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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 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 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 Effect of positive end-expiratory pressure administration on intraocular pressure in laparoscopic cholecystectomy Randomised controlled trial(Lippincott Williams & Wilkins, 2016) Karabayirli, Safinaz; Cimen, Nuran Kavun; Muslu, Bunyamin; Tenlik, Aylin; Gozdemir, Muhammet; Sert, Huseyin; Hepsen, Ibrahim Feyzi[Abstract Not Available]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 Effects of cigarette smoking on choroidal and retinal thickness and ocular pulse amplitude(Taylor & Francis Ltd, 2015) Dervisogullan, Mehmet Serdar; Totan, Yuksel; Tenlik, Aylin; Yuce, AslihanBackground: In our study, we aimed to show the effects of smoking on choroidal thickness and ocular pulse amplitude. It is known that the anatomy and physiologic functions of the choroid is important in ocular diseases like glaucoma and age-related macular degeneration. Choroidal thickness is measured by the spectral domain optical coherence tomography (SD-OCT). The ocular pulse amplitude (OPA) is the difference between the systolic and diastolic intraocular pressure (IOP) and it is an index of choroidal perfusion. Design: This was a cross-sectional prospective observational study at the Turgut Ozal University Hospital setting. Participants: The test subjects were divided into two groups: the smokers group which consisted in 24 participants (20 male, 4 female) and the control group with 22 participants (16 male, 6 female). Methods: The participants underwent full ophthalmological examination including best-corrected visual acuity (BCVA), spherical equivalent (SE) values of refractive errors, intraocular pressure (IOP), ocular pulse amplitude (OPA), central corneal thickness (CCT), axial length (AL) and choroidal thickness. The IOP and the OPA were measured with the dynamic contour tonometer. The CCT and the AL were measured with the Nidek AL-Scan (Nidek Co., Ltd., Gamagori, Japan). The choroidal thickness was measured by the Cirrus high-definition optical coherence tomography (Cirrus Version 6.0; Carl Zeiss Meditec, Dublin, CA). Results: Gender did not differ significantly between the groups (p = 0.12). The age, SE, IOP, OPA, CCT and AL did not differ significantly in smokers and control groups (p = 0.12, p = 0.37, p = 0.54, p = 0.80, p = 0.56 and p = 0.82, respectively). The nasal, temporal, central retinal (p = 021, p = 021, p = 0.11) and nasal, temporal, central choroidal thicknesses (p = 0.80, p = 0.39, p = 0.75) did not differ significantly between smokers and control groups. Conclusions: We could not find a significant difference in OPA, retinal and choroidal thicknesses between smokers and non smokers. Further studies including histopathological changes in larger groups are needed to show the effect of smoking on choroidal thickness especially in patients with ocular diseases like age-related macular degeneration.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 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 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 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 Phakic pattern pseudoexfoliation material accumulation on intraocular lens surface(Turkish Ophthalmology Society info@oftalmoloji.com, 2014) Güler, Emre; Tenlik, Aylin; Kara Akyüz, Tuba; Erdurmuş, Mesut; Feyzi Hepşen, IbrahimPseudophakic pseudoexfoliation is the accumulation of pseudoexfoliation material on the intraocular lens. Most of the cases have showed scattered flecks of pseudoexfoliation material on the surface of the intraocular lens. However, the phakic pattern consisting of classic three-zone on the intraocular lens is rarely observed. In this case report, we describe a phakic pattern pseudoexfoliation material on the intraocular lens surface 8 years after cataract extraction. © 2014 Elsevier B.V., All rights reserved.Öğe Surgical Results in Unilateral Superior Oblique Muscle Palsy(Turkish Ophthalmological Soc, 2014) Tenlik, Aylin; Duranoglu, Yasar; Ilhan, Hatice DenizObjectives: To evaluate the surgical treatments and results of the patients with superior oblique muscle palsy (SOMP). Materials and Methods: Clinical charts of the patients with unilateral SOMP who were operated in our clinic between 1999 and 2009 were evaluated retrospectively. Patients' demographics, preoperative signs, surgical procedure, complications, and final results were recorded. Results: Thirty-seven patients were included in the study, [21 (59%) male, 15 (41%) female]. The mean age was 20.6 years at the time of operation. The mean time interval between diagnosis and operation was 7.3 years. Postoperative follow-up period was 2.04 (ranging 1-10) years. Diplopia was determined in seven (18.9%) patients, and abnormal head position in 36 (97.3%) patients. Only inferior oblique tenotomy with distal muscle resection was performed in 25 patients. In addition, five patients had recession of the contralateral inferior rectus muscle and two patients had recession of the ipsilateral superior rectus muscle additional to inferior oblique tenotomy. Abnormal head position was completely improved in all of the patients postoperatively. The preoperative average score of the inferior oblique muscle (IOM) overaction was + 3.3 +/- 0.8, and postoperative overaction was found in only two patients (+ 1.5). There was statistically significant difference between the two periods (p < 0.001). The average score of the superior oblique muscle hypofunction was -2.18 preoperatively, and in only three patients, the score was found -1.0 postoperatively. Difference between the two periods was statistically significant (p < 0.001). While the preoperative average vertical deviation was 22 PD in primary position, none of the patients had hyperdeviation postoperatively. Diplopia was resolved in all seven affected patients postoperatively. Contralateral IOM hyperfunction was the most common complication (13.5%). Adherence syndrome was seen in none of the patients. Conclusion: It was found that to weaken the IOM solely was satisfactory in the patients with hyperdeviation secondary to unilateral SOMP in this study.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.
