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Yazar "Firat, Murat" seçeneğine göre listele

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  • Küçük Resim Yok
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    An Algorithm Recommendation to Detect Specific Pathology of the Lacrimal Sac
    (Lippincott Williams & Wilkins, 2022) Demirel, Soner; Firat, Murat; Firat, Ilknur Tuncer; Dikci, Seyhan
    We aimed to recommend an efficient algorithm to detect the presence of specific pathologies of the lacrimal sac (LS). The charts of 296 patients who had undergone LS biopsy were reviewed retrospectively. The age, gender, history, examination and radiological findings, sac appearance, and pathology results of the patients were recorded. The power of our data to predict the presence of potential specific pathology was identified by regression analysis. After the causality evaluation of the statistical results, an algorithm was created to differentiate specific LS pathologies from chronic dacryocystitis. Our algorithm was mainly formed by deciding on radiological examination and biopsy according to the risk scoring created by the examination findings. A specific LS pathology was observed in 11(3.7%) patients. When we applied the recommended algorithm to cases with a suspicion of specific pathology and/or found to have a specific pathology, 36.4% of the patients would not require radiological examination and 29.6% of them would not require a biopsy. On the other hand, 80% of the frozen biopsies had been conducted on cases without a specific pathology. Managing the cases according to our algorithm would mean that frozen biopsy would be recommended in only 1 (12.5%) case without a specific pathology. Besides, the detection of cases with a specific pathology would not be prevented and the necessary diagnostic procedures would continue to be performed. Specific LS pathologies can be detected adequately, whereas decreasing unnecessary examinations and procedures in cases without a specific pathology by using our algorithm.
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    Automatic detection of keratoconus on Pentacam images using feature selection based on deep learning
    (Wiley, 2022) Firat, Murat; Cankaya, Cem; Cinar, Ahmet; Tuncer, Taner
    Today, corneal refraction, height, and thickness data, which are required in the diagnosis of keratoconus, can be obtained with corneal tomography devices. Pentacam four map display presenting this data is one of the most basic options in the diagnosis of keratoconus. In this article, an artificial intelligence-based method using Pentacam images is proposed to distinguish keratoconus from healthy eyes. Axial/sagittal curvature, back elevation, front elevation, and corneal thickness map images of a total of 341 keratoconus and 341 healthy corneas obtained from Inonu University ophthalmology clinic as the data set were given as input to AlexNet, one of the deep learning models, and the feature vectors of each image were obtained and combined. The most effective features in the determination of keratoconus were determined by applying ReliefF, minimum-redundancy-maximum-relevance (mRMR) and Laplacian algorithms, which are widely used in feature extraction algorithms, to the obtained feature vector. These features are classified using the support vector machine (SVM) classifier, which has high performance in binary classification. The accuracy, specificity, and sensitivity of keratoconus detection with the proposed method were found to be 98.53%, 99.01%, and 98.06%, respectively. The developed model can support the clinician to evaluate the features of the cornea and to detect keratoconus, which is difficult through subjective assessments, especially in the subclinical and early stages of the disease.
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    Brown syndrome: clinical features and results of superior oblique tenotomy
    (Consel Brasil Oftalmologia, 2021) Ozsoy, Ercan; Gunduz, Abuzer; Firat, Ilknur Tuncer; Firat, Murat
    Purpose: This study was conducted to further de-fine the specific clinical characteristics of patients with Brown syndrome and evaluate the outcomes of superior oblique tenotomy in its surgical management. Methods: A retrospective analysis of the medical charts of 45 patients with Brown syndrome was performed, which revealed that 11 patients underwent superior oblique tenotomy due to abnormal head posture and/or hypotropia and 1 patient underwent bilateral superior oblique tendon elongation with a silicone band due to abnormal head posture. In the last patient, silicone bands were removed at the postoperative 3rd month due to the lack of improvement in the abnormal head posture and the limitation of elevation in adduction. Simultaneous horizontal rectus muscle surgery was performed in four patients. Results: There was a predominance of female gender, right eye, congenital form, unilaterality, A-pattern, and an abnormal head posture type with a combination of chin up and head tilting. Bilateral form was observed only in female patients. Amblyopia was detected in two patients. Among patients aged >5 years, 40% had reduced stereopsis. Abnormal head posture was found in 60% of patients. More than half of them were diagnosed with a vertical and/or horizontal deviation. Tenotomy procedure eliminated the abnormal head posture in all patients and significantly improved the mean limitation of elevation in adduction and hypotropia (p=0.001, p=0.012). Two patients developed inferior oblique overaction in the operated eye. There was complete spontaneous resolution in two patients. Conclusions: The clinical features of patients with Brown syndrome in our study are considerably consistent with those of previous reports. The present study demonstrated the effectiveness of superior oblique tenotomy with less overcorrection in the surgical treatment of Brown syndrome.
  • Küçük Resim Yok
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    Comparison of the simultaneous conjunctiva and oropharynx-nasopharynx swab results in patients applying to the SARS-CoV-2 outpatient clinic for the first time
    (Wiley, 2021) Gunduz, Ayten; Firat, Murat; Turkoglu, Gamze
    The aim is to comparatively evaluate the results of simultaneous conjunctiva and oropharynx-nasopharynx (ONP) swabs in patients who had presented to the outpatient department with a suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). An ONP sample was obtained following bilateral conjunctiva swabs in 85 subjects with a contact history or symptoms but unknown SARS-CoV-2 status and with no ocular symptoms or findings. The results were evaluated according to the patient's symptoms and how the swab was taken. The conjunctiva swab was positive in 29 (34.1%) cases and the ONP swab in 20 (23.5%) cases. Both methods produced positive results in 11 (14.1%) cases. The mean cycle threshold (C-t) value was 30.15 +/- 3.41 in symptomatic cases and 33.62 +/- 1.76 in asymptomatic cases (p = .008). The mean C-t value was 24.37 +/- 3.48 when only the ONP swab was positive and 31.22 +/- 1.99 when only the conjunctiva swab was positive. In cases that were positive by both methods, the mean C-t value was 25.21 +/- 4.94 for the ONP swab and 30.29 +/- 5.05 for the conjunctiva swab. We found higher SARS-CoV-2 detection rates with the conjunctiva swab than the ONP swab in cases with unknown SARS-CoV-2 status in the early period. In addition, the conjunctival viral load seemed to be higher in symptomatic cases than in asymptomatic cases. We, therefore, believe a conjunctiva swab could be an alternative method to detect SARS-CoV-2 at the time of the first presentation to the outpatient department.
  • Küçük Resim Yok
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    Computed Tomography Diagnostic Abilities for Open-Globe Injuries in Pediatric Versus Adult Patients
    (Lippincott Williams & Wilkins, 2021) Dikci, Seyhan; Yildirim, Ismail Okan; Firat, Murat; Firat, Penpe Gul; Demirel, Soner; Yilmaz, Turgut; Tuncer, Ilknur
    Objectives The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups. Methods Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups. Results We included 47 eyes of 47 cases aged 18 years and below (pediatric group) and 85 eyes of 82 cases over 18 years (adult group). The mean +/- SD age was 10.80 +/- 5.11 years (range, 2-18 years) in the pediatric group and 46.34 +/- 19.01 years (range, 19-82 years) in the adult group. Computed tomography images revealed 21.7% of the cases with corneal lacerations, 55.5% with scleral lacerations, and 91.6% with corneoscleral lacerations in the pediatric group, whereas the respective numbers were 48.4%, 66.6%, and 61.9% in the adult group. The detection rates of corneal penetrations and vitreous hemorrhage with CT were significantly lower in the pediatric group than in the adult group (P < 0.05). The CT scans diagnosed 66.6% of the pediatric cases and 90% of the adult cases with an IOFB. Conclusions Corneal lacerations and IOFBs can be missed, especially in the pediatric group, because the eye is smaller in adults. Pediatric patients with a history of ocular trauma should undergo an examination under general anesthesia followed by surgical exploration if necessary.
  • Küçük Resim Yok
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    Correlation between intraocular pressure obtained with water drinking test versus modified diurnal tension curve measurement in pseudoexfoliation glaucoma
    (Springer, 2021) Firat, Penpe Gul; Dikci, Seyhan; Firat, Ilknur Tuncer; Demirel, Soner; Firat, Murat; Ozturk, Emrah; Gok, Zarife Ekici
    Purpose The aim of this paper was to study the correlation and agreement between the intraocular pressure (IOP) peak value and fluctuations detected with the modified diurnal tension curve (mDTC) and the water drinking test (WDT) in pseudoexfoliation glaucoma (XFG) patients. Methods This prospective observational study enrolled 42 eyes of 42 XFG patients. The IOPs were measured at 2-h intervals from 8 am to 4 pm with a Goldmann applanation tonometer by a single observer to establish the mDTC. The WDT was then performed between 4 and 5 pm on the same day and the IOP was measured 4 times at 15-min intervals after water ingestion. The IOPpeak, IOPmean, IO (min), and IOPfluctuation were measured with both the mDTC and WDT. The paired sample t test, Spearman's correlation coefficient and Bland-Altman plots were used for statistical analysis. Results The mean age of the 42 patients consisting of 24 females and 18 males was 66.9 +/- 6.8 years, and the mean central corneal thickness was 517.7 +/- 29.1 mu m. The mean values with the mDTC and WDT measurements were 15.05 +/- 2.75 mmHg and 17.17 +/- 3.25 mmHg (p <= 0.0001, r = 0.884) for IOPmean, 16.76 +/- 3.45 mmHg and 18.92 +/- 3.94 mmHg (p <= 0.0001, r=0.787) for IOPpeak, and 13.61 +/- 2.56 mmHg and 15.11 +/- 2.84 mmHg (p <= 0.0001, r=0.824) for IOPmin, respectively, and a positive correlation was present between these values. Conclusion There was a positive correlation between the peak, minimum, and mean IOP values determined using the mDTC and WDT in treated XFG patients. WDT can be used as an alternative in the assessment of the IOP in these patients as a more practical method.
  • Küçük Resim Yok
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    Effect of inferior oblique anterior transposition in correcting vertical hyperdeviation in primary position
    (Canadian Ophthal Soc, 2019) Gunduz, Abuzer; Firat, Murat; Ozsoy, Ercan; Cankaya, Cem
    Objective: To evaluate the effect of inferior oblique anterior transposition (IOAT) on improvement of vertical hyperdeviation in primary position. Methods: This study was a retrospective review and included 35 eyes of 33 patients (18 males and 15 females). Patients with dissociated vertical deviation were not included in the study. Preoperative and postoperative average follow-up was 11.46 +/- 11.73 and 11.43 +/- 9.73 months, respectively. The eyes were divided into 5 groups according to the amount of transposition. Inferior oblique muscle was transpositioned 2 mm posterior to the inferior rectus insertion in group 1; 1 mm posterior to the inferior rectus insertion in group 2; parallel to the inferior rectus insertion in group 3; 1 mm anterior to the inferior rectus insertion in group 4; and 2 mm anterior to the inferior rectus insertion in group 5. Results: The mean preoperative and postoperative vertical hyperdeviation were 16.52 +/- 5.54 and 0.97 +/- 2.34 prism diopters (PD), respectively. The mean preoperative vertical hyperdeviation in group 1, group 2, group 3, group 4, and group 5 was 11.0 +/- 4.24, 12.88 +/- 4.26, 16.63 +/- 3.50, 19.83 +/- 2.71, and 25.5 +/- 3.00 PD, respectively. Postoperatively, improvement in vertical hyperdeviation in group 1, group 2, group 3, group 4, and group 5 was 11.0 +/- 4.24, 11.63 +/- 3.20, 15.46 +/- 3.19, 18.17 +/- 2.23, and 25.5 +/- 3.00 PD, respectively. The vertical hyperdeviation had improved 100% in group 1; 90.2% in group 2; 92.9% in group 3; 91.59% in group 4; and 100% in group 5. Conclusion: IOAT surgery planned according to hyperdeviation amount has effective and predictable results in correcting vertical hyperdeviation in primary position.
  • Küçük Resim Yok
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    Impact of serous macular detachment on visual recovery in retinal vein occlusion treatment
    (Consel Brasil Oftalmologia, 2022) Firat, Ilknur Tuncer; Polat, Nihat; Firat, Murat
    | Purpose: The aim of this study was to evaluate the effect of serous macular detachment observed during retinal vein occlusion on treatment results. Methods: A total of 117 eyes from 115 patients who had been treated with intravitreal injections for macular edema secondary to retinal vein occlusion were retrospectively reviewed. Visual acuity, optical coherence tomography, and fundus fluorescein angiography findings were evaluated according to the status of serous macular detachment. Results: In the branch retinal vein occlusion group, a statistically significant increase was detected in the mean visual acuity compared to the baseline value at each visit in the absence of serous macular detachment, whereas the increase in the mean visual acuity was significant only at the 3-and 6-month visits in the presence of serous macular detachment. In the central retinal vein occlusion group, there was an increase in the mean visual acuity compared to the baseline value at every visit in the absence of serous macular detachment, whereas the mean visual acuity decreased compared to the baseline value at every visit except at the 3-month visit in the presence of serous macular detachment. The ellipsoid zone defect was more prominent in the presence of serous macular detachment in eyes with branch retinal vein occlusion, whereas there was no significant diffe-rence in the ellipsoid zone in the absence or presence of serous macular detachment in eyes with central retinal vein occlusion. Conclusions: In the group with macular edema due to retinal vein occlusion, the initial mean visual acuity increase observed in the first year was maintained in cases without serous macular detachment but not in those with serous macular detachment. Serous macular detachment could be a negative factor in eyes with retinal vein occlusion.
  • Küçük Resim Yok
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    Inferior oblique anterior transposition according to a different grading scale for hyperdeviation with inferior oblique overaction
    (Canadian Ophthal Soc, 2023) Gunduz, Abuzer; Ozturk, Emrah; Firat, Murat
    Objective: To define an inferior oblique anterior transposition (IOAT) grading scale in patients with hyperdeviation and inferior oblique overaction (IOOA), which we planned based on the data we obtained in our previous retrospective study.Participants: Thirty-eight patients who underwent graded IOAT.Methods: The patients were divided into 5 groups according to the amount of hyperdeviation in the primary position (PPHD). The inferior oblique muscle was transposed 2 mm posterior, 1 mm posterior parallel, 1 mm anterior, and 2 mm anterior to the inferior rectus insertion, respectively. Surgical success was defined as success (PPHD <= 3 PD), partial success (PPHD >3 and <= 6 PD), and nonsuccess (PPHD >6 PD).Results: The mean amount of hyperdeviation correction in groups after IOAT was 9.50 +/- 0.9 PD (range, 8-10 PD), 12.43 +/- 1.5 PD (range, 11-14 PD), 16.67 +/- 1.4 PD (range, 15-18 PD), 19.57 +/- 1.7 PD (range, 16-21 PD), and 22.57 +/- 5.8 PD (range, 14-30 PD), respectively. Surgical success was achieved in 34 patients (89.5%) after surgery, partial success was achieved in 3 patients (7.9%), and nonsuccess was observed in 1 patient (2.6%). All patients in our study had unilateral IOOA preoperatively, and IOOA developed in the contralateral eye of 9 patients (23.7%) during postoperative follow-up. In group 5, 4 patients (57.1%) developed -2 upgaze limitation, but surgery was not required.Conclusions: A high success rate can be achieved with this grading of IOAT in primary and secondary IOOA cases accompanying hyperdeviation in the primary position.
  • Küçük Resim Yok
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    Prediction of Pentacam image after corneal cross-linking by linear interpolation technique and U-NET based 2D regression model
    (Pergamon-Elsevier Science Ltd, 2022) Firat, Murat; Cinar, Ahmet; Cankaya, Cem; Firat, Ilknur Tuncer; Tuncer, Taner
    Keratoconus is a common corneal disease that causes vision loss. In order to prevent the progression of the disease, the corneal cross-linking (CXL) treatment is applied. The follow-up of keratoconus after treatment is essential to predict the course of the disease and possible changes in the treatment. In this paper, a deep learningbased 2D regression method is proposed to predict the postoperative Pentacam map images of CXL-treated patients. New images are obtained by the linear interpolation augmentation method from the Pentacam images obtained before and after the CXL treatment. Augmented images and preoperative Pentacam images are given as input to U-Net-based 2D regression architecture. The output of the regression layer, the last layer of the U-Net architecture, provides a predicted Pentacam image of the later stage of the disease. The similarity of the predicted image in the final layer output to the Pentacam image in the postoperative period is evaluated by image similarity algorithms. As a result of the evaluation, the mean SSIM (The structural similarity index measure), PSNR (peak signal-to-noise ratio), and RMSE (root mean square error) similarity values are calculated as 0.8266, 65.85, and 0.134, respectively. These results show that our method successfully predicts the postoperative images of patients treated with CXL.
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    Traumactic superior oblique tendon rupture: case presentation
    (Medicine Science, 2016) Gunduz, Abuzer; Firat, Murat; Mutlu, Kayhan; Demirel, Ersin Ersan
    Öz (İngilizce): We present a 47-year-old male with superior oblique (SO) tendon rupture that developed due to a broken metal hook while installing snow chains on his car. The patient presented to our clinic as an emergency for the right eye trauma and pain. The examination revealed a small cut in the right upper eyelid and an edematous tendinous structure that extended downwards through the conjunctival cut at the upper fornix. This structure was thought to be the SO tendon. Emergency exploration and SO tendon repair were performed under general anesthesia. The SO tendon was sutured to its own insertion region 5 mm in width and 5 mm behind a point 3 mm temporal to the superior rectus muscle. The conjunctiva was also repaired. There was 6 PD (prism diopter) right hypertropia and vertical diplopia on postoperative follow-up. The diplopia symptoms improved in the postoperative 3rd month. The patient had no diplopia at the 6th month follow-up but 4 PD hypertropia continued

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