Person: UÇAN GÜNDÜZ, GAMZE
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UÇAN GÜNDÜZ
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GAMZE
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Publication Intraocular lens elongation technique with haptic modification for sulcus implantation(Galenos Publ House, 2022-08-01) Efe, Ayşe Çetin; BAYKARA, MEHMET; Gündüz, Gamze Uçan; UÇAN GÜNDÜZ, GAMZE; Yurttaş, Ceren; YURTTAŞ, CEREN; Tıp Fakültesi; Oftalmoloji Ana Bilim Dalı; 0000-0002-5555-1649; 0000-0002-5458-1686; AAH-6661-2021Objectives: To define a haptic modification technique to increase the overall length of the intraocular lens (IOL) and evaluate the postoperative outcomes of patients in whom this technique was applied.Materials and Methods: The preoperative and postoperative characteristics of patients who underwent modified IOL implantation into the sulcus between May 2019 and December 2019 were evaluated. Modified Sensar AR40e lenses with hydrophobic acrylic optic and polymethylmethacrylate haptics were implanted to all eyes. Before implanting the IOL, the haptics were grasped with two toothless forceps and bent to elongate the total diameter of the IOL from 13.0 mm to 14.5 mm.Results: The study included 11 eyes of 11 patients who underwent modified three-piece IOL implantation into the sulcus due to insufficient capsular support. The mean age of the patients was 53.9 +/- 12.2 years. The mean axial length was 24.13 +/- 1.93 mm. Sulcus implantation was required due to aphakia in 9 eyes and IOL dislocation in 2 eyes. No haptic breakage occurred during the IOL modification technique or implantation. The mean preoperative best corrected visual acuity (BCVA) was 0.88 +/- 1.1 logMAR, while postoperative BCVA was 0.28 +/- 0.30 logMAR. No IOL dislocation or decentration was observed during 6-month postoperative follow-up.Conclusion: The larger diameter lenses obtained with this inexpensive and easily applicable technique may allow a more stable sulcus implantation in eyes with inadequate capsular support.Publication 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; Tıp Fakültesi; Göz Hastalıkları Ana Bilim Dalı; JAC-9459-2023; EQX-5743-2022; AAH-6661-2021; JYV-1141-2024Purpose: 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.Publication A comprehensive assessment of long-term complications in patients with stevens-johnson syndrome and toxic epidermal necrolysis(Karger, 2023-07-26) Çekiç, Sükrü; Canıtez, Yakup; Yüksel, Hale; Gündüz, Gamze Ucan; Karalı, Zühal; Yalçınbayır, Özgür; Vural, Pınar; Sapan, Nihat; ÇEKİÇ, ŞÜKRÜ; CANITEZ, YAKUP; Yüksel, Hale; UÇAN GÜNDÜZ, GAMZE; KARALI, ZUHAL; VURAL, AYŞE PINAR; YALÇINBAYIR, ÖZGÜR; SAPAN, NİHAT; Tıp Fakültesi; Çocuk Alerjisi Ana Bilim Dalı; 0000-0002-9574-1842; 0009-0002-4004-449X; 0000-0002-5458-1686; 0000-0002-7311-5277; 0000-0001-8929-679X; L-1933-2017; AAH-1789-2021; IZZ-9492-2023; AAH-6661-2021; CZC-9168-2022; IYJ-9408-2023; GIK-1690-2022; FUI-8766-2022Introduction: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are rare severe hypersensitivity reactions that lead to epithelial sloughing. Studies investigating the chronic multisystem effects of these syndromes and assessing patients in terms of quality of life (QOL), depression, and anxiety in the pediatric population are limited. In this study, we aimed to investigate the long-term effects of these diseases from a multisystem perspective. Method: Sixteen pediatric patients diagnosed with SJS, TEN, and SJS/TEN overlap syndrome were evaluated between September 2020 and March 2021. Physical and eye examinations were performed. To evaluate QOL and psychological status, Children's Dermatology Life Quality Index (CDLQI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Children's Depression Inventory (CDI) were conducted. The patients' general characteristics, symptoms, and examination findings at their first admission were retrospectively obtained from the hospital's electronic records. Results: Nineteen percent of the patients were female (n = 3). There were 7 patients (44%) with the diagnosis of SJS, 5 patients (31%) with TEN, and 4 patients (25%) with SJS/TEN overlap. The median follow-up time of the subjects was 6.5 years. The most common sequelae in the chronic period were skin changes (n = 13, 81%). Hyperpigmentation was the most common skin change (n = 9, 56%). In the last evaluation, 9 cases had eye involvement. In two cases, eye examination was normal in the acute phase, while ocular involvement was present in the chronic period. In 4 (50%) patients, there was height and/or weight percentile loss. Three patients' SCARED scores and 2 patients' CDI scores were high. According to the CDLQI survey, SJS, TEN, or SJS/TEN overlap syndrome had a small to moderate effect on the QOL in the 43% (n = 6) of the patients. The ANA values of 3 patients (60%) were positive at the follow-up and negative at the first admission. Conclusion: SJS, TEN, and SJS/TEN overlap syndrome may cause sequelae even after a long time of the onset of the disease. Patients' QOL and psychological status can be affected negatively. Ocular symptoms may develop in the follow-up, even without involvement in the acute period. Patients with SJS, TEN, and SJS/TEN overlap syndrome should be followed up in the chronic period and approached multidisciplinary.Publication A rare case of recurrence presenting with bilateral exudative retinal detachment in a child with acute lymphoblastic leukemia(Wiley, 2021-08-16) Yalçınbayır, Özgür; Sezgin Evim, Melike; Uçan Gündüz, Gamze; Güler, Salih; Meral Güneş, Adalet; YALÇINBAYIR, ÖZGÜR; SEZGİN EVİM, MELİKE; UÇAN GÜNDÜZ, GAMZE; GÜLER, SALİH; MERAL GÜNEŞ, ADALET; Tıp Fakültesi; Göz Hastalıkları Ana Bilim Dalı; 0000-0002-7311-5277; 0000-0002-1219-8304; 0000-0002-5458-1686; 0000-0002-4792-269X; 0000-0002-0686-7129; IYJ-9408-2023; AAH-1452-2021; AAH-6661-2021; DWH-8632-2022; EXD-8400-2022Publication Sd-oct assessment of macular and optic nerve alterations in patients recovered from covid-19(Canadian Ophthal Soc, 2022-03-28) Yıldız, Ayşegül Mavi; Gündüz, Gamze Ucan; Yalçınbayır, Özgür; Öztürk, Nilüfer Aylin Acet; Avcı, Remzi; Coşkun, Funda; UÇAN GÜNDÜZ, GAMZE; YALÇINBAYIR, ÖZGÜR; ACET ÖZTÜRK, NİLÜFER AYLİN; COŞKUN, NECMİYE FUNDA; Tıp Fakültesi; Göğüs Hastalıkları Ana Bilim Dalı; 0000-0003-3604-8826 ; 0000-0002-6375-1472 ; 0000-0002-7311-5277 ; AAH-6661-2021; IYJ-9408-2023; Z-1424-2019; AAD-1271-2019Objective: To quantify microstructutal alterations in the macula and peripapillary retinal nerve fibre layer (RNFL) in patients recovered from coronavirus disease 2019 (COVID-19) using spectral domain optic coherence tomography (SD-OCT).Design: Retrospective, observational.Participants: This comparative, cross-sectional study included patients who recovered from COVID-19 (Group 1) and age- and sex-matched normal controls (Group 2).Methods: A comprehensive ophthalmic examination, including best-corrected visual acuity and biomicroscopic anterior and posterior segment examination was performed. SD-OCT analysis of the macula and peripapillary RNFL was obtained for each participant. In addition, patient demographics and comorbidities were recorded.Results: 238 eyes of 122 subjects (Group 1: n = 63; Group 2: n = 59) were included. The incidence of coexisting comorbidity was higher in Group 1 (n = 26/63, 41.3%) compared with Group 2 (n = 12/59, 20.3%) (p = 0.013). The central foveal thickness (CFT) was significantly higher in Group 1 (271.0 +/- 26.8 mu m) than Group 2 (263.2 +/- 22.0 mu m) (p = 0.015). The average outer nuclear layer (ONL) thickness at central fovea in Group 1 (85.4 +/- 13.3 mm) was significantly thicker than that in Group 2 (81.4 +/- 15.2 mu m) (p = 0.035). The mean peripapillary RNFL thickness of Group 1 (102.6 +/- 8.8 mu m) and Group 2 (100.9 +/- 8.3 mu m) were similar (p = 0.145). The mean choroidal thickness of groups at the fovea and at 1500 mu m nasal and temporal to the fovea were not significantly different (p> 0.05 for all).Conclusion: Significant thickness alterations in individual retinal layers and CFT was detected in post-COVID-19 patients. The increase in CFT and ONL thickness might be attributed to direct infection or viral-induced inflammatory response of retina.Publication Herpes zoster ophthalmicus and lateral rectus palsy in an elderly patient(Karger, 2011-01-01) Yalçınbayır, Özgür; Yıldız, Meral; Gündüz, Gamze Ucan; Gelişken, Öner; YALÇINBAYIR, ÖZGÜR; YILDIZ, MERAL; UÇAN GÜNDÜZ, GAMZE; Gelişken, Öner; Tıp Fakültesi; Göz Hastalıkları Ana Bilim Dalı; 0000-0002-7311-5277; 0000-0002-5458-1686; HPH-3842-2023; AAH-6661-2021; KBU-8934-2024; EXE-4887-2022Acquired palsy of the lateral rectus presents with horizontal diplopia and has a broad differential. Herpes zoster ophthalmicus-(HZO) related cranial nerve palsy is a transient and self-limiting condition. Systemic antiviral treatment is administered in order to prevent sight-threatening complications. In suspected cases, zosteriform rash should be questioned. One should keep in mind that acquired esotropia in the elderly may sometimes present following HZO.Publication Reconstruction of periocular defects with rhomboid flap: Surgical results(Turkish Ophthalmological Soc, 2012-07-01) Dirim, Ayşe Burcu; Yazıcı, Bülent; Gündüz, Gamze Uçan; UÇAN GÜNDÜZ, GAMZE; Tıp Fakültesi; Göz Hastalıklar Ana Bilim Dalı; 0000-0001-8889-1933; 0000-0002-5458-1686; AAA-5384-2020; AAH-6661-2021Purpose: To review the surgical results in patients who underwent an eyelid reconstruction with rhomboid flap after periorbital and medial canthal tumor excision.Material and Method: This study included 18 patients who underwent eyelid reconstruction with rhomboid flap after periorbital and medial canthal tumor excision. The patient charts were reviewed for topographic data, tumor features, surgical technique, and postoperative results.Results: The mean age of the patients (10 women, 8 men) was 58 years (age range: 22-78 years). The lesion was located in the inferior periorbital-malar area in 8 patients, in the medial canthal area in 8 patients and in the lateral periorbital area in 2 patients. Mean tumor diameter was 8.9 mm (range: 5-13.5 mm). Rhomboid flap was used alone in 14 patients (78%) and in combination with nazojugal advanced flap and semicircular flap in 2 patients (11%) each. The skin defect could be closed primarily in all patients, except one. A secondary surgical intervention was required for ectropion and pyogenic granuloma excision in 1 patient each. The aesthetic outcome was satisfactory in all patients. Mean follow-up time was 23 months (range: 2-64 months).Discussion: Rhomboid flap can be used for medial canthal and periorbital eyelid reconstruction after tumor excision. This flap technique can be combined with other reconstruction methods for large defects. After surgery, aesthetic and functional results are satisfactory in most patients, whereas surgical complications and need for a secondary surgery are rare.Publication Nonperforating intrascleral stabbing for sutureless 23g sclerotomy closure(Lippincott Williams & Wilkins, 2023-02-01) YALÇINBAYIR, ÖZGÜR; Gündüz, Gamze Uçan; UÇAN GÜNDÜZ, GAMZE; Nizam, Sema; NİZAM TEKCAN, SEMA; Yıldız, Meral; YILDIZ, MERAL; Tıp Fakültesi; Oftalmoloji Ana Bilim Dalı; 0000-0002-7311-5277; 0000-0002-5458-1686; IYJ-9408-2023Purpose:The need for suturing leaking sclerotomies have not been eliminated completely in transconjunctival sutureless vitrectomy (TSV). This study aims to describe a novel technique for 23-gauge (G) sclerotomy closure in TSV surgery and discuss its effectiveness. Materials and Methods:Two hundred and thirty cases of 180 patients who underwent 23G TSV with various diagnoses were included to the study. Cases with connective tissue diseases, thin sclera, and significant conjunctival and scleral scarring were excluded. Nonperforating intrascleral stabbing (NIS) was performed to leaking 23G sclerotomies (n = 650) and 27G chandeliers (n = 84). Demographics, rate of sclerotomy closure with NIS procedure, the need for suturing, and complications of the procedure were recorded. Results:The overall success of NIS was found to be 91.0% in sclerotomies. Although 9.1% of sclerotomies required sutures, 592 of the 650 sclerotomies could be closed with NIS procedure (P < 0.001). Nonperforating intrascleral stabbing procedure helped close 98.8% of leaking 27G chandeliers. An average of 1.28 0.52 NIS attempts were needed for successful sclerotomy closure. Closure of sclerotomies with the NIS technique were somewhat related to the location of the sclerotomy, history of TSV and NIS, duration of TSV, and type of endotamponade. Hypotonia and choroidal detachment were seen in one case. No additional interventions were needed to normalize intraocular pressure in any case. Subconjunctival hemorrhage happened to be the leading complication of the procedure. Conclusion:NIS procedure seems as a practical, reproducible, cost-effective, and uncomplicated approach, which significantly reduces the need to suture 23G sclerotomies. Further studies are required.Publication Treatment of dural carotid-cavernous sinus fistula through the superior ophthalmic vein(Turkish Ophthalmological Soc, 2011-10-01) Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Uçan, Gamze; UÇAN GÜNDÜZ, GAMZE; Yazıcı, Bülent; Türüdü, Sevil; Tıp Fakültesi; Göz Hastalıkları Ana Bilim Dalı; 0000-0002-5458-1686; 0000-0001-8889-1933; AAI-2318-2021; AAH-6661-2021; AAA-5384-2020Purpose: To present 3 patients who had a dural carotid-cavernous sinus fistula (CCF) and underwent cavernous sinus embolization through superior ophthalmic vein (SOV) approach.Material and Method.: Medical records of 3 patients with dural CCF who were treated through SOV approach were reviewed. Patient's age, gender, ophthalmic and radiological findings, treatment results, postoperative complications and follow-up time were recorded. Surgical procedure was performed in the interventional radiology unit and using general anesthesia. Through an eyelid crease incision, the SOV was reached and cannulated. The cavernous sinus was embolized with metalic coils advanced through a microcatheter placed into this cannun.Results: All 3 patients (3 female, patient ages: 41, 68 and 71 years) had Barrow type D CCF. One patient had a bilateral CCF. All patients had a history of unsuccessful treatment with interventional transvenous routes. The embolization procedure via the SOV was successfully completed in 2 patients. In a patient with bilateral CCF, the SOV was thin and tortuous, and could not be cannulated. All ophthalmic symptoms were improved in 2 patients with a successful embolization, and did not recur during the follow-up periods of 24 and 22 months. In one of these, an ischemic cerebrovascular event and orbital hematoma developed after the embolization. These complications improved without leaving a permanent impairment.Discussion: Cavernous sinus embolization can be performed through SOV approach, when it can not be done via the interventional transvenous routes. This procedure may not be successfully performed in some cases because of the anatomical features of the SOV. After the operation, complications such as orbital hemorrhage and cerebral ischemic attack may occur.Publication Anti-tumor necrosis factor treatment in the management of pediatric noninfectious uveitis: Infliximab versus adalimumab(Mary Ann Liebert, Inc, 2021-01-28) Uçan Gündüz, Gamze; Yalçınbayır, Özgür; Çekiç, Şükrü; Yiıdız, Meral; Kılıç, Sara Şebnem; UÇAN GÜNDÜZ, GAMZE; YALÇINBAYIR, ÖZGÜR; ÇEKİÇ, ŞÜKRÜ; YILDIZ, MERAL; KILIÇ GÜLTEKİN, SARA ŞEBNEM; Tıp Fakültesi; Pediatrik Alerji ve Klinik İmmünoloji; 0000-0002-5458-1686; 0000-0002-7311-5277; 0000-0002-9574-1842; 0000-0001-8571-2581; AAH-1885-2021; AAH-6625-2021; AAH-6661-2021; IYJ-9408-2023; AAH-1658-2021; JAC-9459-2023; L-1933-2017Purpose: Management of uveitis displays a particular challenge in childhood. This study aims to compare the efficacy and safety of infliximab (IFX) and adalimumab (ADA) in pediatric noninfectious uveitis that were refractory to conventional immunosuppresives.Methods: This retrospective single-center study included 33 patients who were treated with anti-tumor necrosis factor (TNF) agents (16 with IFX and 17 with ADA). Patients had diverse etiologies, including juvenile idiopathic arthritis, idiopathic uveitis, and Behcet's disease. Demographic characteristics, systemic diagnosis, findings of the ophthalmological examination, control of ocular inflammation, response to treatment, and the rate of clinical remission were studied.Results: Fourteen (87.5%) patients receiving IFX and 10 (58.8%) patients receiving ADA achieved response to treatment during the follow-up (P = 0.118). The agents were discontinued with complete clinical remission in 6 (37.5%) patients receiving IFX and in 2 (11.8%) patients receiving ADA (P = 0.118). Baseline visual acuities and parameters of inflammation improved significantly in both groups after anti-TNF therapy.Conclusion: Both IFX and ADA are safe and effective for pediatric noninfectious uveitis.