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Scutca AC, Jugănaru I, Nicoară DM, Brad GF, Bugi MA, Asproniu R, Cristun LI, Mărginean O. Systemic Inflammatory Response Index (SIRI) as a Predictive Marker for Adverse Outcomes in Children with New-Onset Type 1 Diabetes Mellitus. J Clin Med 2024; 13:2582. [PMID: 38731111 PMCID: PMC11084164 DOI: 10.3390/jcm13092582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/20/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: Although most cases of new-onset type 1 diabetes mellitus (T1DM) are managed without serious events, life-threatening complications do arise in a subset of patients. Our objective was to assess the correlation between elevated SIRI values and adverse events related to the onset of T1DM. (2) Methods: This retrospective study, spanning ten years, included 187 patients with new-onset T1DM divided into three groups based on SIRI tertiles. The primary outcome was the occurrence of acute complications during hospital admission, while the secondary outcome was prolonged Intensive Care Unit (ICU) admission. (3) Results: Patients with high SIRI values were more likely to experience higher disease activity, leading to longer ICU admission times and more frequent complications. Multivariate logistic regression analysis revealed that the SIRI was independently associated with acute complications (p = 0.003) and prolonged ICU length of stay (p = 0.003). Furthermore, receiver operating characteristic analysis demonstrated the SIRI's superior predictive accuracy compared to venous pH (AUC = 0.837 and AUC = 0.811, respectively) and to the individual component cell lineages of the SIRI. (4) Conclusions: These findings emphasize the potential utility of the SIRI as a prognostic marker in identifying patients at increased risk during T1DM hospital admissions.
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Affiliation(s)
- Alexandra-Cristina Scutca
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-C.S.); (D.-M.N.); (G.-F.B.); (R.A.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania;
| | - Iulius Jugănaru
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-C.S.); (D.-M.N.); (G.-F.B.); (R.A.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania;
- Research Center for Disturbances of Growth and Development in Children BELIVE, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Delia-Maria Nicoară
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-C.S.); (D.-M.N.); (G.-F.B.); (R.A.); (O.M.)
| | - Giorgiana-Flavia Brad
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-C.S.); (D.-M.N.); (G.-F.B.); (R.A.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania;
| | - Meda-Ada Bugi
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania;
- Ph.D. School Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
| | - Raluca Asproniu
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-C.S.); (D.-M.N.); (G.-F.B.); (R.A.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania;
| | - Lucian-Ioan Cristun
- Ph.D. School Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
| | - Otilia Mărginean
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania; (A.-C.S.); (D.-M.N.); (G.-F.B.); (R.A.); (O.M.)
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania;
- Research Center for Disturbances of Growth and Development in Children BELIVE, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
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Lei C, Gu J, Liu L, Zhang K, Zhang M. The correlation between peripheral complete blood count parameters and diabetic macular edema in proliferative diabetic retinopathy patients: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1190239. [PMID: 37538792 PMCID: PMC10395099 DOI: 10.3389/fendo.2023.1190239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023] Open
Abstract
Background Numerous studies have demonstrated that retinal chronic inflammation plays a critical role in the pathogenesis of diabetic macular edema (DME). However, studies about the association between peripheral complete blood count, an inexpensive and easily measurable laboratory index, and DME are limited. Research design and methods The current study was a hospital-based, cross-sectional study. The participants were inpatients with type 2 diabetes who underwent vitrectomy for PDR, and the contralateral eyes in these PDR patients meeting the criteria were included in the study. Central macular thickness (CMT) was measured automatically and the DME was characterized as CMT ≥ 300 μm. Results A total of 239 PDR participants were enrolled. The average age was 55.46 ± 10.08 years old, and the average CMT was 284.23 ± 122.09 μm. In the fully adjusted model, for CMT, the results revealed a significantly negative association between CMT and both white blood cell (WBC) count and neutrophil count (β = -11.95, 95% CI: -22.08, -1.82; p = 0.0218; β = -14.96, 95% CI: -28.02, -1.90; p = 0.0259, respectively); for DME, the results showed an inverse association between DME and WBC count, monocyte count, and eosinophil count (OR = 0.75, 95% CI: 0.59, 0.95; p = 0.0153; OR = 0.07, 95% CI: 0.00, 0.92; p = 0.0431; OR = 0.03, 95% CI: 0.00, 0.88; p = 0.0420, respectively). Conclusions In conclusion, our results suggest that WBC and its subtypes in circulation may play an important role in the pathogenesis of DME in PDR patients.
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Affiliation(s)
- Chunyan Lei
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Jinyue Gu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Lili Liu
- Department of Ophthalmology, Zigong First People’s Hospital, Zigong, China
| | - Keren Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
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Wang FY, Kang EYC, Liu CH, Ng CY, Shao SC, Lai ECC, Wu WC, Huang YY, Chen KJ, Lai CC, Hwang YS. Diabetic Patients With Rosacea Increase the Risks of Diabetic Macular Edema, Dry Eye Disease, Glaucoma, and Cataract. Asia Pac J Ophthalmol (Phila) 2022; 11:505-513. [PMID: 36417674 DOI: 10.1097/apo.0000000000000571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Inflammation plays a role in diabetic eye diseases, but the association between rosacea and eye diseases in patients with diabetes remains unknown. DESIGN This retrospective cohort study used claims data from the National Health Insurance Research Database in Taiwan to investigate the association between rosacea and eye diseases in patients with diabetes. MATERIALS AND METHODS Taiwanese patients diagnosed as having diabetes mellitus between January 1, 1997, and December 31, 2013, and using any hypoglycemic agents were included and divided into rosacea and nonrosacea groups. After applying 1:20 sex and age matching and exclusion criteria, 1:4 propensity score matching (PSM) was conducted to balance the covariate distribution between the groups. The risk of time-to-event outcome between rosacea and nonrosacea groups in the PSM cohort was compared using the Fine and Gray subdistribution hazard model. RESULTS A total of 4096 patients with rosacea and 16,384 patients without rosacea were included in the analysis. During a mean follow-up period of 5 years, diabetic patients with rosacea had significantly higher risks of diabetic macular edema [subdistribution hazard ratio (SHR): 1.31, 95% confidence interval (CI): 1.05-1.63], glaucoma with medical treatment (SHR: 1.11, 95% CI: 1.01-1.21), dry eye disease (SHR: 1.55, 95% CI: 1.38-1.75), and cataract surgery (SHR: 1.13, 95% CI: 1.02-1.25) compared with diabetic patients without rosacea. A cumulative incidence analysis performed up to 14 years after the index date revealed that the risks of developing ocular diseases consistently increased over time. No significant differences in diabetic retinopathy, age-related macular degeneration, retinal vascular occlusion, ischemic optic neuropathy, optic neuritis, uveitis, or retinal detachment were identified according to rosacea diagnosis. However, we observed significant associations between rosacea and psoriasis, irritable bowel syndrome, anxiety, and major depressive disorder among patients with diabetes. CONCLUSIONS Rosacea is associated with diabetic macular edema, glaucoma, dry eye disease, and cataract development in diabetic patients, as well as increased risks of psoriasis, irritable bowel syndrome, anxiety, and depression in diabetic patients.
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Affiliation(s)
- Fang-Ying Wang
- Department of Biomedical Engineering, College of Medicine, College of Engineering, National Taiwan University, Taipei, Taiwan
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Eugene Yu-Chuan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Hao Liu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chau Yee Ng
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Chieh Shao
- Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chi Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Yi-You Huang
- Department of Biomedical Engineering, College of Medicine, College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Kuan-Jen Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yih-Shiou Hwang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Xiamen, China
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung, Taiwan
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Zuo W, Chen T, Song J, Ai M. Assessment of Systemic Immune-inflammation Index Levels in Patients with Retinal Vein Occlusion. Ocul Immunol Inflamm 2022; 31:491-495. [PMID: 35201964 DOI: 10.1080/09273948.2022.2032199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the predictive value of inflammatory markers calculated from complete blood counts in patients with retinal vein occlusion (RVO). METHODS This was a retrospective cross-sectional study with a total of 56 RVO patients and 56 age- and gender-matched controls involved. All subjects went through a routine ocular examination, and the peripheral venous blood samples were collected to analyze the differences in inflammatory markers between groups. RESULTS The systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) values were significantly higher in RVO patients than those in the controls (p=0.002, p=0.004, respectively). According to the receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) of SII was 0.666. The AUC of NLR was 0.657. CONCLUSION As a novel inflammatory indicator, SII is a more promising indicator than NLR and PLR in the prediction of RVO development.
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Affiliation(s)
- Wen Zuo
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ting Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jiayi Song
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ming Ai
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Salah NY, Radwan N, Atif HM. Leukocytic dysregulation in children with type 1 diabetes: relation to diabetic vascular complications. Diabetol Int 2022; 13:538-547. [PMID: 35693992 PMCID: PMC9174407 DOI: 10.1007/s13340-021-00568-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/26/2021] [Indexed: 01/09/2023]
Abstract
Background Growing evidences highlight the role of the innate immune response in the pathogenesis of type 1 diabetes (T1D) vascular complications. Neutrophil lymphocytic ratio (NLR) and platelet lymphocytic ratio (PLR) are inexpensive but novel markers of chronic inflammation might have prognostic value in children with T1D. Aim To study NLR and PLR levels in children with T1D in comparison to matched controls and correlate them with fraction-C of glycosylated hemoglobin (HbA1C) and micro-vascular complications. Methodology Hundred children with T1D were compared to 100 matched healthy controls. History included diabetes duration, insulin dose and frequency of hypoglycemic attacks. Fundus examination and the simple rapid neuropathy disability score were done. HbA1C, fasting lipids, urinary albumin excretion and complete blood count were measured with assessment of NLR and PLR. Results NLR was significantly higher (p = 0.008) and PLR was significantly lower (p = 0.007) in children with T1D than controls. NLR was positively correlated while PLR was negatively correlated with HbA1C, diabetes duration, fasting cholesterol, triglycerides and LDL. NLR was significantly higher (p < 0.001) and PLR was significantly lower (p = 0.005) in children with microvascular complications than those without. Moreover, multivariate logistic regression revealed that microvascular complications were independently associated with NLR (p = 0.013) and PLR (p = 0.004). Conclusion Children with T1D had significantly higher NLR and lower PLR compared to controls. These changes were more evident in those with diabetic microvascular complications than those without. Furthermore, NLR was positively correlated and PLR was negatively correlated to HbA1C, diabetes duration and hyperlipidemia. Hence, NLR and PLR can be a potential indicator for the risk of development of diabetic microvascular complications in children with T1D.
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Affiliation(s)
- Nouran Yousef Salah
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Pediatric and Adolescents Diabetes Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nesrine Radwan
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Allergy and Immunology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Mohamed Atif
- grid.7269.a0000 0004 0621 1570Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Elbeyli A, Kurtul BE, Ozcan SC, Ozarslan Ozcan D. The diagnostic value of systemic immune-inflammation index in diabetic macular oedema. Clin Exp Optom 2021; 105:831-835. [PMID: 34763621 DOI: 10.1080/08164622.2021.1994337] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
CLINICAL RELEVANCE Diabetic macular oedema (DME) is a significant cause of visual impairment and inflammation plays an important role in its pathophysiology. BACKGROUND This study evaluates the diagnostic value of systemic immune-inflammation index (SII) in the occurrence of DME in patients with non-proliferative diabetic retinopathy. METHODS In this prospective study, the SII was applied to 150 consecutive patients with non-proliferative diabetic retinopathy. The relationship between the SII and the occurrence of DME was examined. Patients with DME were also divided into two subgroups according to the presence of accompanying sub-retinal fluid. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). The risk factors for DME were evaluated using multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve analysis of SII for predicting DME was performed. RESULTS Patients with DME had significantly higher levels of SII than those without DME (599.7 ± 279.2 and 464. 9 ± 172.2, respectively, p < 0.001). However, The SII values were similar between sub-retinal fluid subgroups. Multivariate regression analysis indicated that SII, together with duration of diabetes, was an independent factor for DME occurrence [Odds ratio (OR) = 1.005, 95% confidence interval = 1.001-1.009, p = 0.04, and OR = 1.146, 95% CI = 1.049-1.252, p = 0.003, respectively]. ROC curve analysis revealed that the best cut-off value of SII was 399 (area under the curve: 0.633; sensitivity: 70%; specificity: 60%). CONCLUSION An elevated SII value is strongly associated with the development of DME. The SII may be a diagnostic biomarker for identifying DME to improve the risk stratification and management of non-proliferative patients with diabetic retinopathy.
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Affiliation(s)
- Ahmet Elbeyli
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Bengi Ece Kurtul
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Sait Coskun Ozcan
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
| | - Deniz Ozarslan Ozcan
- Department of Ophthalmology, Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey
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Yalinbas Yeter D, Eroglu S, Sariakcali B, Bozali E, Vural Ozec A, Erdogan H. The Usefulness of Monocyte-to-High Density Lipoprotein and Neutrophil-to-Lymphocyte Ratio in Diabetic Macular Edema Prediction and Early anti-VEGF Treatment Response. Ocul Immunol Inflamm 2021; 30:901-906. [PMID: 33596398 DOI: 10.1080/09273948.2020.1849739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To determine the association of monocyte-to-high-density lipoprotein ratio (MHR) and neutrophil-to-lymphocyte ratio (NLR) with diabetic macular edema (DME) and early anti-VEGF treatment response.Material methods: This was a retrospective and cross-sectional study conducted with 143 patients with diabetes mellitus (53 diabetic retinopathy with DME, 38 diabetic retinopathy without DME, and 52 without diabetic retinopathy).Results: 13.9 was the best cutoff value to predict DME for MHR, and 2 was for NLR (59% and 75% sensitivity and 81% and 59% specificity, respectively). Logistic regression analysis showed that NLR≥2 and MHR≥13.9 were significantly associated with DME prediction. However, neither NLR≥2 nor MHR≥13.9 was associated with central retinal thickness(CRT) or best corrected visual acuity(BCVA) outcomes after anti-VEGF treatment. On the other hand, increased NLR was associated with inferior CRT outcomes.Conclusion: MHR and NLR were simple and cost-effective biomarkers to predict DME. Moreover, higher NLR may contribute to poor CRT outcomes.
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Affiliation(s)
- Duygu Yalinbas Yeter
- Faculty of Medicine, Department of Ophthalmology, Cumhuriyet University, Sivas, Turkey
| | - Serap Eroglu
- Faculty of Medicine, Department of Ophthalmology, Cumhuriyet University, Sivas, Turkey
| | - Baris Sariakcali
- Faculty of Medicine, Department of Endocrinology and Metabolism, Cumhuriyet University, Sivas, Turkey
| | - Erman Bozali
- Faculty of Medicine, Department of Ophthalmology, Cumhuriyet University, Sivas, Turkey
| | - Ayse Vural Ozec
- Faculty of Medicine, Department of Ophthalmology, Cumhuriyet University, Sivas, Turkey
| | - Haydar Erdogan
- Faculty of Medicine, Department of Ophthalmology, Cumhuriyet University, Sivas, Turkey
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