Zuhal Tunay - Profile on Academia.edu (original) (raw)

Papers by Zuhal Tunay

Archives of Disease in Childhood, Oct 1, 2012

Introduction and Background Late preterm infants (LPI) are born at a gestational age between 34 w... more Introduction and Background Late preterm infants (LPI) are born at a gestational age between 34 weeks and 36 weeks and 6 days. They have higher morbidity and mortality than term infants due to their relative physiologic and metabolic immaturity. Method Infants born between July 2008 and July 2010 are identified using NICU and Labor and delivery registry of King Faisal Specialist Hospital-Jeddah. The deliveries are around 1100 births per year. The pertinent data of all mothers and neonates delivered at KFSH&RC-J abstracted from medical records. Results 230 infants' enrolled; incidence rate of LPI in the year 2008 was 6.7%, 2009 was 5.7% and 12.07% in 2012, 101 female and 128 male, 167 (72.6) had no maternal risk factors, artificial reproductive technology 55/230 (23%), maternal hypertension is 5/230 (2.2%). PROM is 3/230 (1.3%), no chorioamnionities or diabetes mellitus. Cesarean sections 121/202(59%) in LPI, vs 200/392 (51%) in full term babies ventous delivery 2/202(1%) vs 7/392(1.8%). Singleton vs. twin or triplet 59.7% vs. 28.7% or 11.6%; the gravida the maternal age and gravida showed no difference; morbidity in LPI, respiratory distress syndrome 92/230 (40%) hyperbilirubineamia required treatment 13/230 (5.7%), apnea 11/230 (4.8%), sepsis 21/230(9.5%), feeding problems 23/230 (10%), hospital readmission 8/230 (3.5%). Admission to NICU was 116/229 (50%). Conclusion Our result is very comparable with previous other studies, however the mortality rate in our series is negligible, perhaps related to our aggressive management and early admission to NICU for 48 hours observation.

Görsel Rehabilitasyonda Görme Alanını Genişletici Sistemler

Turkiye Klinikleri Ophthalmology - Special Topics, 2019

medRxiv (Cold Spring Harbor Laboratory), Mar 16, 2022

Aim: To demonstrate the clinical and demographic features of infants with gestational age (GA) of... more Aim: To demonstrate the clinical and demographic features of infants with gestational age (GA) of 32-37 weeks (wk) and birth weight (BW) of >1500 g who developed treatment requiring retinopathy of prematurity (ROP). Methods: Retrospective, observational, descriptive, multicentre study was conducted by the Turkish Ophthalmological Association ROP commission. Data on the infants with a GA of 32-37 wk and BW >1500 g who developed treatment-requiring ROP were collected from the 33 ROP centres in Turkey. GA, BW, type of hospital, neonatal intensive care units (NICU) level, length of stay in NICU, duration of oxygen therapy, comorbidities, type of ROP and time for treatment-requiring ROP (TR-ROP) development were analysed. Results: Totally 366 infants were included in the study. The mean GA and BW were 33±1 wk and 1896 ± 316 g, respectively. Duration of hospitalization was 3-4 wk in 46.8% of them. The first ROP examination was performed at postnatal 4-5 wk in 80.3% of infants, which was significantly later in lower levels of NICU and non-university clinics. ROP was detected in 90.9% of infants at the first ROP examination, especially in clinics without an ophthalmologist. In 15.3% of the infants, treatment was required in postnatal fourth week, and the mean development of TR-ROP was 6.16 ± 2.04 wk Conclusion: Routine ROP screening thresholds need to be expanded in hospitals with suboptimal NICU conditions considering the development of TR-ROP in more mature and heavier preterm infants, and the first ROP examination should be no later than postnatal fourth week.

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Dec 12, 2014

Kutis marmorata telenjiektatika konjenita (KMTK), etyolojisi bilinmeyen, sporadik, nadir görülen,... more Kutis marmorata telenjiektatika konjenita (KMTK), etyolojisi bilinmeyen, sporadik, nadir görülen, kendiliğinden solma eğiliminde olan, ısı ve hemodinami ile ilişkisiz kutis marmorata, telenjiektaziler ve flebiektazilerle karakterize kutanöz vasküler bir hastalıktır. Bazı vakalarda doğumda görülürken, sonradan da ortaya çıkabilir. Tanı klinik bulgularla konulur. Burada sol bacak ve ayakta, kalçada ve sol karın bölgesinde KMTK lezyonu olan bir kız yenidoğan olgusu sunuldu.

Validation and reliability of the Cardiff Visual Ability Questionnaire for Children using Rasch analysis in a Turkish population

British Journal of Ophthalmology, Aug 18, 2015

To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CV... more To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CVAQC) and to evaluate the validity and reliability of the questionnaire. The study involved two main phases. The first phase involved a cross-cultural adaptation of the CVAQC from English into Turkish. The second phase involved the completion of the Turkish version of the CVAQC by 150 partially sighted children (6-18 years old) and validity and reliability checks. Extent and construct validity were investigated using Rasch analysis and reliability by internal consistency and person separation index (PSI). An adequate conceptual equivalence was achieved following the linguistic adaptation process. The dataset for validation comprised 150 participants, 88 (58.7%) of whom were male. Evidence of disordered thresholds was found for one item (item 17). This item was recorded by collapsing two categories and ordered thresholds were evident. All items of the CVAQC were found to fit the Rasch model (χ² (df)=59.90 (2), p=0.159). The internal construct validity was good (mean item fit (SD) -0.054 (1.132), person fit (SD) -0.629 (2.079)) indicating a single underlying construct. The reliability was good with Cronbach's α of 0.91 and PSI of 0.94. Differential item functioning (DIF) was tested for age, sex, diagnosis, degree of visual impairment, and comorbidity. Evidence of DIF was found on age for one item (item 10, reading the board at school). The Turkish version of the CVAQC is a valid, reliable, and unidimensional questionnaire for partially sighted children aged 6-18 years. Ankara University Ethics Committees registry number 06-177-12.

Türk Oftalmoloji Dergisi, Apr 10, 2016

Objectives: To determine the clinical features and the distribution of diagnosis in partially sig... more Objectives: To determine the clinical features and the distribution of diagnosis in partially sighted school-age children, to report the chosen low vision rehabilitation methods and to emphasize the importance of low vision rehabilitation. The study included 150 partially sighted children between the ages of 6 and 18 years. The distribution of and the methods of low vision rehabilitation (for distance and for near) were determined. The demographic characteristics of the children and the parental consanguinity were recorded. The mean age of children was 10.6 years and the median age was 10 years; 88 (58.7%) of them were male and 62 (41.3%) of them were female. According to distribution of diagnoses among the children, the most frequent diagnosis was hereditary fundus dystrophies (36%) followed by cortical visual impairment (18%). The most frequently used rehabilitation methods were: telescopic ment in visual acuity both for distance and near vision were determined with low vision aids. in partially sighted school-age children. It is important for ophthalmologists and pediatricians to guide parents and children to low vision rehabilitation.

Archives of Disease in Childhood, Oct 1, 2012

count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinica... more count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinical indication. EV or HPeV DNA was detected by PCR in plasma and/or CSF. Urine cultures were performed when urine screening was positive. 10 children with urinary tract infection were excluded. Data of the remaining 148 children were analysed. Results EV/HPeV PCR was performed in 122/148 children: 45 (37%) were EV positive and 22 (18%) HPeV positive. The most prominent difference between children with EV and HPeV was age. HPeV was solely diagnosed in children under 126 days of age. Clinical characteristics at presentation did not differ. Children with HPeV had lower leukocyte counts and lower CRP values. No difference in clinical management was found between EV and HPeV positive children. Conclusion Sepsis-like illness due to EV and HPeV infection is common in young children, and appeared in 37% and 18% of cases respectively. HPeV occurs in younger children and causes less elevation of infectious parameters than EV infection. All other clinical characteristics are similar. Clinical management does not differ.

Pandemi Sonrasında Vasküler Retina Hastalıklarının Takip ve Tedavilerinde Neler Değişmelidir

0-3 Yaş Az Görenlere Yaklaşım ve Görsel Habilitasyon Programları

Turkiye Klinikleri Ophthalmology - Special Topics, 2019

Should parents be present during screening examinations for retinopathy of prematurity?

Indian Journal of Ophthalmology, 2021

Purpose: To investigate whether parents should be present during screening examinations for retin... more Purpose: To investigate whether parents should be present during screening examinations for retinopathy of prematurity (ROP) by investigating the anxiety levels of parents using two different approaches. Methods: This cross-sectional and two-center study was carried out with the parents at the time of the first ROP screening examination of their premature infants. At one center, the parents accompanied the infants during the ROP examination (Group 1), and in the other center, they did not (Group 2). Anxiety levels were assessed with the State-Trait Anxiety Inventory (STAI), which consists of the State Anxiety (STAI-S) and Trait Anxiety (STAI-T) subscales and a visual analog scale (VAS). Results: A total of 147 parents of 127 infants were included in the study. STAI-T and -S levels were 40.5 ± 8 and 37.9 ± 7.5, respectively, in Group 1 and 39.6 ± 8.1 and 39.4 ± 9.1 in Group 2 before the examination. There were no statistically significant differences in terms of these values between the two groups (P > 0.05). The state anxiety levels increased by an average of 1.7 ± 8 in Group 1 and reached 39.6 ± 10.1 after the examination. In Group 2, these levels decreased by an average of − 2.7 ± 7.5 points to a score of 36.4 ± 10.3. This difference was found to be statistically significant (P = 0.001). A similar pattern was observed in the evaluation of the VAS data. Conclusion: As a preliminary opinion, it may be more appropriate for parents to not participate in screening examinations, but single-center controlled studies are required to confirm the results.

Türk Oftalmoloji Dergisi, Jun 8, 2016

Objectives: To evaluate the diagnosis distribution, low vision rehabilitation methods and utiliza... more Objectives: To evaluate the diagnosis distribution, low vision rehabilitation methods and utilization of low vision rehabilitation in partially sighted persons over 65 years old. Materials and Methods: One hundred thirty-nine partially sighted geriatric patients aged 65 years or older were enrolled to the study between May 2012 and September 2013. Patients' age, gender and the distribution of diagnosis were recorded. The visual acuity of the patients both for near and distance were examined with and without low vision devices and the methods of low vision rehabilitation were evaluated. Results: The mean age of the patients was 79.7 years and the median age was 80 years. Ninety-six (69.1%) of the patients were male and 43 (30.9%) were female. According to the distribution of diagnosis, the most frequent diagnosis was senile macular degeneration for both presenile and senile age groups. The mean best corrected visual acuity for distance was 0.92±0.37 logMAR and 4.75±3.47 M for near. The most frequently used low vision rehabilitation methods were telescopic glasses (59.0%) for distance and hyperocular glasses (66.9%) ds. Conclusion: The causes of low vision in presenile and senile patients in our study were similar to those of patients from developed partially sighted geriatric patients. It is important to guide them to low vision rehabilitation.

Journal of Aapos, Jun 1, 2016

To evaluate the longitudinal change of intraocular pressure (IOP) and central corneal thickness (... more To evaluate the longitudinal change of intraocular pressure (IOP) and central corneal thickness (CCT) in healthy premature infants. Methods Premature infants born at 28 weeks' gestational age were included in this prospective, singlecenter longitudinal study. IOP was measured by handheld applanation tonometer (Tono-Pen Avia); CCT measurements were performed by ultrasonic pachymeter. Examinations were held at 32 weeks' gestational age initially and at 2-week intervals thereafter for a total of 5 consecutive measurements by the same ophthalmologist. Results A total of 110 right eyes of 110 healthy premature infants were analyzed. The mean IOP at 32

American Journal of Ophthalmology, Aug 1, 2016

To evaluate the relationship between maternal diabetes and the development of retinopathy of prem... more To evaluate the relationship between maternal diabetes and the development of retinopathy of prematurity (ROP) in infants with a birth weight of 1500 g or more. Design: Retrospective case control study. Subjects and Controls: Data of 78 premature infants from diabetic mothers were compared with data of 258 controls. Methods: We examine the relationship between maternal diabetes and the development of ROP and Type 1 ROP, adjusting for multiple risk factors. In order to identify the risk factors of outcome variables, multivariable logistic regression analysis was used. Prior to multivariable logistic regression analysis, the association of each independent variable with the outcome variables, a univariate estimate was performed. The crude and adjusted odds ratio (OR) values and their 95% confidence intervals (CI) were given. Main Outcome Measures: The development of ROP and the development of Type 1 ROP. Results: The study was conducted on 336 preterm infants, 78 were from diabetic mothers and 258 were from non-diabetic mothers. The rate of ROP (78.2% in case group and 14.7% in control group) and the rate of Type 1 ROP (20.5% in case group and 4.7% for controls) were found significantly higher in case group (p=0.001 for both). Maternal diabetes was shown to be an independent risk factor for both ROP and Type 1 ROP (OR with 95% CI: 25,040 [12,728-49,264]; 6,311 [2,647-15,048] respectively and p< 0.001 for both). Conclusion: Our data suggests that the presence of maternal diabetes is significantly associated with the development of ROP and Type 1 ROP in premature infants with a birth weight of 1500 g or more.

Trombositopeni Regülasyonu ile İyileşme Gösteren Tip 1 Prematüre Retinopatisi Olguları

Retina-Vitreus, 2016

Turkiye Klinikleri Journal of Ophthalmology, 2016

Journal Francais D Ophtalmologie, Dec 1, 2015

To examine refractive errors and refractive development in premature infants. Methods.-Premature ... more To examine refractive errors and refractive development in premature infants. Methods.-Premature infants in the retinopathy of prematurity (ROP) screening program were recruited and examined longitudinally between 28 and 58 weeks postmenstrual age. For performing cycloplegic retinoscopy, 1% tropicamide was administered, two drops with a 10-minute interval, in order to paralyze accommodation and to achieve cycloplegia. Birth weight, gestational age, gender and acute ROP disease were recorded. The relationship between spherical equivalent, astigmatism and postmenstrual age was evaluated. Results.-A total of 798 readings were obtained from 258 infants (131 females, 127 males) between 28 and 58 weeks postmenstrual age. The median number of examinations was 3 (minimum 1, maximum 7). In the comparisons of birth weight, gestational age, spherical equivalent and astigmatism between genders, there were no statistically significant differences (P > 0.05). Gestational age (regression analysis, r 2 = 0.30, P < 0.01) and birth weight (regression analysis, r 2 = 0.22, P < 0.01) had a significant effect on refractive error development. Preterm babies with lower birth weight and those born more prematurely had lower spherical equivalent. The spherical equivalent of the eyes correlated significantly with the postmenstrual age of the infants (r = 0.512, P < 0.01).

Sağlıklı Bireylerde Tonopen Avia ve Goldmann Aplanasyon Tonometrelerinin Klinik Olarak Karşılaştırılması ve Merkezi Kornea Kalınlığının Etkisi

Glokom Katarakt, 2016

Prematüre Retinopatisi Muayenesi Esnasında Saptanan Sarsılmış Bebek Sendromu Olgusu

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Dec 25, 2017

“Shaken baby syndrome” occurs due to shaking of babies under two years of age. It can lead to vis... more “Shaken baby syndrome” occurs due to shaking of babies under two years of age. It can lead to visual impairment, blindness, severe neurological deficit and death. Bilateral retinal hemorrhages are important characteristic finding of shaken baby syndrome but not pathognomonic. Because of the irreversible neurological damage related to shaken baby syndrome, primary prevention is so important. The aim of this case report is to call attention on shaken baby syndrome and to emphasize the importance of training of parents and medical staff in this area.

Bir İnfantta Adenoviral Konjonktivit Nedeniyle Oluşan Pseudomembranların Temizlenmesi

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Jun 18, 2017

A one month-old baby was examined with the complaints of eyelids swollen and ocular discharge for... more A one month-old baby was examined with the complaints of eyelids swollen and ocular discharge for one week. Eyelid edema, ocular discharge, conjunctival hyperemia and pseudomembrane in both eyes but more severe in the right eye were detected. It was considered that the patient had suffered outbreaks of conjunctivitis depends on the epidemic keratoconjunctivitis and pseudomembranes were removed. A corticosteroids ointment was added to the treatment. Four weeks later, the patient’s symptoms were completely recovered.

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Aug 23, 2015

Hipertansif ensefalopati olarak da isimlendirilen Posterior Reversibl Ensefalopati Sendromu (PRES... more Hipertansif ensefalopati olarak da isimlendirilen Posterior Reversibl Ensefalopati Sendromu (PRES) kan basıncında ani değişikliklere yanıt vermesi gereken posterior dolaşımın yetersizliğine ikincil oluşan nörotoksik bir durumdur. Kan-beyin bariyerinin hiperperfüzyon nedeniyle bozulması vazojenik ödem ile sonuçlanır. En yaygın olarak parieto-oksipital bölgelerde görülür (1,2). Çeşitli faktörler PRES'in patogenezinde rol oynamaktadır. Başlıcaları, eklampsi/ preeklampsi ve akut glomerulonefritin neden olduğu ciddi hipertansiyon, hemolitik üremik sendrom, trombositopenik trombositik purpura, sistemik lupus eritematozus ve çeşitli ilaç toksisiteleridir (3).

Archives of Disease in Childhood, Oct 1, 2012

Introduction and Background Late preterm infants (LPI) are born at a gestational age between 34 w... more Introduction and Background Late preterm infants (LPI) are born at a gestational age between 34 weeks and 36 weeks and 6 days. They have higher morbidity and mortality than term infants due to their relative physiologic and metabolic immaturity. Method Infants born between July 2008 and July 2010 are identified using NICU and Labor and delivery registry of King Faisal Specialist Hospital-Jeddah. The deliveries are around 1100 births per year. The pertinent data of all mothers and neonates delivered at KFSH&RC-J abstracted from medical records. Results 230 infants' enrolled; incidence rate of LPI in the year 2008 was 6.7%, 2009 was 5.7% and 12.07% in 2012, 101 female and 128 male, 167 (72.6) had no maternal risk factors, artificial reproductive technology 55/230 (23%), maternal hypertension is 5/230 (2.2%). PROM is 3/230 (1.3%), no chorioamnionities or diabetes mellitus. Cesarean sections 121/202(59%) in LPI, vs 200/392 (51%) in full term babies ventous delivery 2/202(1%) vs 7/392(1.8%). Singleton vs. twin or triplet 59.7% vs. 28.7% or 11.6%; the gravida the maternal age and gravida showed no difference; morbidity in LPI, respiratory distress syndrome 92/230 (40%) hyperbilirubineamia required treatment 13/230 (5.7%), apnea 11/230 (4.8%), sepsis 21/230(9.5%), feeding problems 23/230 (10%), hospital readmission 8/230 (3.5%). Admission to NICU was 116/229 (50%). Conclusion Our result is very comparable with previous other studies, however the mortality rate in our series is negligible, perhaps related to our aggressive management and early admission to NICU for 48 hours observation.

Görsel Rehabilitasyonda Görme Alanını Genişletici Sistemler

Turkiye Klinikleri Ophthalmology - Special Topics, 2019

medRxiv (Cold Spring Harbor Laboratory), Mar 16, 2022

Aim: To demonstrate the clinical and demographic features of infants with gestational age (GA) of... more Aim: To demonstrate the clinical and demographic features of infants with gestational age (GA) of 32-37 weeks (wk) and birth weight (BW) of >1500 g who developed treatment requiring retinopathy of prematurity (ROP). Methods: Retrospective, observational, descriptive, multicentre study was conducted by the Turkish Ophthalmological Association ROP commission. Data on the infants with a GA of 32-37 wk and BW >1500 g who developed treatment-requiring ROP were collected from the 33 ROP centres in Turkey. GA, BW, type of hospital, neonatal intensive care units (NICU) level, length of stay in NICU, duration of oxygen therapy, comorbidities, type of ROP and time for treatment-requiring ROP (TR-ROP) development were analysed. Results: Totally 366 infants were included in the study. The mean GA and BW were 33±1 wk and 1896 ± 316 g, respectively. Duration of hospitalization was 3-4 wk in 46.8% of them. The first ROP examination was performed at postnatal 4-5 wk in 80.3% of infants, which was significantly later in lower levels of NICU and non-university clinics. ROP was detected in 90.9% of infants at the first ROP examination, especially in clinics without an ophthalmologist. In 15.3% of the infants, treatment was required in postnatal fourth week, and the mean development of TR-ROP was 6.16 ± 2.04 wk Conclusion: Routine ROP screening thresholds need to be expanded in hospitals with suboptimal NICU conditions considering the development of TR-ROP in more mature and heavier preterm infants, and the first ROP examination should be no later than postnatal fourth week.

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Dec 12, 2014

Kutis marmorata telenjiektatika konjenita (KMTK), etyolojisi bilinmeyen, sporadik, nadir görülen,... more Kutis marmorata telenjiektatika konjenita (KMTK), etyolojisi bilinmeyen, sporadik, nadir görülen, kendiliğinden solma eğiliminde olan, ısı ve hemodinami ile ilişkisiz kutis marmorata, telenjiektaziler ve flebiektazilerle karakterize kutanöz vasküler bir hastalıktır. Bazı vakalarda doğumda görülürken, sonradan da ortaya çıkabilir. Tanı klinik bulgularla konulur. Burada sol bacak ve ayakta, kalçada ve sol karın bölgesinde KMTK lezyonu olan bir kız yenidoğan olgusu sunuldu.

Validation and reliability of the Cardiff Visual Ability Questionnaire for Children using Rasch analysis in a Turkish population

British Journal of Ophthalmology, Aug 18, 2015

To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CV... more To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CVAQC) and to evaluate the validity and reliability of the questionnaire. The study involved two main phases. The first phase involved a cross-cultural adaptation of the CVAQC from English into Turkish. The second phase involved the completion of the Turkish version of the CVAQC by 150 partially sighted children (6-18 years old) and validity and reliability checks. Extent and construct validity were investigated using Rasch analysis and reliability by internal consistency and person separation index (PSI). An adequate conceptual equivalence was achieved following the linguistic adaptation process. The dataset for validation comprised 150 participants, 88 (58.7%) of whom were male. Evidence of disordered thresholds was found for one item (item 17). This item was recorded by collapsing two categories and ordered thresholds were evident. All items of the CVAQC were found to fit the Rasch model (χ² (df)=59.90 (2), p=0.159). The internal construct validity was good (mean item fit (SD) -0.054 (1.132), person fit (SD) -0.629 (2.079)) indicating a single underlying construct. The reliability was good with Cronbach&amp;amp;amp;amp;#39;s α of 0.91 and PSI of 0.94. Differential item functioning (DIF) was tested for age, sex, diagnosis, degree of visual impairment, and comorbidity. Evidence of DIF was found on age for one item (item 10, reading the board at school). The Turkish version of the CVAQC is a valid, reliable, and unidimensional questionnaire for partially sighted children aged 6-18 years. Ankara University Ethics Committees registry number 06-177-12.

Türk Oftalmoloji Dergisi, Apr 10, 2016

Objectives: To determine the clinical features and the distribution of diagnosis in partially sig... more Objectives: To determine the clinical features and the distribution of diagnosis in partially sighted school-age children, to report the chosen low vision rehabilitation methods and to emphasize the importance of low vision rehabilitation. The study included 150 partially sighted children between the ages of 6 and 18 years. The distribution of and the methods of low vision rehabilitation (for distance and for near) were determined. The demographic characteristics of the children and the parental consanguinity were recorded. The mean age of children was 10.6 years and the median age was 10 years; 88 (58.7%) of them were male and 62 (41.3%) of them were female. According to distribution of diagnoses among the children, the most frequent diagnosis was hereditary fundus dystrophies (36%) followed by cortical visual impairment (18%). The most frequently used rehabilitation methods were: telescopic ment in visual acuity both for distance and near vision were determined with low vision aids. in partially sighted school-age children. It is important for ophthalmologists and pediatricians to guide parents and children to low vision rehabilitation.

Archives of Disease in Childhood, Oct 1, 2012

count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinica... more count, CRP, blood culture and urine screening. Cerebrospinal fluid (CSF) was collected on clinical indication. EV or HPeV DNA was detected by PCR in plasma and/or CSF. Urine cultures were performed when urine screening was positive. 10 children with urinary tract infection were excluded. Data of the remaining 148 children were analysed. Results EV/HPeV PCR was performed in 122/148 children: 45 (37%) were EV positive and 22 (18%) HPeV positive. The most prominent difference between children with EV and HPeV was age. HPeV was solely diagnosed in children under 126 days of age. Clinical characteristics at presentation did not differ. Children with HPeV had lower leukocyte counts and lower CRP values. No difference in clinical management was found between EV and HPeV positive children. Conclusion Sepsis-like illness due to EV and HPeV infection is common in young children, and appeared in 37% and 18% of cases respectively. HPeV occurs in younger children and causes less elevation of infectious parameters than EV infection. All other clinical characteristics are similar. Clinical management does not differ.

Pandemi Sonrasında Vasküler Retina Hastalıklarının Takip ve Tedavilerinde Neler Değişmelidir

0-3 Yaş Az Görenlere Yaklaşım ve Görsel Habilitasyon Programları

Turkiye Klinikleri Ophthalmology - Special Topics, 2019

Should parents be present during screening examinations for retinopathy of prematurity?

Indian Journal of Ophthalmology, 2021

Purpose: To investigate whether parents should be present during screening examinations for retin... more Purpose: To investigate whether parents should be present during screening examinations for retinopathy of prematurity (ROP) by investigating the anxiety levels of parents using two different approaches. Methods: This cross-sectional and two-center study was carried out with the parents at the time of the first ROP screening examination of their premature infants. At one center, the parents accompanied the infants during the ROP examination (Group 1), and in the other center, they did not (Group 2). Anxiety levels were assessed with the State-Trait Anxiety Inventory (STAI), which consists of the State Anxiety (STAI-S) and Trait Anxiety (STAI-T) subscales and a visual analog scale (VAS). Results: A total of 147 parents of 127 infants were included in the study. STAI-T and -S levels were 40.5 ± 8 and 37.9 ± 7.5, respectively, in Group 1 and 39.6 ± 8.1 and 39.4 ± 9.1 in Group 2 before the examination. There were no statistically significant differences in terms of these values between the two groups (P > 0.05). The state anxiety levels increased by an average of 1.7 ± 8 in Group 1 and reached 39.6 ± 10.1 after the examination. In Group 2, these levels decreased by an average of − 2.7 ± 7.5 points to a score of 36.4 ± 10.3. This difference was found to be statistically significant (P = 0.001). A similar pattern was observed in the evaluation of the VAS data. Conclusion: As a preliminary opinion, it may be more appropriate for parents to not participate in screening examinations, but single-center controlled studies are required to confirm the results.

Türk Oftalmoloji Dergisi, Jun 8, 2016

Objectives: To evaluate the diagnosis distribution, low vision rehabilitation methods and utiliza... more Objectives: To evaluate the diagnosis distribution, low vision rehabilitation methods and utilization of low vision rehabilitation in partially sighted persons over 65 years old. Materials and Methods: One hundred thirty-nine partially sighted geriatric patients aged 65 years or older were enrolled to the study between May 2012 and September 2013. Patients' age, gender and the distribution of diagnosis were recorded. The visual acuity of the patients both for near and distance were examined with and without low vision devices and the methods of low vision rehabilitation were evaluated. Results: The mean age of the patients was 79.7 years and the median age was 80 years. Ninety-six (69.1%) of the patients were male and 43 (30.9%) were female. According to the distribution of diagnosis, the most frequent diagnosis was senile macular degeneration for both presenile and senile age groups. The mean best corrected visual acuity for distance was 0.92±0.37 logMAR and 4.75±3.47 M for near. The most frequently used low vision rehabilitation methods were telescopic glasses (59.0%) for distance and hyperocular glasses (66.9%) ds. Conclusion: The causes of low vision in presenile and senile patients in our study were similar to those of patients from developed partially sighted geriatric patients. It is important to guide them to low vision rehabilitation.

Journal of Aapos, Jun 1, 2016

To evaluate the longitudinal change of intraocular pressure (IOP) and central corneal thickness (... more To evaluate the longitudinal change of intraocular pressure (IOP) and central corneal thickness (CCT) in healthy premature infants. Methods Premature infants born at 28 weeks' gestational age were included in this prospective, singlecenter longitudinal study. IOP was measured by handheld applanation tonometer (Tono-Pen Avia); CCT measurements were performed by ultrasonic pachymeter. Examinations were held at 32 weeks' gestational age initially and at 2-week intervals thereafter for a total of 5 consecutive measurements by the same ophthalmologist. Results A total of 110 right eyes of 110 healthy premature infants were analyzed. The mean IOP at 32

American Journal of Ophthalmology, Aug 1, 2016

To evaluate the relationship between maternal diabetes and the development of retinopathy of prem... more To evaluate the relationship between maternal diabetes and the development of retinopathy of prematurity (ROP) in infants with a birth weight of 1500 g or more. Design: Retrospective case control study. Subjects and Controls: Data of 78 premature infants from diabetic mothers were compared with data of 258 controls. Methods: We examine the relationship between maternal diabetes and the development of ROP and Type 1 ROP, adjusting for multiple risk factors. In order to identify the risk factors of outcome variables, multivariable logistic regression analysis was used. Prior to multivariable logistic regression analysis, the association of each independent variable with the outcome variables, a univariate estimate was performed. The crude and adjusted odds ratio (OR) values and their 95% confidence intervals (CI) were given. Main Outcome Measures: The development of ROP and the development of Type 1 ROP. Results: The study was conducted on 336 preterm infants, 78 were from diabetic mothers and 258 were from non-diabetic mothers. The rate of ROP (78.2% in case group and 14.7% in control group) and the rate of Type 1 ROP (20.5% in case group and 4.7% for controls) were found significantly higher in case group (p=0.001 for both). Maternal diabetes was shown to be an independent risk factor for both ROP and Type 1 ROP (OR with 95% CI: 25,040 [12,728-49,264]; 6,311 [2,647-15,048] respectively and p< 0.001 for both). Conclusion: Our data suggests that the presence of maternal diabetes is significantly associated with the development of ROP and Type 1 ROP in premature infants with a birth weight of 1500 g or more.

Trombositopeni Regülasyonu ile İyileşme Gösteren Tip 1 Prematüre Retinopatisi Olguları

Retina-Vitreus, 2016

Turkiye Klinikleri Journal of Ophthalmology, 2016

Journal Francais D Ophtalmologie, Dec 1, 2015

To examine refractive errors and refractive development in premature infants. Methods.-Premature ... more To examine refractive errors and refractive development in premature infants. Methods.-Premature infants in the retinopathy of prematurity (ROP) screening program were recruited and examined longitudinally between 28 and 58 weeks postmenstrual age. For performing cycloplegic retinoscopy, 1% tropicamide was administered, two drops with a 10-minute interval, in order to paralyze accommodation and to achieve cycloplegia. Birth weight, gestational age, gender and acute ROP disease were recorded. The relationship between spherical equivalent, astigmatism and postmenstrual age was evaluated. Results.-A total of 798 readings were obtained from 258 infants (131 females, 127 males) between 28 and 58 weeks postmenstrual age. The median number of examinations was 3 (minimum 1, maximum 7). In the comparisons of birth weight, gestational age, spherical equivalent and astigmatism between genders, there were no statistically significant differences (P > 0.05). Gestational age (regression analysis, r 2 = 0.30, P < 0.01) and birth weight (regression analysis, r 2 = 0.22, P < 0.01) had a significant effect on refractive error development. Preterm babies with lower birth weight and those born more prematurely had lower spherical equivalent. The spherical equivalent of the eyes correlated significantly with the postmenstrual age of the infants (r = 0.512, P < 0.01).

Sağlıklı Bireylerde Tonopen Avia ve Goldmann Aplanasyon Tonometrelerinin Klinik Olarak Karşılaştırılması ve Merkezi Kornea Kalınlığının Etkisi

Glokom Katarakt, 2016

Prematüre Retinopatisi Muayenesi Esnasında Saptanan Sarsılmış Bebek Sendromu Olgusu

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Dec 25, 2017

“Shaken baby syndrome” occurs due to shaking of babies under two years of age. It can lead to vis... more “Shaken baby syndrome” occurs due to shaking of babies under two years of age. It can lead to visual impairment, blindness, severe neurological deficit and death. Bilateral retinal hemorrhages are important characteristic finding of shaken baby syndrome but not pathognomonic. Because of the irreversible neurological damage related to shaken baby syndrome, primary prevention is so important. The aim of this case report is to call attention on shaken baby syndrome and to emphasize the importance of training of parents and medical staff in this area.

Bir İnfantta Adenoviral Konjonktivit Nedeniyle Oluşan Pseudomembranların Temizlenmesi

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Jun 18, 2017

A one month-old baby was examined with the complaints of eyelids swollen and ocular discharge for... more A one month-old baby was examined with the complaints of eyelids swollen and ocular discharge for one week. Eyelid edema, ocular discharge, conjunctival hyperemia and pseudomembrane in both eyes but more severe in the right eye were detected. It was considered that the patient had suffered outbreaks of conjunctivitis depends on the epidemic keratoconjunctivitis and pseudomembranes were removed. A corticosteroids ointment was added to the treatment. Four weeks later, the patient’s symptoms were completely recovered.

Jinekoloji - obstetrik ve neonatoloji tıp dergisi, Aug 23, 2015

Hipertansif ensefalopati olarak da isimlendirilen Posterior Reversibl Ensefalopati Sendromu (PRES... more Hipertansif ensefalopati olarak da isimlendirilen Posterior Reversibl Ensefalopati Sendromu (PRES) kan basıncında ani değişikliklere yanıt vermesi gereken posterior dolaşımın yetersizliğine ikincil oluşan nörotoksik bir durumdur. Kan-beyin bariyerinin hiperperfüzyon nedeniyle bozulması vazojenik ödem ile sonuçlanır. En yaygın olarak parieto-oksipital bölgelerde görülür (1,2). Çeşitli faktörler PRES'in patogenezinde rol oynamaktadır. Başlıcaları, eklampsi/ preeklampsi ve akut glomerulonefritin neden olduğu ciddi hipertansiyon, hemolitik üremik sendrom, trombositopenik trombositik purpura, sistemik lupus eritematozus ve çeşitli ilaç toksisiteleridir (3).