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Papers by Nurten Ünlü

International Ophthalmology, Jun 30, 2023

S.b. Ankara eğitim ve araştırma hastahanesi tıp dergisi, Apr 27, 2021

To evaluate the visual field and corneal topographic findings which occur with combined surgeries... more To evaluate the visual field and corneal topographic findings which occur with combined surgeries in patients who have other involutional periocular changes in association with dermatochalasis. Material and Method: Eighty eyelids of 40 patients were included in the study and the subjects were divided into 2 groups as additional eyelid pathology (Group 1) and additional eyebrow ptosis (Group 2). In the preoperative and postoperative 3rd month, Margin Reflex Distance-1 (MRD-1), corneal parameters obtained by high base topography device and visual field findings obtained by a visual field device were recorded and detailed ophtalmologic examination was performed. RESULTS: A mean elevation of 0.5 mm was observed in the MRD-1 values in both groups. Postoperatively, a marked reduction was observed in the rate of observing scotoma in the visual field and in MD and PSD values (p<0.001)in both groups. Among the corneal topography data, no significant change was observed in the anterior chamber depth and astigmatism axis, whereas a statistically significant increase was found in the strenght of refractivity of the most flat (K1), the most steep meridian (K2) (p<0.05). The postoperative astigmatism value was significantly higher in Group 1 (p<0.001) while the increase in Group 2 was not statistically significant (p=0.599). CONCLUSIONS: More successful functional and cosmetic outcomes can be obtained following combined surgeries directed to different pathologies in involutional eyelid and eyebrow changes.

Journal of Cataract and Refractive Surgery, Jul 1, 2013

To assess the results of phacoemulsification and posterior chamber intraocular lens (PC IOL) impl... more To assess the results of phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in patients with cataract secondary to anterior uveitis. Department of Ophthalmology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey. Case series. Consecutive patients with anterior uveitis and cataract were prospectively studied for outcomes after phacoemulsification and PC IOL implantation. Fifty-five eyes (48 patients; mean age 44.9 years ± 15.6 [SD]) were included. Patients were followed for 6 months. The etiology of uveitis was presumed idiopathic anterior uveitis (n = 22), herpes simplex virus-associated anterior uveitis (n = 10), Fuchs heterochromic iridocyclitis (n = 10), and anterior uveitis associated with collagen vascular disease (n = 13). Preoperative complications secondary to uveitis included posterior synechiae (12 eyes), glaucoma (26 eyes), and sequelae of cystoid macular edema (CME) (21 eyes). At the final visit, the corrected distance visual acuity (CDVA) was 20/40 or better in 52 eyes (94.5%) and 20/20 in 33 eyes (60.0%). The CDVA was worse than 20/40 in 3 eyes because of preoperative anterior and posterior segment abnormalities. Postoperative complications were CME, recurrent uveitis, and posterior capsule opacity in 7 eyes (12.7%) each; fibrinous anterior chamber reaction in 6 eyes (10.9%); raised intraocular pressure in 4 eyes; peripheral anterior synechiae in 1 eye (1.8%); and hypotony in 1 eye (1.8%). Patients with a history of anterior uveitis and cataract having phacoemulsification with PC IOL implantation had excellent visual results with a relatively low complication rate. No author has a financial or proprietary interest in any material or method mentioned.

Eye & Contact Lens-science and Clinical Practice, Jul 1, 2013

To report a patient of lipoid proteinosis (LP) with bilateral keratoconus. Methods: A 16-year-old... more To report a patient of lipoid proteinosis (LP) with bilateral keratoconus. Methods: A 16-year-old boy presented to our institution with a complaint of gradual decrease in vision over the past 4 years in both eyes and a contact lens intolerance. He had a hoarse voice and multiple areas of hyperpigmented lesions over the head and neck region. Slit lamp biomicroscopy of the both eyes showed multiple round solid pearly lesions along the upper and lower lid margins and a mild central corneal ectasia in both eyes. Central corneal thickness and the keratometric values were measured by using Scheimpflug imaging (Pentacam), and the results were compatible with keratoconus. The histopathologic examination of the lesions taken from bilateral eyelid margins showed hyalinosis, papillomatosis, and depositions of eosinophilic material around the blood vessels, which were compatible with LP. Conclusions: With this report, we describe a case of LP with keratoconus. As seen in our case, LP and its characteristic eyelid margin lesions in keratoconus patients can be associated with a contact lens intolerance.

Turkiye Klinikleri Journal of Ophthalmology Special Topics, 2016

Journal of cataract and refractive surgery, 2014

Journal of American Association for Pediatric Ophthalmology and Strabismus, 2011

have amblyopia. The AAPOS referral criteria was found to have an 85% sensitivity, 95%, specificit... more have amblyopia. The AAPOS referral criteria was found to have an 85% sensitivity, 95%, specificity, 5% false positive rate, 15% false negative rate, 96% positive predictive value and a negative predictive value of 82%. Discussion: The AAPOS referral criteria for amblyogenic factors are consensus criteria, which utilized the best available data as well as survey results of pediatric ophthalmologists. Conclusions: The AAPOS referral criteria are quite effective, but our study found that they may under-report amblyopia. We will propose potential modifications to the criteria to increase the sensitivity, and lower the false negative rate.

Ret-Vit, 2000

Ret-vit 2000; Я: 155-159 155 Subhyaloid Hemorajide Nd-Yag Lazer Tedavisi Nurten ÜNLÜ1,Mehmet A. A... more Ret-vit 2000; Я: 155-159 155 Subhyaloid Hemorajide Nd-Yag Lazer Tedavisi Nurten ÜNLÜ1,Mehmet A. AGAR1, Hülya KOCAOGLAN1 ... TARTI§MA Nd-YAG lazer göz ici mercek implantasyo-nunu sonrasi arka kapsül dizisyonu, periferik iridektomi gibi ön segment uygulamalari ...

Glokom- …, 2010

Bulgular: Yirmi beş olgunun 25 gözünde İFİS gözlendi, İFİS insidansı %1.6 (25/1530) olarak bulund... more Bulgular: Yirmi beş olgunun 25 gözünde İFİS gözlendi, İFİS insidansı %1.6 (25/1530) olarak bulundu. Grup 1'deki 5 hastanın 4'ünün 4 gözünde (%80), Grup 2'deki 5 hastanın 3'ünün 3 gözünde (%60), Grup 4'teki 1514 hastanın 18'inin 18 gözünde (%1.18) İFİS'e rastlandı. Grup 3'teki ...

DOAJ (DOAJ: Directory of Open Access Journals), Sep 1, 2013

誗AIM: To describe and compare ocular surface changes in type 2 diabetes patients treated either o... more 誗AIM: To describe and compare ocular surface changes in type 2 diabetes patients treated either oral antidiabetic drugs (OAD) or insulin. 誗METHODS: Forty eyes of twenty patients treated with OAD, 40 eyes of 20 patients treated with insulin and 10 non-diabetic controls seen at the Ministry of Health Ankara Educational and Research Hospital were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis and conjunctival impression cytology analysis. Patients in three groups were compared for tear function parameters, goblet cell density and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorders were noted. 誗 RESULTS: The tear film break-up time values were significantly lower at patients treated with OAD (P<0. 05). Goblet cell density and squamous metaplasia grade were similar at all groups. The median grade was grade 1 in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm and goblet cells are decreased in number. Status of retinopathy did not seem to relate with ocular surface disorders. 誗CONCLUSION: Precorneal tear film stability is found to be worse in patients treated with OAD whereas impression cytology analysis is similar in all groups.

Value in Health, Nov 1, 2016

phase, which may last up to two years. Then, patient vision is assumed to remain stable until yea... more phase, which may last up to two years. Then, patient vision is assumed to remain stable until year 5 in maintenance phase. Base case cost-effectiveness analyses were conducted considering a lifetime horizon, a 4-year maintenance phase duration, utility driven by both eyes (two-eye model approach). Systematic Literature Reviews (SLR) were used to form a Network Meta-Analysis (NMA) of clinical studies on ranibizumab, dexamethasone and laser for the treatment of ME/BRVO. Results of this NMA were used as clinical efficacy inputs for the economic model. Treatment pathway for ME/BRVO was collected from an expert panel. The costs were calculated in TRY and converted to EUR using the current exchange rate (May 2016). Results: € 29,370.03/QALY willingness-to-pay threshold (3-fold of annual income per capita for developing countries as defined by the World Health Organization) was used in the analysis. In comparison to ranibizumab IVT-AFL is a dominant treatment alternative with an ICER value of-€ 12,670.96/QALY. Cost-effectiveness results in comparison to dexamethasone showed that IVT-AFL is a cost effective option with the ICER of € 6968,26/QALY. According to the results of the analysis, IVT-AFL is also a cost effective treatment option when compared with laser at an ICER value of € 12,064.67/QALY. ConClusions: From the perspective of SSI, IVT-AFL is dominant compared to ranibizumab and cost effective compared to dexamethasone and laser treatments for ME/BRVO in a Turkish setting.

Clinical and Experimental Ophthalmology, Nov 14, 2002

ABSTRACT

European Journal of Ophthalmology, Jul 1, 2002

A clinical study of eyes with rhegmatogenous retinal detachment compared the reattachment rate in... more A clinical study of eyes with rhegmatogenous retinal detachment compared the reattachment rate in two groups of eyes: in the control group, cryopexy was applied over the retinal breaks during surgery; in the test group, cryopexy was not applied. There was a similar rate of retinal reattachment in the two groups in the immediate postoperative period. However, during the long followup period (36 months) there was a considerable difference in the two groups. Eyes that had undergone cryopexy had a lower rate of redetachment than eyes that had not. The rate of operative and postoperative complications was low in both groups, except for periretinal proliferation, which was more frequent in the test group. These results suggest that cryopexy may lower the incidence of redetachment after retinal detachment surgery.

Journal of medicine and palliative care, Dec 26, 2022

Diyabetik maküla ödeminde arka vitreus dekolmanının rolü The role of the posterior vitreous detac... more Diyabetik maküla ödeminde arka vitreus dekolmanının rolü The role of the posterior vitreous detachment in diabetic macular edema ABSTRACT Introduction: In this study, we aimed to evaluate the effect of the presence of total posterior vitreous detachment (PVD) on the formation of macular edema in patients with diabetic retinopathy together with other risk factors. Material and Method: 166 eyes of 103 patients with diabetic retinopathy were prospectively included in the study. 96 eyes of 58 patients with macular edema (group 1) and 70 eyes of 45 patients without macular edema (group 2) were compared in terms of the presence of PVD and other risk factors. Results: The mean age was 61.8±5.5 in the first group and 63.6±7.2 in the second group (p> 0.05). There was no significant difference between the two groups in terms of female/male ratio and duration of diabetes. PVD was found in 11 (11.45%) of 96 eyes with macular edema and 8 (11.42%) of 70 eyes without macular edema. There was no statistically significant difference in terms of PVD rates in both groups (χ2 = 0.9953, p> 0.05). Proliferative diabetic retinopathy rates, presence of hypertension and proteinuria, fasting blood glucose, urea, creatinine and HbA1c rates were compared in the two groups. Insulin use rate was higher in the second group (p <0.001). Conclusion: In our study, there was no significant difference between PVD rates in the groups with and without macular edema. Therefore, we concluded that the presence of PVD is not a protective factor against macular edema. Pathogenesis of diabetic macular edema is multifactorial. In order to understand the role of posterior vitreous detachment on macular edema, larger-scale studies that follow macular edema for a long time should be done.

Turkiye Klinikleri Journal of Ophthalmology, 1997

Horizontal kaymada uygulanan cerrahi girişimin binoküler tek görmeye etkisini araştırmak amacıyla... more Horizontal kaymada uygulanan cerrahi girişimin binoküler tek görmeye etkisini araştırmak amacıyla 30 PD ve üzerinde kayma nedeniyle opere edilen ve preoperatif füzyonu olmayan 75 olgu çalışma kapsamına alındı. Ezotropya olgularında %58.49, ekzotropya olgularında %50 ...

Ophthalmologica, 1998

This study compares the predictive accuracy of the SRKII formula for groups with average axial le... more This study compares the predictive accuracy of the SRKII formula for groups with average axial length and long eyes. 344 eyes which underwent cataract extraction with implantation of a posterior-chamber intraocular lens were included in the survey; 246 eyes had an average axial length (22.0–24.49 mm), and 98 eyes had an axial length of more than 24.50 mm. Mean absolute errors were 0.26±0.68 dpt in the first group and 1.16±1.78 dpt in the second group. 94.3% of the average eyes were within 1.0 dpt of the expected refraction, 98.8% within 2.0 dpt, whereas in the long-eye group 58.2% were within 1.0 dpt and 84.7% within 2.0 dpt. The results show that the SRKII formula performed credibly in average-length eyes; in the long eyes the ratio of large refractive deviations was greater than that of the other group.

$Research paper thumbnail of Aflibercept in a Persistent Diabetic Macular Edema Refractory to Previous Ranibizumab Therapy$

European archives of medical research, Jun 1, 2022

Objective: To investigate the visual acuity and anatomical outcomes of intravitreal aflibercept t... more Objective: To investigate the visual acuity and anatomical outcomes of intravitreal aflibercept treatment in patients with diabetic macular edema (DME) who were unresponsive to ranibizumab. Methods: Patients with refractory DME treated with at least 3 consecutive injections of ranibizumab, 4-6 weeks apart, before switch and with at least 2 aflibercept injections after that in the period of May 2013 to October 2017 were considered eligible for study participation. "The patients" demographic characteristics, best-corrected visual acuity (BCVA), and central foveal thickness (CFT) were recorded at baseline, preswitch, the first month post-switch, and the final visit. Results: A total of 33 eyes of 28 patients were investigated. The average number of ranibizumab injections before switching to aflibercept was 4.97±1.94 and that of the subsequent aflibercept injections was 2.54±0.6. The mean baseline BCVA was 0.56 ± 0.38 logMAR. After the switch, the BCVA during the first and final visits was 0.41±0.34 logMAR (p=0.19) and 0.36±0.34 (p=0.16), respectively. After switching, clinical follow-up data for at least 6 months were available for all eyes. The mean baseline CFT was 504±123.7 µm (264-844 µm).One month after the switch, the average CFT had significantly reduced to 338.8±105.3 µm (225-615 µm) (p=0.0001). At the final visit, the average CFT was 345.7±137.4 µm (136-892 µm) (p=0.0002). Before and after the switch, the mean intraocular pressure (IOP) was 14.18±3.66 mmHg and 13.54±3.81 mmHg respectively (p=0.46). Conclusion: Switch to aflibercept from ranibizumab in patients with recalcitrant DME resulted in significant anatomical improvements. Although the BCVA increased and the IOP decreased, these changes were not statistically significant.

European Journal of Ophthalmology

Purpose To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for ... more Purpose To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in Turkey. Methods A panel of 22 retina experts prepared 77 statements of recommendation, and 80 retinal specialists practicing in Turkey were chosen to vote either in support or against each one. A Delphi-based method was used through which the ophthalmologists were able to view all of the results anonymously after two rounds and modify their subsequent answers. The survey was conducted via a mini website, and statements without consensus were resent to the specialists with the latest vote results a week later. Results A total of 72 ophthalmologists answered the first and second round questions. After the first stage, consensus was achieved on 55 of the statements, leaving 22 without agreement. After the second stage, consensus was reached on 11 of the remaining statements. Strong consensus was achieved on statements regarding the etiopathog...