Elif Biler - Academia.edu (original) (raw)

Papers by Elif Biler

Türk Oftalmoloji Dergisi, Jun 29, 2022

A 29-year-old man was referred to the emergency department with periorbital edema, pain, and sudd... more A 29-year-old man was referred to the emergency department with periorbital edema, pain, and sudden loss of vision in the right eye following blunt trauma with a compressed air hose. In ophthalmological examination, visual acuity in the right eye was no light perception. The right pupil was dilated and nonreactive to light. Proptosis, chemosis, conjunctival laceration, and subconjunctival air bubbles were observed on anterior segment examination of the right eye. The cornea and lens were clear.

PubMed, 2019

Duane's syndrome is a rare retraction anomaly characterized by an innervation defect in the later... more Duane's syndrome is a rare retraction anomaly characterized by an innervation defect in the lateral rectus muscle, limitation of abduction and adduction due to the result of abnormal innervation of the horizontal rectus muscles, changes in the eyelid fissures, and abnormal vertical eye movements. The affected eye is displaced up and/or down in adduction. This syndrome, also known as Stilling-Turk-Duane syndrome, accounts for approximately 1 to 5% of all strabismus cases. In this article, we present a one-and-a-half-year-old male patient who had abnormal head position, and was diagnosed as having Duane retraction syndrome. Through this study, we want to draw attention to Duane retraction syndrome, which is one of the rare causes of strabismus.

Chinese journal of traumatology, Apr 1, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

European Eye Research, 2021

The purpose of the study was to evaluate the biometric values of children with congenital nasolac... more The purpose of the study was to evaluate the biometric values of children with congenital nasolacrimal duct obstruction (CNLDO) who underwent nasolacrimal probing after 1-year-old and to determine the effect of probing success and laterality on these values. Methods: The medical records of children with CNLDO who underwent probing were retrospectively reviewed. Biometric measures (cycloplegic refraction, keratometric data, and axial length measurements), presence of anisometropia, and other amblyopia risk factors were analyzed according to both probing success and laterality. In unilateral cases, the affected eyes were compared with contralateral eyes. Results: A total of 49 eyes of 39 patients were examined. One or more amblyopia risk factors were detected in 13 (33.3%) patients. Clinically significant anisometropia was detected in six (20.7%) of 29 unilateral cases and two (20%) of 10 bilateral cases. Six eyes of 6 patients (18.8%) among the 32 eyes for which probing was successful and six eyes of 5 patients (35.3%) among the 17 eyes for which probing failed had at least one risk factor with no statistically significant difference between the groups. In unilateral CNLDO cases, the spherical equivalent refraction of the eyes with CNLDO was significantly higher than that of contralateral eyes (p=0.03). However, no significant differences in terms of keratometric or axial length measurements were detected. Conclusion: The data yielded by this study show amblyopia risk factors in patients with CNLDO regardless of probing results and significantly higher refraction in unilateral CNLDO eyes compared to contralateral eyes.

Journal of Neuro-ophthalmology, Oct 18, 2022

International Ophthalmology, Feb 18, 2016

The purpose of this study was to investigate the interocular symmetry of ultrasonic biometric cha... more The purpose of this study was to investigate the interocular symmetry of ultrasonic biometric characteristics and anterior segment measurements between the fellow eyes of hyperopic anisometropes. Forty-two healthy hyperopic anisometropic cases (1 D mean spherical equivalent difference between eyes) without strabismus were recruited. A range of refractive and ultrasonic biometric parameters were measured in both eyes of each subject including keratometry, mean spherical equivalent, anterior chamber depth (ACD), lens thickness, vitreous depth (VD), axial length (AL), and anterior segment parameters (central corneal thickness (CCT), ACD, anterior chamber volume (ACV)) with Pentacam. Mean spherical equivalent anisometropia was Keywords Anisometropia Á Anterior segment Á Eye Á Pentacam Á Refractive error Anisometropia, an interocular difference in refraction, is an important condition as it can lead to significant visual problems such as aniseikonia, impaired

Graefes Archive for Clinical and Experimental Ophthalmology, Mar 29, 2015

Purpose This study aimed to determine the incidence and characteristics of strabismus following c... more Purpose This study aimed to determine the incidence and characteristics of strabismus following congenital cataract surgery in infants. Materials and methods Patients aged <12 months who underwent surgery for congenital cataract and were followed-up for ≥1 years were included. Patients that had strabismus prior to surgery were excluded. Data regarding gender, cataract laterality, morphology, and density, age at the time of cataract surgery, ocular motility post surgery, and the presence of nystagmus were retrospectively obtained from the patients' records. Results The study included 79 patients (48 male and 31 female). Unilateral surgery was performed in 14 of the patients, versus bilateral surgery in 65. Strabismus did not occur post surgery in 32 (40.5 %) of the patients (group 1), whereas 47 (59.5 %) (group 2) developed strabismus following surgery. The patients in group 1 were followed-up for a mean 50.7± 38.5 months, versus 50.3±39 months in group 2. Mean age at the time of cataract surgery in groups 1 and 2 was 3.6± 1.9 years and 4.6±3.2 months respectively. Mean duration of time between cataract surgery and the development of strabismus was 13.3±13 months (range: 1-60 months). Unilateral cases were more prone to develop strabismus, which was statistically significant (p=0.028). Age at the time of cataract surgery, gender, cataract density, the occurrence of aphakic glaucoma, the presence of nystagmus, and additional ocular surgery were not significantly associated with the development of strabismus. Conclusion Strabismus develops more frequently in children undergoing cataract surgery. In the present study strabismus occurred in more of the patients that underwent unilateral surgery. Based on the present findings, we think that longterm careful follow-up to monitor the development of strabismus is required in all infants undergoing cataract surgery, especially unilateral cases.

International Journal of Radiation Oncology Biology Physics, Oct 1, 2016

58th Annual Meeting of the American-Society-for-Radiation-Oncology (ASTRO) -- SEP 25-28, 2016 -- ... more 58th Annual Meeting of the American-Society-for-Radiation-Oncology (ASTRO) -- SEP 25-28, 2016 -- Boston, MAWOS: 000387655803549Amer Soc Radiat Onco

Türk Oftalmoloji Dergisi, Jan 5, 2014

Tek taraflı non-arteritik ön iskemik optik nöropati (NAİON) geçiren olguların diğer gözleri ile n... more Tek taraflı non-arteritik ön iskemik optik nöropati (NAİON) geçiren olguların diğer gözleri ile normal kontrol grubunun desen görsel uyarılmış potansiyel (VEP) sonuçları açısından karşılaştırılması. Gereç ve Yöntem: Çalışmaya tek gözünde NAİON saptanmış 30 hastanın sağlıklı gözleri (Çalışma grubu) ile rastgele seçilmiş yaş ve cinsiyet uyumlu 30 olgunun birer gözleri (Kontrol grubu) dahil edildi ve desen VEP kayıtları alındı. P100 dalga latans ve amplitütler açısından gruplar karşılaştırıldı. Sonuçlar t-testi ile istatistiksel olarak değerlendirildi. Bulgular: Çalışma grubundaki hastaların 16'sı (%53,3) erkek, 14'ü (%46,7) kadın; kontrol grubundaki olguların 17'si (%56,7) erkek, 13'ü (%43,3) kadındı. Çalışma grubundaki olguların ortalama yaşı 57,9±9,06 iken, kontrol grubunun ortalama yaşı 56,7±9,23 idi. Çalışma ve kontrol grupları arasında düzeltilmiş en iyi görme keskinliği değerleri arasında istatistiksel olarak anlamlı bir fark yoktu (p=0,261). Desen VEP kayıtları değerlendirildiğinde, çalışma grubunda p100 dalga latans ortalaması 112,4±16,7 msn; kontrol grubundaki olguların p100 dalga latans ortalaması 101,9±1,6 msn olarak saptandı (p=0,03). Çalışma grubunda p100 dalga amplitütü 7,03±3,85 µV olarak izlenirken, kontrol grubunda bu değer 9,63±2,6 µV olarak bulundu (p=0,003). Sonuç: Çalışmamızda, tek taraflı NAİON geçiren olguların diğer gözlerindeki desen VEP kayıtlarında kontrol grubuna kıyasla p100 dalga latansında uzama ve amplitütünde azalma izlenmiştir. Etiyolojide, geçirilmiş iskemiye bağlı aksonal kayıp, diğer gözün subklinik etkilenme ihtimali veya yaygın mikroanjiopatik serebral hastalık varlığı düşünülmüştür.

Case reports in ophthalmological medicine, 2015

Purpose. To report clinical and in vivo confocal microscopy (IVCM) findings of two patients with ... more Purpose. To report clinical and in vivo confocal microscopy (IVCM) findings of two patients with ocular ochronosis secondary due to alkaptonuria. Materials and Methods. Complete ophthalmologic examinations, including IVCM (HRT II/Rostock Cornea Module, Heidelberg, Germany), anterior segment optical coherence tomography (AS-OCT) (Topcon 3D spectral-domain OCT 2000, Topcon Medical Systems, Paramus, NJ, USA), corneal topography (Pentacam, OCULUS Optikgeräte GmbH, Wetzlar, Germany), and anterior segment photography, were performed. Results. Biomicroscopic examination showed bilateral darkly pigmented lesions of the nasal and temporal conjunctiva and episclera in both patients. In vivo confocal microscopy of the lesions revealed prominent degenerative changes, including vacuoles and fragmentation of collagen fibers in the affected conjunctival lamina propria and episclera. Hyperreflective pigment granules in different shapes were demonstrated in the substantia propria beneath the basement membrane. AS-OCT of Case 1 demonstrated hyporeflective areas. Fundus examination was within normal limits in both patients, except tilted optic discs with peripapillary atrophy in one of the patients. Corneal topography, thickness, and macular OCT were normal bilaterally in both cases. Conclusion. The degenerative and anatomic changes due to ochronotic pigment deposition in alkaptonuria can be demonstrated in detail with IVCM and AS-OCT. Confocal microscopic analysis in ocular ochronosis may serve as a useful adjunct in diagnosis and monitoring of the disease progression.

Saudi Journal of Ophthalmology, 2016

An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at ... more An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at his right eye for 10 days. He was on full time right eye occlusion therapy for left amblyopia. Slit lamp examination revealed nits and adult lice anchored to the eyelashes in his occluded eye. Eyelashes and all detected lice and nits were mechanically trimmed, and sent for parasitological examination, which confirmed the diagnosis. Upon familial evaluation for additional infestation, the father was also found to have genital phthiriasis pubis and received appropriate treatment. While phthiriasis palpebrarum in children may signify sexual abuse, a detailed investigation by a child psychiatrist was performed and revealed no sign of abuse. Since the infestation was at only on occluded eye, the most possible explanation for the transmission was evaluated as the misusage of the adhesive patch in our case. In conclusion, sexual abuse should be excluded in children with phthiriasis palpebrarum and parents of amblyopic children on occlusion therapy should be warned about the importance of the hygiene of the patching in order to avoid any kind of infection and infestation.

American Journal of Ophthalmology, Mar 1, 2023

Türk Oftalmoloji Dergisi, Jun 29, 2022

Objectives: To compare subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) in... more Objectives: To compare subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) in patients with hyperopic refractive and strabismic amblyopia and healthy subjects. Materials and Methods: The study included 17 patients with strabismic amblyopia (Group 1), 29 patients with hyperopic refractive amblyopia (Group 2), and 16 eyes of 16 healthy volunteers (Group 3). Best corrected visual acuity was noted in all patients and volunteers. In addition to detailed anterior and posterior segment examinations, macular images were obtained by enhanced-depth imaging mode of optical coherence tomography (OCT). SFCT measurements were made from these images and CVI was calculated using the Image J program. Results: No significant difference was found between the groups in terms of age, gender, and intraocular pressure (p=0.27, 0.64, and 0.85, respectively). Mean BCVAs in Group 1 were 0.57±0.16 (0.3-0.8) in the amblyopic eyes, 0.94±0.08 (0.8-1.0) in the fellow eyes, and in Group 2 were 0.61±0.17 (0.2-0.8) in amblyopic eyes, 0.92±0.1 (0.8-1.0) in fellow eyes. BCVA in Group 3 was 1.0±0 (1.0-1.0). Mean SFCT of the amblyopic eyes in Groups 1 and 2 was 341.50±60.4 (277-481) and 370.06±65.3 (247-462), respectively, and in the healthy eyes of Groups 1 and 2 and Group 3 was 321.92±68.26 (251-440), 330.35±74.00 (194-502), and 327.62±40.79 (238-385), respectively. SFCT was significantly greater in the amblyopic eyes of Group 2 compared to Group 3 (p=0.01). Mean CVI was 0.681±0.032 (0.642-0.736) in the amblyopic eyes and 0.685±0.054 (0.587-0.788) in the fellow eyes of Group 1 patients; 0.664±0.033 (0.592-0.719) in the amblyopic eye and 0.707±0.039 (0.625-0.779) in the fellow eye in Group 2 patients; and 0.689±0.031 (0.612-0.748) in Group 3 patients. CVI was significantly lower in the amblyopic eyes of Group 2 compared with fellow eyes (p=0.02) and Group 3 (p=0.025). Conclusion: Morphological changes may be seen in the choroid in amblyopic eyes. We observed that the choroidal stromal component is increased in hyperopic amblyopic patients especially.

Journal of Aapos, Aug 1, 2010

PURPOSE To compare the effects of partial or full hyperopic optical correction on refractive deve... more PURPOSE To compare the effects of partial or full hyperopic optical correction on refractive development in children with accommodative esotropia. METHODS Children with accommodative esotropia and hyperopia .3 D were enrolled in this prospective, nonrandomized study. All children underwent an ophthalmologic examination, including refraction, keratometry, and axial length. Subjects were divided into either full-or partial-correction groups according to their tolerance of the full hyperopic correction. Routine follow-up examinations were performed for at least 3 years. The main outcome measure was cycloplegic spherical equivalent at the end of the study period. RESULTS A total of 120 children were enrolled. The mean cycloplegic spherical equivalent, corneal radius, and axial length were significantly (p \ 0.05) different between the first and last visits in both groups. However, when all the mesurements were adjusted for the age difference between groups, only the difference in axial length between the first and last visits was statistically significant (p \ 0.05). Partial or full optical correction in age-adjusted cohorts with accommodative esotropia did not result in a significant change in refraction, keratometry, or axial length between the first and last visits. CONCLUSIONS Partial or full optical correction of hyperopia had similar effects on refractive development of the eye in children with accommodative esotropia. Treatment of acccommodative esotropia in children older than age 5 did not appear to impair refractive development.

International Ophthalmology, May 9, 2018

Purpose To evaluate and follow-up of functional and morphological changes of the optic nerve and ... more Purpose To evaluate and follow-up of functional and morphological changes of the optic nerve and ocular structures prospectively in patients with earlystage Parkinson's disease. Materials and methods Nineteen patients with a diagnosis of early-stage Parkinson's disease and 19 age-matched healthy controls were included in the study. All participants were examined minimum three times at the intervals of at least 6 month following initial examination. Pattern visually evoked potentials (VEP), contrast sensitivity assessments at photopic conditions, color vision tests with Ishihara cards and full-field visual field tests were performed in addition to measurement of retinal nerve fiber layer (RNFL) thickness of four quadrants (top, bottom, nasal, temporal), central and mean macular thickness and macular volumes. Results Best corrected visual acuity was observed significantly lower in study group within all three examinations. Contrast sensitivity values of the patient group were significantly lower in all spatial frequencies. P100 wave latency of VEP was significantly longer, and amplitude was lower in patient group; however, significant deterioration was not observed during the followup. Although average peripapillary RNFL thickness was not significant between groups, RNFL thickness in the upper quadrant was thinner in the patient group. While there was no difference in terms of mean macular thickness and total macular volume values between the groups initially, a significant decrease occurred in the patient group during the follow-up. During the initial and follow-up process, a significant deterioration in visual field was observed in the patient group. Conclusion Structural and functional disorders shown as electro-physiologically and morphologically exist in different parts of visual pathways in earlystage Parkinson's disease. Keywords Parkinson's disease Á Contrast sensitivity Á Color vision Á Visual field analysis Á VEP Á OCT Á RNFL thickness Á Macular thickness Á Macular volume This original article has been previously presented in Turkish Ophthalmology Society Meeting in 2016 Antalya, Turkey.

Ophthalmic Genetics, Aug 25, 2022

Turkiye Klinikleri Journal of Pediatrics, 2018

Objective: Idiopathic intracranial hypertension is a syndrome characterized by symptoms and signs... more Objective: Idiopathic intracranial hypertension is a syndrome characterized by symptoms and signs of increased intracranial pressure. The aim of this study is to retrospectively evaluate the etiological and clinical features of the cases with the diagnosis of intracranial hypertension. Material and Methods: 14 patients with at least one year of follow up at Ege University Medical School Pediatric Neurology Department with Idiopathic intracranial hypertension diagnosis were included. The etiologic, clinical, treatment features and prognoses were evaluated. Results: Among 14 patients 9 were girls and 5 were boys. Their ages ranged from 3-17 years and the mean age was 10.42 (± 4.65 years). The most common complaint was headache. Seven patients (57.14%) were diagnosed as idiopathic intracranial hypertension. The etiologic factors detected in patients with secondary intracranial hypertension were sinusitis, hypervitaminosis A, obesity, sagittal sinus thrombosis, transverse sinus thrombosis and neuro-Behcet. All of the cases received medical treatment. Optic nerve fenestration was applied to a patient who did not benefit from medical treatment. One patient had recurrence. Conclusion: Idiopathic intracranial hypertension is one of the preventable causes of visual loss and rapid diagnosis and treatment are important because of the rare occurrence of visual field loss and decrease in the accuracy of visual acuity despite adequate treatment. © 2018 by Türkiye Klinikleri

Case Reports, Oct 4, 2016

Technology in Cancer Research & Treatment, Jun 6, 2017

To evaluate the radiation dose-volume effects of optic nerves and chiasm by visual psychophysical... more To evaluate the radiation dose-volume effects of optic nerves and chiasm by visual psychophysical, electrophysiologic tests, and optical coherence tomography in patients with locally advanced nasopharyngeal carcinoma. Materials and Methods: A series of visual tests including visual acuity, visual field, contrast sensitivity, visual evoked potential, and optical coherence tomography were administered to 20 patients with locally advanced (T3-T4) nasopharyngeal carcinoma who were treated with definitive chemoradiotherapy. Volume that received 55 Gy (V 55), mean dose (D mean), highest dose to 5% of the volume (D 5), and maximum dose (D max) for optic nerves and chiasm were evaluated for each patient. Cutoff values were identified as V 55 : 50%, D mean : 50 Gy, D 5 : 55 Gy, and D max : 60 Gy. The effects of radiation dose-volume on ophthalmologic tests were evaluated. Results: Ophthalmological evaluation revealed optic neuropathy with simultaneous retinopathy in 6 eyes of 4 patients and radiation retinopathy alone in both eyes of 1 patient. Regarding radiation dose-volume effects of the optic nerve, significant detrimental effect of all parameters was observed on visual acuity. Visual field and contrast sensitivity were affected significantly with V 55 ! 50% and D mean ! 50 Gy. Visual evoked potential latency was affected significantly with D mean ! 50 Gy, D 5 ! 55 Gy, and D max ! 60 Gy. For the chiasm, significant detrimental effect of all parameters was observed on visual acuity as well. Retinal nerve fiber layer thickness and visual evoked potential amplitude were not affected by any of the dose-volume parameters neither optic nerves nor chiasm. Conclusion: The volume receiving the threshold dose, mean dose, and 5% of the volume receiving the maximum dose are important parameters besides maximum dose to optic nerves and chiasm. A comprehensive ophthalmological evaluation including visual field, contrast sensitivity, visual evoked potential latency, and amplitude should be performed for these patients. Visual evoked potential latency is an objective predictor of vision loss before the onset of clinical signs.

Ophthalmic Plastic and Reconstructive Surgery, Apr 3, 2023

Türk Oftalmoloji Dergisi, Jun 29, 2022

A 29-year-old man was referred to the emergency department with periorbital edema, pain, and sudd... more A 29-year-old man was referred to the emergency department with periorbital edema, pain, and sudden loss of vision in the right eye following blunt trauma with a compressed air hose. In ophthalmological examination, visual acuity in the right eye was no light perception. The right pupil was dilated and nonreactive to light. Proptosis, chemosis, conjunctival laceration, and subconjunctival air bubbles were observed on anterior segment examination of the right eye. The cornea and lens were clear.

PubMed, 2019

Duane's syndrome is a rare retraction anomaly characterized by an innervation defect in the later... more Duane's syndrome is a rare retraction anomaly characterized by an innervation defect in the lateral rectus muscle, limitation of abduction and adduction due to the result of abnormal innervation of the horizontal rectus muscles, changes in the eyelid fissures, and abnormal vertical eye movements. The affected eye is displaced up and/or down in adduction. This syndrome, also known as Stilling-Turk-Duane syndrome, accounts for approximately 1 to 5% of all strabismus cases. In this article, we present a one-and-a-half-year-old male patient who had abnormal head position, and was diagnosed as having Duane retraction syndrome. Through this study, we want to draw attention to Duane retraction syndrome, which is one of the rare causes of strabismus.

Chinese journal of traumatology, Apr 1, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

European Eye Research, 2021

The purpose of the study was to evaluate the biometric values of children with congenital nasolac... more The purpose of the study was to evaluate the biometric values of children with congenital nasolacrimal duct obstruction (CNLDO) who underwent nasolacrimal probing after 1-year-old and to determine the effect of probing success and laterality on these values. Methods: The medical records of children with CNLDO who underwent probing were retrospectively reviewed. Biometric measures (cycloplegic refraction, keratometric data, and axial length measurements), presence of anisometropia, and other amblyopia risk factors were analyzed according to both probing success and laterality. In unilateral cases, the affected eyes were compared with contralateral eyes. Results: A total of 49 eyes of 39 patients were examined. One or more amblyopia risk factors were detected in 13 (33.3%) patients. Clinically significant anisometropia was detected in six (20.7%) of 29 unilateral cases and two (20%) of 10 bilateral cases. Six eyes of 6 patients (18.8%) among the 32 eyes for which probing was successful and six eyes of 5 patients (35.3%) among the 17 eyes for which probing failed had at least one risk factor with no statistically significant difference between the groups. In unilateral CNLDO cases, the spherical equivalent refraction of the eyes with CNLDO was significantly higher than that of contralateral eyes (p=0.03). However, no significant differences in terms of keratometric or axial length measurements were detected. Conclusion: The data yielded by this study show amblyopia risk factors in patients with CNLDO regardless of probing results and significantly higher refraction in unilateral CNLDO eyes compared to contralateral eyes.

Journal of Neuro-ophthalmology, Oct 18, 2022

International Ophthalmology, Feb 18, 2016

The purpose of this study was to investigate the interocular symmetry of ultrasonic biometric cha... more The purpose of this study was to investigate the interocular symmetry of ultrasonic biometric characteristics and anterior segment measurements between the fellow eyes of hyperopic anisometropes. Forty-two healthy hyperopic anisometropic cases (1 D mean spherical equivalent difference between eyes) without strabismus were recruited. A range of refractive and ultrasonic biometric parameters were measured in both eyes of each subject including keratometry, mean spherical equivalent, anterior chamber depth (ACD), lens thickness, vitreous depth (VD), axial length (AL), and anterior segment parameters (central corneal thickness (CCT), ACD, anterior chamber volume (ACV)) with Pentacam. Mean spherical equivalent anisometropia was Keywords Anisometropia Á Anterior segment Á Eye Á Pentacam Á Refractive error Anisometropia, an interocular difference in refraction, is an important condition as it can lead to significant visual problems such as aniseikonia, impaired

Graefes Archive for Clinical and Experimental Ophthalmology, Mar 29, 2015

Purpose This study aimed to determine the incidence and characteristics of strabismus following c... more Purpose This study aimed to determine the incidence and characteristics of strabismus following congenital cataract surgery in infants. Materials and methods Patients aged <12 months who underwent surgery for congenital cataract and were followed-up for ≥1 years were included. Patients that had strabismus prior to surgery were excluded. Data regarding gender, cataract laterality, morphology, and density, age at the time of cataract surgery, ocular motility post surgery, and the presence of nystagmus were retrospectively obtained from the patients' records. Results The study included 79 patients (48 male and 31 female). Unilateral surgery was performed in 14 of the patients, versus bilateral surgery in 65. Strabismus did not occur post surgery in 32 (40.5 %) of the patients (group 1), whereas 47 (59.5 %) (group 2) developed strabismus following surgery. The patients in group 1 were followed-up for a mean 50.7± 38.5 months, versus 50.3±39 months in group 2. Mean age at the time of cataract surgery in groups 1 and 2 was 3.6± 1.9 years and 4.6±3.2 months respectively. Mean duration of time between cataract surgery and the development of strabismus was 13.3±13 months (range: 1-60 months). Unilateral cases were more prone to develop strabismus, which was statistically significant (p=0.028). Age at the time of cataract surgery, gender, cataract density, the occurrence of aphakic glaucoma, the presence of nystagmus, and additional ocular surgery were not significantly associated with the development of strabismus. Conclusion Strabismus develops more frequently in children undergoing cataract surgery. In the present study strabismus occurred in more of the patients that underwent unilateral surgery. Based on the present findings, we think that longterm careful follow-up to monitor the development of strabismus is required in all infants undergoing cataract surgery, especially unilateral cases.

International Journal of Radiation Oncology Biology Physics, Oct 1, 2016

58th Annual Meeting of the American-Society-for-Radiation-Oncology (ASTRO) -- SEP 25-28, 2016 -- ... more 58th Annual Meeting of the American-Society-for-Radiation-Oncology (ASTRO) -- SEP 25-28, 2016 -- Boston, MAWOS: 000387655803549Amer Soc Radiat Onco

Türk Oftalmoloji Dergisi, Jan 5, 2014

Tek taraflı non-arteritik ön iskemik optik nöropati (NAİON) geçiren olguların diğer gözleri ile n... more Tek taraflı non-arteritik ön iskemik optik nöropati (NAİON) geçiren olguların diğer gözleri ile normal kontrol grubunun desen görsel uyarılmış potansiyel (VEP) sonuçları açısından karşılaştırılması. Gereç ve Yöntem: Çalışmaya tek gözünde NAİON saptanmış 30 hastanın sağlıklı gözleri (Çalışma grubu) ile rastgele seçilmiş yaş ve cinsiyet uyumlu 30 olgunun birer gözleri (Kontrol grubu) dahil edildi ve desen VEP kayıtları alındı. P100 dalga latans ve amplitütler açısından gruplar karşılaştırıldı. Sonuçlar t-testi ile istatistiksel olarak değerlendirildi. Bulgular: Çalışma grubundaki hastaların 16'sı (%53,3) erkek, 14'ü (%46,7) kadın; kontrol grubundaki olguların 17'si (%56,7) erkek, 13'ü (%43,3) kadındı. Çalışma grubundaki olguların ortalama yaşı 57,9±9,06 iken, kontrol grubunun ortalama yaşı 56,7±9,23 idi. Çalışma ve kontrol grupları arasında düzeltilmiş en iyi görme keskinliği değerleri arasında istatistiksel olarak anlamlı bir fark yoktu (p=0,261). Desen VEP kayıtları değerlendirildiğinde, çalışma grubunda p100 dalga latans ortalaması 112,4±16,7 msn; kontrol grubundaki olguların p100 dalga latans ortalaması 101,9±1,6 msn olarak saptandı (p=0,03). Çalışma grubunda p100 dalga amplitütü 7,03±3,85 µV olarak izlenirken, kontrol grubunda bu değer 9,63±2,6 µV olarak bulundu (p=0,003). Sonuç: Çalışmamızda, tek taraflı NAİON geçiren olguların diğer gözlerindeki desen VEP kayıtlarında kontrol grubuna kıyasla p100 dalga latansında uzama ve amplitütünde azalma izlenmiştir. Etiyolojide, geçirilmiş iskemiye bağlı aksonal kayıp, diğer gözün subklinik etkilenme ihtimali veya yaygın mikroanjiopatik serebral hastalık varlığı düşünülmüştür.

Case reports in ophthalmological medicine, 2015

Purpose. To report clinical and in vivo confocal microscopy (IVCM) findings of two patients with ... more Purpose. To report clinical and in vivo confocal microscopy (IVCM) findings of two patients with ocular ochronosis secondary due to alkaptonuria. Materials and Methods. Complete ophthalmologic examinations, including IVCM (HRT II/Rostock Cornea Module, Heidelberg, Germany), anterior segment optical coherence tomography (AS-OCT) (Topcon 3D spectral-domain OCT 2000, Topcon Medical Systems, Paramus, NJ, USA), corneal topography (Pentacam, OCULUS Optikgeräte GmbH, Wetzlar, Germany), and anterior segment photography, were performed. Results. Biomicroscopic examination showed bilateral darkly pigmented lesions of the nasal and temporal conjunctiva and episclera in both patients. In vivo confocal microscopy of the lesions revealed prominent degenerative changes, including vacuoles and fragmentation of collagen fibers in the affected conjunctival lamina propria and episclera. Hyperreflective pigment granules in different shapes were demonstrated in the substantia propria beneath the basement membrane. AS-OCT of Case 1 demonstrated hyporeflective areas. Fundus examination was within normal limits in both patients, except tilted optic discs with peripapillary atrophy in one of the patients. Corneal topography, thickness, and macular OCT were normal bilaterally in both cases. Conclusion. The degenerative and anatomic changes due to ochronotic pigment deposition in alkaptonuria can be demonstrated in detail with IVCM and AS-OCT. Confocal microscopic analysis in ocular ochronosis may serve as a useful adjunct in diagnosis and monitoring of the disease progression.

Saudi Journal of Ophthalmology, 2016

An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at ... more An 8-year-old mentally retarded boy is brought to the hospital because of itching and burning at his right eye for 10 days. He was on full time right eye occlusion therapy for left amblyopia. Slit lamp examination revealed nits and adult lice anchored to the eyelashes in his occluded eye. Eyelashes and all detected lice and nits were mechanically trimmed, and sent for parasitological examination, which confirmed the diagnosis. Upon familial evaluation for additional infestation, the father was also found to have genital phthiriasis pubis and received appropriate treatment. While phthiriasis palpebrarum in children may signify sexual abuse, a detailed investigation by a child psychiatrist was performed and revealed no sign of abuse. Since the infestation was at only on occluded eye, the most possible explanation for the transmission was evaluated as the misusage of the adhesive patch in our case. In conclusion, sexual abuse should be excluded in children with phthiriasis palpebrarum and parents of amblyopic children on occlusion therapy should be warned about the importance of the hygiene of the patching in order to avoid any kind of infection and infestation.

American Journal of Ophthalmology, Mar 1, 2023

Türk Oftalmoloji Dergisi, Jun 29, 2022

Objectives: To compare subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) in... more Objectives: To compare subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) in patients with hyperopic refractive and strabismic amblyopia and healthy subjects. Materials and Methods: The study included 17 patients with strabismic amblyopia (Group 1), 29 patients with hyperopic refractive amblyopia (Group 2), and 16 eyes of 16 healthy volunteers (Group 3). Best corrected visual acuity was noted in all patients and volunteers. In addition to detailed anterior and posterior segment examinations, macular images were obtained by enhanced-depth imaging mode of optical coherence tomography (OCT). SFCT measurements were made from these images and CVI was calculated using the Image J program. Results: No significant difference was found between the groups in terms of age, gender, and intraocular pressure (p=0.27, 0.64, and 0.85, respectively). Mean BCVAs in Group 1 were 0.57±0.16 (0.3-0.8) in the amblyopic eyes, 0.94±0.08 (0.8-1.0) in the fellow eyes, and in Group 2 were 0.61±0.17 (0.2-0.8) in amblyopic eyes, 0.92±0.1 (0.8-1.0) in fellow eyes. BCVA in Group 3 was 1.0±0 (1.0-1.0). Mean SFCT of the amblyopic eyes in Groups 1 and 2 was 341.50±60.4 (277-481) and 370.06±65.3 (247-462), respectively, and in the healthy eyes of Groups 1 and 2 and Group 3 was 321.92±68.26 (251-440), 330.35±74.00 (194-502), and 327.62±40.79 (238-385), respectively. SFCT was significantly greater in the amblyopic eyes of Group 2 compared to Group 3 (p=0.01). Mean CVI was 0.681±0.032 (0.642-0.736) in the amblyopic eyes and 0.685±0.054 (0.587-0.788) in the fellow eyes of Group 1 patients; 0.664±0.033 (0.592-0.719) in the amblyopic eye and 0.707±0.039 (0.625-0.779) in the fellow eye in Group 2 patients; and 0.689±0.031 (0.612-0.748) in Group 3 patients. CVI was significantly lower in the amblyopic eyes of Group 2 compared with fellow eyes (p=0.02) and Group 3 (p=0.025). Conclusion: Morphological changes may be seen in the choroid in amblyopic eyes. We observed that the choroidal stromal component is increased in hyperopic amblyopic patients especially.

Journal of Aapos, Aug 1, 2010

PURPOSE To compare the effects of partial or full hyperopic optical correction on refractive deve... more PURPOSE To compare the effects of partial or full hyperopic optical correction on refractive development in children with accommodative esotropia. METHODS Children with accommodative esotropia and hyperopia .3 D were enrolled in this prospective, nonrandomized study. All children underwent an ophthalmologic examination, including refraction, keratometry, and axial length. Subjects were divided into either full-or partial-correction groups according to their tolerance of the full hyperopic correction. Routine follow-up examinations were performed for at least 3 years. The main outcome measure was cycloplegic spherical equivalent at the end of the study period. RESULTS A total of 120 children were enrolled. The mean cycloplegic spherical equivalent, corneal radius, and axial length were significantly (p \ 0.05) different between the first and last visits in both groups. However, when all the mesurements were adjusted for the age difference between groups, only the difference in axial length between the first and last visits was statistically significant (p \ 0.05). Partial or full optical correction in age-adjusted cohorts with accommodative esotropia did not result in a significant change in refraction, keratometry, or axial length between the first and last visits. CONCLUSIONS Partial or full optical correction of hyperopia had similar effects on refractive development of the eye in children with accommodative esotropia. Treatment of acccommodative esotropia in children older than age 5 did not appear to impair refractive development.

International Ophthalmology, May 9, 2018

Purpose To evaluate and follow-up of functional and morphological changes of the optic nerve and ... more Purpose To evaluate and follow-up of functional and morphological changes of the optic nerve and ocular structures prospectively in patients with earlystage Parkinson's disease. Materials and methods Nineteen patients with a diagnosis of early-stage Parkinson's disease and 19 age-matched healthy controls were included in the study. All participants were examined minimum three times at the intervals of at least 6 month following initial examination. Pattern visually evoked potentials (VEP), contrast sensitivity assessments at photopic conditions, color vision tests with Ishihara cards and full-field visual field tests were performed in addition to measurement of retinal nerve fiber layer (RNFL) thickness of four quadrants (top, bottom, nasal, temporal), central and mean macular thickness and macular volumes. Results Best corrected visual acuity was observed significantly lower in study group within all three examinations. Contrast sensitivity values of the patient group were significantly lower in all spatial frequencies. P100 wave latency of VEP was significantly longer, and amplitude was lower in patient group; however, significant deterioration was not observed during the followup. Although average peripapillary RNFL thickness was not significant between groups, RNFL thickness in the upper quadrant was thinner in the patient group. While there was no difference in terms of mean macular thickness and total macular volume values between the groups initially, a significant decrease occurred in the patient group during the follow-up. During the initial and follow-up process, a significant deterioration in visual field was observed in the patient group. Conclusion Structural and functional disorders shown as electro-physiologically and morphologically exist in different parts of visual pathways in earlystage Parkinson's disease. Keywords Parkinson's disease Á Contrast sensitivity Á Color vision Á Visual field analysis Á VEP Á OCT Á RNFL thickness Á Macular thickness Á Macular volume This original article has been previously presented in Turkish Ophthalmology Society Meeting in 2016 Antalya, Turkey.

Ophthalmic Genetics, Aug 25, 2022

Turkiye Klinikleri Journal of Pediatrics, 2018

Objective: Idiopathic intracranial hypertension is a syndrome characterized by symptoms and signs... more Objective: Idiopathic intracranial hypertension is a syndrome characterized by symptoms and signs of increased intracranial pressure. The aim of this study is to retrospectively evaluate the etiological and clinical features of the cases with the diagnosis of intracranial hypertension. Material and Methods: 14 patients with at least one year of follow up at Ege University Medical School Pediatric Neurology Department with Idiopathic intracranial hypertension diagnosis were included. The etiologic, clinical, treatment features and prognoses were evaluated. Results: Among 14 patients 9 were girls and 5 were boys. Their ages ranged from 3-17 years and the mean age was 10.42 (± 4.65 years). The most common complaint was headache. Seven patients (57.14%) were diagnosed as idiopathic intracranial hypertension. The etiologic factors detected in patients with secondary intracranial hypertension were sinusitis, hypervitaminosis A, obesity, sagittal sinus thrombosis, transverse sinus thrombosis and neuro-Behcet. All of the cases received medical treatment. Optic nerve fenestration was applied to a patient who did not benefit from medical treatment. One patient had recurrence. Conclusion: Idiopathic intracranial hypertension is one of the preventable causes of visual loss and rapid diagnosis and treatment are important because of the rare occurrence of visual field loss and decrease in the accuracy of visual acuity despite adequate treatment. © 2018 by Türkiye Klinikleri

Case Reports, Oct 4, 2016

Technology in Cancer Research & Treatment, Jun 6, 2017

To evaluate the radiation dose-volume effects of optic nerves and chiasm by visual psychophysical... more To evaluate the radiation dose-volume effects of optic nerves and chiasm by visual psychophysical, electrophysiologic tests, and optical coherence tomography in patients with locally advanced nasopharyngeal carcinoma. Materials and Methods: A series of visual tests including visual acuity, visual field, contrast sensitivity, visual evoked potential, and optical coherence tomography were administered to 20 patients with locally advanced (T3-T4) nasopharyngeal carcinoma who were treated with definitive chemoradiotherapy. Volume that received 55 Gy (V 55), mean dose (D mean), highest dose to 5% of the volume (D 5), and maximum dose (D max) for optic nerves and chiasm were evaluated for each patient. Cutoff values were identified as V 55 : 50%, D mean : 50 Gy, D 5 : 55 Gy, and D max : 60 Gy. The effects of radiation dose-volume on ophthalmologic tests were evaluated. Results: Ophthalmological evaluation revealed optic neuropathy with simultaneous retinopathy in 6 eyes of 4 patients and radiation retinopathy alone in both eyes of 1 patient. Regarding radiation dose-volume effects of the optic nerve, significant detrimental effect of all parameters was observed on visual acuity. Visual field and contrast sensitivity were affected significantly with V 55 ! 50% and D mean ! 50 Gy. Visual evoked potential latency was affected significantly with D mean ! 50 Gy, D 5 ! 55 Gy, and D max ! 60 Gy. For the chiasm, significant detrimental effect of all parameters was observed on visual acuity as well. Retinal nerve fiber layer thickness and visual evoked potential amplitude were not affected by any of the dose-volume parameters neither optic nerves nor chiasm. Conclusion: The volume receiving the threshold dose, mean dose, and 5% of the volume receiving the maximum dose are important parameters besides maximum dose to optic nerves and chiasm. A comprehensive ophthalmological evaluation including visual field, contrast sensitivity, visual evoked potential latency, and amplitude should be performed for these patients. Visual evoked potential latency is an objective predictor of vision loss before the onset of clinical signs.

Ophthalmic Plastic and Reconstructive Surgery, Apr 3, 2023