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Öğe Alt oblik miyektomi sonrası internal oftalmopleji gelişen iki olgu(2012) Ulaş, Fatih; Doğan, Ümit; Bucak, Y. Yücel; Çelebi, SerdalAlt 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.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 Başarısız intravitreal deksametazon implant uygulaması(2019) Aras, Ferişte; Ulaş, Fatihİntravitreal deksametazon implantı (İVDİ) retina ven tıkanıklığı, diyabetik makülopati ve arka üveite bağlı gelişen maküla ödemi endikasyonlarında kullanıma sunulmuştur. Kliniğimizde diyabetik maküla ödemi tanısıyla intravitreal anti-vasküler endotelyal büyüme faktörü enjeksiyonu uygulanan ve her iki gözünde tedaviye yeterli yanıt alınamayan 65 yaşında erkek hastaya bilateral İVDİ uygulaması planlandı. Sağ gözüne sorunsuz olarak İVDİ uygulanan olgunun, sol göz İVDİ uygulaması sırasında implant aplikatörü ile tam kat skleral giriş yapılamadığından İVDİ uygulaması yapılamadı. Başarısız uygulama sonrası aplikatör kontrol edildiğinde implantın kısmen aplikatör iğnesinin konik kısmından hafi f taşmış olduğu saptandı. İVDİ uygulaması öncesi aplikatör iğnesi ve implant pozisyonunun kontrol edilmesi uygulama başarısı açısından önemlidir.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 Can hypothyroidism cause acute central serous chorioretinopathy?(Taylor & Francis Inc, 2019) Ulaş, Fatih; Uyar, Enes; Tekçe, Hikmet; Çelebi, SerdalPurpose: To evaluate selected systemic findings, especially thyroid functions, in acute central serous chorioretinopathy (CSC) patients. Materials and Methods: In all, 71 consecutive acute CSC patients who fulfilled the inclusion criteria and 70 age-matched healthy control subjects were included in the study. Systemic findings, including serum levels of thyroid hormones, thyroid stimulating hormone (TSH), mean arterial pressure (MAP), pulse rate, serum lipid levels and optical coherence tomography findings, were compared between the groups. Independent samples t-test was used for statistical analysis. Results: The mean ages of the CSC and control groups were 41.06 +/- 6.49 and 40.06 +/- 7.08 years old, respectively. Retinal thickness, choroidal thickness, TSH levels, pulse rate and MAP were significantly different between CSC patients and healthy control subjects (range of p values: <0.001-0.042). In the logistic regression analysis, MAP, serum triglyceride concentration and central choroidal thickness were positively associated with CSC (range of p values: <0.001-0.035). Conclusion: Acute CSC patients had significantly higher pulse rates and MAP and significantly thicker choroidal thickness than were found in healthy subjects. TSH levels were also significantly higher in CSC patients than in controls. Hence, hypothyroidism might be associated with CSC.Öğe Can vitreous reflux affect the short-term treatment response after intravitreal ranibizumab injection?(Taylor & Francis Inc, 2021) Uyar, Enes; Ulaş, Fatih; Alkan, YunusPurpose The aim of this study was to evaluate the effect of vitreous reflux (VR) on the short-term effect of intravitreal ranibizumab injection. Materials and Methods The study included 181 eyes of 81 age-related macular degeneration (AMD) and 100 diabetic macular edema (DME) patients. Treatment response was evaluated by measuring central macular thickness (CMT) as well as 1 mm and 3 mm central macular thicknesses (MT1 and MT3). Patients were grouped as; Group 1: no VR, Group 2: <3 mm VR, and Group 3: >3 mm VR according to conjunctival bleb diameters. The data were analyzed using variance, correlation and regression analyses. Results In AMD patients, reduction of CMT values following the treatment were 88.3 +/- 110.6 mu m in Group 1, 85.6 +/- 158.7 mu m in Group 2, and 93.1 +/- 92.2 mu m in Group 3. Likewise, in DME patients, it was 82.4 +/- 88.4 mu m, 72.9 +/- 109.9 mu m, and 73.7 +/- 113.7 mu m, respectively. Reduction of MT1 values after the treatment were 47.4 +/- 72.6 mu m, 36.0 +/- 131.9 mu m, and 36.7 +/- 114.4 mu m in AMD patients, and 33.3 +/- 72.5 mu m, 36.6 +/- 90.2 mu m, and 46.9 +/- 83.4 mu m in DME patients. In all comparisons among groups of VR, macular thickness (MT) change did not exhibit significant difference following an intravitreal ranibizumab treatment (p> .05). Conclusion We found that the increase in VR amount did not adversely affect the decrease in MT after intravitreal ranibizumab treatment in AMD and DME patients.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 Choroidal thickness changes during the menstrual cycle(Informa Healthcare, 2013) Ulaş, Fatih; Doğan, Ümit; Duran, Bülent; Keleş, Asena; Ağca, Sümeyra; Çelebi, SerdalPurpose: 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.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 A comparison of short-term effects of intravitreal triamcinolone acetonide and bevacizumab on retinal vascular caliber in patients with diabetic macular edema(2013) Ulaş, Fatih; Do?an, Ümit; Çelik, Fatih; Şahin, Saygin; Çelebi, SerdalPurpose: To compare the retinal vascular caliber changes in diabetic macular edema patients receiving intravitreal triamcinolone acetonide and bevacizumab. Materials and Methods: Retinal vascular caliber of 42 patients with diabetic macular edema aged between 41-78 were measured before, 1 week and 4 weeks after the intravitreal injection. 21 (50.0%) patients received 2 mg/0.05 ml intravitreal triamcinolone acetonide and 21 (50.0%) patients received 1.25 mg/0.05 ml intravitreal bevacizumab. Retinal vascular caliber assessment was performed manually on retinal nerve fiber layer imaging mode scan by using semi-automated program of Spectralis optical coherence tomography. Statistical analyses of differences between retinal vascular caliber were determined using repeated measures of analysis of variance and Bonferroni adjustment. Results: Mean retinal arteriolar diameter of healthy control group, triamcinolone group, and bevacizumab group before the injection was 88.55±11.29, 87.19±10.00 and 91.67±16.69 ?m, respectively. Mean retinal venular diameter of healthy control group, triamcinolone group, and bevacizumab group before the injection was 127.00±16.91, 130.38±24.01 and 132.52±18.74 ?m, respectively. In triamcinolone group, there was statistically significant decline in retinal arteriolar and venular diameter during the study period (p values were 0.047 and <0.001, respectively). In bevacizumab group, retinal venular diameter was significantly decreased (p<0.001) but there was no significant change in retinal arteriolar diameter during the study period (p=0.209). Conclusions: In short-term, intravitreal triamcinolone acetonide led to more significant changes than intravitreal bevacizumab in retinal vascular caliber.Öğe 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, ÜmitAIM: 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.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 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, ÜmitThe 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.Öğe Dejeneratif miyop hastada şeffaf lens ekstraksiyonu sonrası gelişen anizokori(2013) Ulaş, Fatih; Çelik, Fatih; Doğan, Ümit; Çelebi, SerdalDejeneratif 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.Öğe Depresyon ve Optik Koherans Tomografi Çalışmalarında Gözden Kaçan Bir Parametre: D vitamini(2024) Turhan, Nur Özgedik; Arisoy, Özden; Ulaş, Fatih; Buğdayci, Güler; Gülner, Melek AltintaşAmaç: Depresyon ve enflamasyon arasındaki ilişki ve buna bağlı oluşan vasküler/nöronal hasar son dönemde yapılan çalışmalarda gösterilmiştir. Çalışmamızda depresyon ve eşlik eden vitamin D eksikliğinin yaratabileceği enflamasyon ve olası dejenerasyonu, non- invaziv bir görüntüleme yöntemi olan Optik Koherans Tomografi (OKT) ile incelemeyi amaçladık. Yöntem: Yaş, cinsiyet ve göz ölçümleri eşleştirilmiş depresif ataktaki ilaçsız 42 majör depresyon hastası ve 24 sağlıklı kontrolde vitamin D, C Reaktif Protein (CRP) ve OKT parametreleri ölçülmüştür. Hastalık şiddeti; Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Klinik Global İzlenim Ölçeği (CGI) ve Global Değerlendirme Ölçeği (GAS) ile belirlenmiştir. Bulgular: Majör depresyon grubunda CRP düzeyi ve koroid kalınlığı sağlıklı kontrol grubuna göre anlamlı derecede yüksek; vitamin D ve ganglion hücre tabakası (GCL) hacmi anlamlı derecede düşük bulundu. Majör depresiflerde HAM-D ile CRP arasında pozitif korelasyon; şimdiki atak süresi ile GCL hacmi arasında negatif korelasyon saptandı. CGI, CRP ve HAM-D ile pozitif korele bulundu. GAS; HAM-D ve CRP ile negatif korele bulunmuştur. Sonuç: Bu çalışmada majör depresyonun, olası dejeneratif süreçlerin gözlenebildiği enflamatuvar bir bozukluk olabileceği OKT ve CRP ölçümleri ile gösterilmiştir. Ancak, nedensel bir ilişkinin ortaya konabilmesi için uzunlamasına izlem çalışmalarına ihtiyaç vardır.Öğe 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, SerdalAmaç: 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.Öğe 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, TubaObjective: 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.Öğe 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, OğuzAmaç: 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
