmektedir. Eşlik eden bu komplikasyonlara yönelik görüş birliğine varılmış bir tedavi şekli bulunmamaktadır.KŞM'ya eşlik eden SRD nedeniyle birkaç yıldır sağ gözde görme azlığı olan 51 yaşındaki kadın olgu kliniğimizde takip edilmekteydi. En iyi düzeltilmiş görme keskinliği (EİDGK) sağ gözde 6/10, sol gözde 10/10 düzeyindeydi. Yaklaşık 1 yıllık takibinde EİDGK'nin SRD'a rağmen stabil kaldığı gözlendi ancak 18. ayda subretinal sıvıda artış ve EİDGK'nde azalma meydana geldi. Bu nedenle hastanın sağ gözüne 1 ay ara ile 2 doz intravitreal Anti-VEGF (ranibizumab) enjeksiyonu yapıldı. Sonraki kontrollerinde enjeksiyona yanıt alınamadığı görüldü. Olgu ek müdahale yapılmadan yakın takip edildi. Son enjeksiyondan yaklaşık 8 ay sonra optik koherens tomografi (OKT) tetkikinde foveadaki SRD'nın spontan olarak yatıştığı ve sağ gözde EİDGK'nin 7/10 düzeyine çıktığı görüldü. SRD'nın spontan regresyonunu takiben hasta 6 ay aynı görme düzeyi ve nüks olmadan takip edildi. Bu olgu sunumunda SRD'nın eşlik ettiği komplike KŞM'lı bir hastanın yaklaşık 3 yıllık takibi sonucunda SRD'nın kendiliğinden gerilediği sürecin paylaşılması amaçlanmıştırÖğe May Monocyte/HDL Cholesterol Ratio (MHR) and Neutrophil/Lymphocyte Ratio (NLR) Be an Indicator of Inflammation and Oxidative Stress in Patients with Keratoconus?(Taylor & Francis Inc, 2020) Katipoglu, Zeynep; Mirza, Enver; Oltulu, Refik; Katipoglu, BilalObjective: To evaluate monocyte/high-density lipoprotein cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) in patients with keratoconus (KC). Methods: Thirty-one patients with KC (group 1) and 31 healthy control subjects (group 2) were included in the study. All participants' ocular examination findings, clinical and laboratory parameters were obtained from file records and laboratory archives. Results: When group 1 was compared with group 2, MHR (13.7 +/- 5.0 vs. 9.1 +/- 3.7; p < .001) and NLR (2.3 +/- 0.8 vs. 1.7 +/- 0.6; p < .001) were statistically significantly higher in group 1. Optimal MHR cutoff value for KC was calculated as 10.2 with 77.4% sensitivity and 64.5% specificity, and optimal NLR cut-off value for KC was found as 1.9 with 71.4% sensitivity and 55% specificity. Conclusion: MHR and NLR values recognized as indicators of oxidative stress and systemic inflammation were significantly higher in patients with KC compared to the control group.Öğe Mesenteric Fibromatosis Due to Malignant Hypertension: A Case Report(2018) Mirza, Enver; Özkağnıcı, Ahmet; Nazmi, Zengin; Okka, Mehmet; Mirza, DenizVR is a rare condition that causes a sudden vision loss. Although VR is considered to be rare but a serious complication of surgery. Ourcase was a 64 years old woman was presented with preretinal haemorrhage including macular area in right eye secondary to VR afteran uneventful cataract surgery under general anesthesia. Her vision was counting fi ngers after the surgery. Although surgical correctionor Nd:YAG laser hyaloidotomy was available she was treated with single intravitreal TPA, intravitreal bevacizumab and 0.2cc SF6 gaseinjection. There was signifi cant reduction of premacular haemorrhage and her vision improved to 7/10 after injection on the fi nal visit.Öğe Monocyte/HDL Ratio and Lymphocyte/Monocyte Ratio in Patients with Pseudoexfoliation Syndrome(Taylor & Francis Inc, 2020) Mirza, Enver; Oltulu, Refik; Katipoglu, Zeynep; Mirza, Guensu Deniz; Ozkagnici, AhmetPurpose: To evaluate the association between monocyte count/high-density lipoprotein (HDL) ratio (MHR) and lymphocyte count/monocyte count ratio (LMR) with pseudoexfoliation syndrome (PEXS) and pseudoexfoliation glaucoma (PEXG). Materials and Methods: A total of 63 participants included in the study. Participants were divided into three groups. Twenty-one patients with PEXS regarded as group 1, 21 patients with PEXG regarded as group 2 and 21 participants without PEXS or PEXG regarded as the control group. Blood parameters were accessed from file records and database retrospectively. Results: The mean MHRs were significantly higher in group 1 and group 2 (p = 0.003, p = 0.036) than the control group, whereas there was no difference between group 1 and group 2 (p = 0.686). The mean LMRs were lower in group 1 and group 2 than the control group but the difference was insignificant (p = 0.232). Conclusion: We found that there is an association between higher MHR and lower LMR with PEXS.Öğe The ocular surface findings in alopecia areata patients: clinical parameters and impression cytology(Springer, 2022) Oltulu, Pembe; Oltulu, Refik; Turk, Huseyin Bugra; Turk, Nazli; Kilinc, Fahriye; Belviranli, Selman; Mirza, EnverPurpose The objective of this study was to examine the effects of alopecia areata (AA) on the ocular surface and conjunctival cytology. Methods A total of 48 subjects were included in the present study. Twenty-three subjects were assigned to group 1 as the patient group, and 25 healthy individuals were included in group 2 as the control group. The ocular surface examination was performed, and the right eyes of all participants were included in the analysis. Both groups underwent the following tests for evaluation of ocular surface: tear break-up time (TBUT), Schirmer I test, Ocular Surface Disease Index (OSDI), and conjunctival impression cytology (CIC). Results obtained from the tests were then analyzed and compared between the groups. Results The mean TBUT value was significantly lower in Group 1 compared to Group 2 (4.96 +/- 3.4 vs 10.52 +/- 4.8 s) (p < 0.001). There was no significant difference between Group 1 and Group 2 in terms of the mean Schirmer I test score (p = 0.129). The mean OSDI score was higher in Group 1 compared to Group 2 (15.48 +/- 10.4 vs 9.61 +/- 13.4), but the difference between both groups was not statistically significant (p = 0.1). The mean CIC score was statistically significantly higher in Group 1 than in Group 2 (1.65 +/- 0.7 vs 0.52 +/- 0.5) (p < 0.001). Conclusion The results of this study showed that AA was correlated with significant disturbances in conjunctival cytology and the tear function.Öğe Ocular-symptoms-related Google Search Trends during the COVID-19 Pandemic in Europe(Springer, 2021) Mirza, Enver; Mirza, Gunsu Deniz; Belviranli, Selman; Oltulu, Refik; Okka, MehmetPurpose To investigate the correlation between the daily relative search volume (RSV) of keywords related to coronavirus and ocular symptoms, and the numbers of the daily coronavirus disease 2019 (COVID-19) new cases and new deaths in Europe using Google Trends (GT). Methods The RSVs of the selected keywords related to coronavirus and ocular symptoms between 24 January and 1 June 2020 in the United Kingdom, Spain, Italy, Germany and Turkey were accessed from GT. The numbers of daily COVID-19 new cases and new deaths in the same time interval in the aforementioned countries were compared with the RSVs of the keywords and terms. Results The United Kingdom, Spain, Italy, Germany, and Turkey were the most affected countries from the COVID-19 pandemic in Europe. In these countries, statistically significant and strong correlations were found between the daily RSVs of most keywords related to coronavirus and ocular symptoms, and the daily numbers of COVID-19 new cases and new deaths ranging from 0.175 to 0.807. Conclusions Ocular symptoms are not the frequent signs of COVID-19, but the ocular surface is a possible route for the transmission of COVID-19. The preliminary outcomes of this study demonstrated that there are significant correlations with the ocular symptoms and COVID-19. The news about the relation of eye and COVID-19 in the mass media may have influenced the Google internet search activity of the public for ocular symptoms.Öğe The outcomes of intravitreal C3F8 gas tamponade combined with laser photocoagulation treatment for optic disc pit maculopathy(Springer, 2022) Mirza, Gunsu Deniz; Mirza, Enver; Satirtav, Gunhal; Kerimoglu, HurkanPurpose To share the anatomical results and visual outcomes of intravitreal gas tamponade combined with laser photocoagulation treatment for optic disc pit maculopathy (ODPM). Methods Intravitreal gas tamponade combined with laser photocoagulation treatment was performed on six consecutive patients with ODPM. A 0.3 mL of 100% perfluoropropane (C3F8) gas was injected intravitreally. The patients were then asked to maintain prone position until the C3F8 gas disappeared. Laser photocoagulation was performed the day after the procedure. The outcomes were determined by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA). Results In the present study, visual improvement and reduction in serous macular detachment were observed in 83% of the ODPM patients. Complete retinal reattachment was achieved in 66% of the ODPM patients. In one patient, no regression was observed after the repeated treatment, and pars plana vitrectomy was performed. The final BCVA improved in five eyes and unchanged in one eye. No postoperative complications were observed during the follow-up period in any patient. Conclusions Intravitreal C3F8 gas tamponade combined with laser photocoagulation procedure is an effective, minimally invasive, and cost-effective treatment method for ODPM.
