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Yayın Helvacioglu reproducibility index: a new algorithm to evaluate the effects of misalignments on the measurements of retinal nerve fiber layer by spectraldomain OCT(IJO Press, 2015) Helvacıoğlu, Fırat; Uyar, Osman Murat; Tunç, Zeki; Kapran, ZiyaAim: To evaluate the effect of misalignment on the measurements of retinal nerve fiber layer (RNFL) by spectral-domain optical coherence tomography (OCT). Methods: A total of 42 eyes from 21 healthy young subjects underwent RNFL measurements with RTVue spectral-domain OCT (Optovue Inc., Fremont, California, USA). Two baseline measurements with perfectly aligned central circle to the borders of the optic nerve and four misaligned measurements which were misaligned towards to four quadrants were taken. The differences in RNFL between the baseline and misaligned measurements were analyzed with a new algorithm called Helvacioglu reproducibility index (HRI) which is designed to measure the reproducibility of the scans by evaluating the RNFL changes in the four main quadrants. Results: The average RNFL scores of the first two baseline measurements have good correlation (c=0.930) and good reproducibility scores (0.15±0.07). Superior misaligned measurements had significantly lower superior quadrant score and higher inferior quadrant score, similar nasal and little higher temporal scores (P1, P2<0.001, P3=0.553, P4=0.001). Inferior misaligned measurements had significantly higher superior quadrant score and lower inferior quadrant score with similar temporal and little lower nasal scores (P1, P2<0.001, P3=0.315, P4=0.016). Nasal misaligned measurements had significantly higher temporal quadrant score and lower nasal quadrant score with little lower superior and inferior scores (P1, P2, P4<0.001, P3=0.005). Temporal misaligned measurements had significantly higher nasal quadrant score and lower temporal quadrant score with similar superior and little higher inferior scores (P1, P2<0.001, P3=0.943, P4=0.001). Conclusion: Good alignment of the central circle to the borders of optic nerve is crucial to have correct and repeatable RNFL measurements. Misalignment to a quadrant resulted in falsely low readings at that quadrant and falsely high readings at the opposite quadrant.Yayın Hemorrhagic Age-Related Macular Degeneration Managed With Vitrectomy, Subretinal Injection of Tissue Plasminogen Activator, Gas Tamponade, and Upright Positioning(SLACK INC, 2013) Kapran, Ziya; Ozkaya, Abdullah; Uyar, O. MuratBACKGROUND AND OBJECTIVE: To investigate the outcomes of vitrectomy, subretinal tissue plasminogen (tPA) injection, gas tamponade, and upright positioning in patients with hemorrhagic neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Retrospective, noncomparative case series. Records of patients who were diagnosed with submacular hemorrhage secondary to neovascular AMD and underwent treatment with the combined method between 2004 and 2010 were reviewed. The main outcome measure was the difference between preoperative and postoperative best corrected visual acuity (BCVA). RESULTS: In 10 eyes of 10 patients, mean preoperative and postoperative BCVA values were 1.75 and 1.23 logMAR, respectively (P = .011), after a mean follow-up time of 38.7 +/- 26.5 months (range: 10 to 71 months). Eight of 10 patients (80%) gained at least three lines. CONCLUSION: In patients with hemorrhagic neovascular AMD, treatment with vitrectomy, subretinal tPA injection, gas tamponade, and upright positioning was associated with better visual outcomes than those reported for patients with untreated disease.Yayın The Isolates in Endophthalmitis Cases Following Eye Surgery(Aves, 2013) Yurttaşer Ocak, Yurttaşer; Altan, Tuğrul; Ocak, Osman Bulut; Kapran, ZiyaObjective: To investigate the isolates of endophthalmitis cases following eye surgery. Methods: 130 eyes of 130 patients who had the diagnosis of postope-rative endophthalmitis were included in the study. Seventy-four (56.92%) of them were male, 56 (43.08%)of them were female. 80 of them (61.5%) were right eye, 50 of them (38.5%) were left eye. Mean age was 65 (18-85) years. Anterior chamber and vitreus samples were sent to the laboratory for microbiological analysis after inoculation into blood culture bottles. Results: While 56 of 130 (43.07%) blood culture bottles yielded positive, 74 of 130 (56.92%) remained sterile. Twenty-nine of 56 (51.7%) isolates were gram positive cocci, 21 isolates (37.5%) were gram negative organisms.The most frequently isolated gram positive bacteria were Staphilococcus aureus and most frequent gram negative bacteria were Pseudomonas ae-ruginosa. Conclusion: Culturing specimens with blood culture bottles may be an alternative to conventional culture media in clinics where adequate microbiology laboratory facilities are not available. Gram negative organisms were more frequently isolated in our series than in the literature.We consider that breaks in the sterilization chain occur more frequently in our country and this issue should be adressed more carefully.Yayın Katarakt ve güncel tedavi yaklaşımları(Maltepe Üniversitesi, 2014) Helvacıoğlu, Fırat; Şencan, Sadık; Tunç, Zeki; Uyar, Osman Murat; Kapran, ZiyaKatarakt, oftalmolojide cerrahi ile tedavi edilen en sık hastalıktır. Derlemede patogenezi, cerrahi tedavi seçenekleri ve cerrahi girişimlerdeki gelişmeler özetlenmiştir. Yeni cerrahi tedavi yaklaşımları da incelenmiştir,Yayın Optical coherence tomography of bilateral nanophthalmos with macular folds and high hyperopia(Turkish Ophthalmology Society, 2014) Helvacıoğlu, Fırat; Kapran, Ziya; Şencan, Sadık; Uyar, Murat; Cam, Özlemmportance. There is a conflict about the content of the macular folds in nanophthalmic eyes in the literature. Our study clearly demonstrated that papillomacular folds seen in nanophthalmos or posterior microphthalmos were only composed of neurosensory retina without involvement of retinal pigment epithelium and choroid. Observations. This is a report of two consecutive nanophthalmic patients with macular folds at Maltepe University School of Medicine, Department of Ophthalmology, from January to June 2012. Anterior segment dimensions were near normal. The axial lengths of the eyes were short with markedly shortened posterior segment. A macular fold extending from the center of the fovea towards the optic nerve head was present in all eyes. Optic coherence tomography clearly demonstrated that folds were only composed of neurosensory retina. Binocular visual acuities and refractive errors of the cases were 0.3, 0.2 and +16.00, +15.75 diopters, respectively. Conclusions and Relevance. Our study proposes a surgical option to treat these folds like serous retinal detachments by showing the true content of the folds, although there is not any surgical operation accepted for this condition yet. Further studies dealing with the surgical interventions of these folds should be performed to support this option.Yayın Postoperatif Endoftalmilerde Girişimsel Tedavi Yaklaşımı Sonuçları(2013) Kapran, Ziya; Ocak, Osman Bulut; Altan, Tuğrul; Yurttaşer Ocak, SerapAmaç: Postoperatif endoftalmide intraoküler antibiyotik enjeksiyonu ve pars plana vitrektominin etkinliğini incelemek. Yöntemler: Nisan 2001-Ocak 2009 tarihleri arasında Beyoğlu Göz Eğitim ve Araştırma Hastanesi 2. Göz Kliniği'nde postoperatif enfeksiyöz endoftalmi tanısı konulan 130 hastanın 130 gözü çalışma kapsamına alındı.Geliş görme keskinliği (GK) ışık hissi (IH) olan olguların hepsine primer pars plana vitrektomi uygulandı.Geliş görme keskinliği el hareketi (EH) ve daha iyi olan olgulara ise primer intraoküler antibiyotik enjeksiyonu (İOAB) veya primer pars plana vitrektomi (PPV) uygulandı. Bulgular: Olgular ortalama 8.62 ay (1 hafta-48 ay) takip edildi. Olguların ortalama yaşı 65 (18-85) olarak saptandı.Toplam 130 olgunun 103'ü (%79.2) akut endoftalmi, 27 olgu (%20.8) ise geç başlangıçlı endoftalmi olarak değerlendirildi. Başvuru anında ışık hissi düzeyinde görme keskinliği olan 27 olguya (%20.76) primer PPV uygulandı. Geliş GK EH ve üstü düzeyinde olan 28 olguya (%27.2) primer PPV, geri kalan 75 olguya (%72.8) ise primer İOAB uygulandı. Primer PPV tedavisine cevap oranı primer İOAB tedavisine cevap oranına göre anlamlı derecede daha yüksek bulundu. Sonuç: Postoperatif endoftalmide klinik tablonun ağırlığına göre intravitreal antibiyotik injeksiyonu veya PPV tedavilerinden biri acil şartlarda uygulanmalıdır. PPV tedavisi tedaviye direnç oranının oldukça düşük olması nedeni ile IOAB tedavisine tercih edilebilir.Yayın Postoperatif Endoftalmilerde Kültür Sonuçları(2013) Altan, Tuğrul; Ocak, Osman Bulut; Kapran, Ziya; Yurttaşer Ocak, SerapAmaç: Postoperatif endoftalmi tanısı konulan olguların retrospektif olarak mikrobiyolojik spektrumunun incelenmesi. Yöntemler: Nisan 2001-Ocak 2009 tarihleri arasında Beyoğlu Göz Eğitim ve Araştırma Hastanesi 2. Göz Kliniği'nde postoperatif enfeksiyöz endoftalmi tanısı konulan 130 hastanın 130 gözü çalışma kapsamına alındı. Olguların 74'ü (%56,92) erkek, 56'sı (%43,08) kadındı. Yüz otuz gözün 80'i (%61,5) sağ göz, 50'si (%38,5) sol göz idi. Olguların ortalama yaşı 65 (18-85) olarak saptandı. Ön kamara ve vitreustan alınan örnekler kan kültürü şişelerine ekim yapılarak incelenmek üzere mikrobiyoloji laboratuvarına gönderildi. Bulgular: Alınan kültürlerin 56'sında (%43,07) üreme tespit edildi. Yetmiş dört olguda (%56,92) ise kültür steril kaldı.Yirmi dokuz olguda (%51,7) gram pozitif koklar, 21 olguda (%37,5) gram negatif çomaklar tespit edildi. Gram pozitif bakterilerden en sık koagülaz negatif stafilokoklar, gram negatif bakterilerden ise en sık Pseudomonas aeruginosa tespit edildi. Sonuç: Ticari olarak hazırlanmış steril kan kültür şişelerine ekim özellikle mikrobiyoloji laboratuvarının ve deneyimli personelin bulunmadığı şartlarda konvansiyonel yöntemlere alternatif olabilir. Literatürle kıyaslandığında kültür sonuçlarında gram negatif çomakların daha fazla izole edilmesi sterilizasyon zincirinde kırılmaların ülkemizde daha fazla oldu- ğunu ve bu nedenle sterilizasyon koşullarına daha fazla dikkat edilmesi gerektiğini düşündürmektedir.Yayın The Results of Interventional Treatment Approach to Postoperative Endophthalmitis(Aves, 2013) Yurttaşer Ocak, Serap; Altan, Tuğrul; Ocak, Osman Bulut; Kapran, ZiyaObjective: To evaluate the effectiveness of intravitreal antibiotic injection (IOAI) and pars plana vitrectomy (PPV) in postoperative endophthalmitis. Methods: One hundred and thirty eyes of 130 patients who had the diagnosis of postoperative endophthalmitis between April 2001-January 2009 were included in the study. We performed pars plana vitrectomyin all patients with initial visual acuity of light perception. Eyes with visual acuity of hand motion or better underwent either intravitreal antibiotic injection or pars plana vitrectomy. Results: The patients' mean follow up time was 8.62 months (1 week to 48 months). Mean age was 65 (18-85) years. One hundred and three of 130 patients (79.2%) had acute endophtalmitis; 27 cases (20.8%) were late-onset endophthalmitis. We performed primary PPV in 27 patients (20.76%) who had initial visual acuity of light perception. Twenty-eight patients (27.2%) who had initial visual acuity hand motion or better underwent primary PPV, the remaining 75 patients (72.8%) underwent primary IOAI. Conclusion: In postoperative endophthalmitis intravitreal antibiotic injection or primary PPV should be made on an urgent basis depending on the severity of clinical presentation in order to salvage vision. Pars plana vitrectomy may be preferable to IOAI in postoperative endophthalmitis since the rate of early reintervention is lower with initial PPV.Yayın Results of Peripheral Vitrectomy Under Air in Rhegmatogenous Retinal Detachment(SLACK INC, 2017) Altan, Tugrul; Ozbilen, Kemal Turgay; Cetin, Turgay; Kapran, ZiyaBACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of peripheral vitrectomy under air in rhegmatogenous retinal detachment (RRD). PATIENTS AND METHODS: Consecutive patients who underwent 23-gauge pars plana vitrectomy for RRD were included. After removal of core vitreous and drainage of subretinal fluid, peripheral vitreous was removed under air infusion without scleral indentation. Silicone oil or C3F8 gas was used as tamponade. RESULTS: Forty-five eyes of 45 patients were evaluated retrospectively. Mean LogMAR, which was 1.65 LogMAR +/- 1.44 LogMAR preoperatively, decreased to 0.26 LogMAR +/- 0.28 LogMAR (P < .001; paired t-test). Initial and final reattachment rates were 91% and 98%, respectively. Scleral indentation was not necessary in any case. Iatrogenic retinal breaks occurred in three initial cases. Macular hole developed in one case after reoperation. CONCLUSIONS: Peripheral vitrectomy under air is safe and effective in cases with RRD. Air eliminates the need for scleral indentation, stabilizes the retina, and allows sufficient clarity for vitrectomy.Yayın Surgical approach in myopic maculopathy(Gazi Göz Vakfı, 2015) Kapran, Ziya; Altan, Tuğrul; Cam, ÖzlemSurgical Approach in Myopic MaculopathyYayın Wide-Field Landers Keratoprothesis in Various Combined Corneal and Vitreoretinal Problems: Twelve-Month Results(SLACK INC, 2017) Kapran, Ziya; Ozkaya, Abdullah; Erdogan, Gurkan; Karakucuk, Yalcin; Gezginaslan, Tugba Aydogan; Perente, Irfan; Taskapili, MuhittinBACKGROUND AND OBJECTIVE: To investigate the outcomes of combined pars plana vitrectomy (PPV), transient keratoprosthesis (TKP), and penetrating keratoplasty (PKP) in patients with coexisting corneal and vitreoretinal diseases. PATIENTS AND METHODS: Patients who underwent PPV, TKP, and PKP were included. The main outcome measures were change in visual acuity (VA), clarity of the graft, and retinal attachment. RESULTS: Twenty eyes were included. The mean follow-up time was 18 months +/- 9.5 months. The baseline VA was light perception in 15 eyes and hand motions in five eyes and was found to be increased in 15 eyes (75%), decreased in one eye (5%), and stable in four eyes (20%). The mean corneal graft survival time was 11.1 months +/- 8.5 months. Three eyes (15%) showed phthisis bulbi at the last visit. CONCLUSION: The triple procedure seems to be an effective treatment option in patients who suffer from coexisting corneal and vitreoretinal diseases.Yayın Yaşa Bağlı Maküla Dejenerasyonunda Anti-VEGF Tedavisi(2015) Kapran, Ziya; Helvacıoğlu, FıratSon yıllarda, anti-VEGF tedavisi neovasküler yaşa bağlı maküla dejenerasyonu tedavisinde altın standart olmuştur. Tedavi stratejileri de aylık uygulamalardan, kişiselleştirilmiş, gerektiğinde tedavi uygulamalarına yönelmiştir. Bu derlemede kullanılmakta olan tedavi yöntemleri ve uygulama stratejileri kanıta dayalı olarak sunulmuştur
