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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 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 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.Öğe Unilateral Spontaneous Descemet Membrane Rupture in a Case With Megalophthalmos(Lippincott Williams & Wilkins, 2018) Guler, Emre; Totan, Yuksel; Hepsen, Ibrahim F.; Tenlik, AylinObjective: To report a case of unilateral spontaneous descemet membrane rupture associated with megalophthalmos. Methods: A case report of a 23-year-old woman with blurred vision of the right eye for 6 months due to spontaneous descemet membrane rupture associated with megalophthalmos is described. Slit-lamp examination demonstrated corneal edema and suggestion of a descemet membrane rupture in the right eye. Results: Anterior segment optical coherence tomography verified the presence of a ruptured descemet membrane separated from the nasal posterior cornea along with corneal edema and intraepithelial cystic lesions. With A-scan ultrasonography, axial lengths were 32 and 28 mm in OD and OS, respectively. Indirect gonioscopy demonstrated a wide iridocorneal angle and a ciliary body band, bilaterally. Corneal pachymetry measurements were performed with Pentacam HR Scheimpflug topography which measured the central corneal thickness 360 mu in OD and 300 mu in OS. Conclusions: Megalophthalmos and spontaneous descemet membrane rupture are rare conditions. To the best literature knowledge, this is the first report of descemet membrane rupture in megalophthalmos.
