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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 Effect of fasting on choroidal thickness and Its diurnal variation(Taylor & Francis Inc, 2019) Uyar, Enes; Doğan, Ümit; Ulaş, Fatih; Çelebi, SerdalPurpose: 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.Öğe Effect of Fasting on Choroidal Thickness and Its Diurnal Variation(Taylor & Francis Inc, 2019) Uyar, Enes; Dogan, Umit; Ulas, FatihÖğe Effect of quadrant switch on intraocular pressure change in intravitreal aflibercept or ranibizumab injection applications(Springer, 2022) Altıntaş, Melek; Ulaş, Fatih; Çelebi, Serdal; Uyar, EnesObjective To evaluate the effect of injection quadrant switch on the intraocular pressure (IOP) change in intravitreal aflibercept or ranibizumab applications. Methods 123 eyes of 123 patients who received intravitreal injection (IVE) into the superotemporal quadrant at least 10 times for age-related macular degeneration or diabetic macular edema have been recruited. The demographic data, lens status, IOP values (preoperative, postoperative 0th min, and postoperative 30th min), and amount of vitreous reflux (VR) following IVE have been recorded. Next IVE application was performed into the inferotemporal quadrant of the patient, which had never been injected before. Results The mean IOP value at postoperative 0th min was 50.24 +/- 7.66 mmHg after injections into the superotemporal quadrant and was 34.85 +/- 4.96 mmHg after injections into the inferotemporal quadrant. No significant difference was observed between the preoperative and postoperative 30th min-IOP values (p > 0.05), while a significant difference was found between the postoperative 0th min-IOP values among quadrants (p < 0.001). VR was significantly higher in applications into the inferotemporal quadrant than those into the superotemporal quadrant (p < 0.001). Conclusion One of the most principal factors affecting the postoperative short-term IOP increase is the amount of VR, and this amount decreases the IOP following an IVE. The high amount of VR produced in the quadrant where the injection was applied for the first time caused a low-level IOP, while the low amount of VR formed in the quadrant where the repeated injections were applied caused a higher IOP.Öğe Evaluation of the acute effects of cigarette smoking on the eye of non-Smoking healthy young male subjects by optical coherence tomography angiography(Taylor & Francis Ltd, 2020) Kaymaz, Abdulgani; Ulaş, Fatih; Toprak, Güvenç; Uyar, Enes; Çelebi, SerdalPurpose: Investigation of the acute effects of cigarette smoking on the eye using optical coherence tomography angiography (OCTA) on young healthy non-smoking male subjects. Materials and methods: The right eye of 25 healthy non-smoking male subjects were included in this study. Selected parameters of the macular and circumpapillary vasculature were measured, including macular flow indices, foveal avascular zone, vessel densities of macula and optic disc using OCTA. The measurements of the subjects were performed on the first day without smoking at 0 min, 5 min, 30 min and 60 min. Measurements were repeated at the same regime on the second day after smoking. Paired samples t-test and repeated measures one-way analysis of variance test was used for the statistical analysis. Results: The repeated measures analysis of variance test using the Bonferroni adjustment demonstrated a significant change for superficial and deep foveal vessel density, flow area of choriocapillaris, and circumpapillary capillary density following smoking (range of p value was <0.001-0.004). Intraocular pressure, foveal avascular zone area, flow area of outer retina and foveal non-flow area of superficial layer measurements did not have any significant changes following smoking (range of p value was 0.192-0.812). Conclusion: In non-smoking cases, even smoking only one cigarette significantly decreased the vessel density parameters at the acute period. Even though there was an increase in measured parameters shortly after smoking, it had lessened when compared to non-smokers, even one hour following smoking.Öğe Evaluation of the Effect of Fasting on Glaucoma Patients(2021) Uyar, Enes; Ulaş, Fatih; Doğan, Ümit; Çelebi, SerdalObjectives: The aim of this research was to evaluate the effect of daytime Ramadan fasting and dehydration on intraocular pressure (IOP) and biometric parameters in primary open-angle glaucoma (POAG) patients.Methods: This prospective study included 30 eyes of 30 POAG patients who were fasting during Ramadan (Group 1), 40 healthy participants who were fasting (Group 2), and 40 healthy individuals who were not fasting (Group 3). The eyes were evaluated twice a day at approximately 8 am and 4 pm during Ramadan and 1 month after Ramadan.Results: IOP values at 4 pm were higher in Group 1 than Groups 2 and 3 in Ramadan (p=0.029 and 0.007, respectively). The diurnal reduction in IOP was significantly smaller during fasting in the glaucoma patients compared with Groups 2and 3 (p=0.012 and 0.007, respectively). Comparisons of biometric parameters revealed less reduction in central corneal thickness (CCT) values from 8 am to 4 pm in glaucoma patients than in Groups 2 and 3 (p<0.05 for all comparisons) during Ramadan and after Ramadan.Conclusion: POAG patients had a higher IOP at 4 pm during the fasting period than was seen following Ramadan. In addition, the diurnal reduction of IOP and CCT was smaller in patients with POAG compared with healthy subjects.Öğe Evaluation of vitreous reflux and intraocular pressure changes in repeated intravitreal injections(Gazi Eye Foundation, 2020) Uyar, Enes; Ulaş, FatihPurpose: To evaluate effects of repeated intravitreal injections (IVIs) on vitreous reflux (VR) and intraocular pressure (IOP) changes in patients receiving intravitreal ranibizumab (IR) treatment. Materials and Methods: We retrospectively reviewed files of patients with wet type age-related macular degeneration or diabetic macular edema patients treated with IR and demographic information0, lens status, IOP values, amount of VR and data regarding intravitreal treatment were recorded in all patients. The study included 74 eyes of 74 patients who had complete data in a least 2 IVI sessions. Data obtained during the first IVI session (IVI1), second IVI session (IVI2) and data from third IVE session in 14 of 74 patients were analyzed. Results: In the study populations, there were 41 female (55.6%) and the mean age was 68.61 ± 9.81 (43-81) years. The mean number of IR injections was 4.89 ± 2.79 (1-10) and mean time was 7.1 ± 3.7 months (1-24 months) between IVI1 and IVI2. IOP values before and immediately after IVI were significantly higher in the IVI2 session, but there was no significant difference in IOP values on minute 30 after IVI (p: 0.032, <0.001, 0.518, respectively). The extent of IOP elevation after IVI was also significantly higher in IVI2 (p <0.001). The amount of VR was decreased in 44 patients (59.46%) whereas it was increased in 9 patients (12.16%) and no change was detected 21 patients (28.38%). There was no significant relationship between IOP changes after IVI and lens status, diagnosis, age and gender and (p> 0.05 for all data). Conclusion: It was found that repeated IVI applications decreased the amount of VR and therefore increased the frequency of short-term IOP after IVI.Öğe Investigation of the short-term effects of water drinking test on the eye using optical coherence tomography angiography in young healthy male subjects(Taylor & Francis Ltd, 2022) Soydan, Adem; Ulaş, Fatih; Kaymaz, Abdulgani; Toprak, Güvenç; Uyar, Enes; Çelebi, SerdalPurpose To evaluate the acute effects of the water drinking test (WDT) on the eye using optical coherence tomography angiography (OCTA) on healthy young male subjects. Methods The study included 25 eyes of 25 male subjects. Selected parameters of the retinal vasculature were measured, including macular flow indices, foveal avascular zone, and vessel densities (VDs) of the macula using OCTA. The measurements were taken on the first day without drinking water at 0 min, 30 min and 60 min, then repeated on the second day before drinking water at 0 min, and after drinking water at 30 min and 60 min. The Paired Samples t-test and repeated measures One-way analysis of variance test were used in the statistical analyses. Results The repeated measures analysis of variance test using Bonferroni adjustment demonstrated a significant increase in superficial and deep foveal VD following WDT (p < 0.001 for both). Intraocular pressure, retinal nerve fibre layer thickness, foveal avascular zone, flow area of choriocapillaris, flow area of outer retina, foveal non-flow area of superficial layer, and retinal thickness measurements showed no significant changes following WDT. Conclusions WDT is associated with temporary flow modifications in superficial and deep foveal vascular plexus in young male subjects.Öğe Major factors affecting intraocular pressure spike after intravitreal ranibizumab injection: Vitreous reflux and its amount(Sage Publications Ltd, 2019) Uyar, Enes; Ulaş, Fatih; Şahin, Saygın; Çelebi, SerdalPurpose: The aim of this study was to assess the effect of vitreous reflux and its amount on short-term intraocular pressure after intravitreal injection of ranibizumab. Methods: The study included 316 eyes of 276 patients. Intraocular pressures were measured before intravitreal injection (preIOP), immediately after intravitreal injection (postIOP0), and 30 min after intravitreal injection (postIOP30). The amount of vitreous reflux was evaluated by measuring conjunctival bleb diameter, and patients were grouped as; group 1: no vitreous reflux, group 2: less vitreous reflux, and group 3: more vitreous reflux. The data were analyzed using variance analysis, chi-square test, and regression analysis. Results: PostIOP0 values were highest in group 1, followed by group 2 and group 3 (all p values < 0.001). PostIOP30 values were similar in group 1 and group 2 (p = 0.261), but were lower in group 3 than other two groups (p < 0.001, p = 0.001, respectively). Vitreous reflux was identified as the only factor affecting postinjection intraocular pressure changes (p < 0.001), and a negative correlation was found between the total number of intravitreal injection and vitreous reflux (p = 0.032). Conclusion: The major factor affecting short-term postinjection intraocular pressure elevation was vitreous reflux, and intraocular pressure levels increased as the amount of vitreous reflux decreased. Vitreous reflux and its amount decreased as the total number of intravitreal injection increased.Öğe Optik düşük koherensli refl ektometri kullanılan katarakt hastalarında göz içi lens gücü hesaplama formüllerinin karşılaştırılması(2017) Ulaş, Fatih; Kaymaz, Abdulgani; Soydan, Adem; Uyar, Enes; Doğan, ÜmitAmaç: Optik düşük koherens refl ektometri cihazı ile çeşitli biyometrik formüller kullanılarak hesaplanan tahmini postoperatif refraksiyon doğruluklarının karşılaştırılması. Gereç ve Yöntemler: Tüm gözler aksiyel uzunluklarına göre kısa (<22.0 mm), ortalama (22.0-24.5 mm) ve uzun (>24.5 mm) olmak üzere 3 gruba ayrıldı. Beş farklı formül için (Haigis, Hoffer Q, SRK/T, Holladay 1 ve SRK II) Ortalama hata ve ortalama mutlak hata (OMH) değerleri hesaplandı ve karşılaştırıldı. Bulgular: Gözlerin %88,7'si 1 D ve %98,3'ü ise 2 D ortalama mutlak hata içindeydi. Kısa gözlerde Haigis, Hoffer Q, SRK/T, Holladay 1 ve SRK II formülleri için OMH değerleri sırasıyla, 0.37±0.28 D, 0.32±0.29 D, 0.42±0.30 D, 0.41±0.25 D ve 0.46±0.33 D idi. Ortalama gözlerde OMH değerleri sırasıyla, 0.52±0.47 D, 0.51±0.46 D, 0.53±0.46 D, 0.51±0.45 D ve 0.58±0.50 D idi. Uzun gözlerde ise OMH değerleri sırasıyla, 0.52±0.47 D, 0.51±0.46 D, 0.53±0.46 D, 0.51±0.45 D ve 0.58±0.50 D idi. Sonuç: Haigis, Hoffer Q, SRK/T ve Holladay 1 formülleri tüm aksiyel uzunluk gruplarında SRK II formülünden daha öngörülebilir refraktif sonuçlar verdi.Öğe Orucun gözün biyometrik parametreleri üzerine olan etkilerinin düşük koheranslı optik biyometri ile değerlendirilmesi(2018) Uyar, Enes; Doğan, Ümit; Ulaş, Fatih; Çelebi, SerdalAmaç: Ramazan orucunun gözün biyometrik parametreleri üzerindeki etkilerinin düşük koheranslı optik biyometre ile değerlendirilmesi. Gereç ve Yöntem: Seksen sağlıklı kişinin 80 gözünde, düşük koheranslı optik biyometre cihazı kullanılarak aksiyel uzunluk, merkezi kor- nea kalınlığı, ortalama korneal kırıcılık, lens kalınlığı ve ön kamara derinliği parametreleri ölçüldü. Bu biyometrik parametrelerdeki diürnal değişiklikler değerlendirildi. Gözler saat 08.00 ve 16.00’da hem Ramazan ayı içerisinde hem de kontrol olarak Ramazan’dan 1 ay sonraki oruç tutulmayan periyotta ölçüldü. Veriler eşleştirilmiş örneklem t testi ile analiz edildi. Bulgular: Oruç sırasındaki ve sonrasındaki saat 08.00 ölçümlerini karşılaştırdığımızda, oruç sırasında anlamlı bir şekilde merkezi kornea kalınlığının daha ince (p<0,001) ve ortalama korneal kırıcılığın daha düşük (p=0,003) olduğunu gözlemledik. Benzer olarak saat 16.00 öl- çümlerinde de merkezi kornea kalınlığı oruç sırasında daha ince idi (p=0,007). Oruç ve kontrol ölçümleri karşılaştırıldığında bütün biyomet- rik parametrelerin diürnal değişikliklerinde anlamlı farklılık olmadığı saptandı. Sonuç: Sonuçlarımız orucun gözün bazı biyometrik parametrelerini etkilediğini göstermekle birlikte biyometrik parametrelerin diürnal de- ğişimlerini etkilemediğini ortaya koymaktadır.Öğe Sağlıklı bireylerde oruç tutmanın göz üzerine olan etkilerinin değerlendirilmesi(Bolu Abant İzzet Baysal Üniversitesi, 2017) Uyar, Enes; Doğan, ÜmitHer yıl milyonlarca insan oruç tutmakta ve insan vücudunda dehidratasyon başta olmak üzere çeşitli değişiklikler meydana gelmektedir. Sonuçta göz ve göz fonksiyonları da oruçtan etkilenebilmektedir. Bu çalışmada sağlıklı bireylerde oruç tutmanın göz üzerindeki etkilerinin değerlendirilmesi amaçlanmıştır. Çalışmaya oruç tutan 80 sağlıklı bireyin sağ gözleri dahil edildi. Saat 08.00 ve 16.00'da,refraksiyon değerleri, pnömotonometri ile göz içi basınçları, biyometri cihazı ile santral kornea kalınlığı, ön kamara derinliği, lens kalınlığı, ortalama kornea kırıcılığı ve aksiyel uzunluk, optik koherens tomografi cihazı ile foveal, temporal ve nazal bölgelerden retina ve koroid kalınlıkları değerlendirildi. Çalışmaya dahil edilen olguların Ramazan ayından 1 ay sonra kontrol ölçümlerialındı. Kontrol ölçümleri ile karşılaştırıldığında oruç sırasında saat 8.00'da santral kornea kalınlığı daha kalın (p<0,001), ortalama kornea kırıcılığı daha düşük (p=0,03), temporalkoroid kalınlığı ise daha inceydi (p=0,005). Saat 16.00'da ise oruç sırasındasantral kornea kalınlığı kontrole göre yine daha kalın (p=0,007), retina ve koroid ise tüm bölgelerde anlamlı olarak daha inceydi (p<0,05). Ramazan ayında alınan ölçümlerle ve kontrol ölçümlerinde yaşanan diürnal değişiklikler karşılaştırıldığındanazal ve temporal retina ile temporal ve fovealkoroid kalınlıklarında anlamlı fark saptandı (p<0,05).Diğer parametrelerde ise anlamlı fark saptanmadı (p>0,05). Sonuçta oruç sırasında retina ve koroid kalınlıklarında anlamlı düzeyde incelme olduğu gözlenmiş ve oruç sırasındavaskülerkomponentin yoğun bulunduğu dokuların daha fazla etkilenebileceği düşünülmüştür. Anahtar kelimeler:Diürnal değişim, Koroid kalınlığı,Oruç, Retina kalınlığı, Santral kornea kalınlığı.Öğe Santral retinal ven tıkanıklığı ve maküla ödeminde patogenez(2019) Ulaş, Fatih; Uyar, Enes; Kaymaz, AbdulganiSantral retinal ven tıkanıklığı (SRVT) yaygın görülen bir retinal vasküler hastalıktır. Fakat SRVT patogenezi tam olarak bilinmemektedir. SRVT gelişiminde çeşitli sistemik ve lokal risk faktörleri rol oynamaktadır. SRVT maküler ödem (MÖ) ve neovaskülarizasyona neden olarak görmeyi olumsuz etkileyebilmektedir. MÖ, maküler bölgede sıvı ve protein birikmesi sonucu oluşmaktadır. MÖ patofizyolojisi oldukça karmaşık bir süreçtir ve MÖ gelişiminde birçok faktör etkili olmaktadır. Bu derlemede SRVT ve SRVT nedeniyle oluşan MÖ patogenezi tartışılmıştır.Öğe Yaşa bağlı maküla dejenerasyonu hastalarında intravitreal aflibersept ve ranibizumab enjeksiyonu sonrası kısa dönem göz içi basıncının karşılaştırılması(2018) Ulaş, Fatih; Uyar, Enes; Bayram, Tuba; Doğan, ÜmitAmaç: Yaş tip yaşa bağlı maküla dejenerasyonu hastalarında intravitreal aflibersept ve ranibizumab uygulamasının kısa dönem göz içi ba- sıncı üzerine etkisinin karşılaştırılması. Gereç ve Yöntem: Yaş tip yaşa bağlı maküla dejenerasyonu tanısıyla intravitreal aflibersept veya ranibizumab uygulanan 83 hastanın (83 göz) bazal demografik/klinik bilgileri, toplam aflibersept veya ranibizumab enjeksiyon sayısı, enjeksiyon öncesi, sonrası ve 30 dakika sonrası göz içi basıncı ve enjeksiyon sonrası vitreus reflüsüne bağlı gelişen konjonktival bleb çapı gibi parametreleri prospektif olarak değerlendiril- di. Bulgular: Aflibersept ve ranibizumab gruplarının demografik ve klinik parametreleri, toplam enjeksiyon sayısı, intravitreal enjeksiyon ön- cesi ve enjeksiyon sonrası 30. dakika göz içi basıncı değerleri arasında anlamlı fark saptanmadı (p değerleri aralığı 0,081 ve 0,840). Erken dönem post-enjeksiyon göz içi basıncı ve post-enjeksiyon vitreus reflüsüne bağlı gelişen konjonktival bleb çapı değerleri gruplar arasında an- lamlı düzeyde farklılık göstermekte idi. Sonuç: Yaş tip yaşa bağlı maküla dejenerasyonu olgularında intravitreal ranibizumab uygulaması aflibersept uygulamasına göre daha kü- çük post-enjeksiyon konjonktival bleb çapı ile birlikte daha yüksek enjeksiyon sonrası kısa dönem göz içi basıncı artışına neden olmaktadır.
