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Gunay BO, Erdogan G, Akalin I, Kalkisim A, Esenulku CM, Gunay M. Is there a relationship between the first-day results of anti-VEGF therapy for macular edema due to vascular diseases and longterm outcomes? Arq Bras Oftalmol 2023; 87:e20220228. [PMID: 37878875 DOI: 10.5935/0004-2749.2022-0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/15/2022] [Indexed: 10/27/2023] Open
Abstract
PURPOSE To evaluate early changes after the first antivascular endothelial growth factor injection for macular edema secondary to diabetic retinopathy and retinal vein occlusion and the relationship between longterm outcomes. METHODS The study enrolled patients who received anti-vascular endothelial growth factor injections for treatment-naive macular edema due to retinal vein occlusion and diabetic retinopathy. The central macular thickness was measured at baseline, post-injection day 1, week 2, and month 1, and at the last visit using spectral-domain optical coherence tomography. A good response was defined as a central macular thickness reduction of ≥10% on post-injection day 1. Patients were reassessed at the last visit with regard to treatment response on post-injection day 1 based on the favorable anatomic outcome defined as a central macular thickness <350 µm. RESULTS In total, 26 (44.8%) patients had macular edema-retinal vein occlusion and 32 (55.2%) had macular edema-diabetic retinopathy. The mean follow-up time was 24.0 (SD 8.5) months. A statistically significant decrease in the central macular thickness was observed in both patients with macular edema-retinal vein occlusion and macular edema-diabetic retinopathy after antivascular endothelial growth factor injection therapy (p<0.001 for both). All patients with macular edema-retinal vein occlusion were good responders at post-injection day 1. All nongood responders at post-injection day 1 belong to the macular edema-diabetic retinopathy group (n=16.50%). The rate of hyperreflective spots was higher in nongood responders than in good responders of the macular edema-diabetic retinopathy group (p=0.03). Of 42 (2.4%) total good responders, one had a central macular thickness >350 µm, whereas 5 (31.2%) of 16 total nongood responders had a central macular thickness >350 µm at the last visit (p=0.003). CONCLUSION The longterm anatomical outcomes of macular edema secondary to retinal vein occlusion and diabetic retinopathy may be predicted by treatment response 1 day after antivascular endothelial growth factor injection.
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Affiliation(s)
- Betul Onal Gunay
- Department of Ophthalmology, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Gurkan Erdogan
- Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University Istanbul, Turkey
| | - Irfan Akalin
- Department of Ophthalmology, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Ahmet Kalkisim
- Department of Ophthalmology, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Cenap Mahmut Esenulku
- Department of Ophthalmology, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Murat Gunay
- Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
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Akalin I, Kalkisim A, Gunay BO, Esenulku CM. Retinal Findings in Hospitalized COVID-19 Patients, Is Routine Ophthalmological Examination Required after Discharge? Prospective Case-Control Study. Klin Monbl Augenheilkd 2023; 240:169-179. [PMID: 36634686 DOI: 10.1055/a-1964-7596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To investigate retinal findings by comparing patients hospitalized for COVID-19 with the control group. METHODS In this prospective study, 188 eyes of 94 recovered COVID-19 patients and 108 eyes of 54 healthy participants as a control group were evaluated. Patients were divided into three groups, those with mild, moderate, and severe COVID-19. Refractometry, tonometry, optical biometry, optical coherence tomography (OCT) measurements, and complete ophthalmological examinations were performed on healthy volunteers and COVID-19 patients on average 2 weeks after discharge. Pulse O2 and vital parameters were also assessed. Primary outcomes were evaluated, such as retinal findings, and secondary outcomes as retinal thickness, choroidal thickness (CT), retinal nerve fiber layer thickness, and ganglion cell layer thickness. RESULTS There was no difference between the groups in terms of demographic data, ocular biometry, and intraocular pressure (p > 0.05). Pulse O2 was lower in the study group (p < 0.001). Retinal findings were detected in 68 (36.1%) of 188 eyes in the study group and 28 (25.9%) of 108 eyes in the control group (p = 0.07). The two most common retinal findings were hypertensive retinopathy and retinal pigment epithelium alterations and/or drusen in both groups. In OCT measurements, significant thinning was observed in nasal macular thickness and superior 2 mm CT in the study group compared to the control group (p < 0.05). In patients divided into subgroups according to disease severity, no significant difference was found between the groups in any OCT parameter (p > 0.05). CONCLUSION It has been observed that COVID-19 infection does not cause a specific and sensitive finding in the ocular tissues, especially the retina, and does not produce a reproducible measurement result. Recommending routine eye exam after COVID-19 does not seem cost-effective.
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Affiliation(s)
- Irfan Akalin
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Ahmet Kalkisim
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Betul Onal Gunay
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Cenap Mahmut Esenulku
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
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Gunay BO, Akalin I, Kalkisim A, Esenulku CM, Turkoglu EB. Effect of FFP2/N95 facemask wear on retinal and choroidal thickness profile in healthy subjects. Int J Ophthalmol 2022; 15:1821-1828. [PMID: 36404981 PMCID: PMC9631179 DOI: 10.18240/ijo.2022.11.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/08/2022] [Indexed: 12/12/2022] Open
Abstract
AIM To investigate the influence of non-oil 95 (N95)/filtering facepiece 2 (FFP2) facemask wear on retinal thickness, choroidal thickness (CT), retinal nerve fiber layer thickness (RNFLT), and ganglion cell layer thickness (GCLT) in healthy subjects. METHODS In this prospective study, 53 healthy participants who used FFP2/N95 facemask were enrolled. Participants underwent optical coherence tomography imaging before and at 1 and 4h following FFP2/N95 facemask wear. The last imaging session was performed 1h after FFP2/N95 removal. Retinal thickness, CT, RNFLT, and GCLT were assessed at each session. Vital parameters were also assessed. RESULTS The pulse rate of the subjects significantly decreased at 1 and 4h compared to baseline values (P<0.05). No significant changes in retinal thickness, RNFLT, and GCLT were observed in the study. CT profile showed a significant increase at all measured locations except 1-mm temporal, 1-mm inferior and 2-mm inferior points following FFP2/N95 wear which turned to baseline values after FFP2/N95 removal. Pulse rate and CT changes at 4h were significantly correlated (P<0.05). CONCLUSION Parasympathetic activation during FFP2/N95 facemask wear might have a role on elevated CT measurements in healthy individuals by virtue of increased choroidal blood flow.
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Affiliation(s)
- Betul Onal Gunay
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon 61040, Turkey
| | - Irfan Akalin
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon 61040, Turkey
| | - Ahmet Kalkisim
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon 61040, Turkey
| | - Cenap Mahmut Esenulku
- Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon 61040, Turkey
| | - Elif Betul Turkoglu
- Department of Ophthalmology, Akdeniz University Hospital, Antalya 07070, Turkey
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Akyol N, Kalkisim A, Turk A, Kola M, Imamoglu HI. Evaluation of the effects on choroidal thickness of bimatoprost 0.03% versus a brinzolamide 1.0%/timolol maleate 0.5% fixed combination. Cutan Ocul Toxicol 2017; 36:397-403. [PMID: 28376651 DOI: 10.1080/15569527.2017.1315128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the effects of two different medical treatment options on choroidal thickness (CT) in cases of open-angle glaucoma (OAG). METHODS Sixty-seven eyes newly diagnosed with OAG and 52 healthy eyes constituting the control group were included in the study. Glaucomatous eyes were randomly divided into two subgroups; Group I was started on bimatoprost 0.03% and Group II on a brinzolamide 1.0%/timolol maleate 0.5% fixed combination (BTFC). Intraocular pressure (IOP), ocular pulse amplitude (OPA) and subfoveal CT measurements were performed in all eyes in the study before treatment and on weeks 2, 4 and 8 after treatment. RESULTS Mean initial IOP values in groups I and II and the control group were 25.5 ± 4.7, 25.1 ± 5.2 and 16.1 ± 2.9 mmHg, mean OPA values were 3.7 ± 1, 3.6 ± 1.4 and 2.4 ± 0.6 mmHg and mean CT values were 269.4 ± 83, 264.5 ± 84.4 and 320.1 ± 56.6 μm, respectively. Eight weeks after treatment, mean IOP values in Groups I and II and the control group were 18.3 ± 2.6, 18.1 ± 3.4 and 15.7 ± 2.9 mmHg, mean OPA values were 2.9 ± 1.2, 2.8 ± 1.5 and 2.3 ± 0.8 mmHg and mean CT values were 290.2 ± 87.3, 271.8 ± 82.5 and 319.3 ± 56.8 μm, respectively. No significant difference was determined in terms of the decrease in IOP and OPA obtained after treatment in Group I and Group II. However, a significant difference was observed between the two groups in terms of choroidal thickening after treatment. CONCLUSION The use of topical ocular hypotensive medication in eyes with OAG results in an increase in CT. This increase is relatively greater with bimatoprost 0.03% therapy compared to BTFC.
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Affiliation(s)
- Nurettin Akyol
- a Faculty of Medicine , Department of Ophthalmology, Karadeniz Technical University , Trabzon , Turkey
| | - Ahmet Kalkisim
- a Faculty of Medicine , Department of Ophthalmology, Karadeniz Technical University , Trabzon , Turkey
| | - Adem Turk
- a Faculty of Medicine , Department of Ophthalmology, Karadeniz Technical University , Trabzon , Turkey
| | - Mehmet Kola
- a Faculty of Medicine , Department of Ophthalmology, Karadeniz Technical University , Trabzon , Turkey
| | - Halil Ibrahim Imamoglu
- a Faculty of Medicine , Department of Ophthalmology, Karadeniz Technical University , Trabzon , Turkey
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Kola M, Kalkisim A, Karkucak M, Turk A, Capkin E, Can I, Serdar OF, Mollamehmetoglu S, Ayar A. Regarding Comments by Yolcu et al. on "Evaluation of Choroidal Thickness in Ankylosing Spondylitis Using Optical Coherence Tomography". Ocul Immunol Inflamm 2015; 23:465-6. [PMID: 25760919 DOI: 10.3109/09273948.2014.999379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mehmet Kola
- a Department of Ophthalmology , Karadeniz Technical University, Faculty of Medicine , Trabzon , Turkey
| | - Ahmet Kalkisim
- a Department of Ophthalmology , Karadeniz Technical University, Faculty of Medicine , Trabzon , Turkey
| | - Murat Karkucak
- b Department of Physical Medicine and Rehabilitation , Karadeniz Technical University, Faculty of Medicine, Division of Rheumatology , Trabzon , Turkey , and
| | - Adem Turk
- a Department of Ophthalmology , Karadeniz Technical University, Faculty of Medicine , Trabzon , Turkey
| | - Erhan Capkin
- b Department of Physical Medicine and Rehabilitation , Karadeniz Technical University, Faculty of Medicine, Division of Rheumatology , Trabzon , Turkey , and
| | - Ipek Can
- b Department of Physical Medicine and Rehabilitation , Karadeniz Technical University, Faculty of Medicine, Division of Rheumatology , Trabzon , Turkey , and
| | - Omer Faruk Serdar
- b Department of Physical Medicine and Rehabilitation , Karadeniz Technical University, Faculty of Medicine, Division of Rheumatology , Trabzon , Turkey , and
| | - Suleyman Mollamehmetoglu
- a Department of Ophthalmology , Karadeniz Technical University, Faculty of Medicine , Trabzon , Turkey
| | - Ahmet Ayar
- c Department of Physiology , Karadeniz Technical University, Faculty of Medicine , Trabzon , Turkey
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Kola M, Kalkisim A, Karkucak M, Turk A, Capkin E, Can I, Serdar OF, Mollamehmetoglu S, Ayar A. Evaluation of choroidal thickness in ankylosing spondylitis using optical coherence tomography. Ocul Immunol Inflamm 2014; 22:434-8. [PMID: 24988331 DOI: 10.3109/09273948.2014.928734] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Abstract Purpose: To investigate posterior segment (PS) findings in the eye in patients with ankylosing spondylitis (AS). METHODS Eighty-four patients with AS and 63 healthy controls were enrolled. PS evaluations were performed using optical coherence tomography (OCT). Foveal thickness, peripapillary retinal nerve fiber layer thickness, macular volume, ganglion cell complex, and choroidal thickness (CT) values were compared between the groups. RESULTS Mean CT was higher in patients with AS (326.5 ± 71.5 µm) than in the healthy controls (286.2 ± 59.5 µm) (p = 0.001). There was no significant difference between patients with AS and the healthy control group in terms of other OCT parameters. There was also no significant correlation between CT, AS activity index, and disease duration. CONCLUSIONS This is the first study to evaluate effects of AS on CT. CT was high in patients with AS compared to healthy controls.
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Affiliation(s)
- Mehmet Kola
- Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University , Trabzon , Turkey
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