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    Acute effects of caffeine on choroidal thickness and ocular pulse amplitude
    (Taylor & Francis Ltd, 2016) Dervisogullari, Mehmet Serdar; Totan, Yuksel; Yuce, Aslihan; Kulak, Ali Ender
    Objective: To explore ocular changes in healthy people after caffeine consumption.Methods: This prospective observational study was carried out with students of the Turgut ozal University Medical Faculty from May 15 to 15 December 2014. Enrolled in the study were 17 healthy subjects (n=17 eyes), with a median age of 24 (IQR 1), ranging between 21 and 26 years. The control group (6 females, 11 males) aged between 23 and 28 (median 25 years [IQR 4.75]). For study, one eye from each participant was randomly selected. To obviate the effect of diurnal variations, tests were performed at the same time of the day (10:00a.m.-12:00p.m.). Each subject was given an ophthalmologic examination before the study to exclude those with undiagnosed ocular disease. Version 6.0 Cirrus high-definition optical coherence tomography (HD-OCT) (Carl Zeiss Meditec, Dublin, CA) was used to measure CT at the fovea, and 1500m nasal and 1500m temporal to the fovea. After baseline OCT measurements, participants were asked to have 200mg oral caffeine intake or a placebo capsule (200mg lactose powder). Two further OCT measurements were applied at the first and fourth hours of caffeine intake. All participants also had intraocular pressure (IOP) and ocular pulse amplitude (OPA) measurements recorded before, first and fourth hours of caffeine intake. IOP and OPA were measured using the dynamic contour tonometry (DCT) (Swiss Micro Technology AG, Port, Switzerland).Results: The groups showed no significant difference by means of age, gender, spherical refraction and axial length (p>0.05). Baseline choroidal thickness measurements of the study and control group showed no significant difference. Oral caffeine intake caused a significant reduction in choroidal thickness compared with baseline, at all three measurement points, (p<0.05). There were no significant changes in IOP and OPA measurements compared with the baseline values (p>0.05). The choroidal thickness still continued to decrease for at least 4h following caffeine intake; whereas, the difference between 1 and 4h was not statistically significant (p>0.05). However, choroidal thicknesses, IOP and OPA values of the control group revealed no significant difference at all points when comparing measurements at baseline with 1 and 4h after placebo intake (p>0.05).Conclusions: We found no significant change in IOP and OPA following oral 200mg caffeine intake, while CT significantly decreased, for at least 4h.
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    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 Feyzi
    Objective: 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.
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    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 Feyzi
    Purpose: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.
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    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, Gaye
    Purpose: 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.
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    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 Betul
    Purpose: 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.
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    Optik biyometri ve ultrason biyometri ile alınan ölçümlerin aksiyel uzunluk, göz içi lens gücü ve refraktif sonuçlar açısından karşılaştırılması
    (Turgut Özal Üniversitesi, 2015) Kulak, Ali Ender; Totan, Yüksel
    Amaç: Yeni parsiyel koherens interferometri (Nidek AL-Scan) ve Aplanasyon A-Scan Ultrason biyometri ile elde edilen biyometrik parametrelerin ve refraktif sonuçların karşılaştırılması ve iki yöntemin birbirinin yerine kullanılabilirliğini belirlemek. Gereç ve Yöntem: Bu prospektif çalışmaya katarakt cerrahisi uygulanacak 125 hastanın 150 gözü dahil edildi. Tüm hastalara AL-Scan ve Ultrason ile ölçüm alındı. Her iki yöntemle elde edilen Aksiyel Uzunluk (AU), Ön Kamara Derinliği (ÖKD) ve Göz İçi Lens (GİL) gücü değerleri arasındaki korelasyon ve uyum, Pearson korelasyon ve Bland-Altman analizi ile değerlenidirldi. Her bir yöntem için ameliyat sonrası 1.ayda ölçülen Sferik eşdeğer (SE) refraksiyon ile hedeflenen SE refraksiyon arasındaki fark karşılaştırıldı. Bulgular: AL-Scan ile ölçülen ortalama aksiyel uzunluk Ultrason ile karşılaştırıldığında 0.11 ± 0.13 mm daha uzundu (p<0.001). Pearson korelasyon analizi iki cihaz arasında AU ve GİL gücü değerleri çok iyi korelasyon göstermekteydi (r>0.90, p<0.05). ÖKD ise iyi korelasyon göstermekteydi. Bland-Altman analizinde her iki yöntem ile elde edilen tüm verilerin %95 uyum aralığı klinik olarak kabul edilebilir sınırlarda idi ve yöntemler arasında iyi uyum mevcuttu. AL-Scan ile elde edilen mutlak refraktif hata SRK-T formülüne göre 0.20 ± 0.17 D iken, US ile 0.29 ± 0.25 D idi. (p<0.001) Sonuç: Her iki yöntem ile elde edilen GİL gücü ve AU değerleri benzerdi ve birbiriyle iyi uyum göstermektedir ve cihazlar arası ölçüm farkları klinik olarak ihmal edilebilir düzeydedir. Bu nedenle iki yöntem birbirinin yerine kullanılabilir.
  • Küçük Resim Yok
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    Optik biyometri ve ultrason biyometri ile alınan ölçümlerin aksiyel uzunluk, göz içi lens gücü ve refraktif sonuçlar açısından karşılaştırılması
    (Turgut Özal Üniversitesi, 2015) Kulak, Ali Ender; Totan, Yüksel
    Amaç: Yeni parsiyel koherens interferometri (Nidek AL-Scan) ve Aplanasyon A-Scan Ultrason biyometri ile elde edilen biyometrik parametrelerin ve refraktif sonuçların karşılaştırılması ve iki yöntemin birbirinin yerine kullanılabilirliğini belirlemek. Gereç ve Yöntem: Bu prospektif çalışmaya katarakt cerrahisi uygulanacak 125 hastanın 150 gözü dahil edildi. Tüm hastalara AL-Scan ve Ultrason ile ölçüm alındı. Her iki yöntemle elde edilen Aksiyel Uzunluk (AU), Ön Kamara Derinliği (ÖKD) ve Göz İçi Lens (GİL) gücü değerleri arasındaki korelasyon ve uyum, Pearson korelasyon ve Bland-Altman analizi ile değerlenidirldi. Her bir yöntem için ameliyat sonrası 1.ayda ölçülen Sferik eşdeğer (SE) refraksiyon ile hedeflenen SE refraksiyon arasındaki fark karşılaştırıldı. Bulgular: AL-Scan ile ölçülen ortalama aksiyel uzunluk Ultrason ile karşılaştırıldığında 0.11 ± 0.13 mm daha uzundu (p<0.001). Pearson korelasyon analizi iki cihaz arasında AU ve GİL gücü değerleri çok iyi korelasyon göstermekteydi (r>0.90, p<0.05). ÖKD ise iyi korelasyon göstermekteydi. Bland-Altman analizinde her iki yöntem ile elde edilen tüm verilerin %95 uyum aralığı klinik olarak kabul edilebilir sınırlarda idi ve yöntemler arasında iyi uyum mevcuttu. AL-Scan ile elde edilen mutlak refraktif hata SRK-T formülüne göre 0.20 ± 0.17 D iken, US ile 0.29 ± 0.25 D idi. (p<0.001) Sonuç: Her iki yöntem ile elde edilen GİL gücü ve AU değerleri benzerdi ve birbiriyle iyi uyum göstermektedir ve cihazlar arası ölçüm farkları klinik olarak ihmal edilebilir düzeydedir. Bu nedenle iki yöntem birbirinin yerine kullanılabilir.
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    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 Feyzi
    PURPOSE: 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.