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Öğe Agreement of Anterior Segment Parameters Between Schiempflug Topography and Swept-Source Optic Coherence Based Optic Biometry in Keratoconus and Healthy Subjects(Lippincott Williams & Wilkins, 2021) Guclu, Hande; Akaray, Irfan; Kaya, Sultan; Sattarpanah, Samira; Cinar, Abdulkadir Can; Sakallioglu, Kursad; Korkmaz, SelcukPurpose: The aim of this study is to compare anterior segment parameters, including corneal thickness (CCT), keratometry and anterior chamber depth (ACD), and white to white corneal diameter (WTW), obtained by Pentacam Schiempflug imaging and intraocular lens (IOL) Master 700 swept-source optic coherence tomography biometry in keratoconus patients and healthy subjects. Methods: This prospective cross-sectional instrument agreement analysis includes 88 eyes of 50 keratoconus patients and 87 eyes of 50 healthy subjects. Biometry was performed using IOL Master 700, and topography was performed using Pentacam. The keratometry values (Kf, Ks, Km, and Kmax), ACD, WTW, CCT, axial length (AL), anterior chamber angle (ACA), and lens thickness (LT) were evaluated. Levels of agreement between devices were evaluated by Bland-Altman plots with 95% limits of agreement. Results: Intraocular lens Master 700 showed higher WTW, ACD, pupil diameter, and CCT values than Pentacam in both the keratoconus and control groups. However, there were no statistically significant differences in flat keratometry (Kf) and steep keratometry (Ks) values between the groups. Conclusion: Pentacam and IOL Master 700 may be used interchangeably in normal eyes and keratoconus eyes for the measurement of keratometry values and axis; however, these two devices should not be considered interchangeable for WTW, ACD, pupil diameter, and CCT measurements in both keratoconus patients and healthy subjects.Öğe Association of Changes in Thickness of Limbal Epithelial and Stroma with Corneal Scars Detected by High-Resolution Anterior Segment Optic Coherence Tomography(Georg Thieme Verlag Kg, 2023) Guclu, Hande; Sattarpanah, Samira; Gurlu, VuslatAim To investigate the corneal central and limbal thickness in cornea scar patients using high-resolution anterior segment optical coherence tomography (AS-OCT) and to determine the changes in the limbal region due to the corneal scar. Also, to evaluate tear film parameters in scar patients. Methods Thirty patients with central corneal scar and 30 control subjects. The control subjects were healthy individuals who came to our clinic for routine ophthalmological examination. They were enrolled in this matched case-control study. Central epithelial thickness (ET), stromal thickness (ST), limbal epithelial thickness (LET), and limbal stromal thickness (LST) were analyzed using high-resolution AS-OCT. For evaluation of the ocular surface, the following techniques were used: tear break-up time (BUT) employing standard sterile strips of fluorescein sodium, Schirmer test- I (SCH), and the Ocular Surface Disease Index (OSDI) Questionnaire. Results The mean central ET of the patient group was 51.5 +/- 12.4 mu m, while the mean central ET of the control group was 59.2 +/- 9.0 mu m. There was a statistically significant difference between patients and controls (p = 0.008). The mean LST of the patients was 747.9 +/- 115.7 mu m, and the mean LST of the controls was 726.3 +/- 79.7 mu m. There was a statistically significant difference between patients and controls according to BUT (p = 0.009) and SCH (p = 0.04). However, there was no significant difference between OSDI results of patients and controls (p = 0.08). Conclusion Corneal monitoring with high-resolution AS-OCT is a simple, noninvasive, useful technique for corneal scar patients. Cornea scars cause decreased ET. This result could be associated with lower tear film parameters in scar patients. The scar length is associated with higher intraocular pressure (IOP) values. Decreased LET and increased LST were detected in scar patients.Öğe Central Retinal Artery Occlusion in Takayasu's Arteritis as the First Presentation of the Disease(Hindawi Ltd, 2016) Guclu, Hande; Gurlu, Vuslat Pelitli; Ozal, Sadjk Altan; Guclu, OrkutTakayasu's arteritis (TA) is a chronic inflammatory granulomatous vasculitis which affects large and medium arterial vessels. The disease involves especially subclavian arteries and aortic branches but it can consist of any arteries. The major pathology is granulomatous panarteritis with intima proliferation and defects of the elastic lamina of the vessels. We present a case of central retinal artery occlusion in TA as the first presentation of the disease. To the best of our knowledge, the present case is the first case that demonstrates central retinal artery occlusion as an initial manifestation in TA. A 48-year-old woman was admitted to our clinic with the complaint of sudden and painless vision loss in her right eye for one day. Although retinal artery involvement is a very rare presentation in TA, it is important to recall TA particularly in young patients with retinal artery occlusion.Öğe Choroidal neovascularization due to the use of clomiphene citrate(Taylor & Francis Ltd, 2023) Cinar, Abdulkadir Can; Cinar, Ayca Kupeli; Guclu, Hande; Gurlu, Vuslat[Abstract Not Available]Öğe Coexistence of optic pit and coloboma of iris, lens, and choroid: a case report(Consel Brasil Oftalmologia, 2016) Ozelce, Ramazan; Gurlu, Vuslat; Guclu, Hande; Ozal, Sadik AltanA 42-year-old woman was admitted to our clinic with a complaint of glare in both eyes. Biomicroscopic examination of both the eyes revealed iris and lens colobomas in the inferior quadrant. Fundus examination of the right eye revealed an oval and gray inferotemporal optic pit and two choroid colobomas in the inferior quadrant. In the left eye, two choroid colobomas were detected that were inferior to the optic nerve head. Furthermore, a 21-year-old man presented to our clinic for a routine ophthalmologic examination. Bilateral biomicroscopic examination was normal. Fundus examination of the left eye revealed an oval and gray inferotemporal optic pit and a choroid coloboma that was inferior to the optic nerve head. Here we describe optic pits co-occurring with iris, lens, and choroidal colobomas. On the basis of these cases, a defect in the closure of the embryonic fissure is the most plausible etiology of the optic pit.Öğe Comparison of corneal endothelial cell analysis in patients with uveitis and healthy subjects(Springer, 2019) Guclu, Hande; Gurlu, VuslatPurposeThe aim of this study is to investigate the effect of uveitis in corneal endothelial cell number and morphology by non-contact specular microscopy.MethodsOur cross-sectional study was performed on 56 eyes of uveitis patients and 53 eyes of healthy subjects. Non-contact specular microscopy was performed to all subjects. The cell density (CD), coefficient of variation, cell minimum area (Min) and cell maximum area (Max), the average of cell size (AVG), percent of hexagonality (HEX%), central corneal thickness (CCT), intraocular pressure (IOP) during uveitis and during remission were measured and compared between two groups.ResultsThe mean endothelial cell analysis of the patients was 2540619 cells/mm(2), and the mean endothelial cell analysis of the control group was 2834 +/- 413 cells/mm(2). The difference was statistically significant between the groups (p=0.01). There was a statistically significant difference between two groups in terms of Max, Min, AVG, and HEX values. However, there was no difference in terms of CCT between two groups. There was a significant negative correlation between CD and IOP during uveitis attack. There was a significant negative correlation between the anterior chamber cell value and CD.Conclusion Our results suggested that uveitis affected endothelial cell density, cell size and shape but not the corneal thickness without being influenced by the duration and number of attacks. Increased IOP during uveitis and anterior chamber cell value had an important role on CD in patients with uveitis.Öğe Comparison of long-term results of trabeculectomy to treat pseudoexfoliative glaucoma and primary open angle glaucoma(Ijo Press, 2018) Gurlu, Vuslat Pelitli; Guclu, Hande; Ozal, Altan; Benian, Omer; Alimgil, LeventAIM: To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma (PEG) and primary open angle glaucoma (POAG) in terms of surgical success. METHODS: The success of the trabeculectomy was evaluated by three criteria. Criterion A: intraocular pressure (IOP) <= 21 mm Hg and decrease in IOP >= 20%; Criterion B: IOP <= 18 mm Hg and decrease in IOP >= 30%; Criterion C: IOP <= 15 mm Hg and decrease in IOP >= 50%. Patients that met these criteria without medical treatment were considered to be completely successful, while those that met these criteria with medical treatment were considered partially successful. Significance levels of differences between the POAG and PEG groups in the Kaplan-Meier survival curves were calculated with the log-rank test. RESULTS: Sixty-four eyes from 64 patients with PEG and 51 eyes from 51 patients with POAG were evaluated. No significant differences were detected between the PEG and POAG groups according to full or partial success relative to each of the three criteria (A: P=0.73, 0.32; B: P=0.73, 0.31; C: P=0.90, 0.27). CONCLUSION: There is no difference in the long-term success of trabeculectomy between PEG and POAG patients whose clinical characteristics are otherwise the same.Öğe Comparison of topical nepafenac 0.1% with intravitreal dexamethasone implant for the treatment of Irvine-Gass syndrome(Ijo Press, 2019) Guclu, Hande; Gurlu, Vuslat PelitliAIM: To compare safety and efficacy of intravitreal dexamethasone (IVD) implant with topical nepafenac (TN) 0.1% in previously untreated Irvine-Gass syndrome (IGS) in clinical practice. METHODS: This was a retrospective study of 62 eyes with IGS after phacoemulsification with posterior chamber intraocular lens (IOL) implantation. None of the patients used treatment before IVD or TN. Best-corrected visual acuity (BCVA) with Early Treatment Diabetic Retinopathy Study chart (ETDRS), slit-lamp, intraocular pressure (IOP) measurement, fundus examination, spectral-domain optical coherence tomography (OCT) and fundus florescein angiography were performed to all subjects at baseline, 1, 3 and 6mo. RESULTS: The mean BCVA of the IVD group was 49.3 +/- 6.8, and the mean BCVA of the TN group was 32.9 +/- 7.3 ETDRS letters in post-treatment month 6. The mean central macular thickness (CRT) of IVD group was 266.6 +/- 53.5 mu m and the mean CRT of TN group was 364.9 +/- 56.3 mu m in post-treatment month 6. Baseline BCVA has correlation with final BCVA in TN group however there was no correlation between baseline BCVA and final BCVA in IVD group. CONCLUSION: IVD is found to be better than TN in controlling pseudophakic macular edema and improving visual acuity. IVD group also has significantly lower CRT however IOP is not significantly different between two groups in post-treatment month 6.Öğe Corneal epithelium and limbal region alterations due to glaucoma medications evaluated by anterior segment optic coherence tomography: a case-control study(Taylor & Francis Ltd, 2021) Guclu, Hande; Cinar, Ayca Kupeli; Cinar, Abdulkadir Can; Akaray, Irfan; Aykutlu, Merve Sambel; Sakallioglu, Ahmet Kursad; Gurlu, VuslatAim To investigate the corneal epithelial and limbal epithelial alterations in patients under topical glaucoma treatment using anterior segment-OCT (AS-OCT) and to determine the changes of the limbal region due to the preservatives and glaucoma drugs, that can progress to limbal stem cell deficiency (LSCD). Limbal thickness was measured by AS-OCT to evaluate limbal cell deficiency. Methods Forty-seven patients using topical medication for glaucoma, and 48 control subjects were enrolled in this matched case-control study. The patients were divided into four groups according to the treatment regimens. Group 1: One-drug regimen, Group 2: Two-drug regimen, Group 3: Three-drug regimen, Group 4: Four-drug regimen For the ocular surface evaluation; tear break-up time with standard fluorescein sodium sterile strip application, Schirmer test-I, Ocular Surface Disease Index Questionnaire, and AS-OCT were performed. Results A total of 95 subjects were included: 47 eyes of 47 patients with glaucoma medication and 48 eyes of 48 healthy subjects. There was a statistically significant difference between patients and controls according to BUT, SCH, and OSDI (p < 0.001). The mean central corneal epithelium thickness was 48.5 +/- 5.3 in patients and 54.5 +/- 5.9 in controls (p < 0.001). The mean central total corneal thickness was 529.2 +/- 41.2 in patients and 536 +/- 35.3 in controls (p = 0.335). The mean limbal epithelium thickness was 64.1 +/- 9.1 in patients and 76 +/- 11.5 in controls (p < 0.001). Conclusion Using at least one glaucoma drug caused limbal area injury, changed ocular surface measurements, and significantly reduced the limbal epithelial thickness where the stem cells reside. The limbal epithelial thickness measurement by AS-OCT seems to be an innovative, non-invasive, and promising technique for detecting and staging corneal damage in topical glaucoma therapy.Öğe Effects of cisplatin-5-fluorouracil combination therapy on oxidative stress, DNA damage, mitochondrial apoptosis, and death receptor signalling in retinal pigment epithelium cells(Taylor & Francis Ltd, 2018) Guclu, Hande; Doganlar, Zeynep Banu; Gurlu, Vuslat Pelitli; Ozal, Altan; Dogan, Ayten; Turhan, Meryem Aysenur; Doganlar, OguzhanAim: Combination therapies of cisplatin with 5-FU (PF) are an effective solution and have been widely used for the treatment of various categories of cancer including anal, gastrointestinal, and oral cancer, as well as head and neck tumors. The effects of combined PF treatment on vital intracellular signalling pathways in nontargeted cells remain unclear. The aim of this study is to explain the possible mechanisms by which combined PF treatment results in retinal toxicity and to investigate the effects of PF on important vital signalling pathways in ARPE 19 retinal pigmented epithelial cells.Materials and methods: We analysed the cellular and molecular effects of PF on cell viability, oxidative stress, gene repair response, and induction of apoptosis in ARPE 19 cells using molecular probe fluorescent staining, cell cytometer, RAPD, qRT-PCR, and western blot assays.Results: We determined that PF causes excessive generation of reactive oxygen species (ROS) and prevents ROS scavenging by suppressing antioxidant systems. We found induction of DNA damage, particularly mismatch and double strand break repair, in ARPE 19 cells treated with PF. In this study, PF also induced both the intrinsic apoptosis pathway and death receptor signalling in ARPE 19 cells.Conclusions: Our data proved that PF causes cytotoxicity and genotoxicity, at both the cellular and molecular levels, in ARPE 19 cells following particularly prolonged treatment (48h). Additionally, our results suggest key molecular signals for prevention strategies that can be developed to reduce the severe side effects of PF chemotherapy.Öğe The effects of delivery type and gender on intraocular pressure and central corneal thickness in newborns(Consel Brasil Oftalmologia, 2016) Ozkurt, Zeynep Gursel; Balsak, Selahattin; Balsak, Berrin; Guclu, Hande; Sahin, Muhammed; Yuksel, Harun; Turkcu, Fatih M.Purpose: To analyze intraocular pressure (IOP) and central corneal thickness (CCT) in newborns during the first 12 h of life. Methods: Forty-three newborns born by vaginal delivery (VD) and 30 newborns born by cesarean section (CS) were evaluated. IOP and CCT were measured using Tono-Pen and handheld pachymeter, respectively, at both the 5th minute after delivery and at the 12th h of life. Results: The mean IOP for the VD group was significantly higher than that of the CS group at both the 5th minute and 12th h (p=0.042 and p=0.018, respectively). In both groups, the IOP decreased by the 12th h, but the decrease was only significant for the CS group (p=0.020). The decrease in CCT over the 12 h was significant for both groups (p<0.001). In the VD and CS groups, the IOP values of the males were significantly higher than those of the females at the fifth minute only (p=0.024 and p=0.043, respectively). No other values were significantly different between the genders. Conclusions: Newborn IOP is affected by the mode of delivery and gender. A higher IOP was found in vaginally delivered newborns than in CS newborns for at least 12 h postpartum. CCT showed a significant decline within 12 h. Male newborns have significantly higher IOP values in the first minutes of life.Öğe Effects of Selective Serotonin Reuptake Inhibitors on Macular Ganglion Cell Complex Thickness and Peripapillary Retinal Nerve Fiber Layer Thickness(Taylor & Francis Inc, 2018) Guclu, Hande; Gorgulu, Yasemin; Gurlu, Vuslat Pelitli; Cinar, Rugul Kose; Ozal, Sadik Altan; Caliyurt, OkanPurpose: To evaluate macular ganglion cell complex (GCC) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in patients treated with SSRIs.Methods: The present study included 62 eyes of 31 patients who were using SSRIs and 60 eyes of 30 healthy, age- and gender-matched control subjects. All patients underwent a full ophthalmological examination in which macular thickness, GCC thickness, and peripapillary RNFL thickness were measured using optical coherence tomography (OCT). The Mann-Whitney U test was used to compare the patients' group with the age- and gender-matched control group. Pearson correlation analyses were also performed to assess the relationships between macular thickness, GCC thickness, RNFL thickness, and the duration of SSRI usage.Results: The mean duration of SSRI usage was 29.9627.19 (range 6-120) months. The foveal thickness was 253.48 +/- 22.77 mu m in the patients' group and 266.60 +/- 20.64 mu m in the control group; the difference between the groups was statistically significant. In addition, the perifoveal GCC thickness in the inferonasal and inferotemporal quadrant were significantly smaller thinner in the patient group (Mann-Whitney U test, p=0.021and p=0.013, respectively).Conclusions: Our results suggest a relation between SSRIs and decreased retinal GCC thickness and RNFL thickness. Future long-term prospective studies should elucidate the actual effect of SSRIs on GCC and RNFL thickness.Öğe Elevated Neutrophil Lymphocyte Ratio in Recurrent Optic Neuritis(Hindawi Ltd, 2015) Guclu, Hande; Ozal, Sadik Altan; Gurlu, Vuslat Pelitli; Birgul, RamazanPurpose. To demonstrate the relation between optic neuritis (ON) and systemic inflammation markers as neutrophil lymphocyte ratio (N/L ratio), platelet count, mean platelet volume (MPV), and red cell distribution width (RDW) and furthermore to evaluate the utilization of these markers to predict the frequency of the ON episodes. Methods. Forty-two patients with acute ON and forty healthy subjects were enrolled into the study. The medical records were reviewed for age, sex, hemoglobin (Hb), Haematocrit (Htc), RDW, platelet count, MPV, white blood cell count (WBC), neutrophil and lymphocyte count, and neutrophil lymphocyte ratio (N/L ratio). Results. The mean N/L ratio, platelet counts, and RDW were significantly higher in ON group (p = 0.000, p = 0.048, and p = 0.002). There was a significant relation between N/L ratio and number of episodes (r = 0.492, p = 0.001). There was a statistically significant difference for MPV between one episode group and recurrent ON group (p = 0.035). Conclusions. Simple and inexpensive laboratory methods could help us show systemic inflammation and monitor ON patients. Higher N/L ratio can be a useful marker for predicting recurrent attacks.Öğe Esculetin Protects Human Retinal Pigment Epithelial Cells from Lipopolysaccharide-induced Inflammation and Cell Death(Taylor & Francis Inc, 2018) Ozal, S. Altan; Turkekul, Kader; Gurlu, Vuslat; Guclu, Hande; Erdogan, SuatPurpose: Age-related macular degeneration (AMD) is the most common cause of visual loss. The dry AMD is characterized by retinal pigment epithelium (RPE) death and changes in AMD lead to severe loss of vision. Coumarin-derived esculetin has a number of therapeutic and pharmacological effects such as anti-inflammatory and antioxidant with various mechanisms. The purpose of this study was to investigate the effects of esculetin treatment on lipopolysaccharide (LPS)-induced inflammation, oxidative stress, and cell survival.Material and methods: Human RPE cells (ARPE-19) were incubated for 24-72h with 5g/ml LPS to induce inflammation and oxidative stress. Esculetin (5 M) was used to protect the cells from LPS-induced damage. The cell viability was evaluated by quantitative 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide test. Interleukin 6 (IL-6), IL-12, and vascular endothelial growth factor (VEGF) levels were determined by enzyme-linked immunosorbent assay (ELISA). IL-1, tumor necrosis factor receptor (TNFR), TNF-related apoptosis-inducing ligand (TRAIL), catalase, glutathione peroxidase (GPx), superoxide dismutase 1 (CuZnSOD) and SOD2 (MnSOD) mRNA expressions were analyzed by RT-quantitative polymerase chain reaction. Apoptosis was monitored by cell-based cytometer. NF-kappa B (NF-B) p65/RelA levels were determined by ELISA, and NF-B protein expression and extracellular signal-regulated kinase (ERK1/2) phosphorylation were evaluated by Western blot analysis.Results: Esculetin treatment significantly suppressed LPS-induced cell death mediated by apoptosis and necrosis in a concentration-dependent manner. While LPS caused significant inflammation with cytokine increase in cells, esculetin reduced the expression of LPS-induced cytokines, VEGF, TNFR, and TRAIL. Furthermore, exposure to LPS increased the expression of GPx and mitochondrial MnSOD, leading to oxidative stress in the cells. Esculetin treatment attenuated phosphorylation of ERK1/2 and NF-B expression mediated by LPS.Conclusions: These results suggest that esculetin may be an alternative treatment option for endotoxin-induced inflammation and oxidative stress, which therefore may inhibit the development of LPS-mediated AMD.Öğe Evaluation of the effect of intravitreal injections on corneal epithelial, scleral and limbal region changes in diabetic retinopathy by AS-OCT(Springer, 2024) Cinar, Abdulkadir Can; Cinar, Ayca Kupeli; Guclu, HandePurposeT he aim of the study is to evaluate the effects of diabetic retinopathy and intravitreal injections on the corneal, limbal and scleral areas. Methods Patients with diabetes mellitus at different diagnosis and treatment levels were compared among themselves and with the control group in terms of corneal, limbal and scleral aspects with the help of anterior segment optical coherence tomography. In addition, clinical tests such as tear break-up time, Schirmer test-I and ocular surface disease index questionnaire were applied to the patients and the difference between the groups was investigated. Results When the groups were examined in terms of BUT, SCH-I and OSDI, there was a statistically significant difference between control group and diabetic group(p < 0.05). In the limbal region, all measurements are higher than in patients with diabetic eye involvement. Thinning was detected in the scleral area with intravitreal injection (p < 0.05). Conclusion It should be known that DM may cause undesirable changes in the limbal region, and the importance of non-invasive detection with AS-OCT should not be forgotten. Since intravitreal injections for DME cause thinning of the sclera, it can cause various complications, and it may be recommended to change the quadrant in repetitive injection applications.Öğe Increased fibrinogen to albumin ratio in ischemic retinal vein occlusions(Sage Publications Ltd, 2017) Guclu, Hande; Ozal, Sadik A.; Gurlu, Vuslat Pelitli; Ozgun, Gulben Sayilan; Ozgun, ErayPurpose: To demonstrate the relationship between ischemia and plasma fibrinogen and serum albumin levels in cases of retinal vein occlusion (RVO). Methods: This study included 44 patients with central RVO (CRVO), 68 patients with branch RVO (BRVO), and 54 age- and sex-matched controls, for a total of 166 subjects. All of the subjects underwent full ophthalmologic examinations and complete physical examinations, including a detailed medical history and blood count, and biochemical parameters. Results: The mean fibrinogen to albumin ratios were 92.5 +/- 36.1 for the patients with CRVO, 84.5 +/- 31.5 for the patients with BRVO, and 68.4 +/- 12.2 for the control group. Overall, the patients with CRVO and patients with BRVO with ischemia had higher fibrinogen to albumin ratios and higher fibrinogen levels. Moreover, significant positive correlations were found between ischemia and the fibrinogen to albumin ratio (r = 0.732, p = 0.001) and the fibrinogen level (r = 0.669, p = 0.001). Conclusions: The fibrinogen to albumin ratio is significantly associated with ischemic RVO. Instead of complicated and invasive methods, such as a retinal angiogram, the fibrinogen to albumin ratio could be a useful initial diagnostic test to predict ischemia in RVO.Öğe An innovation in glaucoma surgery: XEN45 gel stent implantation(Consel Brasil Oftalmologia, 2017) Ozal, Sadik Altan; Kaplaner, Osman; Basar, Baybars Baris; Guclu, Hande; Ozal, EcePurpose: To report follow-up data for patients who underwent XEN45 gel stent implantation, a new method of minimally invasive glaucoma surgery. Methods: Fifteen eyes in fifteen patients who underwent XEN45 gel stent implantation surgery were investigated in the study. All patients were examined preoperatively and at the following postoperative time points: 1 day; 1 and 2 weeks; and 1, 2, 3, 6, and 12 months. Intraocular pressure (IOP) was measured via Goldmann applanation tonometry. Combined surgical procedures (XEN45 + phacoemulsification + intraocular lens) were performed in patients who that had cataracts in addition to glaucoma. Results: The mean IOP values were significantly lower than the preoperative values at all postoperative visits (p<0.001). In two patients, the IOP exceeded 20 mmHg 12 months after surgery. These IOP increases were controlled by medical therapy, and none of the patients needed another surgical procedure. Conclusion: XEN45 gel stent implantation is a minimally invasive glaucoma surgery that ensures the effective reduction of IOP. This new treatment modality also avoids the destructive complications encountered in other invasive surgical procedures. However, further studies with greater numbers of patients and longer follow-up periods are needed to clarify certain points.Öğe Melatonin prevents blood-retinal barrier breakdown and mitochondrial dysfunction in high glucose and hypoxia-induced in vitro diabetic macular edema model(Pergamon-Elsevier Science Ltd, 2021) Doganlar, Zeynep Banu; Doganlar, Oguzhan; Kurtdere, Kardelen; Guclu, Hande; Chasan, Tourkian; Turgut, EsraDiabetic macular edema (DME) is a leading cause of blindness in diabetic retinopathy. Prolonged hyperglycemia plus hypoxia contributes to DME pathogenesis. Retinal pigmented epithelial cells comprise the outer bloodretinal barrier and are essential for maintaining physiological functioning of the retina. Melatonin acts as an antioxidant and regulator of mitochondrial bioenergetics and has a protective effect against ocular diseases. However, the role of mitochondrial dysfunction and the therapeutic potential of melatonin in DME remain largely unexplored. Here, we used an in vitro model of DME to investigate blood-retinal barrier integrity and permeability, angiogenesis, mitochondrial dynamics, and apoptosis signaling to evaluate the potential protective efficacy of melatonin in DME. We found that melatonin prevents cell hyper-permeability and outer barrier breakdown by reducing HIF-1 alpha, HIF-1 beta and VEGF and VEGF receptor gene expression. In addition, melatonin reduced the expression of genes involved in mitochondrial fission (DRP1, hFis1, MIEF2, MFF), mitophagy (PINK, BNip3, NIX), and increased the expression of genes involved in mitochondrial biogenesis (PGC-1 alpha, NRF2, PPAR gamma) to maintain mitochondrial homeostasis. Moreover, melatonin prevented apoptosis of retinal pigmented epithelial cells. Our results suggest that mitochondrial dysfunction may be involved in DME pathology, and melatonin may have therapeutic value in DME, by targeting signaling in mitochondria.Öğe Metabolic Syndrome May Exacerbate Macular and Retinal Damage in Psoriasis Vulgaris(Taylor & Francis Inc, 2019) Korkmaz, Selma; Guclu, Hande; Hatipoglu, Esra Sueheda; Ficicioglu, Sezin; Gurlu, Vuslat; Ozal, Sadik AltanPurpose: To evaluate whether cases with both psoriasis and metabolic syndrome are prone to retinal and macular changes. Materials and Methods: A total of 174 eyes of 87 subjects were evaluated. Of the 87 subjects, 24 had psoriasis, 19 had psoriasis and metabolic syndrome, 18 had metabolic syndrome only and 26 were healthy subjects. Biochemical analysis, anthropometric, blood pressure and optical coherence tomography measurements and thickness analysis were obtained for each case. Results: The superior retinal nerve fibre layer thickness was significantly lower in the psoriasis and metabolic syndrome group than in the psoriasis group. For all parafoveal quadrants, the ganglion cell complex thickness was statistically significantly lower in the psoriasis group than in the healthy group. The central macula was thinnest in the healthy group among the four groups. Conclusions: Psoriasis can cause retinal changes, and metabolic syndrome may cause additional damage in the retina and macula in cases with psoriasis.Öğe MicroRNA-184 attenuates hypoxia and oxidative stress-related injury via suppressing apoptosis, DNA damage and angiogenesis in an in vitro age-related macular degeneration model(Pergamon-Elsevier Science Ltd, 2022) Aykutlu, Merve Sambel; Guclu, Hande; Doganlar, Zeynep Banu; Kurtdere, Ayse Kardelen; Doganlar, OguzhanAge-related macular degeneration (AMD) is one of the leading causes of blindness worldwide, particularly in developed countries. Recently, microRNAs (miRs) have become popular research area to develop new treatment options of AMD. However, interaction between hsa-miR-184 and AMD remain largely unexplored. In this study, sub-lethal levels of Deforoxamine Mesylate salt (DFX) and H2O2 were applied to ARPE-19 cells to establish a severe in vitro AMD model, via durable hypoxia and oxidative stress. We found that up-regulation of miR-184 level in AMD can suppress hypoxia-related angiogenic signals through HIF-1 alpha/VEGF/MMPs axis. Also, miR-184 suppressed the hypoxia sensor miR-155 and genes in the EGFR/PI3K/AKT pathway, which is an alternative pathway in angiogenesis. To investigate the mechanism behind this protective effect, we evaluated the impact of miR-184 on retinal apoptosis in a model of AMD. miR-184 inhibited retinal apoptosis by upregulating BCL-2 and downregulating pro-apoptototic BAX, TRAIL, Caspase 3 and 8 signals as well as p53. Taken together, miR-184 attenuates retinal cell damage induced by severe AMD pathologies through suppressing hypoxia, angiogenesis and apoptosis. The safety profile of miR-184 was observed to be similar to Bevacizumab, which is in wide use clinically, but miR-184 was found to provide a more effective therapeutic potential by regulating simultaneously multiple pathologies.
