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Öğe Assessment of Red Cell Distribution Width, Platelet/lymphocyte Ratio, Systemic Immune-inflammation Index, and Neutrophil/lymphocyte Ratio Values in Patients with Central Retinal Artery Occlusion(Taylor & Francis Inc, 2022) Elbeyli, Ahmet; Kurtul, Bengi Ece; Ozcan, Deniz Ozarslan; Ozcan, Sait Coskun; Dogan, EminePurpose To evaluate complete blood count (CBC)-derived inflammatory indices in central retinal artery occlusion (CRAO). Methods A total of 42 patients with CRAO (CRAO group) and 42 age- and sex-matched subjects without CRAO (Control group) were included. CBC parameters including red cell distribution width (RDW) levels were assayed. Platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and neutrophil/ lymphocyte ratio (NLR) were calculated. Results RDW, PLR, SII and NLR values were significantly higher in CRAO group than control group [15.2 +/- 1.47% vs 13.96 +/- 1.13% (p < .001), 127.94 +/- 48.21 vs 101.16 +/- 24.84 (p = .008), 667.11 +/- 357.84 vs 493.44 +/- 207.07 (p = .008), 2.70 +/- 1.27 vs 2.13 +/- 0.83 (p = .018), respectively]. In multivariate analysis only RDW was independent predictor for CRAO (OR 2.317, p < .001). On ROC analysis, area under curve of RDW, PLR, SII, and NLR for CRAO were 0.761, 0.685, 0.622 and 0.618, respectively. Conclusion RDW seems superior to other inflammatory indices to predict CRAO.Öğe COMPARISON OF ROZASEA PATIENTS AND HEALTHY INDIVIDUALS IN TERMS OF OPHTHALMOLOGICAL PARAMETERS(Nobel Ilac, 2023) Diracoglu, Aynur; Ozcan, Sait CoskunObjective: Rosacea is a chronic inflammatory dermatosis that is common in the population. Ocular involvement is common in these patients and is usually underdiagnosed. The aim of this study is to compare patients with rosacea and healthy individuals in terms of various ocular findings.Material and Method: 102 eyes of 51 patients with rosacea (rosacea group) and 108 eyes of randomly selected 54 healthy individuals (control group) were included in the study. Detailed eye complaint query, detailed eye examination, tear break-up time (TBUT) measurement and Schirmer test were performed in both groups.Results: Among the eye complaints described by the patients, stinging, burning, itching, redness, watering, drying and photophobia were statistically significantly higher in the rosacea group compared to the control group (p<0.05). When the examination findings were compared, blepharitis, meibomite and hyperemia findings were found to be statistically significantly more common in the rosacea group than in the control group (p<0.05). Shirmer and TBUT values were statistically significantly lower in the rosacea group than in the control group (p<0.05).Conclusion: Rosacea patients are risky patients in terms of eye involvement. Therefore, we think that all rosacea patients should be questioned about ocular symptoms and a comprehensive eye examination should be performed, including the Schirmer test, which evaluates tear deficiency.Öğe Corneal biomechanical parameters in systemic autoimmune diseases(Taylor & Francis Ltd, 2022) Ozarslan Ozcan, Deniz; Ozcan, Sait Coskun; Kimyon, GezmisBackground This study aims to evaluate corneal biomechanical changes in patients with systemic autoimmune diseases using Corvis ST. Methods This prospective study included 36 patients with ankylosing spondylitis (AS), 38 patients with rheumatoid arthritis (RA), and 36 age- and sex-matched healthy subjects. After ophthalmologic examinations Pentacam HR and Corvis ST was performed on all eyes. The mean keratometric and pachymetric data, corneal biomechanical parameters, biomechanical intraocular pressure (bIOP) were analysed. Results There was no statistically significant differences among the groups regarding age, gender, refraction, visual acuity, IOP, pachymetry and keratometry. Compared to healthy controls, the mean velocity values of applanation 1 (A1V) and 2 (A2V), deformation amplitude (DA), and corvis biomechanical index (CBI) were statistically significantly higher and stiffness parameter at first applanation (SPA1) was statistically significantly lower in AS and RA patients (all p < 0.05). In both AS and RA groups, disease duration was found to be negatively correlated with SPA1 (p = 0.043, 0.027, respectively) and positively correlated with CBI (p = 0.022, 0.020, respectively). Conclusion AS and RA patients have a decreased corneal stiffness compared to healthy subjects. Disease duration seems to be correlated with these changes.Öğe The diagnostic value of systemic immune-inflammation index in diabetic macular oedema(Taylor & Francis Ltd, 2022) Elbeyli, Ahmet; Kurtul, Bengi Ece; Ozcan, Sait Coskun; Ozcan, Deniz OzarslanBackground This study evaluates the diagnostic value of systemic immune-inflammation index (SII) in the occurrence of DME in patients with non-proliferative diabetic retinopathy. Methods In this prospective study, the SII was applied to 150 consecutive patients with non-proliferative diabetic retinopathy. The relationship between the SII and the occurrence of DME was examined. Patients with DME were also divided into two subgroups according to the presence of accompanying sub-retinal fluid. The SII value was calculated as follows: platelet count x (neutrophil/lymphocyte). The risk factors for DME were evaluated using multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve analysis of SII for predicting DME was performed. Results Patients with DME had significantly higher levels of SII than those without DME (599.7 +/- 279.2 and 464. 9 +/- 172.2, respectively, p < 0.001). However, The SII values were similar between sub-retinal fluid subgroups. Multivariate regression analysis indicated that SII, together with duration of diabetes, was an independent factor for DME occurrence [Odds ratio (OR) = 1.005, 95% confidence interval = 1.001-1.009, p = 0.04, and OR = 1.146, 95% CI = 1.049-1.252, p = 0.003, respectively]. ROC curve analysis revealed that the best cut-off value of SII was 399 (area under the curve: 0.633; sensitivity: 70%; specificity: 60%). Conclusion An elevated SII value is strongly associated with the development of DME. The SII may be a diagnostic biomarker for identifying DME to improve the risk stratification and management of non-proliferative patients with diabetic retinopathy.Öğe Effects of a new-generation hybrid contact lens on visual performance and vision-related quality of life in patients with keratoconus(Consel Brasil Oftalmologia, 2023) Ozcan, Sait Coskun; Ozcan, Deniz OzarslanPurpose: The aim of this study was to eva-luate the efficacy of a new-generation hybrid contact lens for improving visual outcomes and vision-related quality-of-life performance in patients with keratoconus who had intolerance or treatment failure of conventional correction methods such as the use of soft silicone-hydrogel or rigid gas-permeable contact lenses. Methods: Twenty-eight patients with keratoconus (42 eyes) were enrolled in this prospective cross-sectional study. Airflex (Swisslens) lenses were fitted in the patients' eyes in accordance with the manufacturer's instruction. Ophthalmologic examinations, including manifest refraction, best-corrected distance visual acuity, slit-lamp biomicroscopy, and National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) assessment, were performed at baseline and the 6-month visit. Results: An adequate fit was achieved in 39 eyes (92.9%) of 26 patients. Six eyes of 3 patients were excluded from the study owing to discontinuation of lens wearing. The mean age of the successful wearers was 20.3 +/- 4.9 years. The mean best-corrected distance visual acuity was statistically significantly improved from 0.62 +/- 0.30 to 0.11 +/- 0.06 logMAR with the Airflex hybrid contact lenses (p<0.001). The mean overall composite NEI-VFQ-25 score statistically significantly increased with the Airflex hybrid contact lenses at the 6-month visit as compared with that at baseline (from 77.1 +/- 16.3 to 90.9 +/- 7.3, p =0.036). Statistically significantly better scores were obtained with the Airflex hybrid contact lenses in all the NEI-VFQ-25 subscale items (all p<0.05). No significant adverse effects were observed. Conclusions: New-generation hybrid contact lenses can be used as an effective alternative for correction of irregular astigmatism in patients with keratoconus who have intolerance or treatment failure of conventional methods. Significant improvement in vision-related quality-of-life in patients with keratoconus can be achieved with these lenses.Öğe Efficacy of Optic Nerve Sheath Fenestration in Patients with Increased Intracranial Pressure(Galenos Publ House, 2023) Ozcan, Sait Coskun; Deveci, Nedime; Ozcan, Deniz Ozarslan; Onder, FeyzaObjectives: To evaluate the effectiveness of optic nerve sheath fenestration (ONSF) on visual functions in patients with increased intracranial pressure (ICP). Materials and Methods: The medical records of 24 eyes of 17 patients who had ICP due to idiopathic intracranial hypertension, cerebral venous sinus thrombosis, or intracranial cyst and underwent ONSF surgery to prevent visual loss were evaluated. Pre- and postoperative visual acuity, optic disc images, and visual field findings were reviewed. Results: The mean age of the patients was 30.4 +/- 8.5 years, and 88.2% were female. The patients' mean body mass index was 28.67 +/- 6.1 kg/m(2). The mean follow-up time was 24 +/- 12.1 months (range: 3-44). At postoperative 3 months, the mean best-corrected distance visual acuity had improved in 20 eyes (83.3%) and stabilized in 4 eyes (16.7%) compared to preoperative values. In visual field mean deviation, an improvement was observed in 10 eyes (90.9%), while 1 eye (9.1%) eye remained stable. Optic disc edema decreased in all patients. Conclusion: This study indicates that ONSF has beneficial effects on visual function in patients with rapidly progressive visual loss caused by increased intracranial pressure.Öğe Efficacy of two silicone-hydrogel bandage contact lenses after corneal crosslinking(Taylor & Francis Ltd, 2021) Ozcan, Deniz Ozarslan; Ozcan, Sait CoskunSilicone-hydrogel (SiH) contact lenses are frequently used as a bandage after anterior segment surgical procedures. Several types of lenses may exhibit clinical performances with different characteristics. This study aims to evaluate the efficacy of two SiH contact lenses following corneal crosslinking (CXL). Forty-nine keratoconus patients scheduled for consecutive CXL surgery in both eyes were included in this comparative, double-blind, prospective study. A Balafilcon A (Pure Vision 2 HD, Bausch+Lomb, Rochester, NY, USA) or Lotrafilcon B (Air Optix Aqua, Ciba Vision, Duluth, GA, USA) lens was fitted in a randomised fashion in the eyes at the end of the CXL. Remaining epithelial defect area measured by slitlamp biomicroscopy, subjective level of pain and discomfort with visual analogue scale (VAS) and total number of oral analgesics taken were evaluated and compared at post-operative days 0, 1, 2 and 3. The average epithelial defect size was significantly smaller in the eyes with Lotrafilcon B than the eyes with Balafilcon A at post-operative Day 1 (31.2 +/- 4.3 mm(2) and 33.8 +/- 5.2 mm(2), respectively, p < 0.001) and Day 2 (8.2 +/- 3.6 mm(2) and 10.5 +/- 5.4 mm(2), respectively, p = 0.039). There was no statistically significant in the average epithelial defect size between the groups at Day 3 (p = 0.859). Re-epithelialisation time was similar in both groups (p = 0.317) There was no statistically significant difference in VAS scores regarding the lens type in any post-operative follow-up. The mean oral analgesic numbers were similar in both groups (p = 0.217). SiH contact lenses can be used as an effective bandage for corneal re-epithelialisation after CXL. The material and features of bandage contact lens used after CXL may affect the corneal re-epithelialisation process. Lotrafilcon B lens showed faster re-epithelialisation at post-operative days 1 and 2 after CXL.Öğe Evaluation of microvascular changes in optic disc and retina by optical coherence tomography angiography during Valsalva maneuver(Springer, 2020) Ozcan, Sait Coskun; Kurtul, Bengi Ece; Ozcan, Deniz OzarslanPurpose Optical coherence tomography angiography (OCTA) is an increasingly widespread imaging tool that allows the visualization of the microvascular structures of the eye. It should be kept in mind in clinical practice, Valsalva maneuver (VM) may have an effect on OCTA findings. We aimed to evaluate the effect of VM on the optic nerve and retinal blood flow parameters measured by OCTA. Methods Sixty age- and sex-matched healthy volunteers were included into this prospective study. Optic disc status for radial peripapillary capillary (RPC) network [whole image, inside disc and peripapillary capillary densities], superficial and deep capillary plexus whole, foveal, parafoveal and perifoveal densities and foveal avascular zone (FAZ) densities of volunteers were examined by OCTA both at rest and during VM. Results The mean age of the subjects was 31.48 +/- 7.49 (18-50) years and 51.7% were male. Superficial whole, parafoveal and perifoveal vessel densities were found to be significantly decreased during VM (p= 0.008,p= 0.015,p= 0.017, respectively). Lower levels of deep whole, parafoveal and perifoveal vessel densities were also detected while VM (p< 0.001 for all). However, there were no significant differences in terms of foveal vessel and FAZ densities. Additionally, VM significantly decreased RPC densities for whole image, inside and peripapillary capillary (p= 0.005,p< 0.001,p= 0.039, respectively). Conclusion VM may cause a significant decrease in optic nerve and para-perifoveal blood flow. Therefore, patient instruction about not holding breath is required before OCTA scanning.Öğe 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, GezmisPurpose 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.Öğe Increased Systemic Immune-Inflammation Index Levels in Patients with Dry Eye Disease(Taylor & Francis Inc, 2022) Ozcan, Deniz Ozarslan; Kurtul, Bengi Ece; Ozcan, Sait Coskun; Elbeyli, AhmetPurpose To evaluate the systemic immune-inflammation index (SII) levels, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients with dry eye disease (DED) and to compare with control subjects. Methods This prospective study included 47 DED patients and 47 age- and sex-matched healthy controls. Ophthalmological examination, diagnostic DED tests, and routine complete blood cell count parameters were analyzed. The SII value was calculated as follows: platelet count x (neutrophil/lymphocyte). Results The mean SII, NLR, and PLR levels were significantly higher in DED patients compared to controls (p< .001,pp= .009, respectively). Using the receiver operating characteristics (ROC) curve analysis to predict patients with DED, the highest area under the curve (AUC) was determined SII (0.761 for SII, 0.727 for NLR, and 0.653 for PLR). Conclusions As a novel tool superior to other inflammatory markers, SII may be a cheap and reliable indicator of inflammatory status in DED patients.Öğe Plasminogen activator inhibitor-1 4G/5G polymorphism and dyslipidemia with branch retinal artery occlusion in a young lady(Wolters Kluwer Medknow Publications, 2020) Kurtul, Bengi Ece; Elbeyli, Ahmet; Ozcan, Sait CoskunBranch retinal artery occlusion (BRAO) leads obstruction of blood flow in the distribution of the affected vessel giving rise to ischemia and reorganization of the retinal layers. It is a very rare diagnosis and the etiological risk factors of BRAO are not clean in the young population. Various hypercoagulable states leading to thrombosis appeared to be more responsible. Here, the authors present an interesting case of a 25-year-old female patient with BRAO accompanying with plasminogen activator inhibitor-1(PAI-1) 4G/5G gene polymorphism and dyslipidemia together, for the first time. There was a history of sudden painless blurred vision in her right eye 3 months ago. Her visual acuity was 20/20 in both eyes at the admittion. Fundus photo, red-free photo, optical coherence tomography images of 3 months ago revealed BRAO in the right eye. Fundus exam and images taken at the 3th month confirmed the recovery of retinal edema. Attenuation of inferotemporal retinal artery still mildly appeared. Applied confrontation fields showed a visual field defect corresponding with affected area. Ophthalmologists are advised to be aware of the importance of PAI-1 4G / 5G gene polymorphism and dyslipidemia conditions besides the other genetic mutations and thrombophilic markers regarding BRAO in young patients. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.Öğe Schnyder Corneal Dystrophy: A Rare Case Report(Nepal Ophthalmic Soc, 2020) Kurtul, Bengi Ece; Elbeyli, Ahmet; Ozcan, Deniz Ozarslan; Ozcan, Sait Coskun; Karaaslan, AbdulkerimIntroduction: Schnyder corneal dystrophy (SCD) is a rare, autosomal dominant, anterior stromal dystrophy described as progressive bilateral corneal opacification due to abnormal accumulation of cholesterol and phospholipids in the cornea. The clinical signs can change as the patient ages. SCD with different presentations may actually be misdiagnosed. Early diagnosis would help to rule out other potentially sight threatening or treatable conditions like infectious keratitis or drug toxicity. Case: We present a case of a 34-year-old Syrian male patient, came to our clinic for bilateral decreased visual acuity for 5 years. His visual acuity was 0.15 in both eyes. Slitlamp examination revealed corneal arcus or disk-like lesion and polychromatic crystalline depositions in both eyes in subepithelial and the anterior 1/3 of the stroma. The mild onset of arcus lipoides was also seen. Central corneal thickness results were 507 mu m in the right eye and 503 mu m in the left eye. A diagnosis of Schnyder corneal dystrophy was thought based on clinical presentation and coexistence dyslipidemia of the patient. Conclusion: Ophthalmologists should keep in mind SCD and its associated systemic findings that need to be evaluated and managed properly.
