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Öğe A rare case of bilateral incomplete duane’s syndrome with synkinesis of the levator and lateral rectus(Taylor and Francis Ltd., 2021) Tomaç, Sühan; Uyar, Enes; Yaşar, ErdoğanIn the last few decades, Duane’s syndrome (DS) has begun to be classified under as one of the congenital cranial dysinnervation syndromes (CCDDs), as its primary cause is neurogenic. Incomplete forms of DS have been described very recently.Öğe Can hypothyroidism cause acute central serous chorioretinopathy(Taylor and Francis Ltd, 2019) Ulaş, Fatih; Uyar, Enes; Tekçe, Hikmet; Çelebi, SerdalTo 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.Öğe Can vitreous reflux affect the short-term treatment response after intravitreal ranibizumab injection(Taylor and Francis Ltd., 2020) Uyar, Enes; Ulaş, Fatih; Alkan, YunusThe 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: [removed]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 µm in Group 1, 85.6 ± 158.7 µm in Group 2, and 93.1 ± 92.2 µm in Group 3. Likewise, in DME patients, it was 82.4 ± 88.4 µm, 72.9 ± 109.9 µm, and 73.7 ± 113.7 µm, respectively. Reduction of MT1 values after the treatment were 47.4 ± 72.6 µm, 36.0 ± 131.9 µm, and 36.7 ± 114.4 µm in AMD patients, and 33.3 ± 72.5 µm, 36.6 ± 90.2 µm, and 46.9 ± 83.4 µm 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 and Francis Ltd, 2019) Uyar, Enes; Doğan, Ümit; Ulaş, FatihWe really want to thank Dr. Kai Xiong Cheong and his colleagues for all their invaluable considerations on our study. In their letter, they indicated that there is a topographic variation of the choroid and had also pointed out the importance of choroidal thickness (CT) measurements in various subfields of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid compared to only using single point thickness measurements. We were unable to use ETDRS sectors for CT measurements, however as Dr. Kai Xiong Cheong and his colleagues pointed out, we were able to obtain subsequent OCT scans at the same location due to the image registration and tracking feature of the OCT device used in our study. This eliminated the possibility that the detected changes could be affected by the topographic variation of the choroid. In the literature, several studies were found that used CT measurements from three or more points on horizontal and vertical sections.1–3 Although this gives us more information about CT, it is still controversial taking multiple points measurements in order to increase the result reliability. The longer time required to take images from multiple points could adversely impact the patient’s cooperation and result in poor quality images and inaccurate measurements. Therefore, we preferred to use horizontal single line scan results with a follow-up device performing CT measurements.Öğe Effect of fasting on choroidal thickness and Its diurnal variation(Taylor and Francis Ltd, 2019) Uyar, Enes; Doğan, Ümit; Ulaş, Fatih; Çelebi, SerdalThe 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.Öğe Effect of quadrant switch on intraocular pressure change in intravitreal aflibercept or ranibizumab injection applications(Springer Science and Business Media B.V., 2022) Altıntaş, Melek; Ulaş, Fatih; Çelebi, Serdal; Uyar, EnesTo 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.Öğe Evaluating depth and width of corneal wounds using anterior segment optical coherence tomography after foreign body removal(Taylor and Francis Ltd., 2022) Uyar, Enes; Sarıbaş, FerhatTo determine corneal foreign body (FB) location together with corneal wound depth and width by using anterior segment optical coherence tomography (AS-OCT) after uncomplicated FB removal. Method: This prospective study was conducted with patients injured by a superficial metallic corneal FB. Under slit-lamp examination, after determining its location, the FB was removed with a 27-G needle. The depth and width of the corneal wound and the thinnest stromal thickness at the wound site were measured initially using AS-OCT. Measurements were repeated to assess the wound healing process at one week and at two months following FB removal. Results: Totally, 63 eyes of 63 patients were included in this study. The average age was 35.8 ± 11.0 years, and 96.8% of the patients were men. In terms of location of the FBs, 26 (41.3%) were in the central region, 21 (33.3%) were in the paracentral region, and 16 (25.4%) were in peripheral regions. The mean depth and width of the corneal wounds were 117.0 ± 42.5 µm and 332.9 ± 99.4 µm, respectively. The mean percentage of corneal wound depth was 18.9 ± 6.1%. In 20 patients who presented for follow-up, it was observed that the width of the wound increased and the thinnest stromal thickness at the wound site decreased over the two months. Conclusion: The AS-OCT findings of the present study showed that the corneal FBs generally affected the anterior cornea with less than approximately 0.2 mm depth and 0.5 mm width. In addition, FBs were commonly located in the central and paracentral cornea.Öğe Evaluation of the acute effects of cigarette smoking on the eye of non-Smoking healthy young male subjects by optical coherence tomography angiography(2020) Kaymaz, Abdulgani; Ulaş, Fatih; Toprak, Güvenç; Uyar, Enes; Çelebi, SerdalInvestigation 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 vitreous reflux and intraocular pressure changes in repeated intravitreal injections(Gazi Eye Foundation, 2020) Uyar, Enes; Ulaş, FatihTo 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).Öğe Eye-related factors that can be associated with the plane of phacoemulsification(Cureus, 2022) Uyar, EnesPurpose: To evaluate the effect of eye-related factors such as biometric and surgical parameters, nuclear sclerosis (NS) grade, and pupil and capsulorhexis diameters on the plane of phacoemulsification (PP). Material and Methods: This prospective study included 328 eyes of 328 patients who underwent phacoemulsification surgery. The phaco-chop technique was performed in all patients and changes in PP that occurred during surgery were recorded. Patients were grouped as follows: Group 1, > 75% of lens nucleus emulsified in the capsular bag; Group 2, > 75% of lens nucleus emulsified at the pupillary plane; and Group 3, > 50% of lens nucleus emulsified in the anterior chamber. The association between PP and eye-related factors was evaluated. Results: There were 153 patients (46.7 %) in Group 1, 104 patients (31.7 %) in Group 2 and 71 patients (21.6 %) in Group 3. The factors associated with PP were anterior chamber depth (MD) (p= 0.020) and NS grade (p = 0.028). No significant relationship was detected between PP and age, surgical parameters or other biometric values. Moreover, PP was found to be more anterior in patients with soft cataracts and deeper ACD values (p values were 0.002 and 0.036, respectively). Conclusion: The present study has reported that PP may move to more anterior, as softer cataracts may increase the fear of posterior capsule rent. Moreover, PP may move to more posterior due to shallow anterior chambers or high-grade cataracts that could potentially increase the fear of endothelial injury.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 and Francis Ltd., 2022) Soydan, Adem; Ulaş, Fatih; Kaymaz, Abdulgani; Toprak, Güvenç; Uyar, Enes; Çelebi, SerdalTo 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 Late surgical correction of longstanding constant strabismus in adults: Is fusion possible in all successfully aligned patients(Bellwether Publishing, Ltd., 2020) Tomaç, Sühan; Uyar, Enes; Akın, Tuğrul; Mutlu, Fatih Mehmet; Altınsoy, Halil İbrahimTo determine whether late surgical correction provides fusion in adults who have constant strabismus beginning in early childhood. Materials and Methods: This was a prospective study that included 34 consecutive adults with a history of early onset strabismus who had not previously undergone surgery. They were tested with the Bagolini striated glasses (BSG), Worth four-dot (W4D) test, cover test, and four-prism diopter (4-PD) test, preoperatively, and 6 weeks after surgery. Results: The mean age was 23.8 years, 17 patients had esotropia and 17 patients had exotropia. Preoperatively, all patients demonstrated a manifest horizontal deviation ranging from 30? to 60? and had suppression. At 6 weeks postoperatively, 33 patients had a horizontal manifest deviation of <15? (range, 2?-14?; median, 6?), and none were orthotropic as determined by the cover test together with the 4-PD test. All of these 33 patients achieved anomalous retinal correspondence (ARC) with the BSG at near, and 25 (75%) had ARC with the W4D test at near. Conclusions: Although our study has limited number of patients its findings suggest it is possible to develop ARC after surgery in almost all adult patients with childhood-onset strabismus associated with suppression, and who have not previously been operated upon, if satisfactory alignment is achieved in adulthood.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, SerdalThe 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 The assessment of youtube videos as a source of information for amblyopia treatment(Slack Incorporated, 2021) Uyar, Enes; Sarıbaş, FerhatTo evaluate the efficiency of YouTube videos as a source of information for the treatment of amblyopia. Methods: The authors searched YouTube (Google) using the keywords "amblyopia treatment"and analyzed the first 200 most relevant videos. Videos were classified as useful or misleading by two independent ophthalmologists. Videos were scored on 5-point scales to evaluate global quality, reliability, and comprehensiveness. General characteristics, viewer interactions, and sources of videos were also recorded. Results: Eighty-seven of 200 videos were appropriate to be included in the current study. Fifty videos (57.5%) were classified as useful and 37 videos (42.5%) were classified as misleading. General characteristics and viewer interactions were not significantly different between useful and misleading videos (P > .05). The mean Global Quality Score, reliability, and comprehensiveness scores were 3.64 ± 1.1, 3.02 ± 1.0, and 2.74 ± 1.2 in useful videos and 2.03 ± 0.9, 2.08 ± 0.8, and 1.62 ± 0.7 in misleading videos, respectively (P < .05). The data suggested that most of the videos uploaded by university channels or non-profit professionals were useful (79.2%), whereas most of the videos uploaded by medical advertisements or for-profit companies were misleading (59.1%). Conclusions: The results of the current cross-sectional study demonstrated that the number of useful videos for the treatment of amblyopia was higher on YouTube. However, there was still a significant number of misleading videos (42.5%). Therefore, more videos on amblyopia treatment that have sufficient reliability, quality, and comprehensiveness should be uploaded to YouTube. CÖğe The association between postoperative corneal edema and phacoemulsification level(Experimental Biomedical Research, 2022) Uyar, EnesTo evaluate the effect of phacoemulsification level on postoperative central corneal thickness (CCT) differences and to assess the effects of demographic characteristics, biometric values and surgical parameters of patients on postoperative corneal edema. Methods: This prospective study included 232 eyes of 232 patients who underwent phacoemulsification surgery. Biometric values, phacoemulsification time, phacoemulsification power and effective phacoemulsification time (EPT) were evaluated. CCT measurements were repeated at follow-ups on days 1, 7 and 30 after surgery. Phaco-chop technique was performed in all patients and phacoemulsification level changes that occurred during surgery were recorded. Patients were grouped as Group 1: >75% of lens nucleus emulsified in capsular bag; Group 2: >75% of lens nucleus emulsified in iris plane; and Group 3: >50% of lens nucleus emulsified in anterior chamber. Results: Increase in the mean CCT values on the first day (incCCT1) and at the first week after surgery were more pronounced in Group 3 as compared with both Groups 1 and 2 (p < 0.05 for all). In addition, incCCT1 was higher in Group 2 than Group 1 (p=0.040). In the final model of multiple linear regression (R2=0.31), it was determined that EPT, aqueous depth (AD) and phacoemulsification level significantly affected incCCT1 (p range: <0.001 to 0.009). Conclusions: The present study showed that more anterior phacoemulsification levels than the capsular bag caused higher CCT increase postoperatively. In addition, AD, EPT and phacoemulsification level were found as the most significant factors that influence postoperative corneal edema.
