Browsing by Author "Kaderli, Berkant"

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Anatomical and the refractive outcomes in the eyes undergoing laser photocoagulation for retinopathy of prematurity
(Galenos Yayincilik, 2009-09-01) YILDIZ, MERAL; ÖZMEN, AHMET TUNCER; YALÇINBAYIR, ÖZGÜR; Yalçınbayır, Özgür; Ayvaz, Ayse Tor; Kaderli, Berkant; Avcı, Remzi; Gelişken, Öner; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 0000-0002-7311-5277; 0000-0001-9581-4856; AAH-6625-2021; IYJ-9408-2023; JAC-9459-2023
Aim: This study aimed to evaluate the anatomical and the refractive outcomes in cases that underwent laser photocoagulation (LP) for retinopathy of prematurity (ROP).Materials and Method: Medical records of 38 cases that underwent LP for ROP in Uludag University Department of Ophthalmology, between 2004 and 2008, were reviewed. LP was performed in 73 eyes. Stages of ROP before and after LP were recorded. Additionally gestational age and birth weight, complications, sciascopic refractions were assessed and visual acuities were evaluated with "Teller Acuity Cards".Results: Gestational age ranged from 26 to 34 weeks, (mean 29+/-2 weeks), birth weight ranged from 850 g to 1950 g (mean 1262+/-304 g). Among all cases in the study 89%, responded with a remarkable regression of ROP with LP treatment. However, 8 eyes progressed to stage 4 and 5 despite treatment. Three eyes developed vitreous hemorrhage and 2 eyes developed preretinal hemorrhage. In the 6th month of the corrected age, spherical equivalent ranged between -8D to + 2.5D, however it ranged between -11D to + 2D in the 12th month. Hyperopia was present in 53% of all eyes and myopia was present in 25.5%. Mean visual acuity was 3.5 cpd (1.3-6.4) in the 6th month of the corrected age whereas it was 6.2 cpd (1.3-9.6) in the 12th month.Conclusion: Adequate and appropriate treatment with LP, has led to fair visual outcomes and an evident regression of ROP in all cases of the study group. Besides, hypermetropia was detected more commonly.
Behçet hastalığı dışındaki sebeplerle oluşan non-enfeksiyöz posterior üveite sekonder makula ödeminde deksametazon implantın etkinliği
(Uludağ Üniversitesi, 2017-12-01) Gelişken, Öner; Kaderli, Berkant; Yalçınbayır, Özgür; Çalışkan, Enver; Rigan, Mustafa; Uçan, Gamze; Yücel, Ahmet Âli; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.
Amaç İmmünmodülatör tedavi kullanımına rağmen kistoid makula ödemi gelişen Behçet hastalığı dışındaki sebeplerle non-infeksiyoz posterior üveiti olan hastalarda adjuvan intravitreal 0,7 mg deksametazon salınım sistemi uygulamasının etkinliğinin araştırılması Materyal-Metod Bu çalışmaya Behçet hastalığı dışında non-enfeksiyöz posterior üveit tanısı almış 13 hastanın 17 gözüne yapılan ve en az 12 ay takip edilen deksametazon implant olguları dahil edilmiştir. Olguların demografik özellikleri, enjeksiyon sırasında kullanılmakta olduğu sistemik immünmodülatör tedavisi, takip süresi, enjeksiyon öncesi ve enjeksiyon sonrası en iyi düzeltilmiş görme keskinliği, göz içi basınçlar değerleri, optik koherens tomografideki santral makula kalınlığı kaydedilmiştir. İzlem süresince implanta bağlı gelişen glokom, katarakt ve endoftalmi gb. komplikasyonlar ve implant enjeksiyonunun tekrarlanma durumu incelenmiştir. Bulgular Elde edilen veriler olgularda istatistiksel olarak anlamlı seviyede anatomik başarı elde edildiğini ve etkinliğin ilk 2 ay korunduğu göstermektedir. Enjeksiyonu takip eden ilk 2 ay içerisinde görme artışının tepe noktasına ulaşılmasına rağmen istatistiksel olarak anlamlı görme artışı elde edilemediği izlenmektedir. İki olguda gelişen kısa süreli topikal anti-glokomatöz kullanımını gerektiren GİB yüksekliği dışında komplikasyon izlenmemiştir. Sonuç Behçet hastalığı dışındaki non-enfeksiyöz posterior üveit tanılı olgularda sistemik tedaviye rağmen KMÖ gelişen olgularda adjuvan intravitreal deksametazon tedavisi sistemik toksisite oluşturmadan makuler anatominin korunması açısından önem arz etmektedir. Bu çalışmada görmede istenilen seviyede artış elde edilmemiştir.
Comparative evaluation of apoptotic activity in photoreceptor cells after intravitreal injection of bevacizumab and pegaptanib sodium in rabbits
(Assoc Research Vision Ophthalmology, 2009-07) İnan, Ümit Übeyt; Avcı, Berrin; Avcı, Remzi; Kaderli, Berkant; Uludağ Üniversitesi/Tıp Fakültesi/Histoloji ve Embriyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; ABE-6685-2020; 6603017388; 7004838001; 6507602756
To evaluate quantitatively the apoptotic activity after intravitreal injections of pegaptanib sodium and bevacizumab in the rabbit retina. METHODS. Different doses of bevacizumab (0.25, 0.625, 1.25, and 2.5 mg) and pegaptanib sodium (0.15, 0.3, and 0.6 mg) were injected intravitreally in 48 rabbits. The eyes were enucleated at different times for early studies at day 14 and for late studies at 3 months after a single injection or at 3 months, with 1 injection in each of the 3 months (day 90). The time course and dose-response of photoreceptor cells in the rabbit retina after intravitreal injection of bevacizumab or pegaptanib sodium were examined by histologic analysis with hematoxylin and eosin (H&E) staining, caspase-3 and -9 immunostaining, and in situ terminal-deoxynucleotidyl transferase-mediated biotin-deoxyuridine triphosphate nick-end labeling (TUNEL) of DNA fragments of paraffin-embedded sections. RESULTS. No sign of retinal toxicity was seen in H&E stained histologic sections of eyes that had received bevacizumab or pegaptanib sodium. Nuclear DNA fragmentation in the outer retinal layers shown by the TUNEL method was evident in the high-dose groups (55.3% with 1.25 mg and 64.5% with 2.5 mg bevacizumab, and 48.5% with 0.6 mg pegaptanib sodium) at 14 days and also in the clinical dose groups (49.8% with three injections [1 each month] of 0.625 mg bevacizumab and 44.3% with 0.15 mg pegaptanib sodium) at 90 days. The ratios of TUNEL-positive cells in physiologic saline and the sham-control groups were 32.3% and 21%, respectively. CONCLUSIONS. Intravitreal injection of bevacizumab and pegaptanib sodium caused a significant increase in apoptotic activity in rabbit photoreceptor cells. However, although bevacizumab caused increasing apoptotic activity at higher doses, similar dose-dependent adverse effects were not evident for pegaptanib sodium.
Comparison of topical and subconjunctival anesthesia in intravitreal injection administrations
(Sage Publications, 2006) Kaderli, Berkant; Avcı, Remzi; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.
PURPOSE. To compare the effectiveness of topical and subconjunctival anesthesia in intravitreal injection administrations. METHODS. Twenty-eight patients from a university clinic with bilateral diabetic macular edema were prospectively randomized to receive intravitreal injection of 4 mg triamcinolone under topical anesthesia for one eye and subconjunctival anesthesia for the other eye by using lidocaine 4%. Patients were asked to grade the pain they experienced during administration of both anesthesia and intravitreal injection by using a 4-point pain scale: from 0=no pain to 3=severe pain. Complications that developed during both procedures were recorded. RESULTS. The mean pain score experienced during subconjunctival injections was 0. 78 0. 62, whereas no anesthesia-related pain was reported in the topical group. The mean pain score experienced during intravitreal injection was 1.64 +/- 0.67 in the topical and 0.85 +/- 0.52 in the subconjunctival group (p < 0.001). The mean total pain scores of both procedures were 0.82 +/- 0.34 in the topical and 0.82 +/- 0.51 in the subconjunctival group (p > 0.05). Nine eyes (32%) developed subconjunctival haemorrhage after subconjunctival injection, whereas no anesthesia-related complication developed in the topical group. Subconjunctival haemorrhage was also observed in 5 eyes (18%) in the topical group and in 11 eyes (40%) in the subconjunctival group (p > 0.05) after intravitreal injection. CONCLUSIONS. Although subconjunctival anesthesia provides better pain control during intravitreal injections, its application is more painful and leads to subconjunctival haemorrhage. Moreover, the mean total pain scores are similar in both methods. Therefore, topical anesthesia may be more suitable for daily practice.
Complications of intravitreal dexhametasone implant injections
(KARGER, 2014) Kıvanç, Sertaç Argun; Kaderli, Berkant; Asadova, Vusale; Yalçınbayır, Özgür; Yücel, Ahmet Ali; Uludağ Üniversitesi.; 0000-0002-7311-5277; AAH-6518-2021; IYJ-9408-2023
Diabetes mellitus hastalarında sosyoekonomik durumun diyabetik retinopati gelişimine etkisi
(Uludağ Üniversitesi, 2014-02-17) Toka, Fatih; Avcı, Remzi; Kaderli, Berkant; Kıvanç, Sertaç Argun; Yıldız, Meral; Yücel, Ahmet Ali; Yalçınbayır, Özgür; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.
Diabetes mellitus (DM) komplikasyonu olan diyabetik retinopati (DR), çalışan nüfusta en sık körlük nedenidir. Diyabetik retinopati gelişimini etkileyen birçok faktör mevcuttur. Bu çalışmada sosyoekonomik faktörlerin ve HbA1C değerinin retinopati gelişimine etkisini araştırmayı amaçladık. Çalışmaya DM tanısı konulmuş 297 hasta dahil edildi. Hastalara demografik ve sosyoekonomik durumlarını sorgulayan anket uygulandı. Hastalar göz muayeneleri sonrası retinopatinin var olup olmamasına göre 2 gruba ayrıldı. Düşük gelir ve eğitim düzeyinin, 15 yıldan uzun diyabet süresinin, yüksek HbA1C değerinin, insülin kullanımının DR gelişimi ile ilişkili olduğu bulundu. Ayrıca retinopatisi olan hastaların, DM tanısından önce DR’yi bilmedikleri, tanı aldıktan sonra DR’nin kendilerine anlatılmadığı ve bu hastaların düzenli göz kontrolüne gitmedikleri tespit edildi. Bu bulgular, hem hastayla ilişkili olan sosyoekonomik faktörlerin, hem de hekimle ilişkili hastaların bilgilendirilmesi gibi faktörlerin diyabetik retinopati gelişiminde etkili olduğunu göstermektedir.
The duration of dialysis affects central choroidal thickness in dialysis patients
(Oxford University, 2016-05) Oruç, Ayşegül; Kıvanç, Sertaç Argün; Budak, Berna Akova; Yıldız, Abdülmecit; Ayar, Yavuz; Kaderli, Berkant; Yücel, Ahmet Ali; Ersoy, Alparslan; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 0000-0003-4607-9220; 0000-0002-0342-9692; 0000-0002-0710-0923; 0000-0003-4607-9220; 0000-0003-0995-5260; 0000-0003-4607-9220; AGF-0767-2022; AAH-6518-2021; AAH-4002-2021; AAH-5054-2021; O-9948-2015; ABE-3033-2020; GSE-0029-2022
The effect of dexamethasone implant (Ozurdex (R)) on anterior chamber parameters in patients with retinal vein occlusion
(Assoc Research Vision Ophthalmology, 2016-09) Yılmaz, Sami; Budak, Berna Akova; Kıvanç, Sertaç Argun; Kaderli, Berkant; Yalçınbayır, Özgür; Baykara, Mehmet; Yücel, Ahmet Ali; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 0000-0003-0995-5260; ABE-3033-2020; ABI-7051-2020; AAH-6518-2021; AAH-6625-2021
Effect of posterior subtenon injection of 40 mg of triamcinolone acetonide on glycemic control and serum cortisol and adrenocorticotropic hormone in diabetic patients
(Verduci Publisher, 2014) Yılmaz, Sami M.; Avcı, Remzi; İnan, Ümit Übeyt; Kaderli, Berkant; Kıvanç, Sertaç Argun; Ersoy, Canan Özyardımcı; Yücel, Ahmet Âli; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; AAH-6518-2021; AAH-8861-2021; 6507602756; 47861204900; 6701485882; 7005217049
OBJECTIVE: To evaluate the influence of posterior subtenon injection of 40 mg of triamcinolone acetonide (TA) on blood glucose, cortisol and adrenocorticotrophic hormone (ACTH) in patients with clinically significant diabetic macular oedema. PATIENTS AND METHODS: This prospective clinical study included 33 type 2 diabetic patients assigned to receive subtenon injection of 40 mg of TA (study group: 20 patients, 9 women and 11 men, mean age 60.8 +/- 10.1 years) or subtenon injection of 1 ml of saline solution (control group: 13 patients, 7 women and 6 men, mean age 57.9 +/- 7.5 years) as an adjunct to focal/grid laser therapy. Pre-injection laboratory tests consisted of fasting blood glucose (FBG), glicolised hemoglobin (HbA1c), fructosamine, ACTH and cortisol. Post-injection measurements were performed in a following schedule: FBG in day 1; FBG, ACTH and cortisol at week 1; FBG, fructosamine, ACTH and cortisol at month 1, 2 and 3. HbA1c was also measured at 3 months. The mean +/- SD values of groups at each visit were compared. The time-related changes in the parameters in each group were also analyzed using SPSS (Statistical Package for Social Sciences) for Windows 15.0 software. RESULTS: Pre-injection FBG, HbA1c, fructosamine, ACTH and cortisol were similar in both groups (p > 0.05 for all). Pre-injection and final HbA1c values were similar in the study (8.6% +/- 1.9 and 8.7% +/- 1.8, respectively) and control groups (8.6% +/- 1.7 and 8.5% +/- 1.8, respectively) (p > 0.05 for all). None of the patients had a decrease in plasma cortisol that decreased below normal values at either time point. There was no statistically significant difference between groups and between each visit in groups according to FBG levels, blood fructosamine, ACTH and cortisol levels (p > 0.05 for all). No adverse event was observed. CONCLUSIONS: Subtenon injection of 40 mg of TA does not increase blood sugar levels significantly, and it does not suppress blood cortisol or ACTH levels at 1 week or later in patients with diabetes mellitus. Subtenon injection of 40 mg TA seems to be safe in respect to elevation of blood sugar levels or systemic corticosteroid pathways.
Efficacy of dexamethasone implants in uveitic macular edema in cases with behcet disease
(Karger, 2019-01-01) Yalçınbayır, Özgür; Çalışkan, Enver; Gündüz, Gamze Uçan; Gelişken, Öner; Kaderli, Berkant; Yücel, Ahmet Ali; YALÇINBAYIR, ÖZGÜR; Çalışkan, Enver; UÇAN GÜNDÜZ, GAMZE; YÜCEL, AHMET ALİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı; JAC-9459-2023; EQX-5743-2022; AAH-6661-2021; JYV-1141-2024
Purpose: Investigation of the efficacy of intravitreal dexamethasone implants (0.7 mg) in patients with Behcet disease (BD) who had cystoid macular edema (CME) despite immunomodulatory treatment. Materials and Methods: Twenty-seven eyes of 20 patients who had intravitreal dexamethasone implant injections and follow-up for more than 6 months were included in this study. Best corrected visual acuities (BCVA), intraocular pressures (IOP), and central macular thicknesses (CMT) were recorded. Systemic immunomodulatory treatment was noted. Injection-related complications and the need for recurrent injections were recorded. Results: Statistically significant anatomical and functional success was achieved with a single injection. BCVA increased from 0.85 +/- 0.72 to 0.45 +/- 0.52 logMAR, while the mean CMT decreased from 406 +/- 190 to 243 +/- 101 mu m at the sixth month. The peak of visual acuity gain was reached within the first 2 months and a substantial proportion of the patients gained 3 or more lines. There was no complication other than transient IOP elevation in 4 eyes and cataract surgery in 2 eyes. Conclusion: Adjuvant intravitreal dexamethasone implant injections offer promising results in cases of BD with CME. It is effective in preserving the macular anatomy and vision particularly in transition to biological agents.
Eksudatif yaşa bağlı makula dejenerasyonu ile periferik retina dejenerasyonlarının ilişkisi
(Uludağ Üniversitesi, 2011) Çakırlı, Emel Ebru; Kaderli, Berkant; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.
Yaşa bağlı makula dejenerasyonu (YBMD), gelişmiş ülkelerde, 50 yaş üzeri bireylerde gözlenen ciddi görme kaybının esas nedenidir. YBMD' nin primer olarak makulayı etkilemesinin nedeni, makuladaki Bruch membran yapı ve içeriğindeki topografik değişiklerle açıklanabilir. Yaşlanma süreci göz önünde bulundurulduğunda, yaşa bağlı periferik retinal değişikliklerin, YBMD ile birlikte gözlenebilmesi olasıdır. Biz bu prospektif çalışma ile yaşa bağlı makula dejenerasyonu ile periferik retina dejenerasyonları arasındaki ilişkiyi ortaya koymayı amaçladık.Bu çalışma, Uludağ Üniversitesi Göz Hastalıkları polikliniğinde, yaş tip YBMD tanısı konan toplam 100 hastayı (56 erkek, 44 kadın) ve 55 yaş üzeri bilinen göz hastalığı olmayan 100 sağlıklı olguyu (52 erkek, 48 kadın ) içerdi. Ortalama yaş YBMD grubunda 71,9 (55-85), kontrol grubunda ise 68.5 (55-88) idi. Tüm hastalara, Early Treatment of Diabetic Retinopathy (ETDRS) eşeli ile görme keskinliği muayenesi, GİB ölçümü, biomikroskopik muayene ve ardından 3 aynalı Goldmann lensi ile periferik retina muayenesi yapıldı. YBMD grubuna farklı olarak tanı ve koroid neovaskülarizasyonu (KNV) tiplendirmesi amacıyla floreseyin anjiografik görüntüleme yapıldı. YBMD olgularının flöresein anjiografi değerlendirmesinde %56'sı gizli, %18'i baskın klasik tipte KNV bulgularına sahipti, %15'i retinal anjiomatöz proliferasyon, %11'i polipoidal vaskülopati tanısı almıştı. Tüm olgular, yaşa bağlı periferik retinal değişiklikler arasında yer alan periferik tapetokoroidal dejenerasyon(PTKD), kistik dejenerasyon, drusen, dejeneratif retinoşizis, kaldırım taşı dejenerasyon ve lattice dejenerasyon varlığı açısından değerlendirildi. YBMD ve sağlıklı kontrol grubunda periferik retinal değişikliklerin gözlenme oranları karşılaştırıldı. Her iki grupta hastaların yaşı, cinsiyeti ,mesleği, sistemik hipertansiyon (HT) ve/veya diabetes mellitus (DM) varlığı, ilaç kullanımı, ön segment muayene bulguları, GİB değerleri, iris rengi ile periferik retina muayene bulguları karşılaştırıldı. YBMD olgularının %88'inde PTKD, %62'sinde periferik drusen, %22'sinde retiküler dejenerasyon, %20'sinde kaldırım taşı dejenerasyon, %2'sinde dejeneratif retinoşizis, ve % 2'sinde lattice dejenerasyon mevcuttu. Sağlıklı kontrol grubunun %41'inde PTKD, %46'sında drusen, %11'inde pigmenter retinopati, %3'ünde kaldırım taşı dejenerasyon,% 2'sinde lattice dejenerasyon saptandı.Yaş tip YBMD grubunda, PTKD, kaldırım taşı dejenerasyon, retiküler dejenerasyon, drusen ve dejeneratif retinoşizis saptanma oranı, sağlıklı kontrol grubuna göre anlamlı olarak yüksekti (p<0.005).YBMD grubunda, retiküler dejenerasyon ile UV maruziyeti ile ilişkili açık alanda çalışma öyküsü arasında anlamlı ilişki saptandı (p=0,030). YBMD grubunda, diğer periferik dejenerasyon varlığı ve tipi ile yaş, cinsiyet, meslek, HT ve/veya DM varlığı, ilaç kullanımı, lensin durumu, GİB değerleri, iris rengi ve KNV tipi arasında anlamlı bir ilişki saptanmadı. Kontrol grubunda açık iris rengi ile PTKD arasında anlamlı bir ilişki saptandı (p=0,037).Sonuç olarak bu çalışma ile yaşa bağlı makula dejenerasyonunun tüm retinayı ilgilendiren bir hastalık olduğu ortaya kondu. Hastalarda, tanı esnasında retinanın tümüyle değerlendirilmesinin prognozun belirlenmesi açısından faydası olabileceği düşünülmektedir.
Evaluation of arteriovenous crossing sheathotomy for decompression of branch retinal vein occlusion
(Springernature, 2008-09) İnan, Ümit Übeyt; Avcı, Remzi; Kaderli, Berkant; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 7004838001; 6507602756
Purpose To report the effects of arteriovenous adventitial sheathotomy on anatomical and functional improvements in patients with macular oedema due to branch retinal vein occlusion (BRVO). Methods Pars plana vitrectomy and arteriovenous sheathotomy was performed on 11 patients with BRVO who had vision loss due to macular oedema. Ten patients with macular oedema due to BRVO and who have been treated with grid laser photocoagulation were included in the control group. The measurement of visual acuity with ETDRS chart was taken preoperatively and at 1, 3, 6, and 9 months follow-up in the study group and at 1, 3, 6, and 9 months after grid laser in the control group. Results The mean preoperative logMAR visual acuity was 0.84 +/- 0.3 in the surgical group and 1.06 +/- 0.4 in the control group. The postoperative mean logMAR visual acuity was 0.41 +/- 0.2, 0.40 +/- 0.2, 0.40 +/- 0.3, and 0.36 +/- 0.3 at 1, 3, 6, and 9 months follow-up, respectively. In the control group the postlaser mean logMAR visual acuity was 0.92 +/- 0.3, 0.87 +/- 0.4, 0.85 +/- 0.3, and 0.82 +/- 0.3 at 1, 3, 6, and 9 months follow-up, respectively. The improvements of visual acuity in both groups were statistically significant when compared to pretreatment (P=0.003 and P=0.007 at 9 months in the study and control group, respectively). Conclusion Arteriovenous sheathotomy for decompression of BRVO in patients who have vision loss due to macular oedema was safe and effective for anatomical and functional improvement and resulted in significantly better visual outcomes than a matched control group of laser-treated eyes.
The first Susac's syndrome case in Turkey
(Elsevier, 2006-12-21) Erer, Sevda; Boz, Meral; Taşkapılıoğlu, Özlem; Hakyemez, Bahattin; Kaderli, Berkant; Zarifoğlu, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 0000-0002-3425-0740; AAI-2318-2021; AAK-6623-2020; 25635370800; 15070548200; 23037226400; 6602527239; 6507602756; 6603411305
Susac's syndrome is a vasospastic disease resulting from bilateral microangiopathy of the brain, cochlea and retina. It is characterized by encephalopathy, bilateral sensorineural fluctuating hearing loss and visual loss. It is very uncommon and usually affects women during young adulthood. Since all three symptoms of the triad may not be present, the clinical diagnosis is difficult. Therefore, neuroimaging, particularly magnetic resonance imaging, has an important role in establishing the diagnosis. In this case report, we present a young woman who had all the symptoms of Susac's syndrome. This is the first Susac's syndrome case reported in Turkey.
Göz içi yabancı cisim ile oluşan göz yaralanmalarında prognostik faktörler
(Uludağ Üniversitesi, 2017-06-28) Çiçek, Serhat; Kaderli, Berkant; Gelişken, Öner; Avcı, Remzi; Yalçınbayır, Özgür; Yücel, Ahmet Ali; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.
Bu retrospektif çalışmada intraoküler yabancı cisim (İOYC) için vitreoretinal cerrahi yapılan olgularda görmeyi etkileyen prognostik faktörlerinin belirlenmesi amaçlanmaktadır. Çalışmaya 2007-2014 arasında İOYC tanısıyla vitreoretinal cerrahi yapılan ve en az 3 ay takip edilen 52 hasta dahil edilmiştir. Olguların demografik özellikleri, preop ve postop en iyi düzeltilmiş görme keskinliği (EİDGK) kaydedilmiş, postop takiplerindeki anatomik başarı ve EİDGK seviyeleri ile ilişkisi incelenmiştir. Ortalama yaş 34.6 + 14.0 yıl olan bu çalışmada ortalama takip 10,7 ay idi. EİDGK preop 1,74 + 1,15 logMAR iken postop 6. ayda 0,92 + 1,15 logMAR idi. Yabancı cisimin göze giriş yeri ekseriyetle korneal bölge idi. Altıncı ayda anatomik başarı oranı % 88,4 idi. Takiplerde 9 olguda retina dekolmanı geliştiği görüldü. Olguların %42,3’de ilk cerrahiden sonra tekrar cerrahi müdahale yapılması gerekti. Anatomik bütünlük için primer onarım yapılanlarda ve yabancı cismi korneadan çıkarılanlarda 6. aydaki anatomik başarının anlamlı derecede düştüğü tespit edildi (p<0,05).
Impaired aortic stiffness and pulse wave velocity in patients with branch retinal vein occlusion
(Springer, 2010-03) Aydın Kaderli, Aysel; Kaderli, Berkant; Güllülü, Sümeyye; Avcı, Remzi; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 7801322152; 6507602756; 57204660708; 7004838001
Aortic distensibility (AD) and pulse wave velocity (PWV) reflect arterial stiffness, which is linked to increased cardiovascular morbidity and mortality in different diseases such as atherosclerosis, hypertension, and diabetes mellitus, all of which are also common risk factors in patients with branch retinal vein occlusion (BRVO). In the present study, we aimed to determine whether arterial stiffness in different segments of the arterial tree is increased in patients with BRVO. The study group consisted of 35 patients with BRVO (20 female, 15 male, mean age: 55.9 +/- 6.8) and the age-matched control groups consisted of 19 patients with hypertension (9 female, 10 male, mean age: 55.2 +/- 7.6) and 17 healthy subjects (9 female, 8 male, mean age: 53.4 +/- 9.6). Radial artery PWV was measured using a Pulse Wave Sensor HDI system, which measures non-invasively the radial pulse-wave recording with computer analysis of the diastolic decay, and provides separate assessment of the large arterial elasticity index (LAEI) and small artery elasticity index (SAEI). Aortic strain and AD was determined echocardiographically based on the relationship between changes in aortic diameter and pressure with each cardiac pulse. Patients with diabetes mellitus or inflammatory BRVO, and control patients with any occlusive vascular eye disease, were excluded. The results of the three groups were compared. Compared to the subjects of the healthy control group, those with BRVO had lower LAEI (p < 0.05). Both AD and aortic strain were significantly lower in the BRVO group than in both control groups (p < 0.05 for both) and in the hypertensive control group than the healthy controls (p < 0.05). The AD, LAEI and SAEI were positively correlated (p = 0.021, r = 0.307 and p = 0.041, r = 0.269 respectively). The results of this study show that the arterial stiffness indices (large arterial elasticity index and aortic distensibility) are abnormal in patients with BRVO compared to the healthy and hypertensive controls. Arterial stiffness may play a role in the onset or progression of BRVO. Further studies are needed to determine the exact role of AS in the pathogenesis of BRVO, and to reveal its value in predicting systemic morbidity and mortality in patients with BRVO.
Intravitreal triamcinolone for nonarteritic anterior ischemic optic neuropathy - reply
(Lippincott Williams & Wilkins, 2008-03-01) Güler, Kazım; YÜCEL, AHMET ALİ; Kaderli, Berkant; Avcı, Remzi; Gelişken, Öner; Yücel, Ali; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Oftalmoloji Anabilim Dalı.; 0000-0001-9581-4856; 0000-0001-7992-0974; KEH-2402-2024
Intravitreal triamcinolone improves recovery of visual acuity in nonarteritic anterior ischemic optic neuropathy
(Lippincott Williams & Wilkins, 2007-09) Güler, Kazım; Kaderli, Berkant; Avcı, Remzi; Yücel, Ali; Gelişken, Öner; Uludağ Üniversitesi/Tıp Fakültesi/Oftalmoloji Bölümü.; 6507602756; 7004838001; 57225839918; 6602526353
Background: The visual outcome in untreated non-arteritic anterior ischemic optic neuropathy (NAION) is dismal. Because intravitreal triamcinolone (IVTA) has shown promise in improving edematous retinal disorders, a pilot trial of this therapy in NAION was considered reasonable. Methods: Four eyes of 4 patients with severe visual loss due to NAION were treated with 4 mg IVTA (study group). The control group consisted of 6 consecutive patients with NAION who received no treatment. Patients were evaluated by the visual acuity and visual field measurements of the Early Treatment Diabetic Retinopathy Study (ETDRS) and fluorescein angiography. Results: All patients completed at least 9 months of follow-up. In the study group, the mean improvement in visual acuity were 4, 5.8, and 6.2 ETDRS lines at the first and third weeks and final visit, respectively. Optic disc swelling and leakage had markedly decreased at the first postinjection week and had disappeared by the third week examination in all eyes. In the control group, the mean improvements in visual acuity were 0, 0.7, and 1.3 ETDRS lines at the first and third weeks and final visit, respectively. Control eyes showed resolution of the optic disc swelling between the fourth week and third month visits. No marked change in visual field defects was observed in either group. Conclusions: IVTA provided relatively improved recovery of visual acuity and relatively rapid resolution of optic disc swelling in a small sample of patients with acute NAION. It did not provide visual field improvement. A larger trial is merited by the results of this small pilot study
Intravitreal triamcinolone injection for chronic diabetic macular oedema with severe hard exudates
(Springer, 2006) Avcı, Remzi; Kaderli, Berkant; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.
Background: The purpose of the study was to determine the efficacy and safety of intravitreal triamcinolone acetonide ( TA) in chronic diabetic macular oedema with severe hard exudates. Methods: This prospective, interventional consecutive case series study consisted of 33 eyes of 28 patients with chronic diabetic macular oedema and severe foveal hard exudates who received an intravitreal injection of 4 mg of TA. The patients were divided into two groups according to the type of foveal hard exudates: group I, plaque-like ( 17 eyes) and group II, dot-like scattered hard exudates ( 16 eyes). The results of both groups, evaluated by colour fundus photography and fluorescein angiography, were compared and complications were recorded. Results: All patients completed at least 6 months of follow-up. In all eyes, the hard exudates were completely resolved (24% in group I and 50% in group II) or decreased (76% in group I and 50% in group II). In group I, the mean diameter of the exudates plaques significantly decreased from 5.5 +/- 3.8 mm(2) in the pretreatment period to 2.2 +/- 2.7 mm(2) at the end of the follow-up period. There was no recurrence of the hard exudates in either of the groups. The mean +/- SD visual acuity (VA) improved from 0.07 +/- 2.5 at the baseline to a maximum of 0.09 +/- 2.1 lines in group I ( P< 0.01) and from 0.13 +/- 3.9 to a maximum of 0.27 +/- 2.7 lines in group II ( P< 0.01). The mean VA improvement in group II was better than group I (3.2 +/- 2.5 vs. 1.4 +/- 1.0 lines, P< 0.05). Intraocular pressure exceeded 21 mmHg in 10 eyes (30%), which was then controlled by topical medication. Three eyes (9%) exhibited signs of subcapsular cataract progression. Conclusions: Intravitreal TA appears to be a valuable treatment in chronic diabetic macular oedema with severe foveal hard exudates. In all eyes in this study the hard exudates were completely resolved or decreased, and the mean VA improved significantly in both groups. However, the VA improvement was significantly worse in eyes with plaque-like exudates suggesting the possible value of earlier treatment. Further studies would enable the assessment of the universal effectiveness of this treatment.
Intravitreal triamcinolone injection for chronic diffuse diabetic macular oedema
(Wiley, 2006) Avcı, Remzi; Kaderli, Berkant; Akalp, Fatma Duriye; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; 7004838001; 6507602756; 6508127265
Purpose: To determine the efficacy and safety of intravitreal triamcinolone in chronic diffuse diabetic macular oedema. Methods: This prospective, interventional consecutive case series study consisted of 59 eyes (36 patients) with chronic diffuse diabetic macular oedema, which received an intravitreal injection of 4 mg triamcinolone acetonide. The results were evaluated by clinical examination and fluorescein angiography. Potential complications such as a rise in intraocular pressure, cataract progression and endophthalmitis were recorded. Results: All patients completed at least 6 months follow up. The mean visual acuity improved significantly from 0.17 +/- 3.4 to a maximum of 0.30 +/- 3.3 at the third postinjection month (P < 0.01). Mean improvements in visual acuity measured were 2.15 +/- 1.66, 2.42 +/- 2.66, 1.13 +/- 2.74, 0.96 +/- 2.01 and 0.08 +/- 2.34 lines at the 1, 3, 6, 9 and 12 months follow-up intervals, respectively. In all eyes in fluorescein angiography, macular oedema was resolved (63%) or decreased (37%) during the follow up. However, the macular oedema reached the pretreatment level in 29 (49%) of the eyes at 6 months and 15 of 21 eyes (71%) at 9 months after injection. Intraocular pressure exceeded 21 mmHg in 10 eyes, which were controlled by topical medication. Four eyes showed cataract progression. Endophthalmitis was not observed in any of the eyes. Conclusions: Intravitreal injection of 4 mg triamcinolone acetonide appears to be an effective and relatively safe therapeutic method for diffuse diabetic macular oedema. Further studies are warranted to assess the long-term efficacy, safety and the need for reinjection.
Intravitreal versus sub-Tenon posterior triamcinolone injection in bilateral diffuse diabetic macular edema
(Karger, 2011) Yalçınbayır, Özgür; Gelişken, Öner; Kaderli, Berkant; Avcı, Remzi; Uludağ Üniversitesi/Tıp Fakültesi/Göz Hastalıkları Anabilim Dalı.; AAH-6625-2021; 8702056700; 6602526353; 6507602756; 7004838001
Purpose: To compare the efficacy of intravitreal and sub-Tenon (ST) posterior triamcinolone injection in the treatment of bilateral diabetic diffuse macular edema (DDME). Methods: 28 eyes of 14 diabetic patients with bilateral DDME were included in this prospective randomized study. One eye of each individual received a sub-Tenon (ST) posterior triamcinolone injection (ST group), whereas the fellow eye received an intravitreal triamcinolone injection (IV group). All eyes were treated with supplementary focal laser after the injections. Cases were evaluated 1, 2, 3 and 6 months after the initial treatment. Results: Both groups had visual improvement and macular edema reduction following the injections. This temporary effect was prominent for 24 weeks in the IV group and for 8 weeks in the ST group. Edema resorption and visual improvement were more pronounced in the IV group, although this difference was not statistically significant. No major complications were observed except for moderate and reversible intraocular pressure elevation in some cases. Conclusion: Both intravitreal and ST injections of triamcinolone appear to yield a significant visual recovery and prompt resolution of DDME. The beneficial outcome appears to be more longstanding with intravitreal injection.