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    Comparison of ganglion cell and retinal nerve fiber layer thickness in primary open angle glaucoma and normal tension glaucoma with spectral domain OCT
    (Graefe's Archive for Clinical and Experimental Ophthalmology, 2013) Fırat, Penpegül; Doğanay, Selim; Demirel, Ersan Ersin; Çolak, Cemil
    Background The aim of this study was to evaluate the macular thickness (MT), ganglion cell complex (GCC), and circum-papillary retinal nerve fiber layer (RNFL) thickness in primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) with spectral domain optical coherence tomography (SD-OCT). Methods A total of 169 subjects were enrolled: 52 normal subjects, 61 with POAG, and 56 with NTG. Spectraldomain optical coherence tomography (SD-OCT) was used to analyze MT, GCC, and RNFL thickness. To compare the discrimination capabilities between the MT, GCC, and RNFL thickness measurements, we analyzed the areas under the receiver operating characteristic (ROC) curves (AUCs). The relationships between GCC and RNFL measurement and also the relationships of the groups, with age, gender, GCC, and RNFL thickness were assessed. Results Normal subjects showed the thickest superior and inferior GCC, followed by in order NTG and POAG (p<0.05). While there was a statistically difference in MT value of the normal subjects and the glaucoma patients (p<0.05), MT value did not differ between POAG and NTG (p<0.05). RNFL thickness parameters were significantly greater in normal subjects, followed in order by the NTG, and POAG (p<0.05). Between the normal and entire glaucoma groups, all GCC and RNFL parameters showed the similar discrimination power. RNFL thickness parameters correlated significantly with all GCC thickness (p<0.05). Superior RNFL thickness was the only independent variable between the POAG and NTG patients (odds ratio (OR) 0.942, p00.004, 95 %CI 0.905–0.981). Conclusions SD-OCT evaluation results suggest higher GCC and RNFL parameters for NTG than POAG.
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    Comparison of ganglion cell and retinal nerve fiber layer thickness in primary open angle glaucoma and normal tension glaucoma with spectral domain OCT
    (Graefe's Archive for Clinical and Experimental Ophthalmology, 2013) Fırat, Penpe Gül; Doğanay, Selim; Demirel, Ersan Ersin; Çolak, Cemil
    Background The aim of this study was to evaluate the macular thickness (MT), ganglion cell complex (GCC), and circum-papillary retinal nerve fiber layer (RNFL) thickness in primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) with spectral domain optical coherence tomography (SD-OCT). Methods A total of 169 subjects were enrolled: 52 normal subjects, 61 with POAG, and 56 with NTG. Spectraldomain optical coherence tomography (SD-OCT) was used to analyze MT, GCC, and RNFL thickness. To compare the discrimination capabilities between the MT, GCC, and RNFL thickness measurements, we analyzed the areas under the receiver operating characteristic (ROC) curves (AUCs). The relationships between GCC and RNFL measurement and also the relationships of the groups, with age, gender, GCC, and RNFL thickness were assessed. Results Normal subjects showed the thickest superior and inferior GCC, followed by in order NTG and POAG (p<0.05). While there was a statistically difference in MT value of the normal subjects and the glaucoma patients (p<0.05), MT value did not differ between POAG and NTG (p<0.05). RNFL thickness parameters were significantly greater in normal subjects, followed in order by the NTG, and POAG (p<0.05). Between the normal and entire glaucoma groups, all GCC and RNFL parameters showed the similar discrimination power. RNFL thickness parameters correlated significantly with all GCC thickness (p<0.05). Superior RNFL thickness was the only independent variable between the POAG and NTG patients (odds ratio (OR) 0.942, p00.004, 95 %CI 0.905–0.981). Conclusions SD-OCT evaluation results suggest higher GCC and RNFL parameters for NTG than POAG.
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    Comparison of ganglion cell and retinal nerve fiber layer thickness in primary open-angle glaucoma and normal tension glaucoma with spectral-domain OCT
    (Springer, 2013) Firat, Penpe Gul; Doganay, Selim; Demirel, Ersan Ersin; Colak, Cemil
    The aim of this study was to evaluate the macular thickness (MT), ganglion cell complex (GCC), and circum-papillary retinal nerve fiber layer (RNFL) thickness in primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) with spectral domain optical coherence tomography (SD-OCT). A total of 169 subjects were enrolled: 52 normal subjects, 61 with POAG, and 56 with NTG. Spectral-domain optical coherence tomography (SD-OCT) was used to analyze MT, GCC, and RNFL thickness. To compare the discrimination capabilities between the MT, GCC, and RNFL thickness measurements, we analyzed the areas under the receiver operating characteristic (ROC) curves (AUCs). The relationships between GCC and RNFL measurement and also the relationships of the groups, with age, gender, GCC, and RNFL thickness were assessed. Normal subjects showed the thickest superior and inferior GCC, followed by in order NTG and POAG (p < 0.05). While there was a statistically difference in MT value of the normal subjects and the glaucoma patients (p < 0.05), MT value did not differ between POAG and NTG (p < 0.05). RNFL thickness parameters were significantly greater in normal subjects, followed in order by the NTG, and POAG (p < 0.05). Between the normal and entire glaucoma groups, all GCC and RNFL parameters showed the similar discrimination power. RNFL thickness parameters correlated significantly with all GCC thickness (p < 0.05). Superior RNFL thickness was the only independent variable between the POAG and NTG patients (odds ratio (OR) 0.942, p = 0.004, 95 %CI 0.905-0.981). SD-OCT evaluation results suggest higher GCC and RNFL parameters for NTG than POAG.
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    Evaluation of Iron Deficiency Anemia Frequency as a Risk Factor in Glaucoma
    (Hindawi Ltd, 2018) Firat, Penpe Gul; Demirel, Ersan Ersin; Dikci, Seyhan; Kuku, Irfan; Genc, Oguzhan
    Purpose. Iron deficiency anemia is an important public health problem. Also it is considered to be a risk factor for many diseases. The study demonstrates the iron deficiency anemia frequency in glaucoma patients and compares with the normal subjects. We aimed to determine the iron deficiency anemia frequency in glaucoma patients. Methods. Prospective, controlled study in a single university hospital setting. A total of 130 normal subjects (Group 1) and 131 glaucoma patients (Group 2) were included. The erythrocytes parameters, hemoglobin, red blood cell, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and red blood cell distribution width, and iron status indicators, Fe (iron), total iron binding capacity, and ferritin of the cases, in normal subjects and glaucoma patients were compared. Results. There was no statistically significant difference for the erythrocyte parameters between the groups (p >= 0.05). The number of the patients with iron deficiency anemia in both groups was similar. No statistically significant difference was found in the comparison of erythrocyte parameters and iron status indicators values according to the number of antiglaucomatous agents and visual field changes according to the presence of anemia in Group 2 (p >= 0.05). A statistically significant difference was found only in MCH when the erythrocyte parameters and iron status indicators values of the cases in glaucoma patients were compared with the glaucoma duration (p<0.05). Conclusion. The iron deficiency anemia frequency was like the normal population in glaucoma patients.
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    Evaluation of ıron deficiency anemia frequency as a risk factor in glaucoma
    (Hındawı ltd, adam house, 3rd flr, 1 fıtzroy sq, london, w1t 5hf, england, 2018) Firat, Penpe Gul; Demirel, Ersan Ersin; Dikci, Seyhan; Kuku, Irfan; Genc, Oguzhan
    Purpose. Iron deficiency anemia is an important public health problem. Also it is considered to be a risk factor for many diseases. The study demonstrates the iron deficiency anemia frequency in glaucoma patients and compares with the normal subjects. We aimed to determine the iron deficiency anemia frequency in glaucoma patients. Methods. Prospective, controlled study in a single university hospital setting. A total of 130 normal subjects (Group 1) and 131 glaucoma patients (Group 2) were included. The erythrocytes parameters, hemoglobin, red blood cell, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and red blood cell distribution width, and iron status indicators, Fe (iron), total iron binding capacity, and ferritin of the cases, in normal subjects and glaucoma patients were compared. Results. There was no statistically significant difference for the erythrocyte parameters between the groups (p >= 0.05). The number of the patients with iron deficiency anemia in both groups was similar. No statistically significant difference was found in the comparison of erythrocyte parameters and iron status indicators values according to the number of antiglaucomatous agents and visual field changes according to the presence of anemia in Group 2 (p >= 0.05). A statistically significant difference was found only in MCH when the erythrocyte parameters and iron status indicators values of the cases in glaucoma patients were compared with the glaucoma duration (p<0.05). Conclusion. The iron deficiency anemia frequency was like the normal population in glaucoma patients.
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    Glokomlu hastalarda ve normal popülasyonda demir eksikliği anemisi sıklığının karşılaştırılması
    (İnönü Üniversitesi, 2014) Demirel, Ersan Ersin
    Sistemik hastalığı olmayan glokom olguları ile sistemik problemi olmayan olgular arasında demir eksikliği anemisi sıklığını karşılaştırmayı, glokom hastalarında aneminin kullanılan glokom ilacı sayısına, görme alanı üzerine etkisini değerlendirmeyi ayrıca nörodejenerasyon hastalıkların oluşumunda rol aldığı düşünülen demir ve ferritinin glokom hastalarındaki düzeyini sağlıklı bireylere göre karşılaştırmayı hedefledik. MATERYAL-METOD: Glokom biriminde takip edilen, çalışmaya dahil edilme kriterlerine uyan 131 glokom hastası ve rutin göz muayeneleri normal olan 130 sağlıklı birey dahil edildi. Grup 1 ve Grup 2'deki olguların anemisi olan hasta sayıları, hemogram değerleri (Hb, Rbc, Htc, MCV, MCHC, MCH, RDW, Plt), Fe (demir), TDBK ve ferritin değerlerinin karşılaştırması yapıldı. Bunun yanında grup 2'deki olguların kullandığı antiglokomatöz sayısının ve görme alanı değişikliklerinin anemi varlığına göre karşılaştırılması, glokom olgularının kullandığı antiglokomatözlerin sayısına göre hemogram, Fe, TDBK ve ferritin tetkiklerinin karşılaştırması, glokom olgularının glokom süresine göre hemogram, Fe, TDBK ve ferritin tetkiklerinin karşılaştırması yapıldı. BULGULAR: Ortalama yaş Grup 1'de 50,01±13,6, Grup 2'de 49,01±10,7 olarak tespit edildi. Grup 1'i 63 kadın (%48,5), 67 erkek (%51,5), Grup 2'yi 74 (%56,5) kadın, 57 erkek (%43,5) oluşturmaktadır. Hb (g/dl) Grup 1'de 13.73±1.81, Grup 2'de 13.48±1.72 (p=0.21), Rbc (106/ml) Grup 1'de 4,75±0,80, Grup 2'de 4,68±0,79 52 (p=0,51), Htc (%) Grup 1'de 40,94±5,29, Grup 2'de 40,41±4,93, RDW (%) Grup 1'de 14,29±1,81, Grup 2'de 13,81±2,28 ,Fe (μg/dl) Grup 1'de 74,38±36,23, Grup 2'de 71,82±33,89, TDBK (μg/dl ),Grup 1'de 269,67±73,64, Grup 2'de 273,12±66,26, ferritin (n/dl) Grup 1'de 70,60 (1-240), Grup 2'de 70,07 (2-294), Plt (103/ml) Grup 1'de 241,22±80,82, Grup 2'de 268,39±72,00 bulunmuştur. Yapılan karşılaştırmada Plt'de gruplar arasında farkın istatistiksel olarak anlamlı olduğunu tespit ettik (p=0,04, p<0,05). Grup 2'deki olguların kullandığı antiglokomatöz sayısı ve görme alanı değişikliklerinin anemi varlığına göre karşılaştırmasında, olguların kullandığı antiglokomatözlerin sayısına göre hemogram, Fe, TDBK ve ferritin tetkiklerinin karşılaştırmasında istatistiksel olarak anlamlı fark tespit etmedik. Grup 2'deki olguların glokom süresine göre hemogram, Fe, TDBK, ve ferritin değerlerinin karşılaştırmasında yanlızca MCH'de istatistiksel olarak fark tespit ettik (p=0,03, p<0,05). SONUÇ: Bu bulgular bize glokomun etiyopatogenezindeki iskemik teorinin trombosit sayısı ve trombosit agregasyonu ile ilişkili olabileceğini göstermektedir. Glokom kronik bir hastalık olsada demir eksikliği anemisi sıklığı normal popülasyona göre değişmemektedir. Anemisi olan glokom hastalarında antiglokomatöz ihtiyacının artırmadığını, aneminin görme alanınını etkilemediğini bu nedenle daha sık takip gerektirmediğini düşünmekteyiz. İstatistiksel olarak anlamlı fark izlemememize karşın glokom hastalarında demirin ve ferritinin nöronal affinitesinin artmış olabileceğini düşünmekteyiz. Serum demir ve ferritin seviyesinin, beyin demir ve ferritin seviyesi ile korele olmayabileceği dikkate alındığında; glokom hastalarında beyin demir ve feritinin düzeyini araştıran detaylı nöropatolojik çalışmalara ihtiyaç olduğunu düşünmekteyiz.
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    Increased Aqueous Humor Symmetric Dimethylarginine Level in Patients with Primary Open Angle Glaucoma
    (Taylor & Francis Inc, 2019) Firat, Penpe Gul; Demirel, Ersan Ersin; Demirel, Soner; Dikci, Seyhan; Turkoz, Yusuf; Ozyalin, Fatma
    Purpose: To evaluate the asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and L-arginine (L-Arg) levels both in plasma and aqueous humor of primary open angle glaucoma (POAG) patients and matched controls.Patients and Methods: 25 primary open angle glaucoma patients and 42 control cases with senile cataract were included in the study. Plasma and aqueous humor ADMA, SDMA and L-Arg levels of the participants were measured by using liquid chromatography-tandem mass spectrometry.Results: A significant increase in aqueous humor SDMA level was detected in POAG patients compared with controls (p =0.0115). No significant difference was detected in plasma and aqueous humor ADMA, L-Arg levels.Conclusion: The aqueous humor levels of SDMA are found to be associated with POAG. The result of this current study supports the role of nitric oxide pathway in glaucoma.
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    Psödotümör orbita, gerçekten psödo bir tümör
    (2012) Demirel, Ersan Ersin; Çavdar, Müfide; Demirel, Soner; Düz, Cem; Kütükde, Derya
    Öz: Orbital psödotümör etiyolojisi ve patogenezi tam olarak bilinmeyen, nonspesifik inflamatuar bir olaydır. Tüm orbita içi yapılar lokal ya da diffüz olarak tutulabilir. Kliniğinde ani başlangıçlı göz ağrısı en önemli belirti olmakla beraber, göz kapaklarında ödem ve kızarıklık, göz hareketlerinde kısıtlanma ve propitozis görülebilir. Wegener granülomatozisi, sarkoidoz, idiopatik mediastinal fibrozis, retroperitoneal fibrozis, kolanjit, vaskulit ve lenfoma gibi bazı hastalıklar ile birlikte görülebilir. Tanısı çoğunlukla klinik olarak konulur ve radyolojik olarak desteklenir. Olgumuza bir dış merkezde orbital selülit nedeniyle tedavi uygulanmış, diğer bir merkezde ise malignite şüphesiyle biyopsi planlanmıştır. Kliniğimize başvurduğunda ise psödotümör orbita tanısı konulmuş ve başarıyla tedavi edilmiştir.