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Alpha blocker treatment and intra-operative floppy iris syndrome
(Galenos Yayıncılık, 2015) Özyalvaçlı, Mehmet Emin; Doğan, Ümit; Gücük, Adnan
Benign prostate hyperplasia (BPH) in the leading cause of lower urinary tract symptoms (LUTS) in elderly ages. Alpha blocker treatment which is advised by urology guidelines is the main treatment of LUTS related to BPH. Alpha-1 receptor has three different subtypes including alpha-1A, alpha-1B and alpha-1D. About 98% of alpha blockers are related with prostate stromal elements and 70% of the alpha receptors are alpha-1A receptors. These receptors are responsible for contraction of prostate, bladder and urethral smooth muscles. Dizziness, fatigue, orthostatic hypotension, syncope, nasal congestion, and retrograde ejaculation are the common adverse effects of alpha blockers. Intra-operative floppy iris syndrome (IFIS), which may cause irreversible blindness, was firstly defined in patients treated with tamsulosin (an alpha-1A receptor blocker) during cataract surgery. Afterwards, it has also been shown that other alpha blockers may also cause IFIS. Pathophysiology of IFIS has not been clearly defined. This clinical picture may occur within hours after alpha blocker treatment or it may develop many years after cessation of the treatment. This paper reviews the literature and presents alpha blocker related IFIS and preventive measurements to minimalise the development of IFIS.
Alt oblik miyektomi sonrası internal oftalmopleji gelişen iki olgu
(2012) Ulaş, Fatih; Doğan, Ümit; Bucak, Y. Yücel; Çelebi, Serdal
Alt oblik kası aşırı fonksiyonu nedeniyle kliniğimize başvuran 3 ve 38 yaşlarındaki iki kadın olguya alt oblik miyektomi ameliyatı uygulandı. İki olguda da ameliyat sonrası birinci gün internal oftalmoplejiye bağlı anizokori gelişti. İki olguda da internal oftalmopleji üç ay içerisinde tedavisiz düzeldi.
Anterior chamber fixation of a posterior chamber intraocular lens: A novel technique
(Medknow Publications & Media Pvt Ltd, 2014) Kükner, Ahmet Şahap; Alagöz, Gürsoy; Erdurmuş, Mesut; Serin, Didem; Doğan, Ümit
We aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL) in the anterior chamber (AC) with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.
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, Ümit
The 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.
Bilateral nevus comedonicus of the eyelids associated with bladder cancer and successful treatment with topical tretinoin
(Wiley-Blackwell, 2016) Polat, Mualla; Tuman, Bengü Altunay; Şahin, Aslı; Doğan, Ümit; Boran, Çetin
Dear Editor Nevus comedonicus (NC) is a rare epidermalhamartoma of unknown etiology, most com-monly located on the head and neck (1). It ischaracterized by groups of dilated follicular ori-fices resembling comedones, filled with firmhyperkeratotic plugs (1). Although most casesare located unilaterally on the head, neck, andtrunk, the lesions may have a linear or blasch-koid distribution and rarely occur bilaterally(2–8). Histopathologically, the lesions are char-acterized by closely arranged, dilated-invaginated follicular openings containinglamellar keratin and cystic formations. Half ofthe cases are congenital and half develop duringchildhood, usually before the age of 10 years(4–6). Most NC cases are isolated. When NC isassociated with anomalies in the central nervesystem, eye, or skeletal system, and adnexaltumors, it is called NC syndrome (6). We reportlate-onset NC of both eyelids due to its rarity,atypical bilateral localization, and association with bladder cancer.
Choroidal thickness changes during the menstrual cycle
(Informa Healthcare, 2013) Ulaş, Fatih; Doğan, Ümit; Duran, Bülent; Keleş, Asena; Ağca, Sümeyra; Çelebi, Serdal
Purpose: To evaluate the effects of the menstrual cycle on the choroidal thickness of healthy women of reproductive age using spectral-domain optical coherence tomography. Materials and methods: A total of 23 right eyes of 23 women with regular natural menstrual cycles of 28-30 d and ages 22-30 years were included in this prospective study. The choroidal thicknesses of the women were measured using high-resolution spectral-domain optical coherence tomography line scans with the activated enhanced depth imaging mode in the early follicular, ovulatory and mid-luteal phases of the menstrual cycle (3rd, 14th and 21st days) using a follow-up scanning protocol of the Spectralis optical coherence tomograph by setting the early follicular phase scan as the reference image. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 mm nasal and temporal to the fovea. The mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses were also measured. All measurements were taken within the same menstrual cycle. Results: The mean +/- standard deviation (standard error of the mean) of subfoveal choroidal thicknesses in the early follicular, ovulatory and mid-luteal phases were 383.87 +/- 84.38 (17.59), 373.74 +/- 82.40 (17.18) and 359.09 +/- 79.65 (16.61) mm, respectively. The relative reductions in choroidal thickness between early follicular and ovulatory phases and early follicular and mid-luteal phases were 2.64% and 6.47%, respectively. The subfoveal choroidal thickness was decreased significantly in the mid-luteal phase when compared with both the early follicular (p<0.001) and ovulatory phases (p = 0.003). However, the measures of subfoveal choroidal thickness in the early follicular phase were non-conclusively greater (p = 0.071) than in the ovulatory phase. Additionally, the mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses did not significantly differ during the menstrual cycle (p>0.05 for all). Conclusions: The choroidal thickness decreased significantly in the mid-luteal phase of the menstrual cycle in young, healthy women. These findings emphasize the importance of the menstrual phase in the interpretation of choroidal thickness measurements in women of reproductive age.
Comparison of the effect of intravitreal bevacizumab and intravitreal fasudil on retinal VEGF, TNF alpha, and caspase 3 levels in an experimental diabetes model
(Ijo Press, 2014) Çelik, Fatih; Ulaş, Fatih; Özünal, Zeynep Güneş; Fırat, Tülin; Çelebi, Serdal; Doğan, Ümit
AIM: To evaluate the influence of an intravitreal injection of bevacizumab and fasudil on the retinal vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNF alpha), and caspase 3 levels in a diabetic rabbit model. METHODS: The study included 6 healthy rabbits (Group 1), 6 rabbits with experimentally induced diabetes mellitus (DM) (Group 2), 7 rabbits with experimentally induced DM to which intravitreal bevacizumab was administered (Group 3), and 7 rabbits with experimentally induced DM to which intravitreal fasudil was administered (Group 4). An intravitreal injection of 1.25mg/50 mu L bevacizumab in the right eye of rabbits in Group 3 and an intravitreal injection of 0.0064mg/50 mu L fasudil in the right eye of rabbits in Group 4 were administered on day 21 after the induction of DM. The studied eyes of the rabbits were enucleated three days after the intravitreal injection. The TNF alpha, VEGF, and caspase 3 levels were determined using the ELISA method. RESULTS: There was a statistically significant difference in the VEGF and caspase 3 levels between groups (P=0.005 and P=0.013, respectively), but the TNF alpha level did not differ significantly between groups (P=0.792). It was found that VEGF levels were significantly lower in Group 1 and Group 3 than in Group 2 using the Mann-Whitney Utest with the Bonferroni correction (P=0.004 for both comparison). There was no statistically significant difference between other groups with regard to VEGF levels (the P value ranged between 0.015 and 0.886). Although the P values of the caspase 3 levels were 0.015 for Group 1 and Group 4, 0.038 for Group 2 and Group 3, and 0.018 for Group 3 and Group 4, these P values remained above the threshold Pvalue of 0.0083, which was the statistically significant level for post hoc tests. CONCLUSION: An intravitreal injection of bevacizumab decreased both the VEGF level, which plays a role in angiogenesis, and the caspase 3 level, which plays a role in apoptosis. Although not as effective as bevacizumab, fasudil had a beneficial effect on the VEGF levels but significantly increased the caspase 3 levels.
Comparison of the effects of topical corneal inhibitory agents on TTL and PON1 in rats
(Rjpbcs Research Journal Pharmaceutical, Biological & Chemical Sciences, 2017) Soydan, Adem; Yazar, Hayrullah; Çetinkaya, Ayhan; Terzi, Elçin Hakan; Ulaş, Fatih; Doğan, Ümit
The aim of this study was to compare the effects of topical corneal inhibitory agents on total thiol (TTL) and paraoxonase 1 (PON1) levels in rats with experimentally acquired keratoconjunctivitis. Thirty-five rats were divided into five groups. Twenty-four hours prior to the experiment, keratoconjunctivitis was established in the right eye of the rats using sodium hydroxide. The treatments of the five groups were as follows: group I: (control) isotonic saline (0.9%), group II: topical 0.05% cyclosporine A, group III: topical 1% diluted propolis, group IV: topical 3% diluted propolis, and group V: 0.1% dexamethasone. At the end of the 10th day, one rat in each group, except the cyclosporine group (group II), had died. The treatment was applied to all groups three times a day for 10 days. Subsequently, blood samples were obtained and used for determining the levels of TTL and PON1 (Architect C16000). All statistical analyses were performed using IBM SPSS for Windows Version 20.0 software. Descriptive statistics were calculated from the values obtained from this study and shown as arithmetic mean and standard deviation. Kruskal Wallis variance analysis was conducted. p values found to be under 0.05 were accepted as statistically significant. The study was performed after the approval [By The Animal Research Ethics Committee, Bolu Abant Izzet Baysal University, Number: 13.30.2.ABU.0.05.05-050.01.04-1, January.8.2016]. The TTL results were as follows (mu mol/L): group I: 253.24, group II: 238.70, group III: 281.39, group IV: 284.80 and group V: 260.65. No marked differences were observed between the control group and the other groups (P>0.05). The PON1 results were as follows (U/L): group I: 521.49, group II: 472.30, group III: 362.37, group IV: 327.48 and group V: 440.31. No marked difference was observed between the control group and the other groups (P > 0.05). However, there was a marked difference in the PON1 results between the 1% and 3% propolis groups. CNV inhibitor agents' effects on TTL and PON1 values were similar.
Dejeneratif miyop hastada şeffaf lens ekstraksiyonu sonrası gelişen anizokori
(2013) Ulaş, Fatih; Çelik, Fatih; Doğan, Ümit; Çelebi, Serdal
Dejeneratif miyopi 20-50 yaş arasındaki kişilerde görme azalmasının önemli nedenlerindendir. Patolojik mekanizma tam olarak bilinmese de genetik ve çevresel faktörlerin birlikte rol oynadığı düşünülmektedir. Dejeneratif miyopide sklera, koro- id, Bruch membranı, pigment epiteli ve retinada ikincil dejeneratif değişiklikler gelişmektedir. Dejeneratif miyopide şeffaf lens ekstraksiyonu uygulanan tedavi yöntemlerinden biridir. Olgumuz 26 yaşında olup, her iki gözde dejeneratif miyopisi vardı ve her iki gözüne şeffaf lens ekstraksiyonu ve katlanabilir IOL implantasyonu yapıldı. Sağ göze yapılan ilk ameliyat sonrası anizokori geliştiği gözlendi. Sol göze şeffaf lens ekstraksiyonu yapıldıktan sonra anizokorinin düzeldiği ve her iki pupillanın izokorik olduğu görüldü. Meydana gelen anizokorinin kristalin lensin iris üzerindeki mekanik etkisinin kalkma- sına bağlı olarak geliştiğini düşünmekteyiz.
Deneysel kornea neovaskülarizasyonunda bevacuzimab ve deksametazonun etkinliği
(Bolu Abant İzzet Baysal Üniversitesi, 2009) Doğan, Ümit; Çelebi, Serdal
Korneal neovaskülarizasyon, herhangi bir nedenle korneada yeni damarların oluşmasıdır. Enflamasyon, enfeksiyon, dejeneratif hastalık, travma ve hipoksi gibi nedenler, şeffaf ve damarsız korneada neovaskülarizasyona neden olabilir. Tedavide başlıca kortikosteroidler, nonsteroid antienflamatuarlar ve VEGF inhibitörleri kullanılmaktadır. Bu çalışmada, deneysel olarak oluşturulan tavşan kornea neovaskülarizasyonunda topikal deksametazon, subkonjonktival bevasizumab ve topikal bevasizumabın etkilerini araştırmayı ve karşılaştırmayı amaçladık.Çalışmada toplan 24 tane Yeni Zelanda cinsi erişkin erkek tavşan kullanıldı. Kontrol (Grup 1), topikal deksametazon (Grup 2), subkonjonktival bevasizumab (Grup3) ve topikal bevasizumab (Grup 4) grupları olmak üzere toplam dört grup oluşturulup, bütün deneklerin sol göz kornealarında gümüş nitrat-potasyum nitrat ile kimyasal yanık oluşturulduktan sonra, on gün boyunca her gruba ilgili ilaç uygulandı. Onuncu günde denekler sakrifiye edilip, hematoksilen eozin, Masson Trikrom ve immunohistokimyasal boyamalar yapıldıktan sonra, histopatolojik olarak korneal neovaskülarizasyon ve apoptozis değerlendirildi ve gruplar karşılaştırıldı.Subkonjonktival ve topikal bevasizumab gruplarında korneal neovaskülarizasyonda belirgin azalma olduğu, topikal deksametazon grubunda kontrol grubuna göre istatistiksel olarak anlamlı düzeyde daha az neovaskülarizasyon olmakla birlikte (p=0.01), deksametazon grubunda korneal neovaskülarizasyondaki gerilemenin bevasizumab gruplarına göre istatistiksel olarak anlamlı düzeyde daha az olduğu saptandı (Sırasıyla; p=0.004, p=0.004). TUNEL metodu ile yapılan apoptozis değerlendirilmesinde ise bevasizumab gruplarındaki apoptotik hücre sayısının, kontrol ve topikal deksametazon gruplarındaki apoptotik hücre sayısından istatistiksel olarak anlamlı düzeyde daha az olduğu saptandı (Sırasıyla; p=0.004, p=0.004, p=0.004, p=0.004). Apoptotik hücre sayısı bakımından, kontrol ve topikal deksametazon grupları arasında istatistiki bir fark tespit edilmedi (p=0.065).Sonuç olarak, topikal deksametazon, topikal bevasizumab ve subkonjonktival bevasizumabın, deneysel tavşan kornea neovaskülarizasyonunun kontrolünde etkili yöntemler olduğunu, topikal ve subkonjonktival bevasizumabın, topikal deksametazondan daha etkili olduğunu gözledik.
Diyabetik maküler ödemi olan hastalarda intravitreal triamsinolon asetonid ve bevacizumabın retinal damar çapı üzerine kısa dönem etkilerinin karşılaştırılması
(2013) Ulaş, Fatih; Doğan, Ümit; Çelik, Fatih; Şahin, Saygın; Çelebi, Serdal
Amaç: Diyabetik maküla ödemi nedeniyle intravitreal triamsinolon asetonid ve bevacizumab uygulanan hastalarda retina damar çapı değişikliklerinin karşılaştırılması. Gereç ve Yöntem: Yaşları 41-78 arası değişen 42 diyabetik maküla ödemi olan hastanın intravitreal enjeksiyondan önce, enjek- siyondan bir hafta ve dört hafta sonra retina damar çapı ölçümleri gerçekleştirildi. Hastaların 21’ine (%50.0) 2 mg/0.05 ml intra- vitreal triamsinolon asetonid ve 21’ine (%50.0) 1.25mg/0.05 ml intravitreal bevacizumab uygulandı. Retinal damar çapı ölçümleri, Spectralis optik koherens tomografi cihazındaki retina sinir lifi ölçüm modu görüntüsü kullanılarak cihazda yüklü olan yarı oto- matik program yardımı ile manuel olarak yapıldı. Retina damar çapı değişiklikleri arasındaki farkın istatistiksel analizi ilişkili örneklem tek yönlü varyans analizi ve Bonferroni düzeltmesi ile değerlendirildi. Bulgular: Sağlıklı kontrol grubu ile triamsinolon ve bevacizumab gruplarının enjeksiyon öncesi ortalama retinal arteriyol çapları sırasıyla 88.55±11.29, 87.19±10.00 ve 91.67±16.69 ?m idi. Sağlıklı kontrol grubu ile triamsinolon ve bevacizumab gruplarının enjeksiyon öncesi ortalama retinal venül çapları sırasıyla 127.00±16.91, 130.38±24.01 ve 132.52±18.74 ?m idi. Triamsinolon gru- bunda çalışma süresince istatistiksel olarak anlamlı düzeyde retina arteriyol ve venüllerinde daralma gözlendi (p değerleri sıra- sıyla 0.047 ve <0.001). Çalışma süresince bevacizumab grubunda, retina venüllerinde istatistiksel olarak anlamlı daralma olurken (p<0.001), retina arteriyollerinde istatistiksel olarak anlamlı değişiklik saptanmadı (p=0.209). Sonuç: Kısa dönem değerlendirmelerinde, retina damar çaplarında intravitreal olarak uygulanan triamsinolon asetonid, bevaci- zumabdan daha belirgin değişikliklere neden olmaktadır.
Diyabetik olmayan kronik böbrek yetmezliği hastalarında hemodiyalizin gözdeki etkileri
(Turkiye Klinikleri, 2014) Ulaş, Fatih; Doğan, Ümit; Keleş, Asena; Ertilav, Muhittin; Tekçe, Hikmet; Çelebi, Serdal; Taslamacıoğlu, Tuba
Objective: To evaluate effects of hemodialysis on best-corrected visual acuity (BCVA), spherical equivalent, central corneal thickness (CCT), intraocular pressure (IOP), macular volume, and retinal nerve fiber layer (RNFL) thickness in non-diabetic chronic renal failure (CRF) patients. Material and Methods: Twenty-four eyes of 20 male and 4 female CRF patients aged between 46-78 years (mean 61.13±10.31 years) were included in this cross-sectional study. BCVA, spherical equivalent, CCT, IOP, macular volume and RNFLthickness measurements of the patients were recorded before and after hemodialysis. Statistical analysis of the data was carried out using paired sample t-test, Wilcoxon signed rank test and Pearson correlation analysis. Results: Hemodialysis significantly decreased plasma osmolality (p<0.001), increased plasma colloid oncotic pressure (p<0.001) and did not alter mean arterial pressure (p=0.139). There was no statistically significant difference in BCVA, spherical equivalent, CCT and all evaluated macular segment volumes (p values were >0.05). IOP decreased significantly after hemodialysis (p=0.007). There was statistically significant increase in all RNFLsegments (p values for global, superotemporal, superonasal, inferotemporal and inferonasal segments were 0.005, 0.002, 0.021, 0.041 and 0.024, respectively) except in nasal and temporal RNFLsegments. There was no significant correlation between all measured parameters (p values were >0.05) except for moderate significant correlation between plasma colloid osmotic pressure difference and CCT difference (r=-0.451, p=0.027), and plasma colloid osmotic pressure difference and IOP difference (r=-0.415, p=0.044). Conclusion: Hemodialysis did not alter BCVA, spheric equivalent, CCT and macular volume, but altered IOP and RNFLthickness significantly in nondiabetic CRF patients. Ophthalmologic examination of CRF patients treated with hemodialysis must be performed at the same time point based on the time of the hemodialysis sessions.
Diyabetik retinopati gelişmemiş diyabetik olgularda retina, retina sinir lifi tabakası ve koroid kalınlığının değerlendirilmesi
(2015) Ulaş, Fatih; Doğan, Ümit; Çelik, Fatih; Soydan, Adem; Çelebi, Serdal; Dikbaş, Oğuz
Amaç: Diyabetik retinopati gelişmemiş diyabetik olguların retina, retina sinir lifi tabakası (RSLT) ve koroid tabakası kalınlığının sağlıklı bireylerle karşılaştırılması.Gereç ve Yöntem: Çalışmaya 37-78 yaş arasında 133 diyabetik retinopati gelişmemiş diyabetik olgu ve 60 sağlıklı birey dahil edildi. Olguların Fourier prensibiyle çalışan optik koherens tomografi cihazı ile artırılmış derinlik görüntülemesi (enhanced depth imaging) modunda horizontal çizgisel taraması yapıldı. Alınan görüntülemelerde fovea merkezinden, fovea merkezine 1500 µm nazalden ve 1500 µm temporalden retina ve koroid kalınlıkları ölçümü yapıldı. Ayrıca cihazda yüklü bulunan RSLT kalınlığı ölçüm modu değerlerinde değişiklik yapılmaksızın RSLT kalınlığı ölçümü yapıldı.Bulgular: Çalışmaya dahil edilen DM grubunun yaş ortalaması 52.75±12.74 kontrol grubunun yaş ortalaması 53.83±5.95 idi. Göz içi basıncı (GİB) değerleri DM grubunda 16.26±2.90 mmHg ve kontrol grubunda 13.18±2.13 mmHg idi (p<0,001). Santral retina kalınlığı DM grubunda 226.24±18.78 µm, kontrol grubunda 216.37±14.79 µm idi (p<0.001). Subfoveal koroid kalınlığı DM grubunda 301.95±76.20 µm, kontrol grubunda 346.62±82.14 µm idi (p=0.001). RSLT kalınlığında ise gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (p=0.494). Spearman testi ile korelasyon değerlendirmesinde diyabet varlığının artmış foveal retina kalınlığı, azalmış subfoveal koroid kalınlığı ve artmış GİB ile birliktelik gösterebileceği belirlendi (rho değer aralığı -0.262 ile 0.543, p<0.001).Sonuç: DM grubu sağlıklı bireylerle karşılaştırıldığında daha kalın retina, daha ince koroid kalınlığı ve daha yüksek GİB değerleri saptanmıştır. Gruplar arasında RSLT kalınlığı bakımından belirgin fark saptanmamıştır. Sonuçlarımız diyabetik retinopati gelişmemiş diyabetik olgularda GİB ve arka segment değerlendirilmesinin dikkatli yapılması gerektiğini göstermektedir
Effect of smoking on choroidal thickness in healthy smokers
(Informa Healthcare, 2014) Ulaş, Fatih; Çelik, Fatih; Doğan, Ümit; Çelebi, Serdal
Purpose: To evaluate the acute and chronic effects of cigarette smoking on the choroidal thickness of young male smokers with smoking histories exceeding 10 years using spectral domain optical coherence tomography (SD OCT). Materials and methods: The right eyes of 40 never-smoking and 30 smoking healthy subjects were included in this study. We measured the choroidal thicknesses of the never-smoking subjects as a control group. The choroidal thicknesses of the smoking subjects were measured before, 5, 30 and 60 min after smoking. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 mm nasal and temporal to the fovea. Results: No significant difference was found for the retinal thickness, choroidal thicknesses, spherical equivalent, intraocular pressure and central corneal thickness of the smokers and non-smokers (p>0.05 for all). In the measurements that were taken after smoking, a statistically significant increase was found in choroidal thickness that was observed between 0 and 5 min for the central, nasal and temporal segments (p<0.001 for all). Conclusions: Smoking caused acute, significant increase in choroidal thickness that returned to baseline levels after 1 h. The choroidal and retinal thicknesses did not differ significantly between the healthy young smokers and non-smokers.
Effect of fasting on choroidal thickness and Its diurnal variation
(Taylor & Francis Inc, 2019) Uyar, Enes; Doğan, Ümit; Ulaş, Fatih; Çelebi, Serdal
Purpose: The aim of this study was to assess the effect of Ramadan fasting on choroidal thickness (CT) and its associated diurnal variations using spectral domain optic coherence tomography. Materials and Methods: Ocular measurements were performed on a single eye of 87 healthy individuals. Eyes were evaluated twice a day around 8.00 a.m. and 4.00 p.m. during Ramadan. Evaluations were repeated at the same time of the day, 1 month following Ramadan on the same subjects. Measurements of choroidal and retinal thickness were performed at central, temporal and nasal segments. Results: The comparison of measurements revealed that temporal CT at 8.00 a.m. and foveal, temporal and nasal CTs at 4.00 p.m. were significantly reduced during fasting (p values were 0.005, <0.001, 0.001 and 0.046, respectively). Mean changes of CTs during fasting were 14.76 +/- 16.01, 9.90 +/- 19.57 and 8.10 +/- 16.81 mu m at the fovea, temporal and nasal segments, respectively. However, CTs at non-fasting conditions were measured as 6.13 +/- 12.93, 3.78 +/- 15.23 and 5.05 +/- 13.60 mu m, respectively. In comparison, diurnal variations of foveal and temporal CTs during fasting were significantly higher than the controls (p values were <0.001 and 0.004, respectively). Additionally, retinal thicknesses during fasting were significantly reduced compared to the controls in all segments measured at 4.00 p.m. (p for all values <0.05) Conclusions: The results of the present study revealed that fasting and dehydration caused a reduction of the choroidal and retinal thicknesses. Likewise, they are also responsible for the increased diurnal variation of CTs. Therefore, early hours of the day may be preferred to evaluate retinal and choroidal thicknesses during Ramadan to avoid the effects of dehydration on the measurement results.
Effect of fasting on choroidal thickness and its diurnal variation
(Taylor & Francis Inc, 2019) Uyar, Enes; Doğan, Ümit; Ulaş, Fatih
Purpose: The aim of this study was to assess the effect of Ramadan fasting on choroidal thickness (CT) and its associated diurnal variations using spectral domain optic coherence tomography. Materials and Methods: Ocular measurements were performed on a single eye of 87 healthy individuals. Eyes were evaluated twice a day around 8.00 a.m. and 4.00 p.m. during Ramadan. Evaluations were repeated at the same time of the day, 1 month following Ramadan on the same subjects. Measurements of choroidal and retinal thickness were performed at central, temporal and nasal segments. Results: The comparison of measurements revealed that temporal CT at 8.00 a.m. and foveal, temporal and nasal CTs at 4.00 p.m. were significantly reduced during fasting (p values were 0.005, <0.001, 0.001 and 0.046, respectively). Mean changes of CTs during fasting were 14.76 ± 16.01, 9.90 ± 19.57 and 8.10 ± 16.81 µm at the fovea, temporal and nasal segments, respectively. However, CTs at non-fasting conditions were measured as 6.13 ± 12.93, 3.78 ± 15.23 and 5.05 ± 13.60 µm, respectively. In comparison, diurnal variations of foveal and temporal CTs during fasting were significantly higher than the controls (p values were <0.001 and 0.004, respectively). Additionally, retinal thicknesses during fasting were significantly reduced compared to the controls in all segments measured at 4.00 p.m. (p for all values <0.05) Conclusions: The results of the present study revealed that fasting and dehydration caused a reduction of the choroidal and retinal thicknesses. Likewise, they are also responsible for the increased diurnal variation of CTs. Therefore, early hours of the day may be preferred to evaluate retinal and choroidal thicknesses during Ramadan to avoid the effects of dehydration on the measurement results
Effect of nepafenac 0.1% on retinal thickness after cataract surgery in patients without risk factors for cystoid macular edema
(Ijo Press, 2020) Şahin, Asena Keleş; Kükner, Ahmet Şahap; Ulaş, Fatih; Doğan, Ümit
AIM: To evaluate the effect of topical preoperative nepafenac 0.1% treatment on postoperative macular edema using optical coherence tomography (OCT) after uncomplicated cataract surgery. METHODS: Ninety eyes of 90 patients without any risk factors were included in the study. The patients were assigned to three groups: group 1, treated with topical prednisolone acetate 1%; group 2, treated with topical nepafenac 0.1% in addition to prednisolone acetate (1%); and group 3, those who started receiving nepafenac 0.1% treatment 3d prior to surgery and continued the treatment postoperatively in addition to prednisolone acetate (1%). Central retinal thickness (CRT) and macular volume values were recorded using OCT at weeks 3 and 6. RESULTS: The increases in macular volume in the central 1 mm area after 3 and 6wk were significantly lower in patients who used prophylactic topical nepafenac preoperatively (group 3) compared with those in group 1 (P=0.028 and 0.008, respectively). No significant differences in the increase in macular volume and CRT were noted between groups 2 and 3 (P>0.05). In group 1, the increases in macular volume in the central 3 mm area at weeks 3 and 6 were significantly higher than that in group 2 and 3 (3rd week, P=0.004; 6th week, P=0.005). CONCLUSION: Nepafenac 0.1% treatment in addition to topical steroids after uncomplicated cataract surgery reduce the increase in macular volume in the early postoperative period.
Epiretinal membran ile birliktelik gösteren dirençli diyabetik maküla ödeminin tedavisinde intravitreal deksametazon implantasyonu
(2015) Soydan, Adem; Ulaş, Fatih; Doğan, Ümit
Son yıllarda intravitreal deksametazon implantı retina ven tıkanıklığına ve arka üveite bağlı gelişen maküla ödemi endikasyonlarında kullanıma sunulmuştur. Ülkemizde diyabetik maküla ödemi tedavisinde endikasyon dışı olarak ödemesi yapılmaktadır. Daha önce kliniğimizde diyabetik maküla ödemi nedeniyle çeşitli tedaviler uygulanan ve her iki gözünde tedaviye dirençli diyabetik maküla ödemi ve epiretinal membranı (ERM) olan 69 yaşında kadın hastaya intravitreal deksametazon implantı uygulaması planlandı. Tedaviye dirençli maküla ödemi olan hastanın kliniği daha kötü olan sol gözüne yaptığımız intravitreal enjeksiyon sonucu, ilk iki ayda görme keskinliğinde artışın yanısıra maküla ödeminin azaldığı ve ERM'nin retina yüzeyinden kısmen ayrılması ile birlikte maküler traksiyonun gerilediği görüldü. Üçüncü ayda maküler ödem ve ERM'nin tekrar ilerlemeye başladığı saptandı. Vitreomaküler traksiyon ile birliktelik gösteren maküla ödemli olgularda intravitreal deksametazon implantasyonu ERM'nin retina yüzeyinden ayrılması ile birlikte ödemi azaltmaktadır. Ancak ERM'de intravitreal deksametazon implantasyonu sonrası gelişen ayrılmanın traksiyonel komplikasyonlara neden olabileceği de göz önünde bulundurulmalıdır.
Epiretinal Membran ile Birliktelik Gösteren Dirençli DiyabetikMaküla ÖdemininTedavisinde İntravitreal Deksametazon İmplantasyonu
(2015) Soydan, Adem; Ulaş, Fatih; Doğan, Ümit
Son yıllarda intravitreal deksametazon implantı retina ven tıkanıklığına ve arka üveite bağlı gelişen maküla ödemi endikasyonlarında kullanıma sunulmuştur. Ülkemizde diyabetik maküla ödemi tedavisinde endikasyon dışı olarak ödemesi yapılmaktadır. Daha önce kliniğimizde diyabetik maküla ödemi nedeniyle çeşitli tedaviler uygulanan ve her iki gözünde tedaviye dirençli diyabetik maküla ödemi ve epiretinal membranı (ERM) olan 69 yaşında kadın hastaya intravitreal deksametazon implantı uygulaması planlandı. Tedaviye dirençli maküla ödemi olan hastanın kliniği daha kötü olan sol gözüne yaptığımız intravitreal enjeksiyon sonucu, ilk iki ayda görme keskinliğinde artışın yanısıra maküla ödeminin azaldığı ve ERM'nin retina yüzeyinden kısmen ayrılması ile birlikte maküler traksiyonun gerilediği görüldü. Üçüncü ayda maküler ödem ve ERM'nin tekrar ilerlemeye başladığı saptandı. Vitreomaküler traksiyon ile birliktelik gösteren maküla ödemli olgularda intravitreal deksametazon implantasyonu ERM'nin retina yüzeyinden ayrılması ile birlikte ödemi azaltmaktadır. Ancak ERM'de intravitreal deksametazon implantasyonu sonrası gelişen ayrılmanın traksiyonel komplikasyonlara neden olabileceği de göz önünde bulundurulmalıdır
Evaluation of choroidal and retinal thickness measurements using optical coherence tomography in non-diabetic haemodialysis patients
(Springer, 2013) Ulaş, Fatih; Doğan, Ümit; Keleş, Asena; Ertilav, Muhittin; Tekçe, Hikmet; Çelebi, Serdal
The aim of this study is to evaluate the effects of haemodialysis with a high ultrafiltration rate on the choroidal and retinal thickness of non-diabetic end-stage chronic renal failure (CRF) patients using optical coherence tomography (OCT). Twenty-one eyes of 21 male CRF patients aged between 46 and 80 years were included in this prospective study. Retinal and choroidal thicknesses of the patients were measured using high-resolution OCT line scans with the activated enhanced depth imaging mode before and shortly after haemodialysis. Retinal and choroidal thickness measurements were taken at the fovea and at two points that were 1,500 mu m nasal and temporal to the fovea. The relationships between the haemodynamic changes, intraocular pressure (IOP) and central corneal thickness (CCT) were also evaluated. The mean choroidal thicknesses before haemodialysis at the subfoveal, temporal and nasal locations were 232.81 +/- A 71.92, 212.43 +/- A 70.50 and 182.14 +/- A 68.88 mu m, respectively. The mean choroidal thicknesses after haemodialysis at the subfoveal, temporal and nasal locations were 210.90 +/- A 65.53, 195.38 +/- A 66.48 and 165.19 +/- A 66.73 mu m, respectively. There were significant differences between the choroidal thicknesses before and after haemodialysis (p < 0.001 for all). The mean retinal thicknesses before haemodialysis at the foveal, temporal and nasal locations were 215.86 +/- A 41.06, 308.86 +/- A 37.73 and 338.00 +/- A 33.32 mu m, respectively. The mean retinal thicknesses after haemodialysis at the foveal, temporal and nasal locations were 216.90 +/- A 39.70, 313.86 +/- A 32.89 and 335.29 +/- A 36.85 mu m, respectively. There was no significant difference between the retinal thicknesses before and after haemodialysis (p > 0.05 for all). The mean CCT decreased insignificantly from 550.48 +/- A 17.46 to 548.10 +/- A 21.12 mu m (p = 0.411). The mean IOP decreased significantly from 14.09 +/- A 2.58 to 12.54 +/- A 2.23 mmHg (p = 0.003), which did not correlate with the CCT [r = (-)0.134, p = 0.562]. Haemodialysis with a high ultrafiltration volume did not alter the retinal thickness but caused a significant choroidal thinning and an IOP decrease in non-diabetic end-stage CRF patients.

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