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    Effect of isotretinoin on myopia and axial length: a pilot study
    (Taylor and Francis Ltd., 2020) Yaşar, Erdoğan; Gürlevik, Uğur; Kemeriz, Funda; Atalay, Eray
    Purpose: To investigate the effect of oral isotretinoin use on refractive error, axial length, and anteroposterior segment parameters. Materials and methods: In this prospective study, 50 eyes of 50 patients using isotretinoin with a diagnosis of acne vulgaris and 50 eyes of 50 healthy control subjects were included. After detailed biomicroscopy, measurements were taken of axial length, lens thickness, central corneal thickness, anterior chamber depth, central retinal thickness, and subfoveal choroidal thickness. The pupils of both eyes were dilated with one drop of cycloplegic drops after refraction measurement. Visual acuity examination was performed with a Snellen chart the next day. The same procedure was repeated at the end of the third and sixth month of drug treatment. Results: Forty-seven patients with acne vulgaris and 45 healthy controls met the inclusion criteria and were included in the analysis. The mean ages of the patients and the controls were 21.7 ± 2.5 years (range, 18–28 years) and 22.6 ± 2.7 years (range, 19–27 years), respectively. No significant changes were observed in any parameters in the third and sixth month in the control group (p > 0.05). The most important result was significant increases in myopia and axial length in the sixth month of isotretinoin use (p = 0.01, p = 0.04, respectively). There were no significant relationships between increases in myopia and axial length and patients’ age, sex, drug dose, and initial refraction (p > 0.05). The changes in spherical equivalent and axial length differed significantly between the drug group and the control group (p = 0.001, p = 0.001, respectively). Conclusions: Isotretinoin is one of the important molecules in the aetiology of myopia. Oral isotretinoin treatment may increase myopia and axial length, although not to a clinically significant degree. However, as this was a pilot study, there is a need for further studies with more patients and longer follow-up periods.
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    Optical coherence tomography angiography analysis of fabry disease
    (Springer Science and Business Media B.V., 2020) Çakmak, Ayşe İdil; Atalay, Eray; Cankurtaran, Veysel; Yaşar, Erdo?an; Turgut, Faruk Hilmi
    Purpose: Fabry disease (FD) is characterized by a deficiency in ?-galactosidase A activity that leads to the cumulative deposition of unmetabolized glycosphingolipids within organs, including the vascular endothelium and the eyes. The purpose of this study was to assess the effects of FD on the retinal microvasculature, foveal avascular zone (FAZ), macular thickness and retinal nerve fiber layer (RNFL) using optical coherence tomography angiography (OCT-A). Methods: Twenty-five patients (14 female and 11 male; mean age 33.16 ± 11.44) with genetically verified FD were compared with 37 age- and sex-matched healthy controls (mean age 32.36 ± 15.54). The vessel density (VD) values of the superficial and deep capillary plexuses (SCP and DCP), the area of the FAZ, the density of radial peripapillary capillaries (RPC), the macular thickness and the retinal nerve fiber layer thickness were measured by OCT-A examination. Results: The patients showed significantly lower VD values than controls in the foveal regions of both SCP and the DCP (21.15 ± 5.56 vs. 23.79 ± 4.64 (p = 0.048), 37.92 ± 6.78 vs. 41.11 ± 5.59 (p = 0.048), respectively). The FAZ was significantly larger in the FD group than in the control group (0.3 ± 0.1 vs. 0.24 ± 0.08 (p = 0.011)). No significant difference was identified in measurements of RPC density, peripapillary RNFL thickness or macular thickness between the two groups (p > 0.05 for all). Conclusion: Decreased VD and an enlarged foveal avascular area suggest possible changes in the retinal microvasculature of patients with FD. OCT-A can serve as a useful, noninvasive, quantitative tool for diagnosing FD and monitoring its progression.
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    Pseudoexfoliation syndrome and antidepressant drug use
    (Turkish Ophthalmology Society, 2019) Yaşar, Erdo?an; Yıldırım, Nilgün; Atalay, Eray
    Objectives: To investigate the relationship between pseudoexfoliation syndrome (PES) and the use of antidepressant medications. Materials and Methods: This population-based, cross-sectional study included 2,017 of 2,356 invited subjects who were randomly selected from the Turkish Statistical Institute database (www.turksat.gov.tr/) as part of an epidemiologic study which specifically aimed to detect the prevalence of PES in the province of Eskişehir. During the examination, a detailed questionnaire was administered to determine physician-diagnosed systemic disease and drug use. Results: Eight of the 2,017 participants in the study were excluded for various reasons (2 with posterior synechiae, 2 with corneal opacity, 1 uncooperative patient, 1 eviscerated patient, 1 with active adenoviral keratoconjunctivitis, and 1 with a history of angle closure). PES was detected in 100 (5%) of the 2,009 patients whose data were analyzed. The percentage of subjects with concurrent antidepressant drug use in the PES and non-PES non-glaucoma groups were 4.1% (n=3) and 1.1% (n=21), respectively. The difference between the two groups was statistically significant (p=0.024). In addition, the use of medications for hypertension (p<0.001) and coronary artery disease (p=0.009) was also higher in the PES group. Conclusion: The higher prevalence of antidepressant drug use in patients with PES may be related to the processes of vascular damage and inflammation common to the pathogenesis of both PES and depression, as well as the high rate of chronic systemic comorbidities in these patients.
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    Psödoeksfoliasyon sendromu ve antidepresan ilaç kullanımı
    (Türk Oftalmoloji Derneği, 2019) Yaşar, Erdoğan; Yıldırım, Nilgün; Atalay, Eray
    Psödoeksfoliasyon sendromu (PES) ile antidepresan ilaç kullanımı arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntem: Eskişehir’de PES sıklığının saptanması amacıyla yapılan bir epidemiyolojik çalışma için Türkiye İstatistikKurumu tarafından randomize seçilen 2356 kişiden 2017’si çalışmaya katıldı. Muayene sırasında hekim tanılı sistemik hastalıklar veilaç kullanımının belirlenmesi amacıyla ayrıntılı bir anket uygulaması yapıldı.Bulgular: Çalışmaya katılan 2017 kişinin 8’i çeşitli sebeplerle (2 posterior sineşili, 2 kornea opasitesi,1 kooperasyon yetersizliği, 1tek gözlülük, 1 aktif adenoviral konjonktivit ve 1 dar açılı glokom öyküsü) çalışma dışı bırakıldı. Verileri analiz edilen 2009 kişiden100’ünde (%5) PES saptandı. Antidepresan ilaç kullanım sıklığı PES (-) glokomu olmayan grupta %1,1 (n=21), PES (+) glokomuolmayan grupta ise %4,1 (n=3) olarak tespit edildi. Her iki grup arasındaki fark istatistiksel olarak anlamlı idi (p=0,024). Ayrıcaantihipertansif (p<0,001) ve koroner arter hastalığı (p=0,009) için ilaç kullanımı da PES grubunda yüksek saptandı.Sonuç: Antidepresan ilaç kullanım sıklığının PES grubunda yüksek bulunmasının sebebi PES ve depresyonun her ikisinin patogenezindede ortak olan vasküler hasar ve enflamatuvar proçesler dışında kronik sistemik hastalıkların da yüksek bulunması ile ilgili olabilir.
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    Pupillometry as a screening tool to detect pseudoexfoliation syndrome
    (Ovid, 2017) Yaşar, Erdoğan; Yıldırım, Nilgün; Atalay, Eray; Tambova, Emre; Çolak, Ertuğrul
    Purpose Our objective was to evaluate the diagnostic value of a handheld pupillometer in differentiating eyes with pseudoexfoliation syndrome (PXS) from healthy controls. Methods This population-based, cross-sectional study was conducted in the province of Eskisehir, Turkey. Subjects 40 years of age and older were randomly recruited using stratified two-stage cluster sampling from the database of the Turkish Statistical Institute office in Eskisehir. Recruitment took place between June and October 2014. The inclusion criteria were healthy subjects who did not have a previous diagnosis of glaucoma or other issues affecting pupil dynamics. After an extensive ophthalmic examination, pupillometry was performed under standard photopic room lighting conditions. After pupillometry, the pupil was dilated and digital images of the anterior segment were taken for confirmation of PXS. An inter-eye pupil diameter difference of ?0.4 mm was defined as pupil asymmetry. Results Of the 2356 invited subjects, 2017 agreed to participate (85.6%), and 1559 subjects were eligible for the study. An age-matched subgroup consisting of 529 healthy controls was randomly selected to compare with the 60 subjects who were diagnosed with PXS. The mean pupil diameters of subjects with PXS and healthy controls were 3.57 ± 0.68 mm and 3.68 ± 0.63 mm, respectively (P =.652). In the ROC analysis, the precision of pupil diameter in discriminating PXS was low (AUC 0.56, sensitivity 14%, specificity 94%). Pupil asymmetry increased the chances of having PXS by 3.46-fold. Conclusions Pupillometry performed poorly in the detection of PXS scoring a positive predictive value of 26%.