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Öğe Brilliant Blue G assisted Epiretinal Membrane Surgery(Nature Portfolio, 2014) Totan, Yuksel; Guler, Emre; Dervisogullari, Mehmet SerdarWe report intensely staining epiretinal membrane (ERM) with Brilliant Blue G (BBG) under air for two minutes. ERM peeling was performed in 21 cases. After removal of posterior hyaloid, 0.2 mL BBG was first applied on the macula, to stain ERM under air conditions for 2 minutes. Internal limiting membrane (ILM) was intensely stained and peeled in all cases following ERM removal. In 4 cases, the ERM was also observed to be intensely stained with BBG and peeled with an ILM forceps. Postoperatively, the ganglion cell layer thickness was lower in three of the cases, however VA improved in all cases and multifocal electroretinogram revealed no toxicity. Light microscopy of ERM revealed masses of cells whereas; the ILM did not. The increased staining characteristics of ERM and ILM may be resulted from longer contact time of BBG under air pressure.Öğe Brilliant blue G assisted macular surgery: the effect of air infusion on contrast recognisability in internal limiting membrane peeling(Bmj Publishing Group, 2015) Totan, Yuksel; Guler, Emre; Guragac, Fatma B.; Uzun, Erkam; Dogdu, ErdoganBackground To evaluate the potential efficacy and safety of inner limiting membrane (ILM) staining with brilliant blue G (BBG) under air infusion. Methods 63 patients, treated by one surgeon with macular hole or idiopathic epiretinal membrane were evaluated prospectively. BBG was applied under air infusion in 38 patients (group 1), and injected into the vitreous cavity in 25 (group 2). Main outcome measures were the chromaticity difference between the stained ILM and the unstained underlying retina, anatomical-functional outcomes and complications of the surgery. Chromaticity difference was measured by an objective and quantitative analysis method to describe colour contrast strengths as they are perceived by the human eye. Anatomical and functional outcomes were assessed using optical coherence tomography (OCT), visual field analyses (VFA) and multifocal electroretinography (mfERG). Results CIELAB scores showed a significantly superior contrast for group 1 (16.72 +/- 2.36) than group 2 (10.34 +/- 1.29) (p<0.001). Visual acuity had increased in 28 eyes and remained stable in 10 eyes in group 1. In group 2, visual acuity had improved in 17 patients and remained unchanged in 8 patients. Based on postoperative OCT, anatomical success rate was 100%. During the follow-up period, mfERG and VFA demonstrated no case of BBG toxicity in either group. Cataract progression was the main postoperative complication (six eyes in group 1 and four eyes in group 2) and did not show a significant difference between the groups (p=0.45). Conclusions BBG under air infusion yields a significantly higher contrast staining and easy peeling of ILM associated with anatomical and functional improvement and no retinal toxicity after macular surgery.Öğe Choroidal thickness measurement in healthy pediatric population using Cirrus HD optical coherence tomography(Consel Brasil Oftalmologia, 2015) Tenlik, Aylin; Guragac, Fatma B.; Guler, Emre; Dervisogullari, Mehmet Serdar; Totan, YukselPurpose: To investigate the association between central choroidal thickness (CT), axial length (AL), age, gender, and refractive error in a healthy pediatric population using optical coherence tomography (OCT). Methods: This institutional study involved 137 healthy children (57 boys, 80 girls) aged between 4 and 18 years. Each child underwent a dilated eye examination, cycloplegic refraction, and AL measurement using a Nidek AL-Scan optical biometer. The central foveal thickness (CFT) and CT were measured using Cirrus high definition (HD)-OCT. The right eye of each subject was selected for analysis. Results: The mean age of the children was 10.0 +/- 4.7 years (range, 4-18 years). The mean spherical equivalent (SE) was -0.24 +/- 1.24 diopters (D) (range, -2.00 D to +/- 2.25 D). The mean AL was 23.1 +/- 1.2 mm (range, 20-27 mm). The mean central CT was 388.2 +/- 50.0 mu m and was not correlated with age, gender, AL, or refractive error. Conclusions: The data provide a pediatric normative database of CT using enhanced depth imaging OCT. This information may be useful in the diagnosis and monitoring of retino-choroidal diseases in children.Öğe Combined 20-and 23-gauge pars plana vitrectomy(Consel Brasil Oftalmologia, 2015) Totan, Yuksel; Guler, Emre[Abstract Not Available]Öğe Comparison of a new optical biometry with an optical low-coherence reflectometry for ocular biometry(Elsevier Science Bv, 2016) Guler, Emre; Kulak, Ali Ender; Totan, Yuksel; Yuvarlak, Armagan; Hepsen, Ibrahim FeyziObjective: To evaluate the repeatability and agreement of a new partial coherence interferometry optical biometer (AL-Scan, Nidek CO, Aichi, Japan) with optical low-coherence reflectometry device (Lenstar LS 900, Haag-Streit AG, Koniz, Switzerland). Methods: Three consecutive measurements with the 2 devices were performed by the same examiner in 65 eyes of 65 patients with cataract. Patients were divided into 2 groups: axial length (AL) between 22 and 26 mm (Group 1) and more than 26 mm (Group 2). Comparisons were performed for AL, anterior chamber depth (ACD), keratometry (K, over 2.4 mm diameter for AL-Scan and 2.3 mm diameter for Lenstar) and corneal diameter (CD). Repeatability was analyzed using the intraclass correlation coefficient (ICC) and the agreement was by the Bland-Altman method. Results: The repeatability of both devices was high for all biometry measurements (ICC over 0.970) in Group 1 and 2. The best repeatability was achieved for AL in each group. In both groups, the differences were statistically significant for all parameters (p < 0.05) except for the measurement of AL and CCT (p > 0.05). The Bland-Altman analysis showed good agreement between devices for all measurements in both groups. The closest agreement was for the AL measurements (ranged from -0.06 to 0.08 mm in Group 1 and 0.05-0.07 mm in Group 2). Conclusions: The new biometer provided excellent repeatability for all ocular biometry. In addition, there was good agreement between AL-Scan and Lenstar biometers for all parameters in cataractous patients with medium and long ALs. (C) 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.Öğe Comparison of Anterior Segment Measurements With a Dual Scheimpflug Placido Corneal Topographer and a New Partial Coherence Interferometer in Keratoconic Eyes(Lippincott Williams & Wilkins, 2015) Yagci, Ramazan; Kulak, Ali Ender; Guler, Emre; Tenlik, Aylin; Guragac, Fatma Betul; Hepsen, Ibrahim FeyziPurpose:To evaluate the repeatability and agreement of the anterior segment measurements obtained using the Galilei dual Scheimpflug analyzer (Galilei DSA; Ziemer) and Nidek AL Scan (Nidek CO, Aichi, Japan) biometry in keratoconic and normal eyes.Methods:Three consecutive measurements were performed by the same examiner using both devices in 62 healthy and 88 keratoconic eyes. Central corneal thickness (CCT), anterior chamber depth, keratometry readings (K) [in flattest meridian (Kf), in steepest meridian (Ks), and mean (Km)], and white-to-white distance were evaluated. Repeatability was assessed by calculating the within-subject SD and coefficient of variation. The agreement between both devices was assessed using the Bland-Altman method.Results:Both devices achieved excellent repeatability for all parameters in each group. The 95% limits of agreement (LoA) between both devices were also very narrow and acceptable for all parameters in normal corneas. However, the 95% LoA for agreement was large for CCT and measurements related to K (Kf, Ks, and Km) using both 2.4 and 3.3 mm in keratoconic eyes. In addition, compared with the Galilei DSA, K values of the Nidek AL Scan using a diameter of 3.3 mm showed slightly closer 95% LoA than those obtained using a diameter of 2.4 mm.Conclusions:In normal eyes, the Galilei DSA and Nidek AL Scan can be used interchangeably for anterior segment measurements. In keratoconic eyes, both devices yielded interchangeable anterior chamber depth and white-to-white distance measurements, whereas CCT and keratometry measurements showed clinically significant differences.Öğe Comparison of Central Corneal Thickness, Thinnest Corneal Thickness, Anterior Chamber Depth, and Simulated Keratometry Using Galilei, Pentacam, and Sirius Devices(Lippincott Williams & Wilkins, 2014) Anayol, Mustafa A.; Guler, Emre; Yagci, Ramazan; Sekeroglu, Mehmet A.; Yilmazoglu, Meltem; Tirhis, Hakan; Kulak, Ali E.Purpose: The aim was to evaluate the agreement in the central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior chamber depth (ACD), and mean simulated keratometry (simK) measurements using Pentacam, Galilei, and Sirius Scheimpflug systems in normal eyes. Methods: Anterior segment measurements were performed with Pentacam, Galilei, and Sirius devices in 32 healthy subjects. The right eye of each participant was selected. Measurements obtained with the 3 systems were compared using repeated-measures analysis of variance and Bonferroni multiple comparisons test. Results: Analysis of variance determined a significant difference in the anterior segment measurements of CCT, TCT, ACD, and simK between the 3 devices (P < 0.001). Pairwise comparisons of CCT and TCT measurements were significantly different except for the comparison between Pentacam and Sirius. All pairwise comparisons for ACD were statistically significant. The pairwise comparison results for simK values showed that the Galilei and Sirius systems demonstrated better agreement with each other than with Pentacam. Conclusions: The results of this study suggest that the Pentacam, Galilei, and Sirius Scheimpflug systems should not be accepted as interchangeable for CCT, TCT, ACD, and simK in healthy subjects.Öğe Cystoid Macular Edema Associated With Juvenile Idiopathic Arthritis Resolved by a Dexamethasone Intravitreal Implant(Slack Inc, 2014) Totan, Yuksel; Guler, Emre; Guragac, Fatma B.; Dervisogullari, Mehmet S.; Tenlik, Aylin; Hepsen, Ibrahim F.Uveitis, glaucoma, and cystoid macular edema frequently develop in patients with juvenile idiopathic arthritis. The authors describe a case of cystoid macular edema associated with juvenile idiopathic arthritis that had not responded to intravitreal triamcinolone acetonide and bevacizumab but improved significantly following intravitreal injection with a dexamethasone 0.7 mg implant.Öğe Dexamethasone Intravitreal Implant for Chronic Diabetic Macular Edema Resistant to Intravitreal Bevacizumab Treatment(Taylor & Francis Inc, 2016) Totan, Yuksel; Guler, Emre; Guragac, Fatma BetulPurpose: To evaluate the safety and efficacy of intravitreal dexamethasone implant (Ozurdex) in patients with chronic diabetic macular edema (DME) resistant to prior intravitreal bevacizumab (IVB) treatment. Materials and Methods: Thirty eyes of 30 patients were administered intravitreal Ozurdex and examined at baseline and 1, 3, and 6 months postinjection in this prospective study. Main outcomes were the best corrected visual acuity (BCVA, logMAR), central foveal thickness (CFT), mean cube volume (MCV), and intraocular pressure (IOP). Patients had a CFT over 275 mu m (measured by OCT) and were unresponsive to 3 consecutive IVB injections. All data are presented as meanstandard deviation. Results: The mean BCVA significantly increased from 0.56 +/- 0.38 to 0.41 +/- 0.27 (p<0.001), and 0.44 +/- 0.28 (p=0.008) at 1 and 3 months, respectively. At months 1, 3, and 6, the mean CFT significantly decreased from 517 +/- 136 mu m at baseline, to 290 +/- 60 mu m (p<0.001), 314 +/- 88 mu m (p<0.001) and 411 +/- 126 mu m (p=0.01), respectively. However, the mean CFT (p<0.001) and MCV (p=0.01) significantly increased and BCVA significantly decreased (p=0.04) at 6 month compared to 3 month. Compared to baseline, IOP increased significantly at 1 week (p=0.01), 1 month (p=0.01) and 3 months (p=0.04). However eyes with IOP higher than 21mmHg were treated and well controlled with topical anti-glaucoma monotherapy. Macular edema recurrence occurred in 25 eyes (CFT ranged from 321 mu m to 800 mu m) at 6 months. Conclusion: Dexamethasone intravitreal implant may be an effective and safe alternative in treatment of chronic DME nonresponsive to regular IVB. However, its therapeutic efficacy decreases between the third and sixth months following the injection.Öğe Effect of smoking on retina nerve fiber layer and ganglion cell-inner plexiform layer complex(Taylor & Francis Ltd, 2015) Dervisogullari, Mehmet Serdar; Totan, Yuksel; Tenlik, Aylin; Yuce, Aslihan; Guler, EmrePurpose: The aim of this study is to show the effects of smoking on retina layers, especially retina nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer complex (GCIPL). Materials and methods: Participants smoking for more than 10 years at least 1 pack of cigarettes a day and a control group, both including participants between ages of 20 and 50 years with no other systemic or ocular diseases were studied. After normality tests, an independent sample t test was used to analyze the differences in age, sex, spherical equivalent (SE), intraocular pressure (IOP), axial length (AL), GCIPL and RNFL values between the groups. Results: There were 44 participants in each group. There were 32 (62.5%) men and 12(37.5%) women in smokers and 36 (77.88%) men and 8 (22.22%) women in control group. Mean ages were 39.85 +/- 8.41 and 38.66 +/- 10.47 years, mean spherical equivalent (SE) values were +/- 0.15 +/- 0.4 and 0 +/- 0.29 dioptries in smokers and control groups, respectively. The IOP, AXL, GCIPL and RNFL values were 17.58 +/- 3.41 mmHg, 23.69 +/- 0.56 mm, 84.3 +/- 5.83 mu m and 92.3 +/- 3.51 mu m in the smokers group and 18.5 +/- 2.91 mmHg, 23.45 +/- 0.72 mm, 86.11 +/- 8.02 mu m and 97.66 +/- 8.23 mu m in the control group. The inferior, superior, nasal and temporal values of RNFL quadrants were 123.18 +/- 26.14, 117.05 +/- 5.51, 64.95 +/- 8.67 and 63.5 +/- 6.88 mu m in the smokers group and 130.81 +/- 11.8, 123.55 +/- 11.03, 72.44 +/- 9.84 and 58.44 +/- 7.48 mu m in the control group. There were no significant difference of age, sex, SE, IOP, AXL and GCIPL values between the smokers and control groups (p>0.05). The mean RNFL was significantly thinner in the smokers group compared to controls (p = 0.03, independent t test). Inferior and superior quadrants of RNFL decreased in smokers group (p = 0.01 and p = 0.03, respectively) but temporal and nasal quadrants did not seem to be changed (p = 0.96 and p = 0.07, respectively). Discussion: Smoking may affect RNFL thickness but not GCIPL.Öğe Efficacy of Modified 360-degree Suture Trabeculotomy for Pseudoexfoliation Glaucoma(Lippincott Williams & Wilkins, 2016) Hepsen, Ibrahim F.; Guler, Emre; Kumova, Deniz; Tenlik, Aylin; Kulak, Ali Ender; Yazici, Eroglu Hulya; Disli, GayePurpose: In this prospective study, we aimed to investigate the success and safety of a modified 360-degree suture trabeculotomy (ST) technique in patients with pseudoexfoliation glaucoma (XFG). Patients and Methods: The modified 360-degree ST was performed on 15 eyes of 15 patients with XFG resistant to maximal topical treatment. In 6 patients, ST was combined with phacoemulsification. Main outcome measures were the surgical success rate, mean postoperative intraocular pressure (IOP), the number of anti-glaucoma medications, and the operative complications. Results: The mean follow-up period was 8 months (range 6 to 12 mo). Baseline IOP decreased from 27.53 +/- 9.38 mm Hg on 3.26 +/- 0.70 medications to 12.86 +/- 2.72 mm Hg (P = 0.01) on 0.20 +/- 0.56 medications (P = 0.01) at 6 months postoperatively accounting for a 52.82% reduction. The complete and qualified success rates were 77% and 100%, respectively, at the sixth month. The entire circumference of the Schlemm canal was successfully opened in all cases. Hyphema (in all cases), intraoperative iris prolapse (in 3 cases), transient elevation of the IOP (in 1 case), posterior synechia (in 2 phakic cases), and peripheral anterior synechia (in 1 case) were noted. There was not a trend for lower IOP after combined phacomodified 360-degree ST in this small group. Conclusions: The modified 360-degree ST appears to be a valuable option for the surgical treatment of XFG. Future studies are needed to explore the remote side effects and the long-term effects of this procedure on IOP.Öğe Evaluation of Aqueous Endocan and Endostatin Levels in Patients With Pseudoexfoliation Syndrome(Lippincott Williams & Wilkins, 2019) Yagci, Ramazan; Dervisogullari, Serdar; Guler, Emre; Totan, Yueksel; Hepsen, Ibrahim F.Purpose: The purpose of the present study was to evaluate the aqueous humor endocan and endostatin levels in patients with pseudoexfoliation (PEX) syndrome and to compare the results with healthy individuals. Materials and Methods: Twenty nine cataract patients with PEX syndrome (PEX group) and 32 cataract patients without PEX syndrome (control group) were enrolled in the study. Endocan and endostatin were measured in the aqueous humor of the PEX and control groups by enzyme-linked immunosorbent assay. Results: There was no difference between the PEX and control groups in terms of age (P=0.721) and sex (P=0.902). The aqueous levels of endocan in patients with PEX (26.39 +/- 5.80 pg/mL) was significantly higher than in the control group (11.42 +/- 2.44 pg/mL) (P=0.039). The aqueous levels of endostatin was 12.00 +/- 1.35 ng/mL in the PEX group and 14.22 +/- 3.31 ng/mL in the control group, however, the difference was not statistically significant (P=0.41). Conclusions: The findings of the present study could suggest that the increased levels of aqueous endocan may be related to pathogenesis of PEX. However, levels of aqueous endostatin did not show any significant difference in PEX.Öğe Evaluation of Choroidal Thickness in Amblyopia Using Enhanced Depth Imaging Optical Coherence Tomography(Taylor & Francis Inc, 2015) Tenlik, Aylin; Guler, Emre; Kulak, Ali Ender; Totan, Yuksel; Dervisogullari, Mehmet Serdar; Guragac, Fatma BetulPurpose: To evaluate the choroidal thickness (CT) in hyperopic anisometropic amblyopic eyes, fellow non-amblyopic eyes, and age-matched normal eyes, using spectral-domain optical coherence tomography (SD-OCT). Materials and methods: In total 53 subjects (17.8 +/- 11.0 years, mean +/- SD) with hyperopic anisometropic amblyopia (AE) and 53 age-matched controls (17.7 +/- 11.0 years) were included in this prospective study. Each subject underwent a dilated eye examination, cycloplegic refraction and axial length (AL) measurement using Nidek AL-Scan optical biometer (Nidek CO, Aichi, Japan). The CT of subfoveal area and at a radius of 1 and 3mm around the fovea was determined using the enhanced depth imaging program of a SD-OCT (Cirrus HD OCT, Carl-Zeiss Meditec, Dublin, CA). CT, AL and spherical equivalent refraction (SER) of the amblyopic eyes were compared to that of the fellow and control eyes. Results: The mean subfoveal CTwas 305.6 +/- 26.0 mm in the amblyopic eyes, 282.6 +/- 30.7 mm in the fellow eyes and 280.1 +/- 8.8 in the control eyes. The subfoveal choroid in amblyopic eyes was significantly thicker than that of the fellow eyes and control eyes (p<0.001). There was a significant negative correlation between the subfoveal CT and the AL in amblyopic (r=-0.298, p=0.03) eyes but not in the control and fellow eyes. Conclusions: The subfoveal choroid of eyes with hyperopic AE is significantly thicker than that of the fellow eye and the age-matched controls. Hence, CT seems to be effected in AE.Öğe Evaluation of the Retinal Ganglion Cell Layer Thickness in Healthy Turkish Children(Lippincott Williams & Wilkins, 2015) Totan, Yuksel; Guragac, Fatma B.; Guler, EmrePurpose:To identify the distribution, variation, and determinants of ganglion cell-inner plexiform layer (GC-IPL) thickness in healthy Turkish children measured by high-definition optical coherence tomography (HD-OCT).Patients and Methods:This institutional study involved 296 eyes from 296 healthy children aged between 3 and 17 years. Each child underwent a dilated eye examination, cycloplegic refraction, and axial length measurement using Nidek AL-Scan optical biometer. Macular scan was used to measure the GC-IPL thickness, and peripapillary retinal nerve fiber layer (RNFL) thickness was measured using the HD-OCT (Cirrus HD-OCT). Right eye of each subject was selected for analysis.Results:A total of 296 children (125 boys, 171 girls) were included in this study. The mean age of the children was 9.624.10 years (range, 3 to 17 y). The mean spherical equivalent was -0.09 +/- 1.49 D. The mean AL was 23.03 +/- 1.03 mm. The mean overall GC-IPL thickness was 83.44 +/- 5.52 m and RNFL thickness was 96.91 +/- 10.21 m. They were thicker than has been reported in adults. According to age-adjusted multiple regression analyses significant predictors of mean GC-IPL thickness were peripapillary RNFL thickness and AL (P<0.001).Conclusions:This study ensures a pediatric normative database of GC-IPL using spectral-domain OCT. This information may provide to diagnosis and monitoring of optic nerve diseases and glaucoma in children.Öğe Influences of Topical Cyclopentolate on Anterior Chamber Parameters With a Dual-Scheimpflug Analyzer in Healthy Children(Slack Inc, 2015) Guler, Emre; Guragac, Fatma Betul; Tenlik, Aylin; Yagci, Ramazan; Arslanyilmaz, Zeynel; Balci, MehmetPurpose: To evaluate the changes of anterior segment parameters following the topical instillation of cyclopentolate hydrochloride 1% with the Galilei dual-Scheimpflug analyzer (GSA) (Ziemer Ophthalmology Co., Port, Switzerland) in healthy children. Methods: Fifty children (29 boys, 21 girls) were evaluated before and 60 minutes after instillation of three drops of 1% cyclopentolate hydrochloride using the GSA. The measurements before and after cycloplegia, including anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), central corneal thickness (CCT), and pupil size, were evaluated using the paired t test. Results: The mean age of the patients was 10.27 +/- 3.32 years (range: 5 to 15 years). Measurements between the two sessions were significantly different for all parameters (P < .05), except for CCT (P > .05). Conclusions: The GSA demonstrated a statistically significant increase in ACD, ACV, ACA, and pupil size following the topical application of cyclopentolate hydrochloride 1%. These results should be considered during biometric measurement and refractive surgery planning.Öğe Intravitreal bevacizumab and dexamethasone implant for treatment of chronic diabetic macular edema(Taylor & Francis Ltd, 2017) Guler, Emre; Totan, Yuksel; Guragac, Fatma BetulObjective: To evaluate anatomical and functional outcomes of intraviteal bevacizumab (IVB) in patients with chronic diabetic macular edema (DME), and the effectivity and safety of dexamethasone implant in those unresponsive to regular IVB treatment. Methods: Thirty-five eyes of 35 patients (16 male and 19 female) with chronic DME (central foveal thickness (CFT) >275m, duration >6 months) received three injections of 2.5mg IVB with six-week intervals. At 18 weeks, dexamethasone implant was applied to patients unresponsive to IVB. Main outcomes were the change in best corrected visual acuity (BCVA), CFT and ocular and systemic adverse effects for both drugs. The patients responsive to IVB were followed up for 36 weeks and those patients receiving dexamethasone implant were followed up for 24 weeks postoperatively. Results: At 18 weeks, the mean BCVA (0.68 +/- 0.40 logMAR, p=0.45) and CFT (453 +/- 169m, p=0.58) did not show any significant change compared to baseline (0.74 +/- 0.42 logMAR and 521 +/- 151m, respectively). In 20 patients (%57.1) responsive to IVB, the CFT was significantly improved from 12 to 36 weeks with the mean value of 295 +/- 42 (p=0.01). However, no significant difference was observed for BCVA during this period (p=0.17). Dexamethasone was implanted in 15 eyes (42.8%) unresponsive to IVB at 18 weeks. Statistically significant improvements were observed in BCVA (at postoperative 4 and 12 weeks) and CFT (at postoperative 4, 12 and 24 weeks). In addition, both parameters significantly worsened at 24 weeks compared to 12 weeks (p<0.001 and p=0.01, respectively). Conclusions: Patients with chronic DME should be followed in accordance with a fixed treatment protocol combining anti-VEGF and steroid treatments.Öğe Normative Spectral Domain Optical Coherence Tomography Data in Healthy Turkish Children(Taylor & Francis Inc, 2017) Guragac, Fatma Betul; Totan, Yuksel; Guler, Emre; Tenlik, Aylin; Ertugrul, Ihsan GokhanPurpose: To determine the normative database of macular and retinal nerve fiber layer (RNFL) thickness parameters in healthy Turkish children by OCT. Methods: 318 eyes of 318 children (138 boys, 183 girls) aged between 3 and 17 years were evaluated. The children were scanned by Cirrus HD-OCT (Carl Zeiss Meditec) to measure the macula, RNFL, and optic nerve head parameters. Results: Axial length (AL) (p <0.001, R-2 = 0.08), spherical equivalent (SE) (p < 0.001, R-2 = 0.12), and rim area (p <0.001, R-2 = 0.15) were the strongest predictors of RNFL thickness. All of the macular measurements were significantly related to age (p <0.001, R-2 > 5%). Average macular thickness (p < 0.01) and outer macula (p = 0.002) showed significant relationship with the AL and SE. Conclusion: This study ensures an age-adjusted pediatric normative database using OCT to diagnose and monitor macular diseases, optic nerve diseases, and glaucoma in children.Öğe Repeatability and reproducibility of a new optical biometer in normal and keratoconic eyes(Elsevier Science Inc, 2015) Yagci, Ramazan; Guler, Emre; Kulak, Ali Ender; Erdogan, Beyza Doganay; Balci, Mehmet; Hepsen, Ibrahim FeyziPURPOSE: To evaluate the repeatability and reproducibility of measurements obtained by a new optical biometer (Nidek AL-Scan) in normal eyes and keratoconic eyes. SETTING: Department of Ophthalmology, Turgut ozal University, Medical School, Ankara, Turkey. DESIGN: Evaluation of diagnostic technology. METHODS: To assess the repeatability and reproducibility of the optical biometer, 2 independent examiners performed 3 consecutive measurements. The following parameters were evaluated: central corneal thickness (CCT), anterior chamber depth, axial length (AL), corneal dioptric power in the flattest meridian (flat keratometry [K]) and in the steepest meridian (steep K), and white-to-white (WTW) distance. Repeatability was assessed using the within-subject standard deviation (S-w), repeatability, and precision. Reproducibility was evaluated using the 95% limits of agreement proposed by Bland and Altman. RESULTS: Thirty healthy subjects and 27 patients with keratoconus were evaluated. Both examiners achieved high repeatability for all parameters in each group except for the steep K measurement in keratoconic eyes performed by examiner 2 (S-w = 3.341). The WTW in normal eyes and the CCT and steep K in keratoconic eyes showed less repeatability. In both groups, the smallest range of agreement was in AL measurements whereas the largest was in CCT measurements. In keratoconic eyes, the range of agreement for steep K was also greater (3.766). CONCLUSIONS: The precision of the measurements obtained by the new optical biometer was high.Öğe Repeatability and Reproducibility of Anterior Segment Measurements in Normal Eyes Using Dual Scheimpflug Analyzer(Turkish Ophthalmological Soc, 2015) Altiparmak, Zeynep; Yagci, Ramazan; Guler, Emre; Arslanyilmaz, Zeynel; Canbal, Metin; Hepsen, Ibrahim F.Objectives: To assess the repeatability and reproducibility of anterior segment measurements including aberrometric measurements provided by a dual Scheimpflug analyzer (Galilei) system in normal eyes. Materials and Methods: Three repeated consecutive measurements were taken by two independent examiners. The following were evaluated: total corneal power and posterior corneal power, corneal higher-order wavefront aberrations (6.0 mm pupil), pachymetry at the central, paracentral, and peripheral zones, and anterior chamber depth (ACD). Repeatability was assessed by calculating the within subject standard deviation, precision, repeatability, and intraclass correlation coefficient (ICC). Bland-Altman analysis was used for assessing reproducibility. Results: Thirty eyes of 30 patients were included. The best ICC values were for corneal pachymetry and ACD. For both observers, acceptable ICC was also achieved for the other parameters, the only exceptions being posterior corneal astigmatism and total high order aberration. The 95% LoA (Limits of Agreement) values for all measurements showed small variability between the two examiners. Conclusion: The Galilei system provided reliable measurements of anterior segment parameters. Therefore, the instrument can be confidently used for routine clinical use and research purposes.Öğe Repeatability and reproducibility of Galilei measurements in normal keratoconic and postrefractive corneas(Elsevier Science Bv, 2014) Guler, Emre; Yagci, Ramazan; Akyol, Mesut; Arslanyilmaz, Zeynel; Balci, Mehmet; Hepsen, Ibrahim F.Objective: To assess the repeatability and reproducibility of the anterior segment measurements performed with a dual Scheimpflug analyzer (Galilei) in normal, keratoconic and post-refractive surgery corneas. Methods: To evaluate the repeatability, two additional measurements were performed by the first examiner. To assess reproducibility, this was later followed by a single reading by the second examiner. The following parameters were recorded and evaluated in this study; central corneal thickness (CCT), thinnest corneal thickness (TCT), mean total corneal power (TCP) in central (0-4 mm), mean posterior corneal power (PCP) in central (0.5-2 mm), anterior and posterior elevation (best fit sphere [BFS]) in central 8 mm anterior and posterior eccentricity (epsilon(2)) in central 8 mm. Repeatability and reproducibility for each corneal parameter was assessed using the Bland-Altman analysis. Results: Each of the three groups was consisted of 20 subjects (totally 60 patients, 30 men and 30 women). The 95% LoA for repeatability was very small, indicating small discrepancies between measurements related to CCT. Acceptable repeatability was also achieved for the other parameters in each group. However, the 95% LoA for value TCP was larger in keratoconic eyes. The 95% LoA for reproducibility was also very small, and acceptable for all measured parameters in each group. In addition, the 95% LoA was larger for the measurement of CCT and TCT for postrefractive corneas. Conclusions: The anterior segment measurements provided by Galilei showed good repeatability and reproducibility for normal, keratoconic and postrefractive corneas. (C) 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
