Samuray Tuncer - Academia.edu (original) (raw)

Papers by Samuray Tuncer

Biochemical genetics, Jun 24, 2024

Cancers

Although it is a disease that occurs mainly in the Caucasian population, uveal melanoma (UM) is t... more Although it is a disease that occurs mainly in the Caucasian population, uveal melanoma (UM) is the most common primary intraocular tumor in adults. Here, we used digital pathology and image analysis for the diagnosis of UM and the prediction of the prognosis. Our retrospective study included a total of 404 histopathological slides from 101 patients. A digital image acquisition and quantitative analysis of tissue immune biomarkers (CD4, CD8, CD68, CD163) were performed. A negative impact of the intratumoral CD8 positive cell density higher than 13.3 cells/mm2 was detected for both RFS (HR 2.08, 95% Cl 1.09 to 3.99, p = 0.027) and OS (HR 3.30, 95% CI 1.58 to 6.88, p = 0.001). Moreover, we confirmed that older age and stage III were independent negative prognostic factors for both RFS and OS. Our results suggest that a specific distribution profile of CD8 in UM might predict the risk of relapse and death, with potential implications for determining which subgroups of UMs are amenable ...

Türk Oftalmoloji Dergisi, Sep 5, 2014

Uvea melanomu erişkinlerde en sık görülen birincil göz içi tümörüdür. Klinik çalışmalarda, orta b... more Uvea melanomu erişkinlerde en sık görülen birincil göz içi tümörüdür. Klinik çalışmalarda, orta büyüklükteki melanomlarda enükleasyon ile iyod-125 brakiterapi arasında yaşamsal beklenti yönünden bir fark olmadığının görülmesi göz koruyucu tedavilerin önemini arttırmıştır. Brakiterapi, göz çevresindeki dokuları koruyarak direkt olarak tümöre yüksek doz radyasyon vermeyi amaçlayan gözü koruyucu bir tedavi yöntemidir. Uvea melanomu tedavisinde halen en çok tercih edilen tedavi şeklidir. Brakiterapide rutenyum106 ve iyod-125 en sık kullanılan radyoizotoplardır. Radyoterapinin kaçınılmaz sonucu olarak olguların büyük kısmında görmeyi etkileyen komplikasyonlar görülür. Komplikasyonlar genellikle geç dönemde meydana gelir. Tedaviye bağlı en sık görülen komplikasyonlar radyasyon retinopatisi ve katarakt oluşumudur. Brakiterapi ile olguların yaklaşık %90'ında lokal tümör kontrolü (göz korunması) vardır. Transpupiller termoterapi ile birlikte uygulandığında (sandviç tedavisi) tümör kontrol oranı %97'ye çıkmaktadır. Ortalama 5 yıllık takip sonunda olguların yaklaşık %10'unda tümör nüksü veya neovasküler glokom nedeniyle enükleasyon gerekmektedir. Metastatik hastalık gelişme oranı, orta boy melanomlarda 5. yılda %10 olarak bildirilmektedir. Büyük melanomlarda (kalınlık >8 mm), bu oran 10. yılda %55 düzeyine kadar yükselmektedir. Brakiterapi öncesi hastaların bu veriler ışığında bilgilendirilmesi son derece önemlidir.

Turkiye Klinikleri Ophthalmology - Special Topics, 2015

Turkiye Klinikleri Journal of Ophthalmology, 2013

Purpose. Presumed congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) is a rar... more Purpose. Presumed congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) is a rare intraocular finding that is described as a focal, nodular, jet black lesion. These lesions frequently occur at or near the macula and have no known association with changes in the surrounding neurosensory retina, retinal pigment epithelium, or choroid, nor have they been related with exudation or hemorrhage. Until now, there have been no cases reported of CSHRPE with associated vascular activity. Case Report. A 14-year-old Hispanic adolescent girl with a presumed CSHRPE presented with adjacent macular edema. The patient was treated with an off-label intravitreal bevacizumab injection to decrease the edema. Two months later, the patient presented with improved visual acuity and decreased macular edema. Conclusions. This is the first documented case of macular edema secondary to vascular activity being associated with these rare lesions. When CSHRPE is found to have secondary vascular activity and associated macula edema, treatment of intravitreal bevacizumab may lead to improved visual and anatomical outcomes.

Ocular Immunology and Inflammation, Jun 3, 2013

Ophthalmology, Jul 1, 2009

Türk Oftalmoloji Dergisi, 2004

European Journal of Ophthalmology, 2009

Circumscribed choroidal hemangioma (CCH) is a benign vascular tumor of the choroid. Treatment is ... more Circumscribed choroidal hemangioma (CCH) is a benign vascular tumor of the choroid. Treatment is generally reserved for symptomatic patients with decreased visual acuity or metamorphopsia from cystoid macular edema (CME) or exudative foveal detachment (1). The therapeutic options include argon laser photocoagulation, transpupillary thermotherapy, episcleral radioactive plaque therapy, and recently, photodynamic therapy (2). Photodynamic therapy (PDT) has become the treatment of choice for CCH (2). Michels and coauthors (2) reviewed 15 patients with CCH who were treated with PDT. They found complete tumor regression with no re

Journal of Aapos, Jun 1, 2005

We sought to report the incidence of visual axis opacification and to evaluate the complication a... more We sought to report the incidence of visual axis opacification and to evaluate the complication and reoperation rates after intraocular lens implantation in infants. Methods: Twenty-one infants (31 eyes) who had cataract extraction with primary hydrophobic acrylic IOL implantation between October 1996 and May 2002 were reviewed. Posterior capsule was left intact in 14 eyes (group A); posterior capsulorrhexis or capsulotomy with anterior vitrectomy was performed in 17 eyes (group B). Complication and reoperation rates were compared with an age-matched control group of 17 patients (33 eyes) who were left aphakic after pars plicata lensectomy. Mean follow-up period was 41 months (range, 22-75 months) in group A, 37 months (range, 10-75 months) in group B, and 52 months (range, 7-97 months) in the control group. Results: Mean age of the patients was 6.8 months (range, 3-10 months) in group A, 8.9 months (range, 3-18 months) in group B, and 4.9 months (range, 1-15 months) in the control group. Visual axis opacification was significantly higher in group A (86%) when compared with group B (17.6%; P Ͻ 0.0001). No significant difference was found in terms of pupillary irregularities and peripheral anterior synechiae formation between pseudophakic and aphakic group (P ϭ 0.43 and P ϭ 0.306, respectively), whereas pigment dispersion and fibrinous reaction were significantly more common in the pseudophakic group (P ϭ 0.002). Serious complications, such as retinal detachment, pseudophakic bullous keratopathy, and secondary glaucoma, did not develop in any eye. Reoperation rate was significantly higher in group A (78%) when compared with group B (17%) and the control group (12%; P ϭ 0.0011 and P Ͻ 0.0001, respectively). Conclusions: Visual axis opacification requiring a reoperation was significantly more common in patients with an intact posterior capsule. To decrease the reoperation rate and maintain a clear visual axis, posterior capsulorrhexis with anterior vitrectomy should be performed. Even although early complications were quite frequent, serious late complications were not encountered in any eye. Therefore, under appropriate conditions, IOL implantation is a suitable alternative in infants. (

Indian Journal of Ophthalmology, 2011

Indian Journal of Ophthalmology, 2013

Choroidal nevi are the most common benign pigmented lesions of the fundus. Choroidal neovasculari... more Choroidal nevi are the most common benign pigmented lesions of the fundus. Choroidal neovascularization is a rare complication of choroidal nevi. We report herein a young patient managed successfully with intravitreal bevacizumab injections for juxtapapillary choroidal neovascularization secondary to choroidal nevus simulating an inflammatory lesion.

Acta Ophthalmologica Scandinavica, Feb 1, 2004

Indian Journal of Ophthalmology, 2010

A 3-year-old girl presented with a hemorrhagic conjunctival lesion in the right eye. The medical ... more A 3-year-old girl presented with a hemorrhagic conjunctival lesion in the right eye. The medical history revealed premature cessation of breast feeding, intolerance to the ingestion of baby foods, anorexia, and abdominal distention. Prior to her referral, endoscopic small intestinal biopsy had been carried out under general anesthesia with a possible diagnosis of Celiac Disease (CD). Her parents did not want their child to undergo general anesthesia for the second time for the excisional biopsy. We decided to follow the patient until all systemic investigations were concluded. In evaluation, the case was diagnosed with CD and the conjunctival tumor showed complete regression during gluten-free dietary treatment. The clinical fleshy appearance of the lesion with spider-like vascular extensions and subconjunctival hemorrhagic spots, possible association with an acquired immune system dysfunction due to CD, and spontaneous regression by a gluten-free diet led us to make a presumed diagnosis of conjunctival Kaposi sarcoma.

European Journal of Ophthalmology, Apr 3, 2013

PurPose. To identify complications associated with tumor-related lipid exudation (TRLE) after pla... more PurPose. To identify complications associated with tumor-related lipid exudation (TRLE) after plaque radiotherapy of posterior uveal melanoma. Methods. Comparative study including 294 patients with posterior uveal melanoma who developed TRLE after plaque radiotherapy (TRLE group) and 294 patients who did not develop TRLE (non-TRLE group). Patients in the TRLE group were matched with patients in the non-TRLE group for age, gender, and initial tumor thickness. results. The TRLE group was associated with significantly higher incidence of postradiation complications including early transient increase of serous retinal detachment (p<0.001), iris neovascularization (NVI) (p<0.001), neovascular glaucoma (NVG) (p<0.001), posterior synechia (p<0.001), vitreous hemorrhage (p<0.001), subretinal hemorrhage (p<0.001), and retinoschisis (p<0.001). A significant relationship was found between extent of TRLE and NVI (p<0.001), NVG (p<0.001), posterior synechia (p = 0.007), and retinoschisis over tumor (p = 0.010). Radiation-induced retinopathy, maculopathy, and papillopathy were not associated with presence or extent of TRLE. Tumor-related lipid exudation was also associated with worse final visual acuity (p = 0.011), higher rate of secondary enucleation (p<0.001), and lower rate of systemic metastasis (p = 0.006). ConClusions. Tumor-related lipid exudation following plaque radiotherapy of posterior uveal melanoma is associated with major intraocular complications and portends poor prognosis for final visual acuity and eye retention. These findings provide evidence for the presence of 2 distinct pathogenic mechanisms, one radiation-induced and one tumor-related, in development of postradiation complications in eyes with posterior uveal melanoma.

Ophthalmic surgery, lasers & imaging retina, Nov 1, 2011

A 60-year-old woman was referred for a pigmented fundus lesion in her right eye that was suspecte... more A 60-year-old woman was referred for a pigmented fundus lesion in her right eye that was suspected to be a possible choroidal melanoma. She complained of an intermittent floater in the right eye. Funduscopy revealed peripapillary atrophy and posterior staphyloma due to degenerative myopia, large inferior choroidal coloboma, and a cystic pigmented lesion measuring 7 mm in diameter and 3 mm in thickness located inferiorly when the patient was in the upright position. Following supine positioning, the lesion floated to the macular region. Ultrasonography confirmed that the lesion is cystic and freely mobile. Magnetic resonance imaging showed a well-defined, nodular preretinal intraocular lesion that was hypointense in both T1- and T2-weighted, non-contrast axial images. Observation of the benign vitreous cyst was advised. A free-floating pigmented vitreous cyst can be associated with high myopia and uveal coloboma. Its location in the posterior vitreous can lead to a misdiagnosis of a choroidal melanoma.

Türk Oftalmoloji Dergisi, Apr 5, 2015

Retinoblastom çocukluk çağının en sık görülen habis göz içi tümörüdür. Çocukluk çağı kanserlerini... more Retinoblastom çocukluk çağının en sık görülen habis göz içi tümörüdür. Çocukluk çağı kanserlerinin ise ancak %4'ünü oluşturur. 1 Yaklaşık olarak 20,000 canlı doğumda bir görülür. Genellikle 5 yaş altında görülmekle birlikte, olguların büyük çoğunluğu 3 yaşın altında ortaya çıkar. 1 Ortalama tanı yaşı 18 aydır. Retinoblastom görülme sıklığı, cinsiyet, ırk, sağ veya sol göz tutulumu açısından anlamlı bir fark göstermemektedir. Çevresel faktörlerin de retinoblastom gelişiminde belirgin etkisi olmadığı bildirilmiştir. Tümör iki tip geçiş gösterir. Somatik tip daha sık görülür (olguların 2/3'ü). Genellikle tek gözde ve tek bir odak şeklinde kendini gösterir. İlk tanı yaşı ortalama 24 aydır. Daha az sıklıkta

Middle East African Journal of Ophthalmology, 2014

Photodynamic therapy (PDT) has been used for treatment of various intraocular tumors including ch... more Photodynamic therapy (PDT) has been used for treatment of various intraocular tumors including choroidal hemangioma, vasoproliferative tumor, amelanotic choroidal melanoma and choroidal neovascular membrane due to choroidal osteoma. This case report documents the effect of PDT for a presumed acquired retinal astrocytoma. A 42-year-old female with a juxtapapillary acquired astrocytoma was treated with a single session of PDT using standard parameters. The tumor showed dramatic regression over 6 months into a fibrotic scar. It remained regressed and stable with 20/20 vision after 51 months of follow-up. We believe that PDT can be used as a primary treatment for acquired retinal astrocytoma.

Ophthalmic surgery, lasers & imaging retina, Nov 1, 2012

Photodynamic therapy (PDT) has been used for treatment of choroidal neovascular membrane from exu... more Photodynamic therapy (PDT) has been used for treatment of choroidal neovascular membrane from exudative macular degeneration. Other applications include treatment of some intraocular tumors, such as choroidal hemangioma, vasoproliferative tumor, and choroidal osteoma. The authors report the effect of PDT for amelanotic choroidal melanoma. A 40-year-old woman with an amelanotic choroidal melanoma of 6.5 mm thickness showed poor response to iodine brachytherapy (80 Gy apical dose) with no reduction in thickness at 16 months of follow-up. There was prominent residual tumor. The amelanotic tumor was treated with verteporfin PDT using three overlapping spots (8,600 microns), with avoidance of the optic disc using standard treatment parameters. Dramatic tumor regression over 2 months to a completely flat scar (1.3 mm thickness) was documented and remained stable at 50 months of follow-up. Amelanotic choroidal melanoma with incomplete response following conventional plaque radiotherapy can be treated with verteporfin PDT for consolidation.

Turkiye Klinikleri Journal of Surgical Medical Sciences, 2007