Yazar "Tufan, Hasan Ali" seçeneğine göre listele

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    A Minor Modification of Direct Browplasty Technique in a Patient with Brow Ptosis Secondary to Facial Paralysis: Copy-Paste-Excise and Stitch
    (Hindawi Ltd, 2013) Comez, Arzu Taskiran; Gencer, Baran; Kara, Selcuk; Tufan, Hasan Ali
    Purpose. This report aimed to describe a minor modification of the traditional direct browplasty technique that aids in surgical planning for patients with brow ptosis secondary to facial paralysis without changing the shape of the brow. Case Report. A 74year-old male patient with left facial paralysis secondary to chronic otitis media was referred with a complaint of low vision due to brow ptosis. We performed direct browplasty with a minor modification in order to aid a treatment customized to the patient. In this technique, a transparent film paper is used to copy the brow shape. A brow-shaped excision is facilitated just superior to the ptotic brow. Conclusion. The authors found that the copy-paste-excise and stitch technique was effective and successful for deciding the shape and the amount of excision that should be performed in patients with brow ptosis without resulting in asymmetrical, arched, and feminized brows.
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    Alterations in Anterior Segment Parameters After Intravitreal Anti-VEGF Injection Assessed by Scheimpflug Camera
    (2015) Kara, Selçuk; Tufan, Hasan Ali; Gencer, Baran; Arıkan, Sedat; Hondur, Ahmet Murat; Erşan, İsmail
    Amaç: Anti-vasküler endotelyal growth factor (Anti-VEGF) enjeksiyonu sonrası kısa dönem göz içi basıncı (GİB) ve ön segment değişimlerini belirlemek.Gereç ve Yöntem: Vitreus reflüsü olmadan 0.05 ml intravitreal bevacizumab veya ranibizumab enjeksiyonu yapılan prospektif sıralı hasta serisi incelendi. GİB ölçümleri Tono-Pen ile yapıldı. Ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH) ve ön kamara açısını (ÖKA) içeren ön segment parametreleri Sirius Scheimpflug camera ile ölçüldü. Ölçümler enjeksiyondan hemen önce, enjeksiyondan 5 dakika sonra ve enjeksiyondan 24 saat sonra alındı. Bulgular: Bu çalışmaya uygun toplam 42 hasta dahil edildi. Başlangıç ortalama GİB 15.9±3 mmHg idi ve enjeksiyondan 5 dakika sonra 25.9±10.5 mmHg'ye yükseldi (p<0.001). Enjeksiyondan 24 saat sonra GİB 15±3.4 mmHg olarak normale döndü (p>0.05). Başlangıç ile karşılaştırıldığında herbir zaman diliminde ÖKD ve ÖKH istatistiksel olarak anlamlı değildi (p>0.05). Ortalama ÖKA, başlangıçta 38±6.7?'den enjeksiyondan 5 dakika sonra 36.7±7.1?'e düştü (p=0.004). 24 saat sonra ortalama ÖKA değeri 37.6±7.1? olarak normale döndü (p>0.05).Tartışma: İntravitreal enjeksiyon sonrası ön segment parametrelerinin, ÖKA hariç değişmediği görülmektedir. ÖKA'daki değişimler enjeksiyondan 24 saat sonra GİB değerlerinin düşmesiyle normale döndü.
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    Alterations in Iris Structure and Pupil Size Related to Alpha-1 Adrenergic Receptor Antagonists Use: Implications for Floppy Iris Syndrome
    (Mary Ann Liebert, Inc, 2013) Tufan, Hasan Ali; Gencer, Baran; Kara, Selcuk; Comez, Arzu Taskiran; Kurt, Hasan Anil; Alan, Cabir
    Purpose: To evaluate structural alterations of iris and pupil diameters (PDs) in patients using systemic alpha-1-adrenergic receptor antagonists (alpha-1ARAs), which are associated with intraoperative floppy iris syndrome (IFIS). Methods: Eighty-eight eyes of 49 male were evaluated prospectively. Patients were assigned to 2 different groups. Study group included 23 patients taking any systemic alpha-1ARAs treatment, and control group included 26 patients not taking any systemic alpha-1ARAs treatment. All patients underwent anterior segment optical coherence tomography to evaluate iris thickness at the dilator muscle region (DMR) and at the sphincter muscle region (SMR). The PD was measured using a computerized infrared pupillometer under scotopic and photopic illumination. Results: The study group included 46 eyes of 23 patients and the control group included 42 eyes of 26 patients. Most treated patients were on tamsulosin (16/23). Mean age was similar in the study and control groups (61.9 +/- 7.1 vs. 60.3 +/- 8, 2 years, nonsignificant). DMR (506.5 +/- 89.4 vs. 503.6 +/- 83.5 mu m), SMR (507.8 +/- 78.1 vs. 522.1 +/- 96.4 mu m) and the DMR/SMR ratio (1.0 +/- 0.15 vs. 0.99 +/- 0.23 mm) was similar in the study and control groups and these differences were nonsignificant. Scotopic PDs were also similar in both groups (3.99 +/- 1.11 vs. 3.74 +/- 1.35, nonsignificant). A significantly reduced photopic PD (2.89 +/- 0.55 vs. 3.62 +/- 0.64, P < 0.001) and an increased scotopic/photopic PD (1.42 +/- 0.44 vs. 1.02 +/- 0.30, P < 0.001) were found in the study group. Conclusions: Evaluating PD alterations might be more useful than evaluating iris structural alterations in predicting IFIS. There is still a need for a reliable method that will determine the possibility of IFIS.
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    Bacterial Contamination of Needles Used for Intravitreal Injections: Comparison between 27-gauge and 30-gauge Needles
    (Informa Healthcare, 2013) Tufan, Hasan Ali; Vural, Ahmet; Gencer, Baran; Kara, Selcuk; Arikan, Sedat; Yuksel, Erdem
    Purpose: To compare the contamination rate between 27-gauge and 30-guage needles used for intravitreal injection (IVT). Methods: Patients undergoing IVT injections were enrolled prospectively. Injections were performed with 27- or 30-gauge needles. All needle tips were collected and placed in brain-heart infusion broth. The contamination rates of needles were compared. Results: A total of 109 patients participated in the study and a total of 126 IVT injections were performed. Injections were performed by 27-gauge (49%) and 30-gauge (51%) needle. No patient developed endophthalmitis. The overall contamination rate of the used needles were 13% for 27-guage and 29% for 30-guage (p = 0.022). However, this difference was nonsignificant after Bonferroni's correction was applied. The most common bacteria isolated from the used needles are coagulase-negative Staphylococcus (CNS). Conclusion: The results suggest that the needle bore size seems not to be a risk factor for contamination during IVT injection.
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    Behçet üveitli bir olguda oral metilprednisolon tedavisine bağlı inatçı hıçkırık
    (2013) Tufan, Hasan Ali; Kocabıyık, Ömer; Arıkan, Sedat; Gencer, Baran; Kara, Selçuk; Güneş, Fahri
    Kortikosteroidler, üveit tedavisinde kullanılan en önemli ilaç grupları arasında yer almaktadır. Bu ajanların topikal, sistemik veya göz çevresine olan kullanım şekilleri, inflamasyonun yeri ve şiddetine göre değişmektedir. Sistemik steroidler; iştah ve davranış değişiklikleri, flushing, sıvı retansiyonu gibi kısa süreli veya osteoporoz, miyopati, hipertansiyon, Cushing sendromu, katarakt ve glokom gibi uzun süreli yan etkilere neden olabilmektedir. Bu çalışmada Behçet üveiti nedeniyle sistemik metilprednisolon başlanan bir hastada gelişen inatçı hıçkırık tablosu sunulmuştur. (Turk J Ophthalmol 2013; 43: 471-3)
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    Blood gas analyzer utility in evaluating oxygen kinetics of the aqueous humor
    (Consel Brasil Oftalmologia, 2015) Ersan, Ismail; Arikan, Sedat; Toman, Huseyin; Kara, Selcuk; Gencer, Baran; Erbas, Mesut; Tufan, Hasan Ali
    Purpose: To measure the partial pressure of oxygen (PO2) and carbon dioxide (PCO2) and the pH of aqueous humor (AH) and arterial blood samples from rabbits using a blood gas analyzer. Methods: Twenty New Zealand rabbits were anesthetized intramuscularly with ketamine and xylazine and were then allowed to breathe room air. Using a gas blood analyzer, arterial blood and AH samples were analyzed for PO2, PCO2, and pH. Results: The mean arterial blood pressure was 87.14 +/- 15.0 mmHg. The mean blood and AH PO2 were 95.18 +/- 11.76 mmHg and 88.83 +/- 9.92 mmHg, the mean blood and AH PCO2 were 25.86 +/- 5.46 mmHg and 29.50 +/- 5.36 mmHg, and the mean blood and AH pH were 7.38 +/- 0.06 and 7.33 +/- 0.09, respectively. Conclusions: The blood gas analyzer was easily employed to evaluate the aqueous humor in rabbits. When comparing the results of studies evaluating aqueous PO2, care should be taken to determine the methods used in these studies.
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    Central serous chorioretinopathy associated with latanoprost use
    (2013) Tufan, Hasan Ali; Gencer, Baran
    A 55 years old man presented to our clinic with a 3 month history of blurred vision and micropsia in his left eye. He was previously diagnosed with unilateral glaucoma and treatment was initiated with topical latanoprost 0.005% and brimonidine tartrate/timolol maleate 0.2%/0.5% combination for the left eye in another clinic. The symptoms occurred one month after the initiation of glaucoma treatment. Fundus examination, optical coherence tomography and fluorescein angiography revealed a juxtafoveal neurosensory detachment which was coherent with central serous chorioretinopathy (CSC). After the cessation of latanoprost treatment, his clinical status improved and almost complete resolution of neurosensory detachment was observed spontaneously. The use of topical latanoprost may lead to CSC. Clinicians should consider this complication especially in patients presented with decreased visual acuity while using latonoprost.
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    Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study
    (Elsevier Science Inc, 2015) Gencer, Baran; Cosar, Murat; Tufan, Hasan Ali; Kara, Selcuk; Arikan, Sedat; Akman, Tarik; Kiraz, Hasan Ali
    Background and objectives: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. Methods: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline); 10 min after intubation (Supine 1); 10 (Prone 1), 60 (Prone 2), 120 (Prone 3) min after prone position; and just after postoperative supine position (Supine 2). Results: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p=0.009 and p=0.003, respectively). We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. Conclusions: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.
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    Comparison of glaucoma diagnosis rates in the tertiary and district clinics
    (Anatolian Journal of Clinical Investigation, 2014) Gencer, Baran; Tufan, Hasan Ali; Yilmaz, Mehmet; Taşkiran Çömez, Arzu
    Between dates 14.11.2012 - 03.09.2013 the patients over the age of 18 were included to the study who applied to the both centers. In patients whose intraocular pressure was found to be elevated and/or optic nerve was found yo be suspect glaucomatous, the glaucoma diagnosis was confirmed by doing computerized visual field and by measuring the retinal nerve fiber layer thickness. Within a year, in both centers the proportion of patients newly diagnosed with glaucoma were compared. Total number of patients who were examined at district polyclinics was 3032 (1406's men and women 1626's) and 17,173 in the university hospital (8019 males and 9154 females) and the mean age was46.7 and 49.3, respectively. While the average age was found statitically higher in faculty hospital (p <0.05), there was not found significant difference between the groups in terms of gender (p> 0.05). The number of newly diagnosed glaucoma patients was found 2 (0.065%) in district polyclinic and 47 (0.27%) in faculty hospital. The proportion of newly diagnosed patients in the university hospital were statistically higher (p <0.05). Even if in the city center, the location and pre-opening promotion of health institutions are also important. We thought that the studies comparing between previously opened, well-known district polyclinics and university hospitals with longer term follow-up would be useful in this topic. © 2014, Anatol J Clin Investig. All rights reserved.
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    Comparison of Intravitreal Triamcinolone Treatment and Intravitreal Triamcinolone with Grid Laser Treatment in Patients with Diffuse Diabetic Macular Edema
    (Galenos Publ House, 2012) Tufan, Hasan Ali; Ozdek, Sengul; Hasanreisoglu, Berati
    Objective: To compare the efficacy of intravitreal triamcinolone acetonide (IVTA) and IVTA plus macular laser grid photocoagulation therapy in diffuse diabetic macular edema (DME). Material and Methods: Sixteen patients affected by diffuse DME were retrospectively evaulated. Patients were divided into two groups: control group (IVTA injection) and laser group (IVTA plus grid laser). Main outcomes were best corrected visual aquity (BCVA) and central macular thickness (CMT) at the 3rd and 6th months of treatment. IVTA associated complications and reinjection necessity were assessed. Results: Our study comprised 18 eyes of 16 patients. The baseline BCVA and CMT were 0.93 +/- 0.45 and 530 +/- 136 mu m for the control and 1.02 +/- 0.52 and 509 +/- 177 mu m for the laser group respectively. Posttreatment BCVA at the 3rd and 6th month were 0.73 +/- 0.4 and 0.75 +/- 0.45 for control and 0.98 +/- 0.44 and 1.04 +/- 0.4 for laser group respectively (p>0.05 for all). CMT values at the 3rd and 6th months were 260 +/- 174 mu m (p=0.008) and 362 +/- 163 mu m (p=0.05) for control and 331 +/- 161 mu m (p=0.05) and 388 +/- 215 mu m (p>0.05) for laser groups. 55% of control and 66% of laser groups needed reinjection with an avarage of 7 +/- 4 months after the first injection. 22% cataract progression and 33% intraocular pressure elevation were noted. Conclusion: Macular grid laser photocoagulation after IVTA does not have beneficial effects for diffuse DME.
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    Comparison of intravitreal triamcinolone treatment and intravitreal triamcinolone with grid laser treatment in patients with diffuse diabetic macular edema
    (2012) Tufan, Hasan Ali; Özdek, Şengül; Hasanreisoğlu, Berati
    Amaç: Diffüz diabetik maküla ödeminde (DMÖ), intravitreal triamsinolon asetonid (İVTA) ve İVTA’ya ek maküler lazer grid fotokoagülasyon tedavisinin etkinliğini karşılaştırmak. Materyal-Metod: Diffüz DME mevcut 16 hasta retrospektif olarak değerlendirildi. Hastalar iki gruba ayrıldı: kontrol grubu (İVTA enjeksiyonu) ve lazer grubu (İVTA artı grid lazer). Tedavinin 3. ve 6. ayındaki en iyi düzeltilmiş görme keskinliği (DGK) ve santral maküler kalınlık (SMK) değerlendirildi. Aynı zamanda İVTA ile ilişkili komplikasyonlar ve tekrarlayan enjeksiyon gereksinimi değerlendirildi. Sonuçlar: Çalışmamızda 16 hastanın 18 gözü değerlendirilmiştir. Başlangıç DGK ve SMK sırasıyla kontrol grubunda 0.93±0.45 ve 530±136µm ve lazer grubunda 1.02±0.52 and 509±177µm idi. Tedavi sonrası DGK, 3. ve 6. ayda sırasıyla kontrol grubunda 0.73±0.4 and 0.75±0.45 ve lazer grubunda 0.98±0.44 and 1.04±0.4 idi (tüm değerler için p?0.05). 3. ve 6. ayda SMK değerleri, kontrol grubunda 260±174µm (p=0.008) ve 362±163µm (p=0.05) ve lazer grubunda 331±161µm (p=0.05) ve 388±215µm (p?0.05) idi. Kontrol grubunun %55’inde ve lazer grubunun %66’sında ilk enjeksiyondan ortalama 7±4 ay sonra ek enjeksiyon gerekmiştir. %22 katarakt gelişimi ve %33 göziçi basınç artışı izlendi. Tartışma: Diffüz diabetik maküla ödeminde İVTA enjeksiyonu sonrası uygulanan maküler grid lazer fotokoagülsayonun ek faydasının olmadığı izlenmiştir.
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    Derin Yerleşimli kornea yabancı cisminin ön segment optik koherans tomografi ile değerlendirilmesi
    (2014) Gencer, Baran; Arıkan, Sedat; Kara, Selçuk; Çömez, Arzu Taşkıran; Tufan, Hasan Ali
    Derin yerleşimli kornea yabancı cisimlere yaklaşımda ön kamaraya girişini değerlendir- mek önemlidir. Ancak biyomikroskobik muayenede bunu değerlendirmek bazen güç olabilmek- tedir. Bu olgunun biyomikroskopik muayenesinde ön kamaraya girişini net olarak değerlendi- rilemeyen derin yerleşimli bir kornea yabancı cisim olduğunu saptadık. Ön segment optik ko- herans tomografi görüntülemesinde yabacı cismin korneayı tam kat olarak geçmediği net ola- rak görüldü. Bu olgu ile derin yerleşimli kornea yabancı cisimlerin değerlendirilmesinde ön segment optik koherans görüntülerinin faydalı olabileceğini göstermeyi amaçladık.
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    Diyabetik Hastalarda Görülen Retinal Nörodejenerasyon İnsülin Direnci Evresinde mi Başlamaktadır?
    (2016) Arıkan, Sedat; Erşan, İsmail; Eroğlu, Mustafa; Yılmaz, Mehmet; Tufan, Hasan Ali; Gencer, Baran; Kara, Selçuk
    Amaç: Diyabetik hastalarda, diyabetik retinal vaskülopati bulgularının varlığından önce başladığı gösterilmiş olan retinal nörodejenerasyon ve kontrast duyarlılıktaki (KD) bozukluğun insülin direnci döneminde de oluşup oluşmadığını araştırmaktır.Gereç ve Yöntem: Retinal nörodejenerasyonunun varlığını değerlendirmek için, optik koherens tomografi kullanılarak ölçülmüş olan gangliyon hücre-iç pleksiform tabakanın (GHİPT) averaj, minimum ve sektöryel (inferior, superior, inferonazal, superonazal, inferotemporal ve superotemporal) kalınlıkları insülin direnci olan grup ile kontrol grubu arasında kıyaslandı. Bunun yanı sıra, her iki grubun KD fonksiyonel keskinlik kontrast testi (FKKT) kullanılarak fotopik ışıkta, 1,5, 3, 6, 12 ve 18 döngü/derecelik uzaysal frekanslarda ölçülmüş logaritmik değerlerine göre kıyaslandı. Bulgular: İnsülin direnci olan 25 hastanın 25 gözü (insülin dirençli grup) ve sağlıklı olan 25 bireyin 25 gözü (kontrol grup) bu çalışmaya dahil edildi. Her iki grup arasında FKKT'nin tüm uzaysal frekansları açısından istatistiksel olarak anlamlı fark yoktu. Kontrol grubu ile karşılaştırıldığında, insülin dirençli grupta GHİPT'nin ortalama averaj kalınlığı ve GHİPT'nin inferotemporal kısmının ortalama kalınlığı anlamlı olarak daha azdı [(GHİPT'nin ortalama averaj kalınlığı insülin dirençli grup ve kontrol grubunda sırasıyla 83,6±4,7 ve 86,7±3,7 µm idi, p=0,01], (GHİPT'nin inferotemporal bölgesinin ortalama kalınlığı insülin dirençli grup ve kontrol grubunda sırasıyla 83±6,0 ve 86,7±4,6 µm idi, p=0,02)].Sonuç: KD kaybı gibi görme gücünde fonksiyonel bozukluğa yol açmamış olsa bile, diyabetik hastalarda görülen retinal nörodejenerasyon insülin direnci evresinde de başlayabilmektedir.
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    Does Retinal Neurodegeneration Seen in Diabetic Patients Begin in the Insulin Resistance Stage?
    (Turkish Ophthalmological Soc, 2016) Arikan, Sedat; Ersan, Ismail; Eroglu, Mustafa; Yilmaz, Mehmet; Tufan, Hasan Ali; Gencer, Baran; Kara, Selcuk
    Objectives: To investigate whether retinal neurodegeneration and impairment in contrast sensitivity (CS), which have been demonstrated to begin in diabetic patients before the presence of signs of diabetic retinal vasculopathy, also occur in the stage of insulin resistance. Materials and Methods: The average, minimum and sectoral (inferior, superior, inferonasal, superonasal, inferotemporal and superotemporal) thicknesses of the ganglion cell-inner plexiform layer (GCIPL) measured using optical coherence tomography were compared between an insulin-resistant group and control group in order to evaluate the presence of retinal neurodegeneration. The CS of the two groups was also compared according to the logarithmic values measured at spatial frequencies of 1.5, 3, 6, 12 and 18 cycles per degree in photopic light using functional acuity contrast test (FACT). Results: Twenty-five eyes of 25 patients with insulin resistance (insulin resistant group) and 25 eyes of 25 healthy subjects (control group) were included in this study. There were no statistically significant differences between the two groups in any of the spatial frequencies in the FACT. The mean average GCIPL thickness and mean GCIPL thickness in the inferotemporal sector were significantly less in the insulin-resistant group when compared with the control group (mean average GCIPL thicknesses in the insulin-resistant and control groups were 83.6 +/- 4.7 mu m and 86.7 +/- 3.7 mu m respectively, p = 0.01; mean inferotemporal GCIPL thicknesses in the insulinresistant and control groups were 83 +/- 6.0 mu m and 86.7 +/- 4.6 mu m respectively, p = 0.02). Conclusion: Although it may not lead to functional visual impairment such as CS loss, the retinal neurodegeneration seen in diabetic patients may begin in the insulin resistance stage.
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    Effect of Prostaglandin Analogue Medications on Thickness of Corneal Epithelium and Stroma
    (2016) Arıkan, Sedat; Kara, Selçuk; Ersan, İsmail; Gencer, Baran; Tufan, Hasan Ali; Çömez, Arzu Taşkıran
    Amaç: Tek bir göz damlasında veya diğer antiglokom göz damaları ile kombine olarak kullanılan prostaglandin analoglarının (PGA) korneal epitelyum ve stroma kalınlığı üzerine etkisini değerlendirmektir. Gereç ve Yöntem: Bu retrospektif çalışmaya 59 hastanın toplam 82 gözü dahil edildi. Tıbbi kayıtlarında anterior segment optik koherens tomografi (AS-OKT) ile ölçülmüş korneal kalınlık değerleri olan glokom hastaları ve glokom şüpheli bireyler üç gruba ayrılmıştır. Grup 1, üç PGA (latanaprost %0.005, travoprost %0.004, veya bimatoprost %0.03)'dan gerek tek birisini, gerekse de bunlardan birisinin timolol ile kombinasyonunu içeren sadece bir antiglokom göz damlasını kullanmakta olan hastaları içermektedir. Grup 2, PGA'lardan herhangi birisini içermek kaydıyla, birden fazla antiglokom göz damlası kullanmakta olan glokom hastalarını içermektedir. Grup 3, herhangi bir antiglokom göz damlası kullanmayan, glokom şüpheli bireyleri içermektedir. Bulgular: Korneal epitelin ortalama kalınlığı Grup 1ve Grup 2'de belirgin olarak ince idi.[(Grup 1'de 56±3.1 µm iken, Grup 3'de 61.2±2.1 µm, p<0.001), (Grup 2'de 56.3±2.8 µm iken, Grup 3'de 61.2±2.1 µm, p<0.001)]. Bununla birlikte, korneal stromanın ortalama kalınlığı sadece Grup 2'de belirgin olarak ince idi. [(Grup 2'de 448±4 µm iken, Grup 3'de 496±40 µm, p<0.001), (Grup 2'de 448±40 µm iken, Grup 1'de 486±30 µm, p=0.001)]. Sonuç: Prostaglandin analogları tek bir göz damlası şeklinde veya diğer antiglokom göz damlaları ile kombine olarak kullanıldıklarında korneal epitelyal kalınlığı azaltabilmektedirler. Ancak, korneal stromal incelme PGA'lar diğer antiglokom göz damlaları ile kombinasyon halinde kullanıldıklarında ortaya çıkabilir.
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    Effect of Reduced Meal Frequency during Ramadan Fasting on Retinal and Choroidal Thickness
    (Taylor & Francis Inc, 2017) Ersan, Ismail; Tufan, Hasan Ali; Arikan, Sedat; Kara, Selcuk; Gencer, Baran; Hondur, Ahmet Murat
    Purpose: To evaluate the effects of Ramadan fasting on central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) in healthy individuals using enhanced depth imaging optical coherence tomography (EDI-OCT). Materials and Methods: The EDI-OCT scans of 42 healthy individuals obtained after about 12 hours of fasting on at least the twenty-first consecutive day of fasting were compared to scans of the same patients taken one month after the last day they had fasted. Results: CFT values were similar for both time periods (p > 0.05). The SFCT was significantly higher after consecutive fasting days towards the end of Ramadan, compared to the SFCT after one month of no fasting (one month after Ramadan ended) (p < 0.001). Conclusions: Ramadan fasting may lead to a significant increase in subfoveal choroidal thickness without affecting the central foveal thickness.
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    Effects of Lubricating Agents with Different Osmolalities on Tear Osmolarity and Other Tear Function Tests in Patients with Dry Eye
    (Taylor & Francis Inc, 2013) Comez, Arzu Taskiran; Tufan, Hasan Ali; Kocabiyik, Omer; Gencer, Baran
    Purpose: To evaluate the effects of different artificial tear eye drops on Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer's I test, and tear break-up time (TBUT) in patients with dry eye disease. Materials and methods: This 12-week, single-institution, single-masked, randomized, pilot study was conducted in Turkey between March and July 2012 in patients with dry eye. Patients were randomly assigned to receive Systane (R) for their right eye and Eyestil (R) for their left eye or to receive Tears Naturale II (R) for their right eye and Refresh Tears (R) for their left eyes. Outcomes were assessed at baseline and weeks 2, 4 and 12 after treatment initiation. Results: Twenty-two patients received Systane (right eye) and Eyestil (left eye) and 21 patients received Tears Naturale (right eye) and Refresh (left eye). At each visit and for each outcome, each treatment group demonstrated a significant improvement from baseline (p<0.001); however, none of these outcomes were significantly different among treatment groups at any visit. At week 12, the mean OSDI improvement was similar between the Systane/Eyestil group (-26.4 +/- 10.6) and the Tears Naturale/Refresh group (-27.6 +/- 14.8). The mean tear osmolarity decrease (mOsm/L) at week 12 was -33.8 +/- 8.3 for Eyestil, -30.3 +/- 9.2 for Refresh, 28.4 +/- 8.2 for Systane and 25.7 +/- 13.1 for Tears Naturale. The mean Schirmer's test increase at week 12 (mm/5 min) was 6.7 +/- 3.4 for Eyestil, 6.4 +/- 2.9 for Systane, 4.7 +/- 2.4 for Tears Naturale and 4.7 +/- 2.8 for Refresh. The mean TBUT increase at week 12 (s) was 7.0 +/- 3.4 for Systane, 6.1 +/- 3.3 for Eyestil, 5.8 +/- 2.3 for Tears Naturale, and 5.6 +/- 2.8 for Refresh. Conclusion: All four artificial tear formulations were effective in relieving dry eye signs and symptoms. Although the greatest improvement in two of the objective tests was achieved by Eyestil, the drug with the lowest osmolality, differences among the four artificial tear eye drops were not statistically significant.
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    Efficacy of photodynamic therapy versus intravitreal bevacizumab injection for chronic central serous chorioretinopathy
    (2014) Tufan, Hasan Ali; Ünlü, Metin; Arıkan, Sedat; Kara, Selçuk; Gencer, Baran; Özdek, Şengül
    Amaç: Kronik santral seröz koryoretinopati (SSR)tedavisinde fotodinamik tedavi (PDT) ile intravitrealbevacizumabın (IVB) etkinliğini karşılaştırmak.Yöntem : Semptomatik kronik SSR nedeniyle PDT (n=9)veya IVB (n=6) uygulanmış 15 hastanın 16 gözüne aitdosyalar retrospektif olarak incelendi. İki grup, en iyidüzeltilmiş görme keskinliği (EDGK), santral makülarkalınlık (SMK) ve subretinal sıvı (SRS) volümü açıs ındantedavi sonrası 1., 3. ve 6. aylarda karşılaştırıldı.Bulgular: T üm zaman dilimlerinde, ortanca EDGKaçısından her iki grup benzerdi (p>0.05). SMK azalmasıaçısından 1. ve 3. aylarda iki grup arasında anlamlı farkizlenirken (p<0.05), 6. ayda bu fark anlamlı değildi(p?0.05). SRS rezorpsiyonu 1. ve 3. aylarda PDT grubundaanlamlı olarak daha iyi iken 6. ayda bu fark anlamlı değildi(p?0.05).Sonuç : Hem PDT hem de IVB enjeksiyonu kronik CSCdegörsel ve anatomik düzelme sağlamaktadır. Ancak PDT,tedavi sonrası üç aylık dönemde SMKde ve SRSdedüzelme açısından IVBden üstün görünmekterdir.
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    Evaluation of choroidal thickness in patients with obstructive sleep apnea/hypopnea syndrome
    (Consel Brasil Oftalmologia, 2014) Kara, Selcuk; Ozcimen, Muammer; Bekci, Taha Tahir; Sakarya, Yasar; Gencer, Baran; Tufan, Hasan Ali; Arikan, Sedat
    Purpose: To compare the subfoveal choroidal thickness (SFCT) of patients with different severities of obstructive sleep apnea/hypopnea syndrome (OSAHS) and normal controls via enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this retrospective, case-control study, 49 eyes from 49 patients that had undergone polysomnography were included. SFCT of the horizontal and vertical line scans were manually measured for all eyes based on EDI-OCT images. Two separate analyses were performed according to different apnea/hypopnea index (AHI) groupings. Initial testing was conducted using non-OSAHS, mild OSAHS (5 <= AHI<15), moderate OSAHS (15 <= AHI<30), and severe OSAHS (AHI >= 30) patient groupings, while secondary testing used non-OSAHS, mild OSAHS (5 <= AHI<15), and moderate/severe OSAHS (AHI >= 15) patient groupings. Results: The mean SFCT was 314.5 mu m in the non-OSAHS patients (n=14), 324.5 mu m in the mild OSAHS patients (n=15), 269.3 mu m in the moderate OSAHS patients (n=11), and 264.3 mu m in the severe OSAHS patients (n=9). SFCT between the four groups revealed no significant differences despite a trend towards slight thinning in the severe group (P=0.08). When the moderate and severe groups were merged and compared with the mild OASHS and non-OSAHS groups, SFCT of the moderate/severe group was found to be significantly thinner than that of the mild group (P=0.016). A negative significant correlation was found between SFCT and AHI in OSAHS patients (r=0.368, P=0.033). Conclusions: In patients with moderate/severe OSAHS, EDI-OCT revealed a thinned SFCT. Other accompanying systemic or ocular diseases may induce perfusion and oxygenation deficiency in eyes of OSAHS patients. Further studies are required in order to determine the exact relationships between ocular pathologies and clinical grades of OSAHS.
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    Fibrin sealant as a carrier for sustained delivery of antibiotics
    (2014) Kara, Selçuk; Vural, Ahmet; Ünver, Ahmet; Gencer, Baran; Tufan, Hasan Ali; Arıkan, Sedat; Ersan, İsmail
    Amaç: Sık görülen oküler bakteri suşlarında antibiyotiklerin fibrin yapıştırıcıda etkinlik ve sürekli salınımlarının değerlendirilmesi.Yöntemler: Vankomisin, seftazidim, moksilofloksasin ve lomeflokasasin disk şeklinde fibrin yapıştırıcılara katıldı. Her bir antibiyotik diski ve ilaçsız kontrol fibrin diski in-vitro olarak Stafilokok aureus, Stafilokok epidermidis, Streptokok Pnömonia ve Psödomonas aeruginosa standart bakteri suşlarında test edildiler. 37°C'de 24 saatlik inkübasyon sonrasında diskler yeni bakteri pleytlerine transfer edildiler ve bu işlem her antibiyotik için üç kez tekrarlandı.Bulgular: 24 saat sonra tüm antibiyotik diskleri saptanabilir etkinlik gösterdiler. Streptokok Pnömonia'nın ürediği pleytte vankomisin en uzun sureli (4 gün) etkinliğe sahipti. Moksilofloksasin diskleri S. aureus ve S. pnömonia için 3 gün ve diğer suşlara 2 gün uzamış inhibisyon etkisi göstermiştir.Sonuç: Fibrin yapıştırıcılar uzun süreli ilaç dağılımı sağlamaktadırlar. Bu özellik antibiyotik yüklü fibrin pıhtıların erken postoperatif koruma ve tedavi için kullanışlı olabileceğini göstermektedir.