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    Assessment of corneal topographic, tomographic, densitometric, and biomechanical properties of Fabry patients with ocular manifestations
    (Springer, 2020) Cankurtaran, Veysel; Tekin, Kemal; Cakmak, Ayse Idil; Inanc, Merve; Turgut, Faruk Hilmi
    Purpose To investigate whether cornea verticillata affects corneal topography, tomography, densitometry, or biomechanics of Fabry patients with ocular manifestations and to compare these results with those obtained from healthy subjects. Methods This prospective, cross-sectional study included 23 Fabry patients (Fabry group) with cornea verticillata and the 37 age- and sex-matched healthy subjects (control group). After comprehensive ophthalmological examinations, corneal topography, tomography, and densitometry measurements were taken using Pentacam HR and corneal biomechanics were captured via Corvis ST for all participants. Results All the investigated topographic and tomographic values were similar in the eyes with Fabry disease (FD) and the controls (P > 0.05). The corneal densitometry values of patients with FD were statistically significantly higher in all the concentric zones and layers, except posterior 0-2 mm and posterior 2-6 mm zones, compared to the controls (P < 0.05). The mean values of A1 velocity, A2 velocity, deformation amplitude ratio, Corvis biomechanical index, tomographic and biomechanical index, and Stiffness parameter at the first applanation in the Fabry group were statistically significantly different compared to control group (P < 0.05). However, the mean values of A1 length, A2 length, and the biomechanically corrected intraocular pressure were similar between the groups (P = 0.317, P = 0.819, and P = 0.468; respectively). Conclusion Although cornea verticillata associated with FD is not considered to affect vision, it is associated with increased light backscattering and reduced corneal transparency as well as altered corneal biomechanical properties.
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    Association of childhood obesity with retinal microvasculature and corneal endothelial cell morphology
    (Walter De Gruyter Gmbh, 2021) Kurtul, Bengi Ece; Cakmak, Ayse Idil; Elbeyli, Ahmet; Karaaslan, Abdulkerim; El, Cigdem
    Objectives: To investigate the optical coherence tomography angiography (OCTA) and specular microscopy (SM) findings in obese children and compare them with healthy ones. Methods: In this prospective study, 50 eyes of 25 obese children [body mass index (BMI) >= 95th percentile], 36 eyes of 18 control age- and sex- matched healthy subjects (BMI <85th percentile) were included. Demographic features and ophthalmological examination including OCTA measurements as well as SM findings were assessed. Cellular morphology was observed by noncontact SM and results for corneal endothelial cell density (cells/mm(2)), coefficient of variation of cell size and percentage of hexagonal cells were obtained. The OCTA was performed with 6 x 6 mm sections for macula and 4.5 x 4.5 mm sections for optic disc in all eyes. Foveal retinal thickness (FRT), retinal nerve fiber layer (RNFL) thickness, vessel density in different sections of retina and optic nerve head were analyzed. Results: All SM parameters, RNFL thickness for average, and all quadrants and optic disc radial peripapillary capillary densities were similar between groups. However, FRT, flow area for choriocapillaris, superficial and deep foveal capillary densities were significantly higher in obese group when compared to controls (242.4 +/- 18.2 mu m vs. 232.1 +/- 16.5 mu m, p=0.024, 2.2 +/- 0.1 mm(2) vs, 2.2 +/- 0.0 mm(2), p=0.042, 22.4 +/- 6.9% vs. 15.6 +/- 5.5%, p=0.001, and 38.9 +/- 7.5% vs. 31.1 +/- 8.6 %, p=0.001, respectively). Conclusions: Obese children seem to have higher values of FRT, flow area for choriocapillaris, superficial and deep foveal capillary densities. These results may have significant implications for understanding of how childhood obesity could affect retinal microvasculature.
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    Can diplopia complaint be reduced by telerehabilitation in multiple sclerosis patient during the pandemic?: A case report
    (Springer-Verlag Italia Srl, 2021) Dogru-Huzmeli, Esra; Duman, Taskin; Cakmak, Ayse Idil; Aksay, Ufuk
    Hospital visits and regular rehabilitation of chronic patients due to COVID-19 pose a risk. Therefore, patients with chronic illnesses who need regular rehabilitation have been victims of the pandemic process. Because of their fear of being infected, they were deprived of the chance of their symptoms being rehabilitated. Therefore, it is extremely important to rehabilitate individuals with chronic illnesses in need of rehabilitation through telerehabilitation. In this study, we aimed to show the effect of Cawthorne-Cooksey exercises to be applied through telerehabilitation on eye movements, vision, and quality of life in a patient suffering from diplopia due to multiple sclerosis (MS). It has been found that Cawthorne-Cooksey exercises improve the quality of life and reduce the complaints of diplopia in MS patients with diplopia. In addition, the patient verbally stated that his balance increased after Cawthorne-Cooksey exercises. As a result, Cawthorne-Cooksey exercises are a rehabilitation method that gives positive results in the treatment of diplopia and it is recommended to apply this method via telerehabilitation.
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    The Complete Success in Refractory Mooren's Ulcer Treated with Infliximab
    (Taylor & Francis Inc, 2023) Cakmak, Ayse Idil; Akova, Yonca; Yildirim, Nilgun
    Purpose To describe the management and outcome of two extremely rare and painful cases of Mooren's ulcer, an idiopathic peripheral autoimmune-associated ulcerative corneal disease. Methods Case report with literature review on the management of ocular inflammation in Mooren's ulcer. Results A 47-year-old female and a 76-year-old female presented with progressive bilateral Mooren's ulcer that were refractory to conventional immunosuppressive therapy. Following treatment with infliximab, an anti-tumor necrosis factor alpha, a significant improvement in disease progression was observed, with no corneal thinning or perforation at follow-ups. Conclusion This case report highlights how infliximab can be effective in cases with Mooren's ulcer refractory to conventional therapies.
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    Demographic, Epidemiological and Etiological Characteristics of Fungal Keratitis Cases in Southern Anatolia Tertiary Eye Care Center
    (2022) Cakmak, Ayse Idil; Cetın, Meryem; Öz, Yasemin; Kara, Necip
    To evaluate the demographic, epidemiological and etiological characterisitics of fungal keratitis cases in our tertiary eye care center located in the Eastern Mediterraen coast of South Anatolia.A retrospective review of all culture-proven fungal keratitis seen from May 2017 to May 2019 was performed. The demographic features, predisposing factors, associated systemic and ocular characteristics, and microbiological analysis results of cases were evaluated. The mean age of 15 cases with fungal keratitis was 46±7 years (range: 19-77 years) with a male-to-female ratio of 4:1. The majority of the occupations of the cases were agricultural workers or farmers (73%). The etiology was predominantly trauma mostly with an environmental origin (93.3%). Fungal growth was detected in 15 eyes (38.5%) in a total of 39 microbial positive corneal cultures. Filamentous fungi were responsible for all cases, including Fusarium sp. in 8 eyes (53.3%) and Aspergillus sp. in 7 eyes (46.7%). Species of Fusarium were determined in 4 eyes, namely F. Aquaeductus, F. Chlamydosporum, F. oxysporum and F. solani; whereas species of Aspergillus were determined in 3 eyes, namely A. niger and A. flavus. Bacterial and fungal coinfection was shown in two eyes (Aspergillus sp. with Gram (+) beta hemolytic streptococcus; Fusarium sp. with Pseudomonas orzyihabitans). The results of this study, which determines the characteristics of fungal keratitis cases encountered in the Eastern Mediterranean coasts of Southern Anatolia may be useful in the early diagnosis of the disease, in the timely and appropriate empirical treatment of the patients living in this region.
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    Determination of Systemic and Local Causes of Orbital Proptosis Diagnosed by Neuroradiological Modalities
    (2022) Cakmak, Ayse Idil; Burakgazi, Gülen
    Purpose: To determine the demographic and etiological characteristics in patients with orbital proptosis diagnosed by neuroimaging studies. Materials and Methods: We retrospectively analyzed neuroradiological images taken in the obtained during 11-years period (between January, 2009 and July, 2020) by extracting from in the hospital information system. Record system were analyzed retrospectively. An exophthalmometer was performed on the orbital images. The patients diagnosed as orbital proptosis with available clinical and histological data were included in the study. Results: The study included 167 patients (including 30 pediatric patients). It was found that the most common cause of orbital proptosis was inflammatory diseases of orbit, namely orbital cellulitis in children and thyroid orbitopathy in adults; followed by the primary benign tumors of orbit. Among the malignant tumors, primary orbital tumors were more common in children whereas secondary orbital tumors extending from the systemic or local regions were more common in adults. Bilateral proptosis was found in 43.1% of all cases. It was observed that the numbers of systemic (69 cases, 50.3%) and local diseases causing proptosis (68 cases, 49.6%) were comparable in adults while the local diseases causing proptosis (28 cases, 93.3%) were more common than systemic diseases causing proptosis (2 cases, 6.6%) in children. Conclusion: It was found that there was both local and systemic causes of orbital proptosis including those can threaten vision and life. The knowledge of etiological reasons in this series will assist the clinician in assessment of orbital proptosis detected at presentation in patients living in the same geography, ensuring early diagnosis and treatment.
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    The effect of positive airway pressure therapy on intraocular pressure and retina in severe obstructive apnea syndrome
    (Springer Japan Kk, 2022) Dikmen, Nursel; Cakmak, Ayse Idil; Urfalioglu, Selma
    To identify and compare changes in intraocular pressure (IOP), macular, and peripapillary retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) measurements before and after 3 months of positive airway pressure (PAP) therapy in patients with severe obstructive sleep apnea syndrome (OSAS). Twenty-five patients diagnosed with severe OSAS in the neurology sleep outpatient clinic were included in the study. Ophthalmologic examinations were performed at the time of diagnosis and after 3 months of PAP therapy. Statistical analysis of comparisons of pre-treatment and post-treatment measurements of IOP and OCT was performed. Before the PAP therapy, the correlations between central corneal thickness (CCT), body mass index (BMI), OCT, IOP, and sleep parameters were statistically analyzed. Compared to the pre-treatment measurements at the time of diagnosis, post-treatment measurements showed insignificant decrease in IOP, significant increase in mean macular thickness and significant thinning in superior nasal RNFL. There was no correlation found between pre-treatment measurements including IOP, OCT, CCT, BMI, and sleep parameters. The effect of intermittent hypoxia and hypercapnia on the IOP and macula may be reversible in severe OSAS patients receiving 3 months of PAP therapy, but the reversibility of the neurodegenerative effects of OSAS on RNFL with this treatment seems controversial. OCT can be considered to be a promising technique for monitoring disease progression under PAP therapy in patients with severe OSAS.
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    Epidemiological and Clinical Characteristics of Childhood Open Eye Injuries in the South of Anatolia
    (2021) Cakmak, Ayse Idil; Kakaç, Ahmet; Khaleqı, Zikria; Cankurtaran, Veysel; Özcan, Sait Coşkun; Elbeyli, Ahmet; Çetin, Şirin
    Purpose: The aim of this study is to determine the demographic, epidemiological and etiological characteristics of pediatric patients presented\rwith open eye injury (OEI).\rMaterials and Methods: We retrospectively reviewed medical records of the children who presented with OEI to a tertiary eye care center\rbetween January, 2017 and July, 2019. The cases were stratified into two groups as preschool (2-5years) and school-age (6-16years) children.\rResults: The study included 39 eyes of 37 cases. The mean age was 7.38±4.01 years and male: female ratio was 1.85. The study included 22\reyes of 22 preschool and 17 eyes of 15 school-age children. It was seen that the most common OEIs were OEI by a sharp object (25 cases;\r64.1%), penetrating OEI (35 cases; 89,7%), zone I OEI (19 cases; 48.7%), corneoscleral OEI (19 cases; 48.7)) and small OEI (<5 mm in size)\r(18 cases;46,2%). Intraocular foreign body was detected in 5 cases (12.8%). No significant relationship was found between lens damage and\rcause of trauma (p=0.427); whereas there was a significant correlation between size of injury and retinal detachment (p<0.0001 for both). It was\rfound that there was bilateral OEI in 2 of 5 cases injured during the Syrian civil war and that 3 cases underwent evisceration.\rConclusion: Unlike the children who were seriously injured in the war environment, it was determined that children in peace environment were\rexposed to OEI with milder symptoms, mostly by preventable reasons. The results of this study show the severe effects of war on children; in\raddition, it may help to raise awareness and take first steps for prevention of OEI in children in peace.\rKeywords: Eye injuries, open-globe injury, trauma.
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    Evaluation of retinal microvasculature according to stable chronic obstructive pulmonary disease severity and the correlation of pulmonary parameters with optical coherence tomography angiography findings
    (Wolters Kluwer Medknow Publications, 2022) Kurtul, Bengi Ece; Cakmak, Ayse Idil; Kasapoglu Dilek, Ezgi; Dikmen, Nursel
    Purpose: To evaluate the retinal and optic disc microvascular changes according to disease severity in patients with stable chronic obstructive pulmonary disease (COPD), and the correlation of pulmonary parameters with optical coherence tomography angiography (OCTA) findings. Methods: Forty patients with COPD and 30 age- and sex-matched subjects (control group) were included in this cross-sectional prospective study. The COPD group was then divided into two subgroups according to GOLD classification and disease severity as mild-to-moderate COPD group (group 1) and severe COPD group (group 2). OCTA was performed with 6 mm x 6 mm sections for the macula and 4.5 mm x 4.5 mm sections for the optic disc. Foveal retinal thickness (FRT), peripapillary retinal nerve fiber layer (RNFL) thickness, and vessel density in different sections of the retina and optic disc were analyzed. Results: The mean ages, gender, intraocular pressures, peripapillary RNFL thickness, FRT, and optic disc vessel densities were similar among the groups. Compared to the control group and group 1, group 2 showed significantly lower mean foveal vessel density measurements in superficial and deep capillary plexus (P = 0.014 and P = 0.007, respectively). Cigarette packets/year, exacerbation per year, and Modified Medical Research Council showed significant negative correlations, whereas forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity showed significant positive correlations with foveal vessel densities. Conclusion: COPD severity seems to have a negative effect on OCTA measurements. OCTA may reflect the severity of inflammation and hypoxia in COPD and may provide useful detailed information on the role of retinal vascular changes in the follow-up and progression of patients with COPD.
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    Evaluation of systemic immune-inflammation index level as a novel marker for severity of noninfectious uveitis
    (Springer, 2021) Kurtul, Bengi Ece; Cakmak, Ayse Idil; Elbeyli, Ahmet; Ozcan, Sait Coskun; Ozcan, Deniz Ozarslan; Kimyon, Gezmis
    Purpose To evaluate the association of systemic immune-inflammation index (SII) levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) with severity of noninfectious uveitis. Methods This retrospective study included 46 patients with noninfectious uveitis (uveitis group) and 46 age- and sex-matched healthy subjects (control group). The demographic and ocular findings, localization, and activity of uveitis were recorded at the time of onset evaluation. SII, NLR, and PLR levels of patients were compared between the groups. Results SII, NLR, and PLR levels were significantly higher in uveitis group when compared to control group (p < 0.001, p = 0.005, and p = 0.001, respectively). While SII and NLR were significantly higher in severe anterior uveitis than mild anterior uveitis (p = 0.006 and p = 0.021, respectively), only SII was significantly higher in severe posterior and panuveitis than mild ones (p = 0.038). Conclusion SII, as a novel inflammation index, may be more significant tool than NLR and PLR in determining the severity of the uveitis. Furthermore, SII may be a potential useful index in clinical practice to follow-up and manage these patients by monitoring response to anti-inflammatory treatment modalities.
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    Investigation of the optic disc and retinal microvasculature by optical coherence tomography angiography in children with asthma
    (Wolters Kluwer Medknow Publications, 2023) Karaaslan, Abdulkerim; Kurtul, Bengi Ece; Cakmak, Ayse Idil; El, Cigdem
    PURPOSE: To assess the optic disc and retinal microvasculature by optical coherence tomography angiography (OCTA) in asthmatic children. MATERIALS AND METHODS: Thirty asthmatic children (asthma group) and 30 control age- and sex-matched healthy controls (control group) were included in this cross-sectional study. The asthma group was then divided into two subgroups according to the presence of inhaled steroid use. Demographic findings were noted. Retinal nerve fiber layer (RNFL) thickness and vessel density in different sections of the retina and optic nerve head were analyzed by OCTA. RESULTS: RNFL thickness for temporal quadrants and flow area for outer retina levels were significantly lower in the asthma group than the control group (72.58 +/- 10.99 mu m vs 77.73 +/- 9.73 mu m, P = 0.015, and 0.60 +/- 0.31mm(2 vs.) 0.72 +/- 0.31mm(2), P = 0.047, respectively). However, inside disc vascular densities were significantly higher in the asthma group when compared to controls (55.16% +/- 3.71% vs. 52.08% +/- 3.79%, P < 0.001). Inside disc vascular densities were also significantly higher, and RNFL thickness for temporal quadrants was significantly lower in the asthmatic patients without steroid use subgroup when compared to others (P < 0.001, P = 0.012, respectively). CONCLUSION: Lower values of temporal quadrant RNFL, and flow area for outer retina, but higher levels of inside disc vascular density seem to be associated with asthmatic children. OCTA findings in asthmatic children appear to be regardless of inhaled steroid use.
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    Lack of association between obstructive sleep apnea syndrome and specular microscopic features of the corneal endothelium
    (Springer Heidelberg, 2021) Cakmak, Ayse Idil; Dikmen, Nursel; Eren, Ela; Atalay, Eray
    Background Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of hypoxemia and hypercapnia during sleep. The aim of this study was to determine whether OSAS causes significant changes in corneal endothelium detectable by specular microscopy. Methods This prospective, cross-sectional study compared the specular microscopic features of the corneal endothelium of patients with OSAS and age-and gender-matched controls. Patients diagnosed with OSAS by polysomnography in the sleep unit were classified using apnea-hypopnea indexes into two groups as mild-moderate OSAS group and severe OSAS group. All participants were divided into three age groups: 30-45, 46-60, and > 60 years. Corneal endothelial cell density (ECD), percentage of hexagonal cells (Hex), and coefficient of variation of cell area (CV) were obtained using a non-contact specular microscope. The measurements of each group were compared statistically. Results A total of 66 patients (51.1 +/- 9.4 years) and 88 controls (49.2 +/- 10.5 years) were examined. The mild-moderate OSAS group and the severe OSAS group had no significant differences in measures of specular microscopy compared with the controls (ECD, p = 0.84; Hex, p = 0.18; CV, p = 0.41). The mean values of ECD, Hex, and CV were 2552.56 +/- 302.49 cells/mm(2), 54.13 +/- 8.13%, and 36.41 +/- 5.92, respectively, in the mild-moderate OSAS group; 2510.52 +/- 377.12 cells/mm(2), 54.85 +/- 8.68%, and 34.77 +/- 5.02, respectively, in the severe OSAS group; 2543.37 +/- 286.94 cells/mm(2), 51.89 +/- 9.09%, and 36.03 +/- 5.32, respectively, in the control group. Conclusions There were no significant differences in corneal endothelial features between patients and controls. Although OSAS causes systemic hypoxia, its effects do not appear to result in corneal endothelial alterations detectable by specular microscopy.
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    Optical coherence tomography angiography analysis of fabry disease
    (Springer, 2020) Cakmak, Ayse Idil; Atalay, Eray; Cankurtaran, Veysel; Yasar, Erdogan; Turgut, Faruk Hilmi
    Purpose Fabry disease (FD) is characterized by a deficiency in alpha-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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    Optical Coherence Tomography Angiography in Schizophrenia
    (Aves, 2022) Kokacya, Mehmet Hanifi; Cakmak, Ayse Idil
    Objective: The aim of this study is to investigate the retinovascular structure of schizophrenia patients using optical coherence tomography angiography (OCTA). Methods: 47 eyes of schizophrenia patients were compared with 50 eyes of demographically matched healthy controls in terms of OCTA measurements. Schizophrenia patients were evaluated in two groups as short-term (<= 5years) and long-term (> 5years) according to the time elapsed after the diagnosis of schizophrenia. Results: Schizophrenia patients showed overall thinning of retinal nerve fiber layer and macula, and lower vessel density (VD) compared to controls. The results were significant for thickness measurements of general macula and for VD in specific areas (P <0.05); however, they were not significant for the RNFL measurements except the mean circum-papillary RNFL, which was noted to approach significance (P = 0.055). Long-term patients showed significantly lower VD in the whole and perifoveal region of superficial capillary plexus, the whole, perifoveal and foveal region of deep capillary plexus, and the whole area and the disc of radial peripapillary capillaries compared to short-term patients (P= 0.014, P= 0.009, P=0.011, P= 0.010, P=0.011, P= 0.035, P= 0.030). Conclusions: These findings suggest that schizophrenia may be a neurodegenerative disease with progressive microvascular involvement over the years, and that OCTA has the potential to be a useful tool in detecting retinovascular changes in patients with schizophrenia.
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    Our Midterm Outcomes of Strabismus Surgery in Vertical Deviations
    (2020) Gürsoy, Haluk Hüseyin; Cakmak, Ayse Idil; Özalp, Onur; Ozdemir, Omur Can; Colak, Ertugrul
    The evaluation of cases operated for vertical deviation. Materials and Methods: Cases operated between January 2015and June 2016 and followed-up for at least 1 year were evaluated. Pre and postoperative angle of deviations (PD), inferior obliquemuscle (IO) functions, refractive errors, etiologies and surgeries performed were noted. Success was defined as alignment with 10PD of orthophoria and/or inferior oblique overaction (IOOA) ?+1 at the final examination. 32 out of 172 cases, surgery due tovertical deviation was performed. Primary IOOA cases (group 1; n=19; 15 was associated with esotropia, 4 with exotropia) werecompared with cases (group 2; n=13) due to other etiologies [3 Duane retraction syndrome (DRS) type 3, 4 fourth nerve palsy, 4dissociated vertical deviation (DVD), and double elevator palsy (DEP)]. IO recession was performed in all primary IOOA andfourth nerve palsy. Y-split and lateral rectus recession was performed in DRS, superior rectus recession in DVD, and inferior rectusrecession in DEP. Right spherical equivalent (SE) (D) was 1.5 (0.75-2.5) in group 1 and 0.5 (-0.625-0.875) in group 2 (p=0.014).Left SE (D) was 1.5 (0.75-2.5) in group 1 and 0.5 (0.125-1) in group 2 (p=0.024). IOOA decreased from 3.16±0.60 to 0.89±0.81postoperatively in group 1 cases (p<0.01). The upshoot regressed in 3 DRS type 3 cases postoperatively. Successful outcome wasobtained in 16 cases in group 1 (84%) and 11 cases in group 2 (84%). Satisfactory outcome is possible by case-by-case approach invarious vertical deviations.
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    Proptozisin Görüntü İşleme ve Analizi ile Değerlendirilmesi
    (2021) Cakmak, Ayse Idil; Çetin, Şirin; Burakgazi, Gülen; Özseven, Turgut
    Amaç: Proptozisli hastaların orbita manyetik rezonans görüntüleri üzerinde görüntü işleme ve analizle elde edilen antropometrik ölçümleri değerlendirmek. Gereç ve Yöntem: Geriye dönük olan bu çalışmada hastane kayıt sisteminde değerlendirilen 1-18 yaş arası çocukların orbita manyetik rezonans görüntüleri üzerinde ekzoftalmometre yapıldı. Proptozis olduğu belirlenmiş 17 hasta (hasta grubu) ile proptozis olmayan 17 hastanın (kontrol grubu) T2 ağırlıklı manyetik rezonans görüntülerinden en net alınan aksiyel ve koronal kesitleri üzerinde 15 adet ant-ropometrik ölçüm yapıldı. Bu görüntüler Matlab yazılım programında analiz edildi. Her iki grubun analiz sonuçları birbirleri ile karşılaştırıldı. Analizlerde istatistiksel anlamlılık düzeyi p?0,05 olarak belirlendi. Bulgular: Hasta grubu (9±5.65 yaş) (6 kız, 11 erkek) ve kontrol grubu (7.82±5.46 yaş) (7 kız, 10 erkek) arasında cinsiyet ve yaş açısından anlamlı farklılık gözlenmedi (sırasıyla p=0,360, p=0,734). Hastaların %82’sinde sağ gözde proptozis mevcuttu. Hasta grubunun ant - ropometrik ölçümleri ile kontrol grubunun antropometrik ölçümleri birbirleri ile istatistiksel olarak karşılaştırıldı. İstatistiksel analiz sonucuna göre hasta grupta göz küresinin arkası ile temporal kemik iç tabulası arasında ölçülen mesafenin her iki göz arasındaki farkı, her iki göz küresinin dış kenarının birbirlerine olan uzaklığı ve her iki göz küresi nazal sınırının frontal lob ve nazal septum anteriorunu birleştiren orta hatta olan uzak farkı anlamlı oranda daha yüksek; sağ göz lens kalınlık ölçümleri ise anlamlı oranda daha düşük saptandı (sırasıyla p=0,003, p=0,030, p=0,014 ve p=0,05). Sonuç: Orbital patolojileri olan hastaların orbita manyetik rezonans görüntülerinin görüntü işleme ve analizle yapılan antropometrik ölçümleri proptozisli hastalarda önemli farklılıklar göstermiştir. Bu çalışma, bu konuda ileride yapılacak çalışmalar için temel bir çalışma işlevi görebilir.
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    Systemic and ocular determinants of mean ocular perfusion pressure in a population-based sample
    (Springer Japan Kk, 2020) Cakmak, Ayse Idil; Atalay, Eray; Gultekin Irgat, Saadet; Koktas, Zulfiye; Yildirim, Nilgun
    Purpose To investigate the associations between mean ocular perfusion pressure (MOPP) and several variables including body mass index (BMI), comorbid medical conditions and various ocular parameters in a population-based sample. Study design Cross-sectional. Methods Data of 2091 healthy participants from a previous population based cross-sectional study were reviewed. Inclusion criteria were adults >= 40 years of age who were screened on-site for glaucoma. Data on medical history, height, weight, systolic and diastolic blood pressures (SBP and DBP, respectively) were obtained. A basic ocular examination was performed which included intraocular pressure (Tono-Pen XL, Reichert Technologies) and central corneal thickness (Pacline pachymetry;) measurement, slit-lamp examination and non-mydriatic optic disc photography (nonmyd alpha fundus camera, Kowa). MOPP was calculated using the formula [2/3 x (DBP + 1/3(SBP-DBP)]-IOP and low MOPP was defined as MOPP <= 45 mmHg. Results Mean age of the subjects was 63.04 +/- 9.7 years (range: 44 and 99 years) and the majority were women (74.1%, n = 1549). Mean MOPP values in normal weight (BMI < 25), overweight (BMI = 25-29.9) and in obese individuals were 46.9 +/- 9.0 mmHg, 48.6 +/- 9.2 mmHg and 50.7 +/- 10.0 mmHg, respectively (p < 0.001, in all pairwise comparisons). In the multivariable logistic regression analysis, migraine and IOP elevation (per 1 mmHg increment) were significantly associated with a low MOPP (OR: 2.10 and 1.22, p = 0.008 and < 0.001, respectively). On the other hand, risk of low MOPP was reduced in subjects with hypertension, and with increasing age (per 1-year increment) and BMI (per 1-unit increment) (OR: 0.15, 0.97, and 0.95, respectively, and p < 0.001 for all). Conclusion Migraine and elevated IOP increase the risk of low MOPP and this may have a causal relationship with impaired optic nerve head blood flow.