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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 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 Effect of Age on the Retinal Nerve Fiber Layer Thickness and Standard Parameters of GDx(Turkish Ophthalmological Soc, 2006) Gurlu, Vuslat Pelitli; Samut, H. Semih; Ozkan, Hakan; Alimgil, M. LeventPurpose: To investigate the age related changes on the retinal nerve fiber layer thickness (RNFL) and the effects thereof on the standard parameters of Scanner Laser Polarimeter (GDx). Method: 100 cases, examining to the Department of Ophthalmology, School of Medicine, Trakya University, with a refractive error less than 1 diopters in spheric equivalent and a cup/disc rate of less than 0.4, who did not have medii opacity or history of retinal disorder and glaucoma, were included into the study. Following the ophthalmologic examination of all cases, GDx images of both eyes were taken. One eye of each case was selected randomly and the integral values for the total and four quadrants of 100 eyes of the 100 cases were investigated along with the age-related changes in the standard parameters of GDx. Results: Based on the findings from the GDx images of the cases with an age average of 40.68+ 13.08; the quadrant with the thickest peripapillary RNFL was the inferior quadrant, which was followed by the superior, nasal and temporal integral values. Moreover, a negative correlation was determined between age and the'total, superior and inferior integral values (p= 0.008, p= 0.005, p= 0.002). A negative correlation was determined between age and the GDx parameters of maximal modulation (p= 0.044), average thickness (p= 0.008), ellipse average (p= 0.004), superior average (p= 0.002) and inferior average (p= 0.001), and a positive correlation was determined with the number parameter (p= 0.015). Conclusion: The area with the thickest RNFL in the peripapillary area is the inferior quadrant, and the integral values of the total, superior and inferior quadrant are decreased with age while the number parameter is increased.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 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 Fluorescein angiographic findings in cases with intermediate uveitis in the inactive phase(Canadian Ophthal Soc, 2007) Gurlu, Vuslat Pelitli; Alimgil, Murat Levent; Esgin, HalukBackground: To determine fundus fluorescein angiography (FA) findings in cases with intermediate uveitis in the inactive phase. Methods: This prospective study included all eligible cases with a diagnosis of intermediate uveitis that were treated at the uvea unit of Trakya University ophthalmology department between January 2002 and January 2004. Study criteria included patients in the inactive phase who had no complaints, no biomicroscopic or ophthalmoscopic inflammatory findings in the anterior and posterior segments, and no period of inflammation that had occurred within the previous 6 months. Cases receiving immunosuppressive treatment were not excluded. FA was performed in all cases, which were evaluated by 2 independent observers. Results: A total of 21 eyes from 21 cases with intermediate uveitis were included in the study. FAs of the cases were taken approximately 8.8 (SD 5.4) months (range 6-23 months) after the last activation. In these FAs, no pathological findings were identified in 5 eyes (23.8%); optic disc hyperfluorescence was observed in 14 eyes (66.7%); large vein staining was observed in 2 eyes (9.5%); peripheral venous leakage was observed in 6 eyes (28.6%); and cystoid macular edema was observed in 5 eyes (23.8%). Interpretation: These findings indicate that retinal vascular inflammatory changes persist in cases with intermediate uveitis even if the clinical manifestations have been treated.Öğe Fresh Frozen Plasma Treatment of Ligneous Conjunctivitis: Use of Heparin and Allogeneic Serum Reply(Lippincott Williams & Wilkins, 2009) Gurlu, Vuslat Pelitli; Demir, Muzaffer[Abstract Not Available]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 A Moyamoya Patient with Bilateral Consecutive Branch Retinal Vein Occlusion(Taylor & Francis As, 2016) Guclu, Hande; Gurlu, Vuslat Pelitli; Ozal, Sadik Altan; Esgin, HalukWe describe a moyamoya (MMD) patient with bilateral consecutive branch retinal vein occlusion (BRVO). The patient had a medical history of severe headache, cranial haemorrhage, bilateral supraclinoid carotid artery occlusion, and puff of smoke collaterals on cerebral angiography and an encephalomyosynangiosis operation. On ophthalmic examination, he had superior temporal branch vein occlusion with intraretinal haemorrhage and visual acuity of 20/25 in the right eye. Twelve years later, he presented with superior temporal branch vein occlusion in the left eye and visual acuity of 20/60. The patient was initially treated with a dexamethasone intravitreal implant, and later intravitreal ranibizumab injections. We describe the first reported case of bilateral consecutive BRVO and management in MMD.Öğe Prognostic factors for stereopsis in refractive accommodative esotropia(Professional Medical Publications, 2015) Guclu, Hande; Gurlu, Vuslat Pelitli; Ozal, Sadik Altan; Ozkurt, Zeynep GurselObjective: To determine the prognostic factors affecting stereoacuity in patients with refractive accommodative esotropia (RAE) according to the results of long follow- up period. Methods: We reviewed the charts of 70 patients with RAE between the years 1985-2014. Patients were classified into three groups. G-1: Stereoacuity score 40 second/arc. G-2: Stereoacuity score >40 second/arc (50-3000). G-3: No binocular vision. Initiation age of RAE, duration of deviation, refractive error, amblyopia, amblyopia treatment, anisometropia, visual acuity, family history, angle of deviation for distance and near at each group and the prognostic factors affecting stereoacuity were analyzed. Results: The mean initiation age of RAE was 2.7 +/- 1.5 years, the mean age at first visit was 6.4 +/- 4.2 years. The mean follow up time was 7.3 +/- 4.4 years. Seven patients had 40 second/arc, 48 patients had 50 to 3000 second/arc stereoacuity, 15 patients had no binocular vision. Mean deviation for near was statistically higher in group 2 and 3. Visual acuity levels were higher in group 1 and 2 and was statistically significant. Low visual acuity (p=0.001, 0.008), higher angle of deviation at near (p=0.01), increased duration of deviation (p=0.01), presence of amblyopia (p=0.001) and irregularity of amblyopia treatment (p=0.01) were significantly related with poor stereoacuity. Conclusion: According to the prognostic factors low stereoacuity was mostly related with amblyopia as a result the late presentation of the patients in seeking care. Appropriate treatment as full refractive correction and amblyopia treatment during the RAE is important for development of good stereopsis. Also angle of deviation at near and duration of deviation can be a useful predictor for poor stereoacuity levels.Öğe Reproducibility of Automatic Endothelial Cell Analysis Performed With Non-Contact Specular Microscopy(Turkish Ophthalmological Soc, 2006) Gurlu, Vuslat Pelitli; Bulbul, Ebru Demet; Erda, SaitObjective: To investigate the reproducibility of automatic endothelial cell analysis performed with non-contact specular microscopes. Method: Fifteen eyes of 15 case were included in the study. From each eye 2 consecutive endothelial images of central cornea obtained with the Topcon SP-2000P by the first observer. Firstly, first image of each eye was assessed by correcting the cell borders defined by automatic analysis system (IMAGEnet) and using standart frame. Intra-operator reproducibility was investigated by comparison of results of these analysis with the analysis results of uncorrected cell borders defined by the automatic analysis system (I), with the use of smaller frame rather than the standard frame (II) and with the analysis results of second image of each eye captured by the first observer (III). In the second phase, inter-operator reproducibility was investigated by comparison of the results of the first observer with the results obtained by assessment of the first image of each eye by a second observer. Findings: Both the assesment made for the intra-operator reproducibility and inter-operator reproducibility revealed a medium-low degree of correlation for the coefficient of variation and hexagonality rates while a high correlation was observed for the values of cell density and average cell area. Conclusion: In conclusion, assesments made with the non-contact specular microscopy and automatic analysis system have a substantially high rate of reproducibility when standard frame and corrected cell borders are used.Öğe Retinal ganglion cell complex and peripapillary retinal nerve fiber layer thicknesses following carotid endarterectomy(Springer, 2019) Guclu, Orkut; Guclu, Hande; Huseyin, Serhat; Korkmaz, Selcuk; Yuksel, Volkan; Canbaz, Suat; Gurlu, Vuslat PelitliPurpose To examine changes in retinal ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thicknesses by optical coherence tomography (OCT) in contralateral and ipsilatateral eyes of carotid artery stenosis (CAS) patients before and after carotid endarterectomy (CEA). Methods Forty-two consecutive patients diagnosed with CAS (70-99% stenosis rate) who underwent CEA were included in this prospective cross-sectional study. The indication for CEA was based on the Asymptomatic Carotid Atherosclerosis Study. Doppler ultrasonography and computed tomography angiography were performed to calculate CAS. All the subjects underwent an ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP) measurements, biomicroscopy, fundoscopy, and OCT before and after the surgery. ResultsThe mean preoperative intraocular pressure was 15.2 +/- 2.1mmHg in the ipsilateral eye and 15.8 +/- 2.7 in the contralateral eye. The mean post-operative intraocular pressure in the ipsilateral and contralateral eye was 18.6 +/- 3.0 and 19.3 +/- 3.8, respectively. The intraocular pressure was significantly higher in postoperative eyes (p=0.0001). There was a statistically significant decrease in peripapillary RNFL thickness in superior quadrants postoperatively in ipsilateral eyes. The retinal GCC layer thickness was not significantly different before and after CEA in ipsilateral and contralateral eyes. Conclusions Carotid endarterectomy results in thinning of the superior peripapillary RNFL thickness. To the best of our knowledge, this is the first study to examine peripapillary RNFL and GCC thicknesses before and after CEA.
