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    Conjunctival Histopathological Changes in Children With Vitamin D Deficiency
    (Lippincott Williams & Wilkins, 2022) Aydemir, Gozde Aksoy; Ilhan, Cagri; Pehlivanoglu, Burcin; Aydemir, Emre; Kiziltoprak, Hasan; Bolu, Semih
    Purpose: The aim of this study was to investigate tear function-associated clinical findings and conjunctival histopathological changes in children with vitamin D (Vit-D) deficiency. Methods: This study used a prospective case-control design. Group 1 (n=38) comprised pediatric patients with Vit-D deficiency, and group 2 (n=45) was the control group. Tear break-up times (TBUTs), Schirmer-1 test measurements, ocular surface disease index (OSDI) scores, and conjunctival impression cytology (CIC) results of the groups were compared. Results: The participant demographic characteristics, including the mean age and the male-to-female ratio, were similar (P>0.05). The median TBUT and Schirmer-1 test measurement were 10 s (5-15) and 12 mm (6-19) in group 1 and 11 s (6-16) and 15 mm (8-21) in group 2 (P=0.004 and P=0.013, respectively). The median OSDI scores were 16 (10-20) in group 1 and 17 (10-21) in group 2 (P=0.092). According to the CIC, 25 samples in group 1 and 40 samples in group 2 were categorized as grade 0, 11 samples in group 1 and 5 samples in group 2 were categorized as grade 1, and 2 samples in group 1 and no sample in group 2 were categorized as grade 2 (P=0.027). Conclusion: Significant conjunctival histopathological changes occur in children with Vit-D deficiency, and these changes have effects on some tear function-associated clinical findings including the Schirmer-1 test and TBUT measurements.
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    Long-term Complications of Conventional and Chandelier-Assisted Scleral Buckle for Primary Repair of Rhegmatogenous Retinal Detachment
    (Wolters Kluwer Medknow Publications, 2022) Ilhan, Cagri; Citirik, Mehmet; Dulger, Selda Celik; Ozdemir, Mesut
    Purpose: To compare the outcomes of conventional indirect ophthalmoscopy and wide-angled visualization with chandelier endo-illumination methods in scleral buckle surgery by focusing on postoperative complications in the postoperative long-term period.Methods: In this retrospective comparative study, patients who underwent scleral buckle surgery due to rhegmatogenous retinal detachment were included in the study. Conventional scleral buckle surgery using indirect ophthalmoscopy was performed in Group 1, and wide-angled visualization with chandelier endo-illumination method in scleral buckle surgery was performed in Group 2. The outcomes of the two methods were compared.Results: The demographic and baseline clinical characteristics of the groups were similar (P > 0.05, for all). The mean follow-up time was 70.47 +/- 20.32 weeks (52-116) in Group 1 and 64.89 +/- 18.12 weeks (52-100) in Group 2 (P > 0.05). There was no significant difference in the mean postoperative best-corrected visual acuity and redetachment rates of the groups (P > 0.05, for both). The cumulative rate of postoperative complications was more frequent in Group 1 (P = 0.011) despite being not significant in one-by-one comparison of the complications including epiretinal membrane, proliferative vitreoretinopathy, glaucoma, cystoid macular edema, foveal atrophy, gaze restriction, and macular hole (P > 0.05, for all).Conclusion: Using wide-angled visualization with chandelier endo-illumination in scleral buckle surgery, favorable surgical outcomes can be achieved in the postoperative long-term period with fewer complications.
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    Long-term Outcomes of Submacular Perfluorocarbon Liquid Removal with Internal Limiting Membrane Peeling and Transretinal Aspiration
    (Georg Thieme Verlag Kg, 2023) Ilhan, Cagri; Ceran, Tugce Horozoglu; Citirik, Mehmet; Teke, Mehmet Yasin
    Background An important complication associated with per-fluorocarbon liquid (PFCL) use during pars plana vitrectomy (PPV) is its retention in the submacular area. The aim of this study was to present the long-t erm outcomes of the surgical method used in this study to remove submacular PFCL and toshed light on the advantages and disadvantages compared to othermethods. Material and Methods This is a retrospective, single-center, observational study. Patients who underwent surgical inter-vention due to submacular PFCL were included in this study. The surgical procedural includes internal limiting membrane (ILM) peeling, transretinal aspiration of submacular PCFL with a 25/27-gauge soft-tipped cannula, then perfluoropropane (C3F8) gas tamponade, and facedown positioning for 5 days. The long-term anatomical and functional outcomes were evaluated with an ophthalmological examination and optical coherence tomography (OCT).Outcomes A total of 15 patients with submacular PFCL were included in this study, and the mean age of the patients was 64.33 +/- 10.36 years (47-83). The localization of submacular PFCL was subfoveal in nine patients (60.00%), non-subfoveal in four patients (26.67%), and both subfoveal and non-sub-foveal in two patients (13.33%). The mean time of submacu-lar PFCL diagnosis was 4.86 +/- 1.02 weeks (2-8) and the mean time of the surgery was 9.80 +/- 1.17 weeks (8-14). Complete removal of submacular PFCL was achieved in all cases (100%) and no significant treatment-associated complications were observed. The mean follow-up time was 37.60 +/- 14.00 months (18-60) and the best-corrected visual acuity was sig-nificantly improved (p = 0.001). At the end of the follow-up time, prominent ellipsoid zone disruption was observed in six patients (40.00 %), while in nine patients (60.00%), there was no prominent ellipsoid zone disruption.Conclusions The surgical procedural for submacular PFCL re-moval is a reasonable option and improves visual acuity in the long term without any significant treatment-associated com-plications.
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    Non-damaging retinal laser therapy in chronic central serous chorioretinopathy
    (Springer, 2023) Ilhan, Cagri; Citirik, Mehmet; Ozdemir, Mesut
    PurposeTo investigate the functional and anatomical outcomes of non-damaging retinal laser therapy (NRT), in cases with chronic central serous chorioretinopathy (CSCR).MethodsTwenty-three eyes of 23 treatment-naive chronic CSCR patients were included in this study. The irradiation of 577 nm yellow light was conducted on the serous detachment area after switching over to the NRT algorithm. Anatomical and functional changes after treatments were investigated.ResultsThe mean age of the subjects was 48.68 +/- 5.93 years (41-61). The mean best-corrected visual acuity (BCVA) and the mean central macular thickness (CMT) values were 0.42 +/- 0.12logMAR (0.20-0.70) and 315.69 +/- 61.25 mu m (223-444) before NRT; and 0.28 +/- 0.11logMAR (0.10-0.50) and 223.26 +/- 60.91 mu m (134-336) at the 2nd month follow-up visit (p < 0.001, for both). At the 2nd-month follow-up visit after NRT, complete resorption of subretinal fluid was observed in 18 eyes (78.3%) and incomplete resorption in five eyes (21.7%). Worse values of BCVA and CMT before NRT were found as increased risk for incomplete resorption (p = 0.002 and rho = 0.612 for BCVA, and p < 0.001 and rho = 0.715 for CMT).ConclusionSignificant functional and anatomical improvements can be observed in the early period after NRT in patients with chronic CSCR. Patients having worse baseline BCVA and CMT have increased risk for incomplete resorption.
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    Use of automated quantitative pupillometric evaluation for monitoring the severity of diabetic retinopathy
    (Consel Brasil Oftalmologia, 2021) Cankurtaran, Veysel; Ilhan, Cagri; Tekin, Kemal; Citirik, Mehmet; Dirican, Emre; Gurkan, Eren
    Purpose: We aimed to evaluate the use of automated quantitative static and dynamic pupillometry in screening patients with type 2 diabetes mellitus and different stages of diabetic retinopathy. Method: 155 patients with type 2 diabetes mellitus (diabetes mellitus group) were included in this study and another 145 age- and sex-matched healthy individuals to serve as the control group. The diabetes mellitus group was divided into three subgroups: diabetes mellitus without diabetic retinopathy (No-diabetic retinopathy), nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy. Static and dynamic pupillometry were performed using a rotating Scheimpflug camera with a topography-based system. Results: In terms of pupil diameter in both static and dynamic pupillometry (p <0.05), statistically significant differences were observed between the diabetes mellitus and control groups and also between the subgroups No-diabetic retinopathy, nonproliferative diabetic retinopathy, and proliferative diabetic retinopathy subgroups. But it was noted that No-diabetic retinopathy and nonproliferative diabetic retinopathy groups have showed similarities in the findings derived from static pupillometry under mesopic and photopic conditions. The two groups also appeared similar at all points during the dynamic pupillometry (p>0.05). However, it could be concluded that the proliferative diabetic retinopathy group was significantly different from the rest of the subgroups, No-diabetic retinopathy and nonproliferative diabetic retinopathy groups, in terms of all the static pupillometry measurements (p<0.05). The average speed of dilation was also significantly different between the diabetes mellitus and control groups and among the diabetes mellitus subgroups (p<0.001). While weak to moderate significant correlations were found between all pupil diameters in static and dynamic pupillometry with the duration of diabetes mellitus (p<0.05 for all), the HbAlc values showed no statistically significant correlations with any of the investigated static and dynamic pupil diameters (p>0.05 for all). Conclusion: This study revealed that the measurements derived from automated pupillometry are altered in patients with type 2 diabetes mellitus. The presence of nonproliferative diabetic retinopathy does not have a negative effect on pupillometry findings, but with proliferative diabetic retinopathy, significant alterations were observed. These results suggest that using automated quantitative pupillometry may be useful in verifying the severity of diabetic retinopathy.