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Öğe Anti-inflammatory effect of cortistatin in rat endotoxin-induced uveitis model(Wolters Kluwer Medknow Publications, 2020) Balbaba, Mehmet; Dal, Ali; Çolakoğlu, Neriman; Bulmuş, Özgür; Ulaş, Fatih; Yıldırım, Hakan; Aydemir, OrhanPurpose: To evaluate the anti-inflammatory effect of cortistatin (CST) in endotoxin-induced uveitis (EIU) model and to compare the results with corticosteroid treatment. Methods: A total of 35 healthy Wistar albino rats were randomly divided into five groups. EIU was induced by a single subcutaneous injection of lipopolysaccharide (LPS). Group I received intraperitoneal (ip) normal saline (NS), Group II received ip 150 mu g LPS plus NS, Group III received ip 150 mu g LPS plus 250 mu g/kg CST, Group IV received ip 150 mu g LPS plus 1mg/kg dexamethasone, and Group V received ip 250 mu g/kg CST only. The aqueous humor was collected 24 h after injection and the infiltrating cells were determined. Moreover, histopathological and immunohistochemical examinations were also performed. Results: The clinical score and infiltrated cell count were reduced in Groups III and IV compared with Group II (P < 0.001). The pathological findings of Groups III and IV were significantly reduced compared with Group II (P < 0.001). These findings were similar between Groups III and IV (P = 1.000). Tumor necrosis factor-alpha (TNF-alpha) and interleukin 1 beta (IL-1 beta) immunoreactivity in the ciliary body of Group III and Group IV were significantly reduced compared with Group II (P < 0.001). TNF- and IL-1 beta immunoreactivity in the ciliary body of Group III and Group IV were similar compared with Group I and Group V (range of P values was 0.539-0.958). Conclusion: CST administration as a therapeutic agent might ameliorate the severity of intraocular inflammation in uveitis patients. In conclusion, effect of CST and dexamethasone in EIU model was comparable.Öğe Association of dehydroepiandrosterone sulfate, serum lipids, C-reactive protein and body mass index with age-related macular degeneration(Springer, 2013) Ulaş, Fatih; Balbaba, Mehmet; Özmen, Sedat; Çelebi, Serdal; Doğan, ÜmitThe present study was designed to evaluate the associations between exudative age-related macular degeneration (AMD) and the serum concentrations of C-reactive protein (CRP), dehydroepiandrosterone sulfate (DHEAS), and lipids as well as the relationship between exudative AMD and body mass index (BMI). This cross-sectional study included of 141 healthy control subjects (70 males and 71 females with a mean age of 71.01 +/- A 3.84 years) and 142 exudative AMD patients (70 males and 72 females with a mean age of 70.92 +/- A 3.60 years). BMI and the serum concentrations of CRP, DHEAS, and lipids were measured in both groups. The data were statistically analysed using the Mann-Whitney U test, Chi squared test, independent sample t test, Cramer's V, point biserial correlation and logistic regression analysis. BMI values and serum concentrations of CRP, total cholesterol, and low-density lipoprotein (LDL) cholesterol were significantly higher in exudative AMD patients compared with normal controls (p values were 0.001, < 0.001, 0.005 and < 0.001, respectively). The serum concentrations of DHEAS were not significantly different between the controls and the exudative AMD patients for the subgroups of either gender (p values in males and females were 0.785 and 0.159, respectively). A logistic regression analysis revealed that the BMI and serum concentration of CRP moderately contributed to the predictive ability of the model (odds ratios were 1.205 and 1.179, respectively). Elevated total cholesterol concentrations and LDL cholesterol concentrations, BMI values and serum concentrations of CRP were associated with exudative AMD. However, no association between the serum DHEAS concentration and exudative AMD was established.Öğe Bilateral katarakt ameliyatı yapılan üç olgu ışığında gevşek iris sendromu(2011) Balbaba, Mehmet; Ulaş, FatihAmaç: Tamsulosin kullanan ve ilk göz katarakt ameliyatlarında gevşek iris sendromu (GİS) gelişen üç olgunun diğer gözlerinin katarakt ameliyatında yapılan müdaheleleri değerlendirmek. Gereç ve Yöntem: Kliniğimizde 2008 Haziran-2011 Ocak tarihleri arasında katarakt ameliyatı yapılan 564 hastanın 628 gözü geriye dönük olarak incelendi. İlk gözlerinin katarakt ameliyatında şiddetli GİS tablosu gelişen ve tamsulosin kullanan olguların ikinci gözlerinde literatür ışığında alınan önlemler ve sonuçları değerlendirildi. Bulgular: Olguların tümünün ikinci gözlerinde de tamsulosinin ameliyattan 3-9 ay önce kesilmesine ve ketorolak trometamin, epinefrin, fenilefrin, ağır viskoelastik, iris çengellerinin kullanılmasına rağmen şiddetli GİS tablosu gelişti. Olguların tümünde ameliyat esnasındaki travmaya bağlı olarak iris hasarı ve pupilde düzensizlik oluştu. Tartışma: Bir yıldan daha uzun süre tamsulosin kullanan olgularda tamsulosinin kesilmesi, alınan medikal önlemler ve iris çengellerinin kullanımı GİS gelişimini engelleyemeyebilir.Öğe Changes in corneal biomechanical properties following hemodialysis in non-diabetic end stage renal disease(2019) Balbaba, Mehmet; Ulaş, Fatih; Evren, Özge; Yiğit, İrem PembegülPurpose: The aim of this study was to evaluate changes in corneal biomechanical properties following hemodialysis using an ocular response analyzer (ORA) in non-diabetic end stage renal disease Materials and Methods: We included one eye of 50 non-diabetic chronic renal failure patients (25 females and 25 males) with a mean age of 56.94 ± 9.95 years (range 36-80 years) in this cross-sectional study. Corneal compensated intraocular pressure (IOPcc), corneal hysteresis (CH) and the corneal resistance factor (CRF) were measured for included the eye of each participant using an ORA before and after hemodialysis. Central corneal thickness (CCT), blood pressure, plasma osmolality and plasma colloid osmotic pressure were also measured before and after the hemodialysis session. A paired samples t-test and Pearson’s correlation analysis were carried out for statistical analysis. Results: The mean CCT, IOPcc, CH and CRF of the patients before hemodialysis were 550.20±19.64 ?m, 16.84±3.20 mmHg, 10.68±2.41 mmHg and 11.36±2.50 mmHg, respectively. The mean CCT, IOPcc, CH and CRF of the patients after hemodialysis were 547.30±19.83 ?m, 15.61±2.77 mmHg, 11.38±2.91 mmHg and 11.37±2.96 mmHg, respectively. The mean plasma osmolality, plasma colloid oncotic pressure and mean arterial pressure (MAP) of the patients before hemodialysis were 309.12±9.10 mOsm/L, 23.86±1.49 mmHg and 99.74±12.84 mmHg, respectively. The mean plasma osmolality, plasma colloid oncotic pressure and mean arterial pressure (MAP) of the patients after hemodialysis were 293.74±8.82 mOsm/L, 28.72±2.19 mmHg and 87.53±10.98 mmHg, respectively. Signifi cant changes occurred in IOPcc, CH, mean arterial pressure, serum osmolality and plasma colloid oncotic pressure (p values of 0.006, 0.036, <0.001, <0.001 and <0.001, respectively). There was no signifi cant difference in the CRF or CCT values before and after hemodialysis (p values of 0.980 and 0.084, respectively). There were signifi cant moderate correlations between differences in IOPcc and CH (r=-0.369, p=0.008) and MAP and CH (r=0.355, p=0.011). Conclusion: Hemodialysis did not alter CCT and CRF but caused a signifi cant IOP decrease and CH increase in non-diabetic chronic renal failure patients that need be taken into account during the evaluation of IOP in hemodialysis patients.Öğe Clinical and demographic features of pediatric-onset Behcet's disease and evaluation of optical coherence tomography findings(Taylor & Francis Inc, 2020) Balbaba, Mehmet; Ulaş, Fatih; Postacı, Sevinç Arzu; Çeliker, Ülkü; Gürgöze, Metin KayaPurpose: To evaluate the clinical characteristics, including spectral domain optical coherence tomography (SD-OCT) findings, of pediatric-onset Behcet's disease (PBD) patients. Methods: Medical records of 23 PBD (15 males and 8 females) and 24 (15 males and 9 females) healthy subjects were evaluated retrospectively. The main outcomes were compared between PBD patients, with and without ocular involvement, and healthy subjects. Results: The mean age at onset was 12.00 +/- 2.10 years. Mean follow-up period was 25.17 +/- 15.36 months (range 6-48). Retinal vasculitis was the most common ocular finding (7 patients). Most of the complications of systemic treatment were associated with long term corticosteroid therapy. There was no significant difference between the mean retinal thickness of the PBD patients and healthy controls (p > 0.05). The mean choroidal thickness was significantly increased in all measured segments of PBD patients with ocular involvement (p < 0.01). Conclusion: Choroidal thickness of PBD patients with ocular involvement was significantly thicker compared to the PBD patients without ocular involvement and to healthy control subjects.Öğe Coexistence of familial adenomatous polyposis and optic disc drusen in two patients from the same family(2019) Balbaba, Mehmet; Ulaş, FatihFamilial adenomatous polyposis (FAP) is an autosomal dominant disease characterised by the development of multiple adenomatous polyps throughout the colon. There may be other associated systemic abnormalities including extacolonic malignancy. Congenital hypertropy of the retinal pigment epitelium (CHRPE) is a common eye sign in patients with familial adenomatous polyposis. In the current report, we presented two brothers having FAP with optic disc drusen which might be incidental or associated ocular FAP manifestation.Öğe Comparison of the effects of two different concentrations of ketorolac tromethamine solutions in patients with allergic conjunctivitis(Ortadogu Ad Pres & Publ Co, 2012) Ulaş, Fatih; Balbaba, Mehmet; Çankaya, CemObjective: To evaluate the clinical efficacy and side effects of two different concentrations of KT solutions (0.5% and 0.4%) in allergic conjunctivitis patients. Material and Methods: Thirty-six patients (20 females and 16 males) who did not have any ocular or systemic disorder other than allergic conjunctivitis were enrolled in the study, ages of the patients ranged from 24 to 35 years. Patients randomly received treatment to one eye with KT 0.4% and to the other eye with KT 0.5%. Patients were evaluated after one week and symptoms, signs before and after the treatment, drug related adverse effects and intolerance were assessed. Results: Although the signs and symptoms of the allergic conjunctivitis in both eyes improved significantly, it did not recover completely in 77.8% of the patients. Either concentrations of the KT solutions did not cause any adverse effect or significant intolerance that might cause cessation of treatment. Comparable mild drug intolerance for both KT solutions, was reported by 41.7% of the cases while 50.0% of the patients reported better tolerance for KT 0.4%, 8.3% of the patients reported better tolerance for KT 0.5%. Conclusion: Both concentrations of the KT solutions provided partial clinical improvement of allergic conjunctivitis but did not cause any adverse effect. This study suggests that KT 0.4% has better tolerance and is as effective as KT 0.5%; however drug intolerance still remains as an issue.Öğe Comparison of the Effects of Digoxin and Bevacizumab on Oxygen-Induced Retinopathy Rat Model(Gazi Eye Foundation, 2023) Balbaba, Mehmet; Guler, Seda Duran; Ulas, Fatih; Canleblebici, Mehmet; Yıldırım, Hakan; İncili, Canan AkdenizPurpose: To evaluate the effect of digoxin on oxygen-induced retinopathy (OIR) model and compare the results with bevacizumab treatment. Methods: Twenty-eight newborn Sprague-Dawley rats were randomly divided into four groups:control group, normoxia+intraperitoneal (ip) normal saline (NS); OIR group, OIR+ip NS; OIR+digoxin group, OIR+ip 0.1 mg/kg of digoxin; and OIR+bevacizumab group, OIR+ip 2.5 mg/kg of bevacizumab. The rats were exposed to 50% oxygen for 24 h, followed by 10% oxygen for 24 h, to induce OIR. This cycle was repeated seven times until 14 days postnatal (P). In all groups, single-dose injections were administered on P15th day. Histopathological and immunohistochemical examinations were performed at the end of the study. Results: The mean neovascular cell nuclei counts (NVCN) of the four groups were 9.00±3.16, 41.80±11.44, 19.38±2.20, and 16.00±2.62. The mean NVCN count was significantly reduced in the treatment groups compared to the OIR group (p<0.001). The mean NVCN count was similar between the treatment groups (p=0.078). In immunohistochemical staining, the immunoreactivity values of the vascular endothelial growth factor (VEGF) were 0.01±0.00, 1.65±0.30, 0.09±0.08, and 0.04±0.02, and the tumor necrosis factor alpha (TNF-?) values were 0.10±0.00, 1.12±0.18, 0.18±0.13, and 0.14±0.05. In the OIR group, VEGF and TNF-? immunoreactivity increased markedly compared to the control group (p<0.001). VEGF and TNF-? immunoreactivity of the treatment groups decreased significantly compared to the OIR group (p<0.001). VEGF and TNF-? immunoreactivity were similar between the treatment groups (VEGF:p=0.752; TNF-?:p=0.099). Conclusions: Retinal neovascularization was significantly suppressed by digoxin treatment, and this effect was comparable to bevacizumab in the OIR model. © 2023 Gazi Eye Foundation. All rights reserved.Öğe Effect of decorin and bevacizumab on oxygen-induced retinopathy in rat models: a comparative study(Wolters Kluwer Medknow Publications, 2021) Güler, Seda Duran; Balbaba, Mehmet; Çolakoğlu, Neriman; Bulmuş, Özgür; Ulaş, Fatih; Eröksüz, YesariPurpose: The aims of this study were to evaluate the effects of decorin (DCN) in rat oxygen-induced retinopathy (OIR) model and to compare the results with those of bevacizumab. Methods: Twenty-eight newborn Sprague-Dawley rats were randomly divided into four groups. Group I (control): normoxia plus intraperitoneal (ip) normal saline (NS), Group II (sham): OIR plus ip NS, Group III (DCN): OIR plus ip 0.1 mg/kg DCN, and Group IV (bevacizumab): OIR plus ip 2.5 mg/kg bevacizumab. The OIR model was induced by cycling the oxygen concentration between 50% and 10% every 24 h for 14 days following their birth. In all groups, injections were administered on postnatal day (PD) 15. All animals were sacrificed and their right eyes were enucleated on PD 18. The nuclei of neovascular endothelial cells on the vitreal side of the inner limiting membrane were counted, and vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF)-? immunoreactivity were detected in histopathological and immunohistochemical examinations. One-way analysis of variance and post hoc Tukey tests were used for statistical analyses of the data. Results: In Groups II, III, and IV, the mean neovascular cell nuclei counts were 13.14 ± 1.34, 6.57 ± 1.51, and 6.71 ± 1.49, respectively. The mean neovascular cell nuclei count was significantly reduced in treatment groups compared with sham group (P < 0.001). In immunohistochemical staining, the immunoreactivity of VEGF was 0.07 ± 0.02, 0.97 ± 0.21, 0.37 ± 0.12, and 0.23 ± 0.17, respectively. Likewise, immunoreactivity of TNF-? was 0.02 ± 0.02, 1.11 ± 0.36, 0.37 ± 0.13, and 0.62 ± 0.21, respectively. VEGF and TNF-? immunoreactivity increased markedly in the sham group compared with those in the control group (P < 0.001). VEGF and TNF-? immunoreactivity of treatment groups decreased significantly compared to sham group (P < 0.001). Conclusion: The beneficial effects obtained by DCN administration in OIR model were comparable to the effects of bevacizumab.Öğe Effect of hemodialysis duration on conjunctival bacterial flora and susceptibility of conjunctival bacterial isolates to fluoroquinolones(Taylor & Francis Inc, 2013) Balbaba, Mehmet; Ulaş, Fatih; Altunışık, SibelPurpose: To determine the differences between conjunctival bacterial flora of hemodialysis patients and healthy subjects, the effect of duration of hemodialysis on conjunctival bacterial flora, and in vitro antibiotic susceptibility patterns of conjunctival bacterial flora to fluoroquinolones. Methods: Sixty healthy subjects (32 male, 28 female) and 60 hemodialysis patients (33 male, 27 female) who had renal failure due to reasons other than diabetic nephropathy and with no previous history of intraocular surgery participated in this study. Statistical analysis of the difference between the culture positivity of hemodialysis patients and a control group was determined using the chi-square test. Pearson's correlation test was used to quantify the correlations among culture positivity and duration of hemodialysis. Results: Conjunctival culture positivity of the hemodialysis patients and the control group was 58.3 and 45.0%, respectively, and there was no statistically significant difference between these groups (p = 0.144). Pearson's correlation test revealed that there was a weak but statistically significant positive correlation between culture positivity and duration of hemodialysis (r value was 0.378 [p = 0.003]). Staphylococcus aureus (28.3%) and Staphylococcus epidermidis (20.0%) were the most frequently isolated organisms in the hemodialysis patients, Staphylococcus epidermidis (26.7%) and Staphylococcus aureus (6.7%) were the most frequently isolated organisms in the control group. Resistance of most frequently isolated organisms (Staphylococcus aureus and Staphylococcus epidermidis) from control group and hemodialysis patients to ofloxacin, levofloxacin, moxifloxacin, and gatifloxacin were 20, 15, 5, and 5%, and 34.5, 20.7, 6.9, and 6.9%, respectively. Conclusions: As distinct from the control group, S. aureus colonization was isolated more from the hemodialysis patients. Culture positivity of the hemodialysis patients was positively correlated with the duration of hemodialysis. Antibiotic susceptibility of isolates from conjunctival bacterial flora of hemodialysis patients were less than healthy control group.Öğe Effect of prophylactic intraocular pressure-lowering medication on pain during cataract surgery(Mary Ann Liebert, Inc, 2013) Ulaş, Fatih; Balbaba, Mehmet; Çelebi, SerdalPurpose: This study evaluated the effects of acetazolamide, latanoprost, travoprost, bimatoprost, brimonidine, brinzolamide, and timolol on pain during phacoemulsification cataract surgery. Methods: This prospective randomized comparative study included 323 eyes of 323 patients with no history of intraocular surgery or chronic eye disease who underwent uncomplicated phacoemulsification cataract surgery and foldable intraocular lens implantation under topical anesthesia. Patients were divided into 8 groups according to the preoperative prophylactic intraocular pressure (IOP)-lowering medication. The intraoperative pain was assessed postoperatively using a visual analog pain scale. The Kruskal-Wallis test investigated the differences in the visual analog pain-scale scores of the groups, and the Mann-Whitney U test investigated the pairwise comparison of the groups. Results: The median visual analog pain-scale score of the group that did not receive any IOP-lowering medication was 2.0 +/- 1.89. The brimonidine group exhibited the lowest visual analog pain-scale scores, and the prostanoids, especially the bimatoprost group, demonstrated the highest visual analog pain-scale scores (median +/- standard deviation were 0.0 +/- 1.50 and 2.0 +/- 1.91, respectively). The median visual analog pain-scale scores of the acetazolamide, latanoprost, travoprost, brinzolamide, and timolol groups were 0.0 +/- 1.62, 2.0 +/- 1.67, 2.0 +/- 1.73, 0.0 +/- 1.66, and 1.0 +/- 1.54, respectively. A pairwise comparison using the Mann-Whitney U test with Bonferroni correction revealed significant differences between the groups of acetozolamide and travoprost (p = 0.001), acetozolamide and bimatoprost (p < 0.001), travoprost and brimonidine (p < 0.001), bimatoprost and brimonidine (p < 0.001), and bimatoprost and timolol (p = 0.001). Conclusions: Prophylactic application of the IOP-lowering medication may alter the pain sensation during phacoemulsification cataract surgery.Öğe Effects of a water-loading test on intraocular pressure and corneal hysteresis in young healthy subjects(Lippincott Williams & Wilkins, 2014) Ulaş, Fatih; Balbaba, Mehmet; Çelebi, SerdalPurpose:To evaluate the influence of a water-loading test on corneal compensated intraocular pressure (IOPcc) and corneal hysteresis (CH) in young healthy subjects.Materials and Methods:Forty healthy adult subjects (20 female and 20 male), with a mean age of 27.552.57 years (range, 24 to 35 y), participated in this prospective study. IOPcc and CH were measured for 1 eye from each participant with an Ocular Response Analyser. These measurements were taken before and 10, 20, and 30 minutes after water loading.Results:Thirty-seven right and 3 left eyes of the 40 subjects fulfilled the study's inclusion criteria. A statistically significant increase in IOPcc was observed between 0 and 10 minutes (P=0.002) and a significant decrease between 10 and 30 minutes (P<0.001). We did not observe any statistically significant changes in CH. The Pearson correlation revealed that there was a weak negative correlation between IOPcc and CH measurements taken at the baseline, 10 minutes, and 30 minutes [r values were -0.275 (P=0.086), -0.369 (P=0.019), and -0.246 (P=0.125), respectively].Conclusions:This study revealed changes in IOPcc and CH after a water-loading test, but only the change in the IOPcc measurement was statistically significant. The association of changes in IOP and CH identified in this study suggests that IOP changes might alter corneal biomechanical properties.Öğe Evaluation of aqueous humor and serum cortistatin levels in diabetic patients with and without diabetic retinopathy(Sage Publications Ltd, 2019) Balbaba, Mehmet; Ulaş, Fatih; Erdağ, Murat; Yıldırım, Hakan; Çeliker, Ülkü; Aydın, SüleymanPurpose: To evaluate the aqueous humor and serum cortistatin levels in diabetic patients with and without diabetic retinopathy and its relationship with various metabolic markers that have been reported to be associated with diabetes mellitus. Methods: The current study included 20 diabetes mellitus patients with diabetic retinopathy, 20 diabetes mellitus patients without diabetic retinopathy, and 20 healthy control subjects with the same sex and age characteristics. Aqueous humor and serum cortistatin, fasting blood glucose, hemoglobinA1c, 25-hydroxyvitamin D levels, blood lipid profiles, and body mass index were measured in all subjects. Results: In diabetic patients with and without diabetic retinopathy and in healthy control subjects, the mean aqueous humor cortistatin levels were 25.55 +/- 2.03, 27.71 +/- 2.01, and 32.76 +/- 3.43 ng/mL, respectively. Likewise, the mean serum cortistatin levels were 6.16 +/- 1.08, 6.57 +/- 1.00, and 7.56 +/- 1.51 ng/mL, respectively. Aqueous humor cortistatin levels were decreased in diabetic patients with and without diabetic retinopathy when compared to healthy controls (p < 0.001). Although aqueous humor cortistatin levels tended to be reduced in diabetic patients with diabetic retinopathy, the difference was not statistically significant between diabetic patients with and without diabetic retinopathy (p = 0.147). Serum cortistatin levels were not statistically significant between diabetic patients with and without diabetic retinopathy and healthy control subjects (p = 0.166). Body mass index, fasting blood glucose, and hemoglobinA1c levels were significantly different between the groups (p < 0.05 for all parameters tested). Conclusion: Aqueous humor cortistatin levels were decreased in diabetic patients with and without diabetic retinopathy. The results suggest that a local decrease in the amount of cortistatin may play a role in the pathogenesis of diabetic retinopathy.Öğe Evaluation of macular thickness measurement in healthy subjects using different scanning modes of optical coherence tomography(2013) Ulaş, Fatih; Soydan, Adem; Balbaba, Mehmet; Çelebi, SerdalPurpose: To evaluate the measurements of macular thickness obtained by the fast macular thickness scanning mode and posterior pole analysis (PPA) mode in healthy, young subjects using optical coherence tomography (OCT). Materials and Methods: This prospective study was performed on 70 healthy, young subjects [35 (50%) males and 35 (50%) females] aged between 20 and 30 years who had no history of chronic eye disease and attended the ophthalmology outpatients between March 2012 and August 2012. Only the right eyes of the subjects were included to the study. Macular thickness measurements were performed with the default fast macular thickness scanning mode and PPA mode in random order. All OCT scans were performed by a single experienced physician without pupil dilation within one session. Statistical analyses of fast macular thickness scanning mode and PPA mode differences were performed using the paired samples t-test, the agreement of the measurements was analyzed using the intra-class correlation coefficient (ICC) and the dispersion of the measurements was analyzed using the coefficient of variation (CV). Results: There was no statistically significant difference between the fast macular thickness scanning mode and PPA mode measurements of all evaluated segments (p values ranged between 0.055 and 0.571). ICC values for these measurements were very high and ranged between 0.984 and 0.992. CV values for the fast macular thickness scanning mode and PPA mode measurements were quite low and ranged between 4.40-5.79% and 4.33-5.76%, respectively. Conclusion: The fast macular thickness scanning mode and PPA mode measurements using OCT have quite high agreement in healthy, young subjects.Öğe Farklı tip göz içi lensi kullanılarak yapılan fakoemülsifikasyon ameliyatları sonrası ön kamara derinliğinin ve sferik refraksiyonun değerlendirilmesi(2012) Balbaba, Mehmet; Ulaş, Fatih; Çelebi, SerdalAmaç: Fakoemülsifikasyon ameliyatında kapsül içerisine farklı tip göz içi lens (GİL) implante ettiğimiz olgularda ön kamara derinliği (ÖKD) ve sferik refraktif değerlerdeki değişiklikleri değerlendirmek. Gereç ve Yöntemler: Haziran 2011-Mayıs 2012 tarihleri arasında fakoemülsifikasyon yöntemiyle katarakt ameliyatı ve farklı dört tip katlanabilir GİL implantasyonu yapılan 80 hastanın 80 gözü prospektif olarak değerlendirildi. Ameliyatta 20 hastaya Acriva UD 613, 20 hastaya Alcon Acrysof MA60BM, 20 hastaya Eyecryl HS AS600, 20 hastaya Zaraccom F 260 GİL implante edildi. Ameliyat sonrası 1. gün, 1. hafta, 1. ve 3. ay kontrolleri yapılan hastaların ameliyat öncesi göz içi basınçları, aksiyel uzunlukları (AU), ÖKD'leri, SRK II formülü kullanılarak GİL gücü diyoptrileri belirlendi. Ameliyat sonrası 1. hafta, 1. ve 3. ayda ÖKD ve refraksiyon değerleri ölçümleri yapıldı. Ameliyat öncesi ve sonrası 1. hafta, 1. ve 3. ayda ÖKD ve refraksiyon değerlerinin istatistiksel analizi Wilcoxon işaretli sıra testiyle gerçekleştirildi. Bulgular: Tüm olgularda ameliyat sonrası ÖKD ölçümleri artmış olarak saptandı. Ameliyat öncesi ÖKD ile ameliyat sonrası 1. hafta ÖKD ölçümleri karşılaştırıldığında, ÖKD artışının en fazla Alcon GİL implante edilen grupta olduğu saptandı. Ameliyat sonrası 1. hafta ÖKD ölçümü ile ameliyat sonrası 1. ve 3. ay ÖKD ölçümleri karşılaştırıldığında Zaraccom GİL implante edilen grupta istatistiksel olarak anlamlı düzeyde ÖKD değerlerinde ameliyat sonrası 1. haftaya göre azalma olduğu saptandı (p=0.003). Ameliyat sonrası 1. hafta ve ameliyat sonrası 1. ay ölçümlerinde sferik refraktif sapma açısından gruplar arasında refraksiyon ölçümlerinde istatistiksel olarak anlamlı bir fark saptanmadı (p değeri Acriva, Alcon, Eyecryl ve Zaraccom grupları için sırasıyla 0.178, 0.154, 0.153 ve 0.206). Tartışma: Ameliyat sonrası hedef refraksiyona ulaşabilmek için, ÖKD'ni etkileyen faktörlerin dışında da ameliyat sonrası refraksiyonu etkileyen GİL'ine ait faktörlerin bulunabileceğinin bilinmesi gerekmektedir.Öğe Gebe bir olguda gelişen santral seröz koryoretinopatinin klinik seyri ve optik koherans tomografi bulguları(2012) Balbaba, Mehmet; Ulaş, Fatih; Yılmaz, TurgutBu olgu sunumunda gebe bir olguda saptanan santral seröz koryoretinopatinin (SSKR) tanı ve takibinde Optik Koherans Tomografi (OKT) bulguları değerlendirilmiştir. 30 yaşında 32 haftalık gebe olan ve sol gözde görme azlığı şikayeti ile kliniğimize konsülte edilen hastanın ilk OKT’sinde sağ göz doğal, sol gözde ise seröz nörosensöryel dekolman ve pigment epitel dekolmanı (PED) izlendi. Doğumu takiben yapılan kontrol OKT’sinde ise seröz nörosensöryel dekolmanın ve PED’nin düzeldiği gözlendi. İyi prognoza sahip olan SSKR, gebelikte doğumu takiben herhangi bir tedaviye gerek kalmadan kendiliğinden düzelebilmektedir.Öğe Glokom olgularında moorfield regresyon(2012) Ulaş, Fatih; Bucak, Yasin Yücel; Balbaba, Mehmet; Erdurmuş, Metin; Çelebi, SerdalAmaç: Heidelberg retinal tomografi (HRT) 3 cihazında bulunan Moorfield regresyon analizi (MRA) ve glokom ihtimali skoru (GPS) yöntemlerinin duyarlılığını karşılaştırmak. Gereç ve Yöntem: Bu prospektif çalışmaya 115 orta derecede görme alanı kaybı olan primer açık açılı glokomu (PAAG) olan (56 erkek, 59 kadın) hasta dahil edildi. HRT 3 cihazından elde edilen MRA ve GPS sonuçları normal sınırlarda (WNL), sınırda (BL) ve normal sınırların dışında (ONL) olmak üzere üç kategoriye ayrılmaktadır. PAAG hastalarının MRA ve GPS sonuçlarının istatistiksel analizinde ki-kare testi ve Cramer’in V katsayısı kullanıldı. Ayrıca, MRA ve GPS sonuçları arasındaki uyumun değerlendirilmesi için kappa değeri hesaplandı. Bulgular: Hastaların yaş ortalaması 63,95±9,26 ve göz içi basıncı ortalaması 14,28±1,65 mmHg idi. HRT 3 cihazıyla ortalama çukurluk/disk oranı ve disk alanı büyüklüğü sırasıyla 0,49±0,14 (0,21-0,77) ve 2,01±0,25 mm2 (1,68-2,39) olarak ölçüldü. Global sektördeki MRA sonuçları 37 kişide (%32,2) WNL, 36 kişide (%31,3) BL ve 42 kişide (%36,5) ONL saptandı. Global sektördeki GPS sonuçları; 9 kişide (%7,8) WNL, 30 kişide (%26,1) BL ve 76 kişide (%66,1) ONL saptandı. Tüm sektörlerde MRA ve GPS sonuçları arasında istatistiksel olarak anlamlı fark vardı (tüm sektörler için p değeri 0,01 veya altındaydı). Tüm sektörlerdeki MRA ve GPS duyarlılıkları sırasıyla %14-50 ve %66-73 aralığında değişmekteydi. Tüm sektörlerin kappa değeri 0,27’nin altındaydı. Sonuç: Çalışmamızda, orta derecede görme alanı kaybı olan PAAG hastalarında, glokom tanısı koymak için HRT 3 cihazı ile ölçülen GPS’nin duyarlılığı, MRA’nın duyarlılığından daha yüksek bulunmuşturÖğe Gün içi dalgalanmaların kısmi koherens interferometre kullanılarak hesaplanan göz içi lens gücü üzerine etkisi(2011) Ulaş, Fatih; Balbaba, Mehmet; Çankaya, CemAmaç: Sağlıklı bireylerde kısmi koherens interferometre (KKİ) cihazı kullanılarak sabah ve akşam saatlerinde yapılan ölçümlerle hesaplanan göz içi lens (GİL) gücü diyoptrilerinin karşılaştırılması. Gereç ve Yöntem: Yaşları 25-36 arası değişen 32 sağlıklı bireyin 62 gözünün sabah ve akşam saatlerinde KKİ cihazı ile Haigis, Hoffer-Q, Holladay-1 ve SRK/T formüllerini kullanarak GİL güçleri hesaplandı. Bulgular: Hesaplanan GİL güçleri diyoptri farkı göz önüne alındığında dört formül arasında sağ ve sol gözde anlamlı fark bulunamamıştır (sırasıyla p=0.511 ve p=0.206). İstatistiksel olarak anlamlı farklılık olmasa da en az değişkenlik gösteren formül SRK/T, en çok değişkenlik gösteren formül Haigis olarak saptandı. Post hoc testleriyle formüllerin kendi aralarında karşılaştırılması yapıldığında ise sadece sol gözde Haigis ve SRK/T testleri arasında anlamlı fark saptandı (p=0.046). Sonuç: Bu sonuçlar KKİ cihazı kullanılarak elde edilen değerlerle ve farklı formüllerle hesaplanan GİL gücünün gün içinde istatistiksel olarak anlamlı değişkenlik göstermediğini ortaya koymakla birlikte GİL gücü hesabında en az değişkenlik gösteren formül SRK/T olarak saptandı.Öğe Protective effect of filgotinib in rat endotoxin-induced uveitis model(SPRINGER, 2021) Erdağ, Murat; Balbaba, Mehmet; İlhan, Nevin; Çalık, İlknur; Ulaş, FatihPurpose To investigate the protective effect of filgotinib in endotoxin-induced uveitis model in rats. Materials and method This study used 24 Wistar Albino rats. Group I (control group) included the healthy controls; in Group II (sham group), only 300 mu g/kg intraperitoneal (ip) lipopolysaccharide (LPS) was administered; and in Group III (treatment group), 3 mg/kg/day filgotinib was administered orally for 10 days followed by 300 mu g/kg ip LPS. In all groups, clinical activity scores were evaluated after 24 h. Moreover, histopathological and immunological examinations were performed. Results In Groups I, II, and III, the mean clinical activity and histopathological examination scores were 0.00, 3.25 +/- 0.70, and 1.89 +/- 0.60 and 0.00, 2.88 +/- 1.12, and 1.44 +/- 0.52, respectively. The clinical activity and histopathological examination scores were significantly increased in the sham group compared to the control group (p < 0.05); these findings were significantly reduced in the treatment group (p < 0.05). The mean TNF-alpha and IL-6 ELISA levels in all groups were 50.20 +/- 3.24, 59.87 +/- 2.98, and 54.34 +/- 4.62 and 30.88 +/- 1.79, 36.77 +/- 1.21, and 33.66 +/- 1.86, respectively. The TNF-alpha and IL-6 ELISA levels were significantly decreased in the treatment group compared to the sham group (p < 0.05); there was no significant difference between the treatment group and the control group (p = 0.105, p = 0.067, respectively) Conclusion Filgotinib may be an alternative treatment option in preventing the development of noninfectious uveitis.Öğe Sağlıklı bireylerde optik koherens tomografi cihazı kullanılarak yapılan retina sinir lifi tabakası kalınlığı ve arka kutup analiz ölçümlerinin tekrarlanabilirliği(2012) Ulaş, Fatih; Soydan, Adem; Balbaba, Mehmet; Çelebi, SerdalAmaç: Sağlıklı bireylerde optik koherens tomografi (OKT) cihazı kullanılarak yapılan retina sinir lifi tabakası kalınlığı (RSLT) ve arka kutup analiz (PPA) ölçümlerinin tekrarlanabilirliğinin değerlendirilmesi. Gereç ve Yöntem: Yaşları 20 ile 30 arasında değişen 50 sağlıklı bireyin sağ gözlerinde RSLT kalınlığı ve PPA ölçümleri yapıldı. Hastaların 25’i (%50) erkek ve 25’i (%50) kadındı. OKT cihazı ile RSLT ve PPA çekim ayarları değiştirilmeksizin rastgele sırayla ilk ölçümler alındıktan sonra hastanın başını geri çekip, OKT cihazının ayarları ve pozisyonu değiştirilmesi için en az 10 saniye beklenildi ve sonrasında ikinci ölçümler alındı. RSLT kalınlığı ölçümlerinin istatistiksel analizi, cihazın yaptığı segmentasyonlardan elde edilen yedi segmentin sonuçları değerlendirilerek yapıldı. PPA ölçümlerinin istatistiksel analizinde ise 8x8 olarak karelere bölünmüş arka kutbun superotemporal ve inferotemporal köşelerindeki karelerin ve santral makülayı çevreleyen merkezdeki dört karenin ölçüm sonuçları değerlendirildi. Tekrarlanan RSLT ve PPA ölçümleri arasındaki farkın istatistiksel analizi eşleştirilmiş örneklem t-testi ile yapıldı. RSLT ve PPA ölçümlerinin tekrarlanabilirliği sınıf içi korelasyon katsayısı (ICC) değerleri hesaplanarak belirlendi. Bulgular: RSLT ve PPA ölçümlerinde değerlendirilen tüm segmentlerde birinci ve ikinci ölçümler arasında fark saptanmadı (p değerleri 0.06 ile 0.91 arası). RSLT ve PPA ölçümlerinde değerlendirilen tüm segmentlerin ICC değerleri ise 0.90 ile 0.99 arası değişmekteydi. Sonuç: Sağlıklı bireylerde OKT cihazı kullanılarak yapılan RNFL ve PPA ölçümlerinin tekrarlanabilirliği çok yüksektir.
